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The Effectiveness Of Educational Empowerment Groups Among Undocumented Female Victims Of Intimate Partner Violence

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This literature review will analyze a study done in a community-based setting that has implemented the educational empowerment framework in groups as the primary source for intervention when dealing with victims of intimate partner violence (IPV). The study focuses on immigrant women, predominantly Mexican and undocumented, residing in the United States. This paper will pull from additional sources, such as journal articles that explain this social phenomenon further and delve into protective factors, risks, and challenges that this population faces. The information gathered will be used to establish a similar intervention method for female, predominantly undocumented, survivors of IPV in Boynton Beach, Florida, at the Caridad Center, a clinic for the uninsured.

Introduction

Intimate partner violence (IPV) is a global public health problem that particularly affects Latina women. IPV is a pattern of abusive and coercive behaviors in current or former partners via physical and sexual violence, threats of violence, and emotional abuse. In the US, Latina women are more likely to experience more severe effects from IPV, such as depression, low self-esteem, unplanned pregnancies, sexually transmitted infections, and HIV infection. Lack of culturally sensitive and Spanish-language treatment programs may be partially why Latina female victims of IPV receive less support than their non-Latina White counterparts. Undocumented women and their children are in particularly riskier positions as they lack the support from government funded welfare programs to become autonomous after leaving a violent relationship. They are not even unable to obtain a driver’s license, a bank account or a credit history. Undocumented women are least likely to reach out for medical attention or police aid due to the fear of being deported.

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‘Machismo’ is particularly significant to point out in gender roles of the Latino community. ‘Machismo’ is interpreted as behaviors displayed by Latino men that reinforce their dominance, superiority, and strength in relationships over women. This cultural nuance may prevent women from reporting to avoid social isolation from family and members of their own community. In Caridad Center, 3 in 4 women that are treated in the Mental Health Department are undocumented, predominantly from Central America, including Mexico and Guatemala, and have been affected by IPV. To address this issue, the head psychiatrist and the social work intern will be developing an intervention plan. Analyzing the following study used to support women in similar circumstances and backgrounds will provide clarity as to the best culturally-competent and effective intervention method to use at the Caridad Center.

Out of the few recentmodern studies that exist involving undocumented Latinas who have been victims of IPV, it was clear that the evidence-based intervention that proved the most effective was a community-based group that utilized the empowerment education framework. Although comprehensive, systematic reviews on empowerment are limited, one systematic review analyzed studies that used empowerment as an intervention for diabetes treatment among patients. At the end, most patients in the studies described having a better grasp on their diabetes’ treatment. The findings also showed that the studies that were most successful used empowerment interventions that were based on measurable markers: goal setting, problem solving skills and the implementationantation of coping skills. As in, there was a clear definition of empowerment and the process that it entailed with no ambiguity around it. Empowerment is not a new concept; it has been used notably for the Black liberation, feminist and anarchism movements. The empowerment process recognizes the intersectionality of an individual’s life and how that is tied to their welfare. Second, it involves fostering a sense of self-worth and competence, validation through collective experiences, gaining access to resources and information, and acting to better oneself. Similarly, Paulo Freire’s empowerment education models start with helping the client with self-management, providing access to resources, and encouraging the client.

One study provided empowerment education intervention to the parents of children going through congenital heart diseases through 40-minute face-to-face sessions and six monthly visits. It resulted in improvements to the parents’ self-efficacy and caregiving capabilities. Another study examined the factors associated with the empowerment of 350 families in Japan raising children with developmental disorders. The parents’ sense of empowerment was connected to using the local resources appropriately, gaining awareness of social support and growing competent in taking care of their child. Intervention strategies that empower clients are effective and have profound, positive ripple effects on the individual, their families and communities. Empowerment as it refers to working with individuals and groups can be best summed as the process of increasing self-efficacy and confidence in people so that they can make changes to better themselves and their lives. The group component to the empowerment model is powerful because of the validation one feels from a group going through similar circumstances, especially for women. A systematic review of done to find out if self-help groups improve a woman’s empowerment groups, which improve a woman’s empowerment, demonstrated is important to point out here because it showed that self-help groups positively increased a women’s mobility and control.

Search Methods and Criteria

The off-campus FAU Library online system proved useful to me throughout this entire process. Specifically, I used the Course Guide for SOW 6404: Social Work Research on the FAU site to help guide me. I used PsycINFO, ProQuest, SocINDEX with Full Text, Sociological Abstracts and SearchWise. For search terms, I used: Latina, Latino, Hispanic, domestic violence, intimate partner violence, sexual violence, gendered violence, rape, sexual assault, support, abuse, intervention, community, undocumented, illegal status, therapy, low-income, education, socio-economic status, focus groups, case studies. The search terms were meant to reflect the current population that the Caridad Clinic caters to: low-income, undocumented Latinas, that have suffered some form of violence or abuse. The search terms were also used independently or in variation with one another to elicit multiple results. To determine the best scientific evidence supporting the effectiveness of the interventions, quantitative and qualitative studies were explored. This included, mix-methods, single-subject designs, case studies and focus groups.

Considerations of the Caridad Center clients were taken into place, such as hosting the intervention in the clinic, which is in a community setting. Based on more than half of our patients, they preferred the intervention to happen away from home, where they were free from family and home demands. The focus was to draw from studies that occurred in a community-setting and culturally sensitive to the nuances of the undocumented community. This is particularly hard to do as many individuals are not forthcoming with information regarding their undocumented status and the studies on this population are limited. The study that I believed was the most successful with the empowerment model garnered trust from the participants, who revealed their undocumented status. In turn, the team could assist the women appropriately with legality issues that aid with their circumstances surrounding IPV. We concluded that the following study was the best intervention to model at our clinic because it was feasible under our clinic’s small donation-based budget.

Results

The study by Fuchsel, et al. (2016) proved to have the most effective intervention by using the empowerment framework in a group setting with women suffering from IPV. It involved 14 immigrant Latina women asked to participate in a 11-week educational group for domestic violence. The “Si Yo Puedo” (SYP) curriculum was specific to their culture, including discussing family dynamics, the cultural construct of machismo, stories of migration, and centered on the empowerment framework. This study was a mix-methods design and placed the 14 women in two separate groups using criterion sampling. Both groups reported higher levels of self-esteem after the 11 weeks further reinforcing the argument for empowerment interventions. In the SYP study, the women were 78% Mexican and self-identified as first-generation immigrants who speak only Spanish and lacked a lawful immigration status. This is shockingly close to the target population of the Caridad Center, where more than 75% are undocumented and from Mexico and 100% self-identify as first-time immigrants and solely Spanish-speaking. In the study, 86% did not finish high school, which is like 92% of Caridad patients who did not obtain their high school diploma The sample demographics of the participants that followed the SYP curriculum mirroring the Caridad Center participants is significant because it demonstrates that the positive results that occurred in this study may be replicated with the participants of our clinic.

To use another study as a model for the Caridad Center women’s program that does not closely represent the Caridad women’s backgrounds would not be as valuable to our clients. This SYP study’s evidence is stronger for the target population of the clinic than evidence gathered from a study done on a different racial or ethnic immigrant group with legal immigration standing. Oftentimes studies done on undocumented Latinas are sparse and difficult to come across. This is due to many undocumented persons living clandestinely and not publicly disclosing their immigration status for fear of law enforcement involvement that threatens their livelihood in the U. S. It is evidenced that the study’s facilitators took into consideration this caveat and other cultural aspects of the women’s lives and, thus, created safe spaces for the women to express themselves confidentiality and anonymously. The qualitative data acquired in form of exit interviews ensures that the women felt understood and valued by the program. The women provided first-hand experiences on the impact the group had on them. The fact that the participants’ sense of empowerment attributed to better self-esteem and self-efficacy is incredibly promising to the future implementation of this educational empowerment curriculum to a demographically similar group. In another study that identified social, political, and cultural barriers to seeking help for abuse, Latina and Asian immigrant women were interviewed with open-ended questions in focus groups that met once. While the study is dated, it points out how important follow-up and long-term treatment is with immigrant victims of IPV. The participants said they felt socially isolated, did not know their rights, and lacked information on resources for abused women. If the educational empowerment framework in community-based groups was being used, the women would be informed of resources at their disposal and the sessions would be catered to their needs. (i. e. , legal rights training for undocumented women) to enable to women to act and make informed decisions in their current situations. Furthermore, the group setting that is crucial to the empowerment process, and used in the SYP curriculum, would have provided a space for collective story-telling and build a community to alleviate the sense of isolation that often comes from being an immigrant, especially an undocumented immigrant.

The strength of the SYP study is the attention it took in ensuring it was done in a culturally sensitive manner that honored the participants ethnic/racial and migratory backgrounds. This study chose facilitators who were part of the Latino culture and spoke Spanish fluently. The study was authored by women of color, predominantly immigrant women of color who used intersectionality and feminist theory to understand the links between class, education, environment, ethnicity/race, and how it impacts the women in question, which is also part of implementing an empowerment intervention. As such, machismo, traditional gender roles, family dynamics, and immigration concerns were addressed: all risk factors for IPV. Intervention PlanCaridad Center is hoping to address the prevalence of IPV in female, immigrant, mostly undocumented clients of the center by using the educational empowerment framework in a community-based group setting. Participants will be gathered from the mental health department who have expressed interest in speaking to other women about their experience of abuse, at-risk women, and women who have a background of abuse or currently in an abusive relationship. The participants will be phoned and invited to an 8-week women’s support group. Instead of focusing on the victim aspect of IPV, the group will be focused on developing existing strengths, raising self-esteem, creating a haven and network of support, and dispensing knowledge on the topic of IPV, which is in line with the educational empowerment framework.

By following an 8-week curriculum, patients will be incentivized by an end-of-group graduation ceremony where they will be commended for their progress. This kind of positive reinforcement will enhance the level of personal agency felt by the women after the program. Since empowerment is a broad concept to measure, we can measure markers of empowerment, such as higher self-esteem and better knowledge of the topic, in this case, distinguishing between abusive and healthy relationships. Like the SYP group, we will be administering a Spanish-translated version of the Rosenberg Self-Esteem Scale (RSES) in the beginning of the program and once more at the end. The RSES is a Likert-type scale made of 10 items ranging from 1-4. 1 is strongly agree and 4 is strongly disagree. According to the study, it is a highly reliable and widely used scale to report feelings. Most of the women in the study, scored higher in the post-test showing evidence for the effectiveness of educational empowerment groups. Excellent In addition to the RSES, we will be facilitating the Attitudes About Relationship Violence Questionnaire (ARQV) in Spanish, which the SYP study also administered. This is a 22-item questionnaire to measure differences in knowledge about this topic before and after the end of the 8 weeks. Unlike the study, the statements on the scales will be read out-loud by a facilitator and be given to each woman to read at their own pace. This is to ensure that the group is catering to all educational levels and that everyone is comprehending the questions since these scales may use more complex language. This is something that SYP could have done differently to increase the reliability and validity of their results. The groups will be confidential and anonymous and led by what the women want to learn. Regular check-ins will happen at each meeting to ensure that needs are being met and that the sessions are focused on issues important to the women. Still, the focus will be on self-esteem and healthy relationships. Each week will build on the last and use empowerment as the driving intervention. The SYP study (2016) defines empowerment as “the ability to become critically aware and conscious of self and environmental factors that influence an individuals’ ability to create goals for change in the present or in the future. ” The more self-aware the women are of their environment and themselves, the more empowered the women will be to examine their current relationships and choices and, ultimately, capable of making decisions and planning for the future.

The prospective facilitators of the Caridad Center’s group are the head psychiatrist and the social work intern. As members of the Latino community, they can both ensure that the curriculum stays culturally relevant, even within an empowerment framework. They can address the emotional borders that exist when one flees from their home country and migrates to the U. S. to start anew, which can be very stressful in many instances. The facilitators understand the additional barriers that stand in the way of many immigrant women seeking help when faced with IPV. As the study summarized in the end results, the fear of deportation and mistrust in officers was prevalent among the women when deciding not to report. More information regarding human rights and legal autonomy can be added to facilitate the empowerment of participants in the program at the Caridad Center.

More than an 8-week program, the tools gained from the women’s group will spill into the women’s sense of worth, strengthen their family relationships, build competency in professional skills, and overall add to the creation of healthy communities in Palm Beach County. As shown, using an educational empowerment framework in a community group setting is the best intervention when assisting victims of IPV and breaking cycles of abuse. The facilitators will be advocates for the resilient, undocumented women in the program who have endured IPV, but will also be advocates for comprehensive immigration reform by understanding that concrete change for this population must come from a policy level, as well.

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