Mental and Active Preparation: Examining Variations in Women’s Processes of Preparing to Leave Abusive Relationships

Abstract

Although the process of leaving abusive relationships has received increased research attention, preparing to leave is still largely understudied. Despite an emphasis on safety planning, not all women take active steps to prepare, and the characteristics and experiences of those who do or do not actively prepare are unknown. We address this gap with a secondary data analysis of interviews with 25 abused mothers in the process of leaving. All women initially engaged in mental planning, where they had emotionally disconnected from their partners. Using constructivist grounded theory techniques, we identified two distinct groups: those whose mental planning led to active planning (n = 11), and those who moved directly from mental planning to leaving (n = 14) with little time or need to actively plan. The groups differed on several individual, relationship, and child factors, which may have impacted the ability or decisions to prepare. This study supports the feminist view that survivors are not helpless victims but active agents who strategize for safety. Those who engage solely in mental planning still prepare to leave, even if they do not engage in active planning. Practitioners should consider factors affecting preparations and acknowledge mental planning as a necessary effort in leaving.

Keywords

grounded theory help-seeking strategies intimate partner violence preparation process of leaving

An important agenda in intimate partner violence (IPV) research is to better understand the process of leaving abusive partners. Numerous studies have shown that leaving an abusive partner is a complex process occurring in stages, rather than a single isolated event (Riddell, Ford-Gilboe & Leipert, 2009). Most abused women leave multiple times before permanently leaving their abusive relationships (Lacey, Saunders, & Zhang, 2011). Furthermore, studies suggest that women face both internal (e.g., profound attachment to abusers) and external (e.g., lack of social support) barriers to leaving (Anderson & Saunders, 2003). Despite these barriers, most abused women do leave, and they actively engage in help-seeking and protective strategies to keep themselves and their children safe (Goodkind, Sullivan, & Bybee, 2004).

An understudied area in the process of leaving and help-seeking literatures is women’s preparations to leave. Most studies (e.g., Burke, Denison, Gielen, McDonnell, & O’Campo, 2004) define preparing to leave as an engagement in behavioral strategies to plan for the physical departure from the relationship. These preparation strategies include saving money, securing a safe place to go to upon leaving, making a safety escape plan, and safekeeping important documents (Goodkind et al., 2004). Although some studies have underscored the need to safely prepare to leave abusive relationships (Lindhorst, Nurius, & Macy, 2005), others have shown that active preparation strategies are often skipped over by women who leave (Chang et al., 2006). To our knowledge, no studies have explicated the variations in women’s experiences of preparing to leave. In this study, we conducted a secondary data analysis of interviews with 25 abused mothers to identify and compare the different processes experienced by women who either prepared or did not prepare to leave abusive partners.

Background

IPV is a serious preventable health problem (Centers for Disease Control and Prevention [CDC], 2015). In the United States, more than a third of women report being raped, physically assaulted, and/or stalked by an intimate partner, and nearly half have experienced some form of psychological abuse in their lifetime (Black et al., 2011). Given these trends, much of earlier IPV research often focused on why women stay in abusive relationships and what obstacles they face that hinder leaving (e.g., Herbert, Silver, & Ellard, 1991). Feminist scholars are critical of this approach because of its inaccurate portrayal of abused women as passive victims who were trapped in violent relationships without a sense of agency (Gondolf & Fisher, 1988). Instead, they advocate for strength-based studies that acknowledge abused women as survivors and active agents in their relationships. Subsequently, the focus has shifted from exploring why women stay to how and why women leave their abusive partners. Indeed, numerous studies have now documented abused women’s active engagement in multiple strategies to keep themselves and their children safe from violence throughout the relationship (Goodkind et al., 2004; Nurius, Macy, Nwabuzor, & Holt, 2011), including when leaving their abusive partners (Anderson & Saunders, 2003; Burke et al., 2004; Riddell, Ford-Gilboe, & Leipert, 2009).

In general, research suggests that leaving an abusive relationship is complex and multifaceted, with most women making several attempts to leave before permanent separation (Lacey et al., 2011; Merritt-Gray & Wuest, 1995). Early qualitative studies support the notion of leaving an abusive partner as a process that occurs over different stages. Although the names and number of stages vary across studies, they are organized in a fairly consistent pattern. Specifically, the earliest stage is often characterized by an abused woman not yet recognizing or denying that she is being abused, and therefore, leaving is not yet an option (e.g., “counteracting abuse,” in Merritt-Gray & Wuest, 1995; or “being in,” in Moss, Pitula, Campbell, & Halstead, 1997). Once she recognizes her situation, she moves into the middle stage, where she actively tries to cope with the abuse, begins to consider leaving her partner, and makes the decision to leave (e.g., “breaking free,” in Merritt-Gray & Wuest; or “getting out,” in Moss et al.,1997). Finally, the last stage illustrates the woman’s efforts to remain separated from and prevent returning to her abusive partner (e.g., “not going back,” in Merritt-Gray & Wuest; or “going on,” in Moss et al.).

Recent studies that have adapted a theoretical model known as the Stages of Change Model to explore the process of leaving report similar transitions (e.g., Burke et al., 2004; Chang et al., 2006). According to this model, there are five stages of leaving that abused women typically go through (i.e., precontemplation, contemplation, preparation, action, and maintenance). Although some women experience all five stages in a linear fashion, Khaw and Hardesty (2007) found that many experience nonlinear trajectories of leaving, where they go back and forth between stages or skip particular stages altogether. Such findings suggest that the processes women engage in leaving are far more complex than originally thought and that women make more active decisions than these models originally depicted, including both emotionally and behaviorally (Khaw & Hardesty, 2015). Furthermore, variations in women’s trajectories of leaving suggest that as women move through the stages, they encounter a multitude of other factors that influence their decision making throughout the process (Chang et al., 2006).

In an exhaustive review of the literature, Anderson and Saunders (2003) identified a myriad of societal (e.g., access to external resources) and individual factors (e.g., commitment to the relationship) that may influence women’s stay/leave decisions. Similarly, Liang, Goodman, Tummala-Narra, and Weintraub (2005) theorized that a woman’s decision making within an abusive relationship is intricately dependent on three overarching factors: individual (e.g., one’s readiness to leave), interpersonal (e.g., attachment to abuser), and sociocultural factors (e.g., cultural beliefs about IPV and pressures to stay based on family’s cultural background). On top of these factors, there is still the concern that the act of leaving itself can put women and children in greater risk of danger. For example, women are 3 times more likely to be killed by their abusers if they have left or attempted to leave, and the risk increases ninefold if their abusers were also controlling (Campbell et al., 2003). As reported by Thomas, Goodman, and Putnins (2015), the consequences of leaving may be more detrimental and result in greater unexpected losses than remaining in the relationship. Although dependent on a multitude of factors (e.g., level of enmeshment in the relationship), when abused women leave, they potentially risk losing “everything” (p. 170), including their emotional and physical safety, social support, financial stability, their homes, and personal freedom (Thomas et al., 2015). Therefore, leaving is not always a viable option for some women, who instead may choose to utilize other strategies to resist IPV and achieve nonviolence while remaining in the relationship (Goodkind et al., 2004). For example, interviews conducted by Goodkind and colleagues with 160 abused mothers revealed an average use of 16 different action-oriented strategies, with formal (e.g., calling police) and informal (e.g., talking with family) safety planning strategies being used more often than escape planning strategies (e.g., hiding important documents). Other studies illustrate that the selection and use of preparation and safety planning strategies depend on many other individual and interpersonal factors, including the survivor’s mental and physical health as well as the type, duration, and severity of IPV experienced (Duterte et al., 2008; Leone, Lape, & Xu, 2014; Nurius et al., 2011).

Because the process of leaving is complex and potentially life-threatening, the safety of survivors and children is of paramount importance to practitioners and advocates (Sullivan, 2011). Consequently, most IPV interventions revolve around action-oriented safety planning, whereby practitioners equip survivors with information and tools to make strategic preparations to leave (Murray et al., 2015; Wood, 2015). These preparations include creating an emergency escape plan, asking family and friends for help, and hiding important documents needed for safe relocation (Davies, Lyon, & Monti-Catania, 1998; Lindhorst et al., 2005; Sullivan, 2011; U.S. Department of Health and Human Services, 2011). Some evidence supports the effectiveness of interventions that promote safety planning. For example, in a longitudinal study with 360 abused women seen in a primary care setting, McFarlane, Groff, O’Brien, and Watson (2006) found that performing a quick assessment for abuse and providing referrals to safety planning resources were associated with a reduction in IPV and an increase in safety behaviors after 24 months.

Despite the emphasis placed on preparing for safe departure, several process of leaving studies reveal that not all women utilize active behavioral-based preparation strategies. For example, studies using the Stages of Change Model, which has a distinct preparation stage, noted many survivors skipping this stage and moving directly from contemplating leaving into action (i.e., they left without having made active preparations; Burke et al., 2004; Chang et al., 2006). Although they did not appear to have employed active preparation strategies, studies have shown women may primarily employ other strategies that are more emotional-based to disengage from their partners (Khaw & Hardesty, 2015). For example, women who skip active preparation have described thinking about leaving yet never made physical plans to leave, resulting in often quick and spontaneous decisions to leave that were made in response to external circumstances (e.g., when IPV became life-threatening; Chang et al., 2006). Nonetheless, few studies have explored what this emotional work looks like and what role it plays in leaving. It is also unclear if actively preparing or not preparing may result in different consequences for survivors; studies like the one conducted by Goodkind et al. (2004) have explored the consequences of using specific preparation strategies, but not the consequences of forgoing active preparation altogether. From an advocacy and intervention standpoint, forgoing active preparation potentially brings more harm than good, which is why safety planning is often addressed at each contact point with IPV survivors (Murray et al., 2015). Indeed, in conjunction with the emphasis placed on other resources (e.g., filing for a restraining order, crisis counseling), active safety planning is the cornerstone of most IPV intervention and support services (Davies et al., 1998; Murray et al., 2015). Therefore, it is imperative to understand how survivors engage in preparation, why some women actively prepare and others do not, and the potential consequences of not preparing. To our knowledge, no studies have explicated the nuances and experiences of women who do or do not actively prepare to leave an abusive partner. Based on these identified gaps, we sought to explore the following questions using existing data from a sample of 25 abused mothers who had left or were in the process of leaving an abusive partner: (a) How do women prepare to leave abusive relationships, if they do prepare? (b) How do leaving processes and outcomes differ between women who actively prepare versus those who do not?

Method

Original Recruitment and Procedure

The purpose of the original study was to examine changes in family relational boundaries throughout the process of leaving using the Stages of Change Model (Khaw & Hardesty, 2015). Twenty-five abused mothers were recruited in 2008 from numerous townships and cities in a Midwestern county through flyers posted in domestic violence shelters, various community locations (e.g., coffee shops), and locally sourced websites (e.g., blogs for local mothers). Potential participants learned that the study’s purpose was to understand how mothers make decisions in relationships in which their partner has physically or emotionally hurt them. Per the original study’s focus on family boundaries, participants had to have at least one child below 18 years with their current or former partner and had left that partner at some point, regardless of whether they remained separated. Upon meeting the first two criteria, they were then screened for IPV experiences throughout their relationship using a checklist derived from the Revised Conflict Tactics Scale (CTS2; Straus, Hamby, Boney-McCoy, & Sugarman, 1996). Participants met the third criterion if they endorsed at least one physical (e.g., hitting) or nonphysical (e.g., controlling behaviors) IPV item on the CTS2. Women who met all three criteria and agreed to participate were invited for an interview at a safe location or over the phone.

Guided by a semistructured interview protocol, interviews were conducted by the primary author in the original study. Questions were organized in a way that allowed women to chronologically share their experiences, opening with questions about the beginning of their relationship and events leading up to their decisions to leave, to their current family relationships and subsequently closing the interview with questions about their plans for the future. All of the interviews were conducted in English. Interviews lasted between 1.5 and 4 hr (M = 2.3 hr), and participants were compensated US$30 for their time. All interviews were audio-recorded and transcribed verbatim by the original researchers (Khaw & Hardesty, 2015), who are also coauthors on the current paper. Any identifying information (e.g., names, locations) had been removed from the transcripts used in the current secondary data analysis. To further protect the anonymity and the safety of all participants, new pseudonyms were assigned.

Secondary Data Analysis

We obtained institutional review board (IRB) approval to conduct a secondary data analysis of the existing interview data. Secondary data analysis is the use of existing data to explore additional research questions that are distinct from the purpose of the original study (Hinds, Vogel, & Clarke-Steffen, 1997; Szabo & Strang, 1997). Given the overarching purpose of the original study, much of the original interview protocol consisted of questions on mothers’ experiences of IPV, relationship history, and perceptions of family members’ roles and relationships (Khaw & Hardesty, 2015). In the current study, with the goal of further explicating mothers’ experiences in the preparation stage, we paid attention to mothers’ responses to interview questions pertaining specifically to their decisions (e.g., “Tell me about the time when you decided to leave”) and preparations to leave (e.g., “Some women make plans to leave and others do not. To what extent do you think planning was a part of your leaving?”). In addition, we focused on narratives regarding their experiences and perceptions post leaving (e.g., “What are some of the good things of being separated from your former partner?” and “How do you foresee your relationship with your former partner over the next 5 years?”). The term planning was purposefully left broad and undefined in the questions so mothers would have the opportunity to describe what the planning process looked like for them, without imposing researcher definitions onto their experiences.

Sample

All of the original 25 mothers’ narratives were included in this study. The mothers had self-identified as White (n = 11), Black (n = 9), Hispanic (n = 3), or biracial (n = 2). They were between 21 to 54 years old (M = 37.2 years). They resided in four urban and three rural locations in one Midwestern state, and no qualitative differences were reported in mothers’ responses based on location. Although the original researchers did not specifically ask about socioeconomic status (SES), mothers’ education levels and employment status at time of separation had been coded as indicators of mothers’ SES (Khaw & Hardesty, 2015). Mothers’ education ranged from some high school to post-master’s education (M = some college) and 17 mothers were employed at the time of interview. Fourteen mothers were married and 11 were in dating or cohabitating relationships with the abusive partner. At the time of the interview, most mothers (n = 22) were permanently separated from their partners. Relationship length was between 1 and 18 years (M = 7.5 years). Mothers had 1 to 4 children (M = 2); two abusers fulfilled parenting roles as nonbiological fathers. All 25 mothers had experienced some form of physical abuse with a majority (n = 20) reporting physical violence in the context of coercive control. For example, in addition to physical abuse, these mothers reported verbal, emotional, psychological, sexual, and financial abuse aimed at dominating or controlling their daily lives.

Theoretical Framework and Analysis

Our approach to secondary data analysis was guided by a feminist lens, which assumes that IPV survivors have agency to engage in efforts to keep themselves and their children safe within the constraints of a violent relationship (Gondolf & Fisher, 1988; Merritt-Gray & Wuest, 1995). Throughout data analysis, we were attuned not only to mothers’ engagement in physical strategies to prepare and seek help safely but also to any mental and emotional work involved in the process. In addition, given research demonstrating multiple individual, relational, and sociocultural factors involved in the process of leaving (e.g., Liang et al., 2005), we were attentive to the influences of any internal and external factors that may have facilitated or hindered mothers’ decisions and actions regarding preparation. Although feminist methodologies emphasize leveling power hierarchies between researchers and participants and involving participants at every stage including data interpretation (Hesse-Biber, 2014), given the secondary nature of the data and often transitory living conditions of survivors post separation, we were unable to involve the participants in member checking in the current study.

Constructivist grounded theory methods (Charmaz, 2006; Clarke, 2007) were used to analyze the data. According to Charmaz, constructivist grounded theory methods offer systematic yet flexible guidelines to analyze qualitative data to construct theories that explain “how and . . . why participants construct meanings and actions to specific situations” (Charmaz, 2006, p. 130) within larger cultural and social contexts. At the same time, we remained cognizant of our theoretical orientation as researchers in interpreting the data and constructing theory (Charmaz, 2006). For example, given our use of a feminist lens, we were especially attuned to hegemonic social conditions inherent in gender and power dynamics that potentially affected women’s preparation processes.

Four coding levels were used in the current analysis. First, during initial coding, we coded the first 10 interviews by studying fragments of interview data and assigning descriptive codes to the data. For each participant, the goal of initial coding was to discover preliminary patterns of what was happening in her process of leaving as well as how and why she responded in the way that she did. Thus, the initial codes we developed were broad and generally descriptive in nature. Examples of some initial codes include “staying for survival” and “mentally thinking about leaving.” Whenever possible, we used in-vivo codes from participants’ own narratives (Charmaz, 2006). For example, one mother noted how she “had to leave” her abuser, which led to the code “having to leave.” Initial codes were then compiled into a codebook, along with a list of a priori codes that were informed by sensitizing concepts from the process of leaving and other help-seeking literatures. Examples of these codes include “preparation,” “formal help-seeking,” and “informal social support.” Codes were then combined and organized into larger categories. For example, codes such as “safety planning” or “finding a safe place to relocate” were subsumed under the umbrella category of “preparation.” In focused coding (Charmaz, 2006), we applied the most salient initial codes and categories to the remaining interviews. One such code was “mentally thinking about leaving,” which we had identified in earlier transcripts as women’s engagement in some mental work before physically leaving. However, upon applying this code in subsequent transcripts, we recognized its significance in helping women to physically leave. Thus, we relabeled the code as “mental preparation” and redefined it as another form of preparation to leave. We continued this back and forth process throughout focused coding, as we added any new codes to the codebook, revised existing codes, and returned to earlier transcripts to revise coding as needed.

Next, we engaged in theoretical coding (Charmaz, 2006), where we made theoretical connections and comparisons between codes and categories, paying specific attention to the nuances and variations in how they related to each other across narratives. For example, we compared the use of any formal help-seeking sources or informal social support in the narratives of mothers who were coded as having prepared to leave versus those who were coded as having not prepared to leave. Using constant comparative techniques (Charmaz, 2006), new interviews were evaluated for how they fit or did not fit with the patterns of preparing versus not preparing observed in earlier interviews. In the final phase of selective coding, we sought to bring together the connections among codes derived in theoretical coding to explain why some mothers actively prepared to leave (and some did not) and what happens when mothers do or do not actively prepare.

To establish trustworthiness of our results, all interview transcripts were independently coded and analyzed by each member of the research team. As a group, we met after coding each interview to discuss similar coding patterns and resolve any discrepancies that may have surfaced in the analysis process. Coding continued until all properties, dimensions, and relations among codes related to the process of preparation were fully explicated with the available data. Because this was a secondary data analysis, we were not able to theoretically sample new data for the purpose of theoretical saturation (Charmaz, 2006). However, the depth and richness of the data allowed for the saturation of key constructs related to preparation.

Results

Mothers’ narratives (N = 25) of their preparations to leave shed light on a relatively unexplored facet of the process of leaving abusive relationships. For the mothers in this study, preparation was a process of its own within the larger leaving process. Primarily, mothers engaged in mental preparation, in which they emotionally detached from their abusive partner and began to imagine what life would be like without him. Mental preparation appeared to be a covert effort, and this type of preparation was agency-driven and necessary in the process of preparation. Following mental preparation, mothers either engaged in active preparation (n = 11), in which they gathered material and social resources, or they (n = 14) left without using any active preparation strategies. Compared with mental preparation, active preparation represented more overt behaviors of preparation that often demonstrated some form of tangible outcome. In this study, the only demographic difference found was that mothers who had engaged in active preparation had older children on average than those who did not. Regardless of whether they only mentally prepared or moved on to actively prepare, almost all mothers (n = 23) engaged in multiple exits from and reentries into the relationship. We delineate the paths (i.e., mental only, mental and active) the mothers in this study took in preparing to leave their abusive relationships.

Mental Preparation

The process of mentally preparing to leave abusive partners began as most mothers started visualizing what their life would be like without the abuser. For instance, they considered what they would do and how they would live if they were no longer married to or involved with their abusive partners. Women appeared to utilize mental preparation as a covert strategy to emotionally cope with the violence endured from their partners. For instance, Stacy, a White, 35-year-old mother of one, characterized her mental preparation as follows:

Daydreams that it was possible to go and get a job and how I would fill out applications and . . . go and stay with my mom and eventually go and get my own apartment. I didn’t actually plan it. Maybe that is a form of planning. I guess I daydreamed planning.

Mental planning was reflected in some mothers’ urgency to “get away” and, for some, it involved a conscious decision to end the violence or the relationship. The increasingly negative effects of IPV prompted Kristen, a 35-year-old White mother of two, to leave:

I needed to get away. I had become kind of numb. I was having a really hard time having any emotions at all; I was getting really depressed. I was kind of suicidal. I felt like I might kill myself and I was thinking to myself right before I left that . . . how can a mother not have any feelings and be around her kids? Oh my gosh, this is dangerous. I can’t handle this.

Mothers described mental preparation as a process distinct from active preparation to leave. During mental preparation, mothers employed a variety of strategies to prepare themselves to leave “at the back of their heads.” For Rachel, a 50-year-old White mother of two, a mental preparation strategy was disassociating the abuser from her family:

[By the time] I was able to leave . . . I didn’t have any connection to him, other than [our son]. I don’t even remember when I decided that he’s my son’s dad and that’s it. Not part of our family.

On the contrary, Yesenia, a 54-year-old Hispanic mother of two, identified a specific point within this process at which her thinking shifted and she mentally prepared to leave:

I started to go to a psychologist and then a psychiatrist. I was so low. The psychologist told me, “What are you doing there?” I don’t know. He asked me, “Tell me ten bad things about you.” Oh I [made] a big list. But when he asked me [for] ten good things about me, I never found one. . . . I couldn’t find not one good thing about me. So finally I did commit [to leaving].

Ongoing exposure to abuse and a will to survive also facilitated mental preparation. Christine, a 54-year-old Black mother of two children, described how her perspective shifted toward a desire to transcend the will for survival into thriving: “the biggest thing that kept me going . . . at first was just that I didn’t want to die, but then it turned into, I wanted to live.” Although Christine had not yet actively prepared to leave, her statement signals a transition toward mental preparation.

Mothers who only mentally prepared and did not engage in active preparation strategies before leaving did so for one of two reasons: either they were forced to leave without active planning to protect themselves or because their partner’s controlling behaviors made it difficult for them to actively plan. Stefanie, a 39-year-old Black mother of three, described in her narrative how fear for her personal safety necessitated leaving without actively preparing:

The first few times I think it was just easier for me to just pick up the kids and go, . . . and him just putting his hands on me in front of my children, and by [my son] . . . (who was) going to try and fight this man, and I don’t want him to hurt my son [or] my babies. The last time it was different; I had to make some crucial decisions quickly.

Similar to Stefanie, several mothers described how they felt as though they had no choice but to leave quickly, often out of fear for their lives. To illustrate, Alex, a White, 42-year-old mother of one, shared how she desperately needed to leave to protect herself, which left her with no time to actively prepare: “I was freaking out, but I was like, I’m still getting out . . . of this place somehow. . . . I got that front door open and I ran.” Ana, a 28-year-old Hispanic mother of one, also shared a time she was forced to leave for her safety:

There was one time where there was throwing of beer and he was just going completely nutso and very intoxicated and . . . [my friend] came . . . and we packed everything in like an hour and just got the hell out of there. Just like, out of desperation. Just like, “Let’s go, let’s go, let’s go!”

Given heightened levels of control in their relationships, some mothers described skipping active preparation because it was unfeasible for them to do so. For example, as Lauren, a 35-year-old White mother of four, recalled,

Planning was a big problem because I couldn’t take anything out of the savings account without him knowing, and we didn’t have a credit card. We didn’t get a credit card until about three or four years ago. You can only take so much out of a checking account without waiting for approval. So I was too afraid that he would find out. The planning could be overwhelming.

Similarly, Holly, a 44-year-old White mother of two, described how she “didn’t have an active plan [to leave]. I just wanted the bad things to stop. I didn’t have much control in my life because I had my babies.” Indeed, Holly was not the only mother to discuss her children as a factor in her decisions around leaving. For example, although the characteristics of those who engaged in active preparation were fairly parallel to those who did not, one noticeable difference between the two groups of women was that those who moved from mental to active preparation tended to have older children (M = 4.68 years) than those who did not engage in active preparation (M = 1.96 years). Rachel, who did actively prepare, provided a possible explanation for this trend. As she noted, “it became harder when the children got older because I had to take into account what they were thinking and what they were willing to do, how I was going to manage to do anything.” On the contrary, Sara, a 42-year-old biracial mother of three, who skipped active preparation, surmised that it may be more urgent to take younger children out of violent homes quickly than older children, which interferes with the ability to prepare:

When it comes to children, there shouldn’t be no “let me grab my bags” or none of that. Let’s go. Their safety is more important than the Social Security card, than an ID, or your jewelry. . . . You can always gain your materialistic things but you can never gain the development of this kid. The more [abuse] happens [in front of] our kids, the more the future’s going to be messed up. . . . Even though we don’t want to admit it as adults, kids learn from what they see.

Active Preparation

Following the covert process of mental preparation, mothers diverged in their preparation processes. While most mothers (n = 14) had continued to mentally plan while staying with their partners, some (n = 11) begun engaging in the process of active planning. Active preparation involves overt preparation behaviors engaged by mothers that promoted their safety in the process of leaving. Examples included making safety exit plans, resource gathering (e.g., saving money, finding new residence), and seeking assistance from family and friends. The transition toward this more overt type of preparation may have been facilitated by women’s reports of growing increasingly “tired” of the abuse, thus lessening their emotional attachment to the abuser. Tara, a 31-year-old Black mother of one, explained,

It was just like every day when he’d be gone, I’d call my best friend and be like, “You know, girl, I’m just tired of this. I’m tired of this. What am I gonna do?” . . . So at times . . . I’d tell him I was going to my mom’s when really I was out looking for apartments. . . . I had paid a deposit down, did the lease process and everything . . . and [one day] I just packed all my stuff and then just left.

Similarly, Rebecca, a 49-year-old White mother of one, described her realization that her relationship would not last and she

was trying to devise something in case. . . I was taking out money and hiding them in cushions of my couch. Just in case. I didn’t know when I was going to leave but I knew it wasn’t getting better.

After the process of mentally preparing to leave for months, Christine described the night she made the decision to leave:

. . . he did some terrible stuff [that night]. But I figured if I just don’t say anything I’ll live. Because all I wanted to do was just live until the sun comes up. I just made a point that I wasn’t going to sleep that night and when he passed out, I had everything in a tote bag, some paperwork, . . . a credit card, . . . some toothbrushes, . . . and a change of underwear. Then the next morning I got up like I was going to go to work, got the boys ready, . . . dropped them off at my sister-in-law’s, and she kept them there until the bus came to pick them up. . . . I went to the train station and I waited for a girlfriend who I asked that she come and get me. And when she came [to] pick me up, we went and got the boys out of school, we went to the bank, and we headed out.

Another mother, Yesinia, described how after some time of engaging in mental preparation, she negotiated some work logistics with her employer months before she actually physically left her partner:

I asked my [employer], “Can you please send my check to another place?” And they say, “Yes we can.” So then I could leave because I have a little more freedom. And with that freedom, that worked because then I can do my work at another place. Not only that, I did something else. I prepared some of my work ahead because I have to do [certain tasks] every week. I went ahead and worked like crazy like for a couple of months ahead, then I don’t have to do nothing for a couple of months.

Almost all (n = 23) women, regardless of whether or not they actively prepared, engaged in multiple exits throughout the relationship (i.e., they left and returned more than once). When they reentered the relationship, they reengaged in the preparation process, either mentally, actively, or both. This pattern was consistent in the case of Monica, a 25-year-old biracial mother of two. Following multiple cycles of mentally preparing, leaving, and returning, she eventually made her final exit:

The first three times [I left] I felt so horrible. Then within a month and a half, two months, I went back to him. Then the fourth time and fifth time. The fifth time I went back because I wanted Christmas to be as a family before I left him left him. At that time frame between November to January, I had everything planned. I was just thinking this is what’s going to happen. I’m going to give him one more time to put his hands on me and as soon as he does, I’m gone. January 28th he put his hands on me; that night I left.

Overall, the mothers in this sample followed one of two paths in preparing to leave their abusive relationships. Both paths began with engagement in mental preparation, which was agency-driven and a necessary process in preparing to leave. Mothers were then split between those who utilized active preparation strategies to physically leave (n = 11) and those who left without having used active preparation strategies (n = 14). Children’s age was the only demographic difference between the two groups in that mothers who used active preparation strategies had older children on average compared with mothers who only mentally prepared. Finally, almost all mothers (n = 23) engaged in multiple exits during this process with some using more active preparation strategies and others using only using mental strategies during subsequent exits. It should be noted that the paths taken by each mother at each exit were unique, as mothers engaged in different number of exits, and the path taken at each exit was unique to the individual circumstance to the relationship.

Discussion

Current best practices recommend women to actively prepare to leave abusive relationships (U.S. Department of Health and Human Services, 2011). Although this may aid in safety for the survivor and her children (Sullivan, 2011), studies indicate that active preparation is not always feasible (e.g., Kasturirangan, 2008). In fact, less than half of the 25 women in our study (n = 11) described engaging in the forms of active preparation that are most often prescribed by practitioners (e.g., saving money, finding housing). However, as indicated by these mothers’ narratives, the lack of physical resource gathering was not indicative of an absence of planning. Instead, our findings demonstrate that preparation is more than just a step within the larger process of leaving; preparation is a complex process within itself. Our results support the feminist view that women in abusive relationships are empowered survivors (Gondolf & Fisher, 1988) and demonstrate that their agency in the process of leaving includes a great deal of invisible mental work, which is not often recognized as a tangible effort to leave (Daniels, 1987). Instead of cognitive shifts necessary for planning or preparation to take place, our results suggest expanding our conceptual understanding of preparing to leave to include the invisible work of mental preparation.

Our findings are consistent with previous research, which describes leaving an abusive partner as a complex, nonlinear process (Chang et al., 2006; Cluss et al., 2006; Khaw & Hardesty, 2015). Although stage-based process of leaving studies (e.g., Stages of Change Model) acknowledge the mental processes involved as women consider their options and think about leaving, they do not explicitly identify these mental processes as a part of the preparation to leave (Chang et al., 2006). Rather, mental preparation resembles what studies using the Stages of Change Model describe as a transition between the stages of contemplation and preparation—or work that is necessary before planning or preparation can take place. For instance, Keeling, Smith, and Fisher (2016) reported evidence of “a preemptive stage to the women’s decision to leave the violent relationships” (p. 5) that resembles mental preparation. Similarly, in a study of abused women’s interactions with physicians, Zink, Elder, Jacobson, and Klostermann (2004) noted that while some women began to engage in active preparation by reaching out to their doctors for support, others were not ready to disclose IPV but hoped for their physicians to follow up for them to begin the preparation process. In both studies, mental work was attributed to being a part of the contemplation, rather than preparation, stage (Keeling et al., 2016; Zink et al., 2004).

On the contrary, our study suggests this “preemptive stage” involving mental preparation is more characteristic of preparation than of contemplation because of its resemblance to invisible work, or work undertaken without tangible results (Daniels, 1987). To our knowledge, the concept of invisible work has not been explicitly applied to women’s process of preparing to leave abusive relationships. Instead, according to the original Stages of Change Model, contemplation is the stage when women are beginning to weigh the pros and cons of leaving and consider the possibility of leaving their partners (Prochaska & DiClemente, 1984). However, in our study, women often recalled feeling as though their relationship had already ended and the next step was to leave. Murray, Crowe, and Flasch’s (2015) study revealed a similar observation; it was during this stage where some women knew their relationship was over and had begun experiencing decreased emotional attachment to their partner. As a result, they envisioned their lives without their abusers while emotionally distancing themselves before moving into the active planning stage of preparation (Murray et al., 2015).

In the current study, some women reported that they “daydreamed” plans to leave, even if they did not engage in physical efforts to actively prepare. Such feelings of decreased attachment and increased negative feelings toward the abuser were labeled by Keeling and colleagues (2016) as “transformative feelings” (p. 4). In another study, Shorey, Tirone, Nathanson, Handsel, and Rhatigan (2013) found a correlation between decreased relationship commitment and the preparation and action stages of change. Therefore, previous stage-based studies have characterized women who do not actively gather resources prior to leaving as skipping the preparation stage entirely (Chang et al., 2006; Keeling et al., 2016). Based on the narratives provided by the mothers in our study, however, visualizing a life without their partners suggests engagement in mental preparation. Consistent with a feminist framework that views survivors as active agents of their own leaving (Gondolf & Fisher, 1988; Merritt-Gray & Wuest, 1995), acknowledging mental preparation as a legitimate form of preparation assumes women to be at the forefront of their own leaving processes while challenging the narrower definition of preparation as previously viewed by others (Kasturirangan, 2008). This acknowledgment brings to light the often-neglected tasks undertaken in invisible work, which may be overlooked by practitioners (Daniels, 1987).

Despite a desire to empower women who are leaving their abusive relationships, many existing services do not adequately address their unique circumstance (Goodman et al., 2016; Kasturirangan, 2008; Morgan & Coombes, 2013; Wood, 2015). Instead of attempting to empower women through a reliance on others, it is crucial for survivors to navigate empowerment processes on their own (Morgan & Coombes, 2013), which is in alignment with a feminist perspective. Although gathering resources is an often recommended active preparation strategy and does aid in keeping women safe when leaving (McFarlane et al., 2006), not all women will have time, opportunities, or equal access to resources to actively prepare (Kasturirangan, 2008; Sokoloff & Dupont, 2005; Wood, 2015). Instead, women prepare to leave within unique sociocultural locations, which then individualizes the preparation process for each survivor (Morgan & Coombes, 2013). By recognizing mental preparation as a form of preparation and acknowledging women’s invisible work toward changing their situations, practitioners can best assist survivors to identify potential sources of support in the event that they need to exit the relationship quickly (Murray et al., 2015).

Also consistent with prior literature, most of the mothers in this study engaged in multiple exits throughout their leaving process. Leaving and returning to the abuser is considered normative in the leaving process (Lacey et al., 2011). Khaw and Hardesty (2007) identified the cycle of leaving and returning as the process of “backing and forthing” (p. 418) across the stages of contemplation through action. In the current study, backing and forthing appeared salient between preparation and the decision to leave. For example, although all participants moved from either mental or active preparation to leaving their partners, most had also returned to their relationship at some point and reengaged in the process of preparation when they do. However, multiple exits may have aided the emotional disengagement aspect of mental preparation. Furthermore, backing and forthing between preparation and leaving appears to bolster women’s sense of self-efficacy, or the belief that they possess the ability to leave or keep themselves safe. Cluss and colleagues (2006) posited that this sense of self-efficacy is necessary for women in preparing to leave. Providing multiple viable options for preparing and actually leaving, as opposed to imposing one ideal path, has been shown to foster women’s self-efficacy (Tarzia et al., 2016).

Finally, our findings about the influence of children’s age on mothers’ preparations to leave seem to both support and contradict previous literature. Specifically, mothers who did not use active preparation strategies had younger children on average (M = 1.96 years), compared with those who did use active preparation (M = 4.68 years). This finding is consistent with the body of literature that highlights children as an important factor for staying in (e.g., Bliss, Ogley-Oliver, Jackson, Harp, & Kaslow, 2008) or leaving abusive relationships (e.g., Semaan, Jasinski, & Bubriski-Mckenzie, 2013). With regard to the age difference, however, some studies have found opposite effects. For example, Keeling and colleagues (2016) found that older mothers were more likely than younger mothers to leave without engaging in active preparation strategies. They posit that due to the increased formal support, younger mothers may have access to more formal support when leaving (e.g., social workers, domestic violence advocates). The mothers in our study did not explicitly address this possible difference. Instead, our findings suggest that the dependence of younger children on their caregivers may make active preparation seem overwhelming or perhaps necessitating a more quick and spontaneous exit. In contrast, as children grow increasingly independent, mothers not only have to take into account the children’s physical necessities and preferences (e.g., clothing, food, shelter) but also their social needs external to the family (e.g., access to peers and school), which may prompt an increased need to actively plan.

Future Directions

The current study builds upon extant literature to provide valuable insight into the complex process of preparing to leave an abusive partner, but there are some limitations. First, the study used secondary data, which limited our ability to theoretically sample on potentially relevant contextual factors, such as access to resources. As such, data on mothers’ SES were not collected by the original authors and could only be inferred by their level of education and employment status at the time of separation. Second, mothers provided retrospective accounts of their experiences, which may be influenced by recall bias. Thus, future research should examine women’s experiences of preparing as they occur in the process of leaving. Finally, the sample of women who participated in the original study self-selected based on the information presented on a recruitment flyer, which included the following statement: “We would like to talk to moms who have ever separated (either temporarily or permanently) from their partners.” This statement may have excluded mothers who had been mentally planning but had not yet left their partner at any point. Despite these limitations, the current study illustrates the processes in which women prepare to leave abusive relationships and points to several important future directions.

Research

Our findings indicate that preparing to leave is a complex process in and of itself that warrants further empirical development. More research using primary data sources with the explicit goal of understanding preparation is needed to further tease apart the nuances of the process, including the conceptual differences between mentally and actively preparing. An intersectional approach would be particularly useful for identifying how larger contextual factors, such as race, ethnicity, and class, in addition to factors such as ages of children, may play a role in whether and how mothers mentally and/or actively prepare to leave abusive partners (Morgan & Coombes, 2013). For example, resource accessibility is likely a key factor for some women who may desire to engage in active preparation strategies but are unable to do so due to structural constraints (Liang et al., 2005). Indeed, intersectionality scholars contend that access to resources may be influenced by various intersections of oppression (e.g., gender, race, and class; Crenshaw, 1991; Sokoloff & Dupont, 2005). Although all women in this study experienced IPV, women of color may have faced unique barriers to accessing formal help-seeking. Given the nature of secondary data (Szabo & Strang, 1997), analyses based on these axes of identity were not possible. Furthermore, although there is some research on various social identities that may influence women’s access to resources during help-seeking (e.g., race and SES; Sokoloff & Dupont, 2005), most studies have primarily explored the individual effects of such factors. The lack of between-group differences in terms of individual identities (e.g., race, age, SES) suggests the need to examine how multiple factors interact and collectively impact women’s preparation processes (Goodman et al., 2016).

Practice

Despite progress in addressing the variations in women’s experiences of leaving abusive relationships (Wood, 2015), there are still many opportunities to implement a more individualized framework when providing advocacy services to survivors (Kasturirangan, 2008; Morgan & Coombes, 2013). Practitioners, including social workers, shelter staff, and physicians, should be trained to take into account different ways women prepare to leave abusive relationships and to avoid one-size-fits-all approaches (Goodman et al., 2016). The present study offers some examples of the invisible, covert strategies women use as part of mental preparation, which practitioners can explicitly acknowledge as part of the necessary work of preparation or as indicators of agency. As Goodman and colleagues (2016) have found, survivor-defined practices that emphasize choice, partnership, and sensitivity to one’s unique needs and experiences are linked to feelings of empowerment to maintain safety in an abusive relationship.

Furthermore, information should be made available via online resources that also address differences between mental and active preparation. Currently, the U.S. Department of Health and Human Services’ website and other IPV advocacy services emphasize engagement in active preparation strategies, such as safety planning and resource gathering for abused women who are thinking of leaving. These materials could be expanded to recognize the important mental, and not just physical, work involved in preparing to leave. Online resources tend to have the most up to date information (CDC, 2015) and are safer for survivors seeking information, as they allow for quick escape buttons not available in print sources (e.g., the National Domestic Violence Hotline, n.d.). Naming this invisible work in the safest delivery format and validating its importance in the most updated resources, just like normalizing multiple exits as part of the leaving process, can help to further educate and empower survivors of IPV.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Autumn M. Bermea, MS, is a doctoral student and research fellow in Family Studies at Montclair State University. Her research interests include intimate partner violence, particularly in adolescence. Specifically, she is interested in intimate partner violence in queer youth relationships with queer, feminist, and intersectionality lenses using qualitative methods.

Lyndal Khaw, PhD, is an associate professor in Family and Child Studies at Montclair State University. Her interests include intimate partner violence and family relationship dynamics. Specifically, she is interested in women’s processes in leaving these relationships using feminist perspectives and qualitative methods.

Jennifer L. Hardesty, PhD, is an associate professor in Human Development and Family Studies at the University of Illinois at Urbana–Champaign. Her research interests include intimate partner violence, separation and divorce, as well as coparenting after separation using qualitative and quantitative methods.

Lindsay Rosenbloom, BA, completed her bachelor’s degree in Family and Child Studies at Montclair State University. She is currently working toward her MA in social work at Rutgers University with a special interest on intimate partner violence.

Craig Salerno, BA, completed his bachelor’s degree in Family and Child Studies at Montclair State University. He currently leads an after school program for low-income adolescent boys in Essex County, New Jersey, and is interested in working with survivors of human trafficking.

References

Anderson

D. K.

Saunders

D. G.

(2003). Leaving an abusive partner: An empirical review of predictors, the process of leaving, and psychological well-being. Trauma, Violence, & Abuse, 4, 163-191.

Black

M. C.

Basile

K. C.

Breiding

M. J.

Smith

S. G.

Walters

M. L.

Merrick

M. T.

Stevens

M. R.

(2011). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 summary report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

Bliss

Ogley-Oliver

Jackson

Harp

Kaslow

(2008). African American women’s readiness to change abusive relationships. Journal of Family Violence, 23, 161-171.

Burke

J. G.

Denison

J. A.

Gielen

A. C.

McDonnell

K. A.

O’Campo

(2004). Ending intimate partner violence: An application of the transtheoretical model. American Journal of Health Behavior, 28, 122-133.

Campbell

J. C.

Webster

Koziol-McLain

Block

Campbell

Curry

M. A.

. . . Laughon

(2003). Risk factors for femicide in abusive relationships: Results from a multisite case control study. American Journal of Public Health, 93, 1089-1097.

Centers for Disease Control and Prevention. (2015). Intimate partner violence. Retrieved from http://www.cdc.gov/violenceprevention/intimatepartnerviolence/

Chang

J. C.

Dado

Ashton

Hawker

Cluss

P. A.

Buranosky

Scholle

S. H.

(2006). Understanding behavior change for women experiencing intimate partner violence: Mapping the ups and downs using the stages of change. Patient Education and Counseling, 62, 330-339.

Charmaz

K. C.

(2006). Constructing grounded theory: A practical guide through qualitative analysis. London, England: Sage.

Clarke

A. E.

(2007). Feminisms, grounded theory, and situational analysis. In Hesse-Biber

S. N.

(Ed.), Handbook of feminist research: Theory and praxis (pp. 345-370). Thousand Oaks, CA: Sage.

10.

Cluss

P. A.

Chang

J. C.

Hawker

Scholle

S. H.

Dado

Buranosky

Goldstrohm

(2006). The process of change for intimate partner violence: Support for a psychosocial readiness model. Women’s Health Issues, 16, 262-274. doi:10.1016/j.whi.2006.06.006

11.

Crenshaw

(1991). Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43, 1241-1299.

12.

Daniels

A. K.

(1987). Invisible work. Social Problems, 34, 403-415. doi:10.2307/800538

13.

Davies

Lyon

Monti-Catania

(1998). Safety planning with battered women: Complex lives/difficult choices. Thousand Oaks, CA: Sage.

14.

Duterte

E. E.

Bonomi

A. E.

Kernic

M. A.

Schiff

M. A.

Thompson

R. S.

Rivara

F. P.

(2008). Correlates of medical and legal help seeking among women reporting intimate partner violence. Journal of Women’s Health, 17, 85-95.

15.

Gondolf

E. W.

Fisher

E. R.

(1988). Battered women as survivors: An alternative to treating learned helplessness. Lexington, MA: Lexington Books.

16.

Goodkind

J. R.

Sullivan

C. M.

Bybee

D. I.

(2004). A contextual analysis of battered women’s safety planning. Violence Against Women, 10, 514-533.

17.

Goodman

L. A.

Thomas

Cattaneo

L. B.

Heimel

Woulfe

Chong

S. K.

(2016). Survivor-defined practice in domestic violence work: Measure development and preliminary evidence of link to empowerment. Journal of Interpersonal Violence, 31, 163-185.

18.

Herbert

T. B.

Silver

R. C.

Ellard

J. H.

(1991). Coping with an abusive relationship: I. How and why do women stay? Journal of Marriage and Family, 53, 311-325.

19.

Hesse-Biber

S. N.

(2014). Feminist research practice: A primer (2nd ed.). Thousand Oaks, CA: Sage.

20.

Hinds

P. S.

Vogel

R. J.

Clarke-Steffen

(1997). The possibilities and pitfalls of doing a secondary analysis of a qualitative data set. Qualitative Health Research, 7, 408-424.

21.

Kasturirangan

(2008). Empowerment and programs designed to address domestic violence. Violence Against Women, 14, 1465-1475.

22.

Keeling

Smith

Fisher

(2016). A qualitative study exploring midlife women’s stages of change from domestic violence towards freedom. BMC Women’s Health, 16, Article 13. doi:10.1186/s12905-016-0291-9

23.

Khaw

Hardesty

J. L.

(2007). Theorizing the process of leaving: Turning points and trajectories in the stages of change. Family Relations, 56, 413-425.

24.

Khaw

Hardesty

J. L.

(2015). Perceptions of boundary ambiguity in the process of leaving an abusive partner. Family Process, 54, 327-343. doi:10.1111/famp.12104

25.

Lacey

K. K.

Saunders

D. G.

Zhang

(2011). A comparison of women of color and non-Hispanic White women on factors related to leaving a violent relationship. Journal of Interpersonal Violence, 26, 1036-1055.

26.

Leone

J. M.

Lape

M. E.

(2014). Women’s decisions to not seek formal help for partner violence A comparison of intimate terrorism and situational couple violence. Journal of Interpersonal Violence, 29, 1850-1876.

27.

Liang

Goodman

Tummala-Narra

Weintraub

(2005). A theoretical framework for understanding help-seeking processes among survivors of intimate partner violence. American Journal of Community Psychology, 36, 71-84.

28.

Lindhorst

Nurius

Macy

R. J.

(2005). Contextualized assessment with battered women: Strategic safety planning to cope with multiple harms. Journal of Social Work Education, 41, 331-352.

29.

McFarlane

J. M.

Groff

J. Y.

O’Brien

J. A.

Watson

(2006). Secondary prevention of intimate partner violence: A randomized controlled trial. Nursing Research, 55, 52-61.

30.

Merritt-Gray

Wuest

(1995). Counteracting abuse and breaking free: The process of leaving revealed through women’s voices. Health Care for Women International, 16, 399-412.

31.

Morgan

Coombes

(2013). Empowerment and advocacy for domestic violence victims. Social & Personality Psychology Compass, 7, 526-536. doi:10.1111/spc3.12049

32.

Moss

Pitula

Campbell

Halstead

(1997). The experiences of terminating an abusive relationship from an Anglo and African American perspective: A qualitative descriptive study. Issues in Mental Health Nursing, 18, 433-454.

33.

Murray

C. E.

Crowe

Flasch

(2015). Turning points: Critical incidents prompting survivors to begin the process of terminating abusive relationships. The Family Journal: Counseling and Therapy for Couples and Families, 23, 228-238. doi:10.1177/1066480715573705

34.

Murray

C. E.

Horton

G. E.

Johnson

C. H.

Notestine

Garr

Pow

A. M.

. . . Doom

(2015). Domestic violence service providers’ perceptions of safety planning: A focus group study. Journal of Family Violence, 30, 381. doi:10.1007/s10896-015-9674-1

35.

National Domestic Violence Hotline. (n.d.). The National Domestic Violence Hotline. Available from http://www.thehotline.org/

36.

Nurius

P. S.

Macy

R. J.

Nwabuzor

Holt

V. L.

(2011). Intimate partner survivors’ help-seeking and protection efforts: A person-oriented analysis. Journal of Interpersonal Violence, 26, 539-566.

37.

Prochaska

J. O.

DiClemente

C. C.

(1984). The transtheoretical approach: Crossing traditional boundaries of change. Homewood, IL: Dow Jones/Irwin.

38.

Riddell

Ford-Gilboe

Leipert

(2009). Strategies used by rural women to stop, avoid, or escape from intimate partner violence. Health Care for Women International, 30, 134-159. doi:10.1080/07399330802523774

39.

Semaan

Jasinski

J. L.

Bubriski-Mckenzie

(2013). Subjection, subjectivity, and agency: The power, meaning, and practice of mothering among women experiencing intimate partner abuse. Violence Against Women, 19, 69-88.

40.

Shorey

R. C.

Tirone

Nathanson

A. M.

Handsel

V. A.

Rhatigan

D. L.

(2013). A preliminary investigation of the influence of subjective norms and relationship commitment on stages of change in female intimate partner violence victims. Journal of Interpersonal Violence, 28, 621-642. doi:10.1177/0886260512455520

41.

Sokoloff

N. J.

Dupont

(2005). Domestic violence at the intersections of race, class, and gender challenges and contributions to understanding violence against marginalized women in diverse communities. Violence Against Women, 11, 38-64.

42.

Straus

M. A.

Hamby

S. L.

Boney-McCoy

Sugarman

D. B.

(1996). The revised Conflict Tactics Scales (CTS2): Development and preliminary psychometric data. Journal of Family Issues, 17, 283-316.

43.

Sullivan

C. M.

(2011). Evaluating domestic violence support service programs: Waste of time, necessary evil, or opportunity for growth? Aggression and Violent Behavior, 16, 354-360. doi:10.1016/j.avb.2011.04.008

44.

Szabo

Strang

V. R.

(1997). Secondary analysis of qualitative data. Advances in Nursing Science, 20, 66-74.

45.

Tarzia

Murray

Humphreys

Glass

Taft

Valpied

Hegarty

(2016). I-DECIDE: An online intervention drawing on the psychosocial readiness model for women experiencing domestic violence. Women’s Health Issues, 26, 208-216. doi:10.1016/j.whi.2015.07.011

46.

Thomas

K. A.

Goodman

Putnins

(2015). “I have lost everything”: Trade-offs of seeking safety from intimate partner violence. American Journal of Orthopsychiatry, 85, 170-180.

47.

U.S. Department of Health and Human Services. (2011). Safety planning for abusive situations. Retrieved from http://womenshealth.gov/violence-against-women/get-help-for-violence/safety-planning-for-abusive-situations.html

48.

Wood

(2015). Hoping, empowering, strengthening: Theories used in intimate partner violence advocacy. Journal of Women and Social Work, 30, 286-301. doi:10.1177/0886109914563157

49.

Zink

Elder

Jacobson

Klostermann

(2004). Medical management of intimate partner violence considering the stages of change: Precontemplation and contemplation. Annals of Family Medicine, 2, 231-239. doi:10.1370/afm.74