“Back Home You Just Go Talk to the Family”: The Role of Family Among Women Who Seek Help for Intimate Partner Violence Pre- and Postresettlement to the United States

Abstract

Gaps in knowledge remain regarding how and from whom women resettling to the United States as refugees seek help for intimate partner violence (IPV), and what happens when they do. This study examined ways in which women seek help for IPV across varied contexts and at different times both pre- and postresettlement. Researchers used a purposive sampling approach to recruit women who resettled to the United States as refugees (n = 35). An inductive approach to thematic analysis led to an examination of the role of family in seeking help for IPV and seeking help in the absence of family. The findings speak to the importance of applying a social support lens to theory, practice, and research concerned with women’s help-seeking for IPV in the resettlement context.

Keywords

domestic violence refugees help-seeking social support resettlement

Evidence highlights intimate partner violence (IPV) as a significant yet less acknowledged form of violence against women in war and displacement (Vu et al., 2014). Migration can intensify risk factors for IPV (Frye, Hosein, Waltermaurer, Blaney, & Wilt, 2005; Messing, Amanor-Boadu, Cavanaugh, Glass, & Campbell, 2013), as well as serve as an impetus for women to relocate in search of safety (Cook Heffron, Snyder, Wachter, Nsonwu, & Busch-Armendariz, 2016). Many women resettling to the United States as refugees faced increased risk of violence amid armed conflict, in flight, and during displacement (World Health Organization, 2017). The physical, psychological, social, economic, and other consequences of IPV can endure over time and shape resettlement processes in ways that may not be readily apparent to frontline service providers (Wachter, Dalpe, Cook Heffron, 2019). Women may confront new or ongoing abuse after arriving to the United States but without established social networks to turn to for help or the skills to navigate new and complex social service systems (Bhuyan & Velagapudi, 2013). Gaps in knowledge remain regarding how and from whom women resettling to the United States seek help for IPV, and what happens when they do. The study, from which this analysis drew, sought to address some of those gaps.

Refugee Resettlement

Refugee resettlement is the selection and transfer of refugees from a State in which they have sought protection to a third State that has agreed to admit them with permanent residence status and an opportunity to naturalize (United Nations High Commissioner for Refugees [UNHCR], 2011). The majority of registered refugees currently reside in Africa, Asia, and the Middle East, and less than 1% of refugees officially will resettle to a third country (UNHCR, 2018). From 1975 to 2018, the U.S. government has resettled approximately 3.3 million individuals with refugee status (U.S. Department of State, n.d.). A network of agencies and community partners provides a wide range of services to refugees resettling to the United States (Office of Refugee Resettlement, n.d.) and prioritizes clients becoming economically self-sufficient within 120 to 180 days (Office of Refugee Resettlement, 2012). However, in the rush to secure employment, attention to other aspects of resettlement processes may be overlooked, such as the loss of social support and issues related to past and current violence (Wachter et al., 2016).

Seeking Help for IPV

The literature has conceptualized help-seeking as the disclosure of violence or abuse to obtain assistance (Morrison, Luchok, Richter, & Parra-Medina, 2006). Across diverse samples, women disclose first and most often to those within close personal social networks (Barrett & Pierre, 2011; Garcia-Moreno, Jansen, Ellsberg, Heise, & Watts, 2006; Sokoloff & Pearce, 2011; Sylaska & Edwards, 2014). Seeking help for IPV has been associated with helping survivors identify the scope and severity of the abuse they face, reducing the frequencies of violent episodes, and decreasing the distress they experience (Coker, Smith, Bethea, King, & McKeown, 2002; Morrison, Luchok, Richter, & Parra-Medina, 2006). Help-seeking for IPV is associated with access to social support, which serves to mitigate negative consequences and promote better mental health (Coker, Watkins, Smith, & Brandt, 2003). Both formal support delivered by service providers and informal support available through personal social networks may offer some protection against future violence (Goodman, Dutton, Weinfurt, & Vankos, 2005).

Immigration status can exacerbate existing barriers to informal support and formal services and can complicate women’s access to services and care for the IPV they have experienced (Runner, Yoshihama, & Novick, 2009). The literature highlights lack of familiarity and awareness of services and rights in a new setting, social isolation and exclusion, gender role expectations and shame or silence, and discrimination (Acevedo, 2000; Adams & Campbell, 2012; Dutton, Orloff, & Hass, 2000). These factors may also play a role in how survivors weigh the costs and benefits of seeking help and may ultimately determine that the cost of some help does not merit the expected benefits (Liang, Goodman, Tummala-Narra, & Weintraub, 2005). Discrimination, racism, and anti-immigrant sentiments play a role in hindering immigrant women’s help-seeking and access to services (Bauer, Rodriguez, Quiroga, & Flores-Ortiz, 2000; Crandall, Senturia, Sullivan, & Shiu-Thornton, 2005), in part due to efforts to transmit an untarnished and positive image of the immigrant community (Erez, Adelman, & Gregory, 2009). Other research suggests that fear of public violence in the new environment may also contribute to staying in an abusive relationship (Kiwanuka, 2008). Fears of arrest and deportation also inhibit help-seeking, particularly, among immigrants who perceive their legal status in the United States as precarious (Frias & Angel, 2005; Guruge & Humphreys, 2009; Levine & Peffer, 2012).

Gender role expectations and pressures to uphold traditional gender and parenting roles also contribute to help-seeking efforts for IPV (Acevedo, 2000; Crandall et al., 2005; Fuchsel, Murphy & Dufresne, 2012). Immigrant survivors often report that IPV is considered a private problem in their country of origin, resulting in efforts to maintain silence, keep families intact, and avoid disclosure to both formal and informal avenues for help (Bauer et al., 2000; Crandall et al., 2005). Sokoloff and Pearce (2011) found that although women prefer informal sources of support when facing abuse, they may become disengaged from any networks that reinforce silence around violence, seeking support elsewhere, such as from religious leaders. Similarly, Guruge and Humphreys (2009) found that limited support from family and friends may facilitate help-seeking from and access to support offered through formalized social service delivery systems. Depending on the type and quality of informal support, survivors may perceive or experience that help as not being useful and/or as being inadvertently harmful (Morrison et al., 2006). In addition, accessibility, quality, and relevance of available services hinder help-seeking efforts for IPV (Kennedy et al., 2012). However, Guruge and Humphreys (2009) found that limited social support from family and friends may facilitate help-seeking from and access to support offered through formalized social service delivery systems.

Help-Seeking Conceptual Models

Two IPV help-seeking conceptual models are particularly relevant to women resettling to the United States as refugees. The theoretical framework developed by Liang et al. (2005) examines individual, familial, economic, and cultural influences on women’s help-seeking and support for IPV. In this model, women who face IPV undergo three interrelated stages of seeking informal and/or formal help for IPV that involve (a) defining the problem, (b) deciding to seek help, and (c) selecting a source of support, as well as feedback loops between stages. Individual and relational history shape internal processes—cognitions, emotions, and intentional actions—as well as “the economic, political, and cultural context in which her life experiences are embedded” (Liang et al., 2005, p. 74). Later work built on this model and incorporated additional factors shaping disclosures and their outcomes such as self-blame, psychological symptoms, and substance abuse (Ullman, 2010).

Kennedy et al. (2012) conceptualized their model for formal help-seeking and attainment in relation to physical and sexual victimization and mental health outcomes. The model highlights factors that influence the help-seeking process: women’s identification and assessment of their own needs, their perceptions of the availability or accessibility of help, and their previous experience with and ideas around the benefits or quality of that help. This model situates the help-seeking and formal help attainment process over time and highlights the cumulative effect of help attainment experiences within nested layers of social location; prior cumulative adversity, victimization, and stress; community context and resources; and the developmental and situational context. Importantly, the model foregrounds the interplay between the spheres of influence that shape women’s individual decision making about whether and where to seek formal services. The model furthermore underscores the need to examine women’s actual reception of services that address self-identified needs and to empirically establish associations between help attainment and improved mental health outcomes.

Theoretical Perspectives Guiding the Current Study

A number of theoretical perspectives guided the current study and analysis. The help-seeking conceptual models described above informed both the study design and analysis of data. Their focus on the multitude of factors shaping women’s help-seeking processes over time, and social and economic marginalization, were particularly relevant to the research at hand. In addition, the analysis drew from feminist perspectives to foreground the subjectivities of actors and complexity of lived experiences within the past and present and across local and international contexts (O’Mahony & Donnelly, 2010; Wachter & Snyder, 2018). This feminist grounding values intersectional identities, recognizes heterogeneity within and across refugee communities, and affirms individual agency, resilience, and creativity among refugee women (Cook Heffron, et al., 2016). These perspectives draw from the work of transnational feminist scholar Chandra Mohanty (2003) who warns against generalizations of women in the global south as agency-less victims. Finally, although this research was not designed to study culture, the project nevertheless employed a critical understanding of culture that promotes moving away from “essentialist and one-dimensional notions of identity and oppression” (Warrier, 2009, p. 79).

The Current Study

Drawing from these theoretical perspectives and conceptual models, the current study examined ways in which women seek help for IPV across varied contexts and geographic regions—Central and East Africa, the Middle East, and South and Southeast Asia—and at different times both pre- and postresettlement, with the aim of informing practice. Two research questions sparked the current analysis:

Research Question 1: How and from whom did women access formal/informal help, pre- and postresettlement?

Research Question 2: What happens when women seek help?

An inductive analytical process led to an examination of the specific role of family in women’s help-seeking for IPV among refugees who resettled to the United States.

Method

The current analysis drew from a broader qualitative study that examined help-seeking related to experiences of IPV among women who resettled to the United States as refugees. Researchers employed an inductive approach to thematic analysis, which generated findings related to the role of family in women’s help-seeking for IPV. In collaboration with the first author, the International Rescue Commitee implemented the study from 2016 to 2018 in a large U.S. urban metropolitan area in the South.

Recruitment

The original study included three groups of participants, of which two informed the current analysis. Agency staff used a purposive sampling approach to recruit participants. Group A comprised women who disclosed having experienced IPV and/or sexual assault during routine screening and/or had otherwise disclosed to agency staff. Agency staff did not recruit women known to be currently at threat of IPV and asked all women recruited as Group A participants about any risk they may currently face. Group B included women who did not disclose having experienced IPV and/or sexual assault during routine screening and/or programming. All Group A and B participants were clients of the recruiting agency and had immigrated to the United States through the refugee resettlement program. Women recruited for Groups A and B were informed that they would receive transportation to and from the meeting location and a Visa gift card. All participants were over the age of 18 years.

Participants

Table 1 provides details of participant demographics. In total, 35 individuals comprised the subsample included in the current analysis. As an added layer of protection, participants are located only by region as opposed to specific countries of origin. The age range among Group A participants (n = 10) was between 20 to 53 years. With the exception of two participants who did not describe a pattern of abuse per se, women in Group A described experiencing multiple and extremely violent forms of IPV over time (estimated range: 1-30 years). Participants described a range of IPV, inclusive of physical and sexual violence, intimidation and threats, controlling and degrading behaviors, and emotional and economic abuse. Three women disclosed having resettled with an abusive partner to the United States and continued to experience IPV post resettlement. Group B participants (n = 25) ranged in age from 18 to 69 years. The majority of Group B participants were unemployed at the time of data collection and staying home to care for young children.

Table 1.

Study Participants’ Demographics (n = 35).

	Group A	Group B
	(n = 10)	(n = 25)
Region of origin
South and Southeast Asia	—	8
Central and East Africa	8	17
Middle East	2	—
Age
18-29 years	2	8
30-39 years	3	7
≥40 years	5	10
Years of formal education
0-5	5	15
6-12	5	9
4 years post secondary (attained undergraduate degree)	—	1
Marital status
Married	2	15
Divorced/separated	3	1
Widowed	1	4
Single	2	5
Number of children
0	1	4
1-3	4	9
4-6	1	9
≥7	3	3
Time in the United States^a
<12 months	4	5
12-24 months	6	13
>2 years	—	4
Employment status
Employed part time or full time	6	7
Unemployed	4	18

Missing data for Group B (n = 22).

Data Collection Procedures

With the assistance of language interpreters, researchers conducted 10 interviews with Group A participants and eight focus group discussions with Group B participants (four groups had four participants, one group had three, and three groups had two). Both interviews and focus group discussions averaged 84 min in duration (range for Group A participants: 56-113 min; range for Group B focus groups: 69-103 min). Meetings took place in a private room at either the agency or a local church. Interviews and group discussions began by gathering basic demographic information. A semistructured interview guide examined various aspects of participants’ personal and professional experiences, and queried women’s help-seeking related to IPV. Individual interviews with women in Group A explored participants’ personal experiences with IPV and related help-seeking. The Group B focus group guide queried challenges women face postresettlement and help-seeking options for women experiencing IPV across contexts. All interviews were audio recorded, professionally transcribed, and reviewed for accuracy. The study utilized professionally trained language interpreters who were part-time employees of the resettlement agency to assist with Group A and B interviews and focus groups. All interpreters were female and originated from the same geographic regions as the participants. The majority of Group A and B participants were familiar with the interpreters, given their role at the agency. Prior to data collection, all interpreters participated in 3 hours of training with the researchers.

Protection of Human Subjects

The University of Texas at Austin Institutional Review Board (IRB) reviewed and approved the study. The study adhered to ethical standards in researching violence against women (Ellsberg & Heise, 2002). Recruitment, data collection, and participant distress protocols developed in collaboration the partner agency and approved by the IRB helped ensure the confidentiality, safety, and well-being of participants (Campbell, Sefl, Wasco, & Ahrens, 2004; Ellsberg & Heise, 2002). With the assistance of language interpreters, researchers provided participants detailed information about the study, who in turn gave verbal consent to participate and to allow researchers to audio-record the discussion. Following the informed consent procedures and before starting the interview or focus group discussion, all Group A and B participants received a US$25 gift card and two round-trip tickets for the local public transportation system. All interpreters assisting with data collection participated in additional training and signed confidentiality agreements, which researchers reiterated with both interpreters and participants throughout the data collection process. Researchers reminded participants that they were free to pause the interview or exit the discussion at any time without any consequence. If unmet service needs arose in the discussion, the researcher discussed referral options with the participant once the interview ended.

Data Analysis

The research team first used structural coding to inform ongoing data collection at the midway point of the project. When data collection was complete, two members of the research team applied those structural codes to the remainder of the data to assist with data management (Guest, MacQueen, & Namey, 2012). The lead researcher then proceeded with the analysis using an inductive coding approach. Preliminary analysis of data generated from women who had disclosed IPV (Group A) formed preliminary themes, and comparative approaches served to detect variation within and between cases. This approach prioritized and brought women who disclosed IPV into the center of the analysis. The analysis of data from Group B participants—women who had not disclosed IPV—added another layer of perspective from the broader refugee community and served to finalize the two overarching categories. A process of moving from initial themes to a broader level of abstraction (Saldaña, 2012) included an iterative review and refinement of themes through memo writing and peer debriefing among team members. Researchers used qualitative data analysis software (NVivo, Version 11) to manage and code data.

The researchers followed procedures to ensure rigor outlined by Creswell (2013). Members of the research team met throughout the analysis process to deepen the examination of themes. Researchers detailed all major activities in an audit trail (Rodgers & Cowles, 1993). Team members wrote memos to document observations during data collection, examine preliminary themes, and note questions as they arose. These techniques also served to engage the team in a reflexive process (Gringeri, Wahab, & Anderson-Nathe, 2010).

Findings

Participants described seeking help for IPV across a variety of geographic and sociocultural contexts in their countries of origin, while getting displaced, and/or since resettling to the United States as refugees. Women’s attempts to seek help varied from isolated events to sustained efforts over years, and responses to and outcomes of women’s disclosures and help-seeking efforts varied considerably across cases. However, participants consistently referred to the central function of family in women’s efforts to seek help for IPV, and women’s experiences of seeking and receiving help differed whether or not they had family to turn to. As such, two overarching categories emerged inductively and formed the basis for the current analysis: (a) the role of family in seeking help and (b) seeking help in the absence of family. All names that appear are pseudonyms given only to women who were recruited based on prior disclosure of IPV (Group A participants).

“You Just Go Talk to the Family”: The Role of Family in Seeking Help

Having family to turn to was paramount for women experiencing IPV. In countries of origin, while getting displaced, and since resettling to the United States, participants described women turning to family for assistance, following episodes of violence and abuse. Women described considerable variation in the willingness of families to intervene and provide assistance, with actions ranging from providing somewhat passive support (i.e., respite shelter) to families actively taking steps to identify solutions. Families, most oftentimes parents, allowed women (daughters) experiencing IPV back into their house and provided them with temporary or longer-term shelter. If and how families took action beyond providing them a place to stay varied, as well as whether participants perceived those actions as supportive or a hindrance to their well-being and aspirations.

Families may insist that women seeking refuge in their home return to their husbands, for instance, by allowing them to stay no more than one night and escorting the woman back to her husband the following morning. Jeanne’s story reflects this experience and highlights complex social and economic dynamics shaping her decision making and the role her family played in supporting her. Over the many years living in a refugee camp in Central/East Africa, Jeanne cyclically returned to her family’s home countless times seeking relief from her husband’s physical and emotional violence. She repeatedly requested that her family allow her to leave him. Her family would permit her to spend the night but would always send her back the following morning. Jeanne explained that it was customary “for your own family to take you back [to the husband],” as her family had accepted a dowry when they married. “It’s like they buy you,” Jeanne explained, and her family would be obligated to reimburse the dowry were she to return to her original family and thereby break their agreement. Jeanne went on to describe how important it was that her family grant her permission to leave her husband, without which she may face serious consequences. She shared,

Many people were telling me, “No, you cannot live like this, you need to go, to leave that man.” But I said, “How I’m going to leave him when my family doesn’t accept it? My family refused [forbade] me . . . .” So I started to think, “If I leave and my family doesn’t accept me, I’m gonna leave anyway.” But then I thought, “If I leave and my family doesn’t accept and I go live by myself, maybe my family will curse me.”

In thinking about leaving without her family’s blessing, Jeanne weighed the possibility that they might go so far as to punish her. The possibility of having a curse placed on her, which she believed could result in her and her children’s demise, served as an effective deterrent to taking action contrary to the will of her family, and by extension, the will of her husband’s family. It was only when an agency in charge of the refugee camp intervened and facilitated their separation that her family finally accepted that they should separate. Jeanne explained,

Back home, if my family—even if they see that you need to separate with that man, they will not tell you. They wished you could separate with that man because he’s mistreating you. But if the organization tells you both to separate, they [the family] will say, “Okay,” because the organization said that. But it’s what they had wished for a long time.

In this case, her family needed an authority figure to facilitate the separation to sanction it. The agency orchestrated their separation by facilitating her husband’s return to their country of origin with his second wife, and Jeanne’s departure to a different camp with her children, thereby providing an element of social protection and most likely releasing the family from the social obligation to repay the dowry. Although her family might have been unwilling under any circumstances to repay the dowry, it is important to acknowledge the financial burden within the context of extreme poverty among refugee populations residing in camps. Given this context, abusers may utilize dowry practices and related threats, whether explicit or implicit, as mechanisms of economic abuse and control.

Other families allowed their daughters to remain indefinitely in their home but concurrently mistreated them during their stay. Lili was born and raised in a Middle Eastern context. Lili’s parents allowed her to return to their home when she escaped her husband’s home within the first year of marriage, fearing for her life and desperate to get away from the criminal activity in which he was involved. Although her parents provided her respite shelter, her father was physically and emotionally abusive toward her, and her mother refused to believe the seriousness of the violence Lili faced. However, although staying with her parents, Lili was able to pursue a legal divorce. In a legal context typically unfavorable toward women, neighbors who had witnessed the violence in her husband’s home readily testified on her behalf in court and a sympathetic judge granted her the divorce. Although the respite shelter her family provided allowed Lili to pursue this option, her family became exasperated with her for seeking the divorce and adopting an alternative religion. They ultimately threw her out and severed all ties. Devastated, Lili fled the country alone and resettled to the United States.

Other families provided shelter but did not take action otherwise in support of or against their daughters. As such, these families were both somewhat passive and neutral in their response to their daughters’ requests for help. Raha lived in the Middle East well into adulthood. She described her mother as very traditional and someone who believed that a “woman entered her husband’s home upon marriage and only left when she was dead.” Like Raha, her mother had also suffered terrible mistreatment and abuse by her husband (Raha’s father) but had never entertained the possibility of leaving him. When Raha’s husband discovered that she was laying the groundwork to divorce him after a decade of severe abuse, he choked her as if he intended to kill her. She survived the brutal assault and escaped to her mother’s home. Raha explained,

This time my mother believed that I was really suffering . . . . The only support she gave me was to let me stay in her place with my daughter for all the time I needed to go through the divorce . . . I was lucky enough that my mom gave me space so I didn’t have to suffer other types of abuse just to have a place to live.

With the support of respite shelter, Raha’s mother helped shield her and her daughter from additional hardship, and allowed Raha to pursue the divorce. Her mother’s support was pragmatic on the surface but reflected a shift in her understanding and empathy for what Raha had gone through. Raha fled her home country many years later and ultimately resettled to the United States but is still grappled with the physical and mental health consequences of IPV.

Participants described yet another level of engagement that went beyond passive forms of support (i.e., respite shelter) and involved families actively seeking solutions. For instance, since resettling to the United States from Central/East Africa, Mathilde would inform her in-laws and her brother whenever her husband physically assaulted her. They would regularly intervene on her behalf by speaking with him and advising him to stop drinking and abusing her. Her supporters, however, grew weary of the situation and ultimately advised her to leave him. Once the family told her there was nothing else they could do for her and that she should leave him if she wanted to, she decided to take action and report the abuse to the resettlement agency in the United States. She thought, “If it continues like this, I will die.” The resettlement agency helped her to locate temporary shelter while her husband vacated the apartment. Another case illustrates this more actively supportive form of family response, complicated by some members of the family playing different roles. In a refugee camp located in Central/East Africa, Viviane was terrified that she would never be able to leave her abusive partner if they were to marry officially. Viviane pleaded with her mother to refuse any dowry her partner’s family might offer. Yet, abuse and violence also permeated her parents’ relationship, and her father ignored her mother’s requests. Instead, extended family on her mother’s side intervened and systematically advocated over the course of months on Viviane’s behalf until she was able to leave safely with her infant son. They first convinced Viviane’s father to refuse the dowry and allow her to return home, and then they successfully intervened with Viviane’s abusive partner and his family to negotiate her return to her parents. When the family eventually received notification that the U.S. government had accepted their application for resettlement, Viviane’s ex-partner threatened to curse her family if she took their son with them. Again, her mother’s family intervened and staunchly defended Viviane’s right to resettle with her son, which she did. With emotion, Viviane remarked that their actions must mean that they really love her. Viviane expressed having sustained significant trauma and indicated that she continued to struggle with psychological consequences of IPV post resettlement to the United States.

“I Didn’t Have Anywhere to Go”: Seeking Help in the Absence of Family

Across contexts, both pre- and postresettlement to the United States, participants described seeking help in the absence of having family to turn to for any kind of support as a profoundly different experience. Those who had never been able to “just go talk to the family” perceived a veritable absence of support options. Still in her country of origin, Gizelle described running to the forest with her baby to escape the beatings. Gizelle shared,

I didn’t have my dad or my mom, they passed away already. I didn’t have anywhere to go, so I slept in the woods two days . . . . [I thought to myself] “What am I doing in the woods? I need to go back home. I don’t have anywhere to go.” So I went back. I found that he put all my belongings outside and he locked the door . . . . He did that many times.

Her husband appeared to use the fact that she did not have family who could help her to torment her. She explained that despite not having family to return to,

He was telling me, “If you don’t decide to go back to your parents . . . you will see . . . .” That’s why he was beating me. “Why are you still here? I told you to go back to your family” . . . . It was too much.

People who genuinely commiserated with her also told her to return to her family, emphasizing for her that this avenue to seeking help was not open to her. Despite the severity of abuse she faced prior to and after fleeing war, Gizelle struggled to remember times when she had sought help. She recalled more easily her tireless efforts to “become a better cook and wife” and to support herself and her children. She indicated having talked to other women to seek advice. She shared, “They were telling me, ‘Just be patient, one day he’s going to change’. I was patient until he passed away. He didn’t change.” She took care of him in his final months, and shortly after he passed away, she learned that she would resettle to the United States.

Women who had lost their parents due to natural causes or armed conflict, or who were otherwise separated from trusted family because of displacement, did not have the option of seeking help from their own families. Similarly, participants described the dramatic loss in family support by virtue of resettling to the United States. The shift in how women sought help for the IPV they experienced post resettlement was very apparent to Julie. Prior to resettling, Julie had been able to seek assistance from her family when her husband was physically violent, but this changed after they arrived to the United States. The last time her husband physically assaulted her in the United States, Julie ran to her neighbors in the apartment complex. He followed her and declared that he was throwing her out. Not having family to turn to, Julie disclosed to her caseworker at the resettlement agency that he was physically abusive and that she needed a divorce. The caseworker gave her an address of where to go for help with getting a divorce, but she was unable to locate the agency. She instead went to another agency, which helped her to pursue her case in court. On her own, Julie found a new apartment. However, the new apartment was in the same complex where her (ex)-husband lived, and she indicated at the time of the interview that she remained fearful of him.

Participants discussed the impacts of the loss of family on help-seeking in explicit terms. Focus group participants explained how women sought help differently because of the loss in family support through the resettlement process:

Back home in Africa, when we don’t get along with the husband, even if he beats you, you wake up in the morning and you just go talk to the family. We deal with it in the family. But in America, you have to call the police. You’re calling the police because you need peace to protect yourself. But if you call the police, [they come and tell you to separate]. And he [the husband] will say, “No, no, no. Now, I have to go because you called the police.” You have to leave the house. So the women, they don’t know what to do (Group B participant, Central/East Africa).

Now, in the absence of robust family networks in place to turn to, women might be compelled to reach out to the police when they would have otherwise sought assistance from family in the past, which might lead to unintended outcomes. Group B participants spoke about resettlement agencies as the people responsible for bringing and welcoming them to the United States, thereby taking on the role of family or parents. As one woman shared, “The caseworker, he’s the one who received me the first time when I came here. We don’t know anybody else here. He’s like my mom and my dad. So if I have problem, I have to go to him” (Group B participant, Central/East Africa). Without family to turn to, women may no longer know where to go for help and therefore may not seek it. As another participant explained,

Here, everybody lives differently. You don’t have family [here] like that. You don’t have all your relatives here. So even if [a couple] is going through something like this [IPV], I don’t know if they will seek help. Even if they seek help, I don’t know if they would know any resources (Group B participant, South/Southeast Asia).

In losing access to family networks and support due to war, displacement, and the resettlement process, women may lose the compass they had formerly relied on to navigate hardship, including IPV. One participant shared that women in her community wished they were still in Africa because there they can take the suffering with the support of their family, “there [my family] will stand up with me, they will help me, support me with my kids, but here, who do I have? Who is going to help me?” (Participant from Central/East Africa). In the United States and separated from immediate and extended family, it becomes less clear where to go for help or if help is even available. Women may be altogether unfamiliar with alternative sources of help, inexperienced in how to access outside, nonfamily assistance and support, or simply not interested in alternative avenues. Furthermore, seeking or receiving help from new and unknown sources in untested waters may result in unanticipated and sometimes undesired outcomes such as the arrest of husbands, backlash from family and community members, and financial difficulties.

Discussion

This study examined strategies women employed to seek help for IPV in their countries of origin, while displaced, and since resettling to the United States as refugees, and what happened when they did. The central role of family in shaping women’s perceptions of help-seeking options emerged, with significant variation in the types and levels of support women might receive from their families. These data highlighted the extent to which having family to turn to provides a clear—albeit complicated and often problematic—avenue of support. Indeed, the findings revealed substantial costs involved for some women in seeking support from family. Nevertheless, the existence and presence of family explicitly informed whether participants perceived having options and shaped whether or not, and from whom, to seek help. Access to family offered some women a landing spot from which to pursue formal services and durable solutions over time. In contrast, experiencing IPV in the absence of family across contexts appeared to have limited women’s support options and their perception of viable alternatives to living with the abuse. In complex ways, both proximity to and separation from family shapes the actions women take to seek help and secure safety for themselves and their children. Women lacking family support—or a viable substitute—may not know what first steps to take and what might be more likely to endure living indefinitely with the abuse and/or the consequences of IPV. Indeed, women may not have been aware of formal support options available to them pre- and postresettlement to the United States. These findings suggest that separation from immediate and extended family due to resettlement processes as well as other factors associated with forced migration may compound barriers women face in seeking help for IPV post arrival to the United States. In other words, if women consider family the most obvious source of support, they are likely to feel uncertain of where to turn for help for IPV in the postresettlement context. The implications of these findings for theory, practice, and research form the basis of the discussion here.

The findings highlight the importance of informal support available through personal networks for women resettling to the United States as refugees from diverse contexts. In discussing strategies and preferences for seeking help, women inevitably and simultaneously talked about the role of family. Women expressed a familiarity of navigating complex familial relationships to access some type and level of support, in spite of the costs involved. Although these perspectives are rooted in specific geographic and sociocultural contexts, it is consistent with literature indicating that women typically turn to friends and family first to seek help for IPV and other forms of violence they confront. In contrast, the absence of family potentially rendered women feeling lost in their longing for solutions, limiting their help-seeking efforts. These findings reflect previous research in which more access to informal social support was associated with a greater number of help-seeking efforts for IPV (Ansara & Hindin, 2010; Mitchell & Hodson, 1983). As such, a social support perspective highlights both the significance of family support and the implications of help-seeking in the absence of personal networks. This is particularly true among women for whom social support may have held particular meanings and served specific purposes in the past. For example, a recent qualitative study conducted with Congolese women who resettled to the United States highlighted the extent to which social support had been integral to daily life (Wachter & Gulbas, 2018). Women described past ways of life characterized by reciprocal and dependable sources of support in which informational, pragmatic, and emotional support flowed among trusted family and community members. Social support subsequently severely constricted over time due to war, forced migration, and resettlement processes that systematically downsized trusted networks, curtailing access to support (Wachter & Gulbas, 2018).

Despite strong consensus around the need for social support and the challenges posed through migration, this study serves as a reminder of the fallacy of assuming women seek help and conceptualize help-seeking in known or predictable ways. Throughout the interviews, women who were survivors of IPV struggled to varying degrees to remember and explain what help they had sought in the past and since resettling to the United States. Strikingly, a subset of participants initially could not recall ever having sought help, despite the violence and acute suffering they expressed. Indeed, “victims do not always ask for the support they need” (Liang et al., 2005, p. 71), and women may not be aware of available support options where they exist. Among myriad factors, not seeking help may reflect the multiple traumas women had endured within and beyond the scope of their abusive relationships and/or point to methodological issues in which certain interview questions may not have held specific meaning for some participants. Furthermore, the absence of help-seeking may reflect sociocultural nuances in the normalization, identification, and/or recognition of IPV. The findings, therefore, reiterate the importance of highlighting variation and heterogeneity and highlight the care required to avoid generalizing and essentializing experiences of “victimized refugee women” (Mohanty, 2003; Warrier, 2009). In addition, the apparent absence of “asking” among some study participants may also reflect context-specific expectations of how social support flows within relational networks versus clearly delineated acts of asking and receiving. That is, due to families’ intense involvement in women’s lives, they can offer help without being invited to do so, whereas formal networks, especially in the context of resettlement, often do not spontaneously intervene or offer concrete support. In turn, although the findings point to the importance of strengthening survivors’ access to familiar and survivor-identified forms of support, it nevertheless remains critical that providers attend to the experiences of women for whom family support is nonviable, absent, harmful, and/or unwanted.

These findings reflect and contribute to models of help-seeking that emphasize the extent to which individual, interpersonal, sociocultural, and additional factors shape the help-seeking process. The help-seeking framework proposed by Liang and co-authors (2005) highlights how individual, interpersonal, and sociocultural factors shape a person’s ideas and actions related to help-seeking. A social support perspective undergirds their model in which case vignettes from refugees and immigrants at the individual level illustrate the framework in application. Mentions of family, parents, and relatives—as positive and negative supports—are frequent throughout their analysis. In contrast, Kennedy and co-authors (2012) make a compelling argument for examining the attainment of effective formal help in recognition that low-income women of color often do not seek formal help for IPV and instead rely on informal personal networks (Ahrens, Isas, Rios-Mandel, & Lopez, 2010; O’Campo, McDonnell, Gielen, Burke, & Chen, 2002). Their structural analysis of community-level factors, combined with cumulative effects of help attainment experiences, bring to light complex forces that compound disparities in accessing formal support among socially and economically marginalized populations. In the Kennedy et al. (2012) model the role of immediate and extended family in help-seeking for support—positive or negative, informal or formal—is perhaps overshadowed by structural analyses and an imperative to ensure access for marginalized women to quality services. The current study highlights the need for bringing nuanced meanings that women associate with family and social support into structural analyses of help attainment, and vice versa. The findings point to the potential interchange between informal and formal support, the importance of not letting one overshadow the other in conceptualizations of practice and research, and the need for understanding that balance within context and in recognition of past and present lives.

Implications for Practice

Practitioners also need to consider structural elements and the role of family in interrelated ways. Findings reveal opportunities for service providers across social services—refugee resettlement, domestic violence/sexual assault, health, public benefits—to consider their role in supporting and strengthening informal support as well as linkages to formal services among IPV survivors post arrival to the United States. Across social services, practitioners must consider the importance of assessing the viability of their clients’ social networks, helping women to build new connections post arrival to the United States, and encouraging their use of transnational networks as sources of support (e.g., by ensuring access to the technology that facilitates those networks). A transnational approach recognizes that despite geographic distance, immigrants’ ties to home and their senses of belonging, identity, and responsibility—related to family economic expectations, parenting roles, and communication—are often maintained and continue to evolve during displacement and after resettlement (Furman, Negi, Schatz, & Jones, 2008; Schiller, Basch, & Blanc-Szanton, 1992).

Understanding and acknowledging informal support, the complicated role of family in women’s lives, and assessing clients’ preferences for family involvement also serve as a cue to women that there are culturally responsive and survivor-centered approaches at work (Wachter, Dalpe, Cook Heffron, 2019). As opposed to singular interventions, it is important to revisit support needs among resettling women on a regular basis in recognition that both needs and networks are fluid. In light of diminishing sources of social support and potential limitations of those networks, it is imperative to increase accurate information to arriving refugees and other immigrant groups regarding the availability of formal services. Outreach that goes beyond the targeting of victims for information sharing is crucial. Service options for women who do have family in the United States are also limited, as family and community members may not have the necessary information to advise them appropriately in this context. Research indicates that help-seeking efforts increase together and also decrease together (Cattaneo, Stuewig, Goodman, Kaltman, & Dutton, 2007). Therefore, when women decline to use one form of help, they may decline other forms of help as well. Similarly, seeking one form of help often gives rise to other forms of help-seeking, and facilitating access to one kind of support, such as familial and social support, may serve as a catalyst to accessing additional forms of support. In other words, “part of practitioners’ response to a victim reaching out for help, then, should be to facilitate her path back to any form of help the next time she feels she needs it” (Cattaneo et al., p. 476). Therefore, it is important for service providers to keep in sight the potential link between informal and formal support. Indeed, “a trusted credible help provider may bridge the gap between informal and formal forms of support by serving as a personal advocate” (Liang et al., 2005, p. 82).

Future Research

In addition to shedding light on important components of help-seeking processes among resettling women who have experienced IPV, this study also incurred new questions that speak to future areas of inquiry. Deeper insights into the role and expectations of immediate and extended family are important for practitioners and researchers alike, as well as the implications of seeking help locally and transnationally within the context of diminishing access to family. The study points to the need for research designs that expand data collection over time (predisplacement, during displacement, and following resettlement) and across multiple geographic contexts (both across and within countries of origin) and thus consider the feasibility of longitudinal and multicontext designs in building the help-seeking and attainment of evidence base among diverse groups. This area of research may also lend itself to mixed methods typological approaches to bring additional precision and nuance to the types of support migrating women seek for IPV and from whom. Questions remain regarding the degree to which women’s transnational relationships with family and friends in international and national contexts are supportive vis-à-vis their experiences with IPV.

Limitations

This analysis served to explore the role of family in shaping how women seek help for IPV. Although the findings reflect the study aim to address gaps in understanding of the ways in which women seek help for IPV across varied contexts and at different times, a number of limitations are noteworthy. In light of the study aims, qualitative approach, and sample size, the study findings are not generalizable and the findings must be understood within those boundaries. As referenced above, the researchers posit the possibility of methodological issues in the research design in which certain questions around “asking for help” may not have held specific meaning for some participants and is worthy of ongoing reflection. The researchers’ backgrounds, professional experiences, and social positions informed the analysis and serves to reiterate the importance of increasing diversity among researchers engaging with refugee and other vulnerable immigrant groups. The involvement of language interpreters facilitated communication with diverse participants and their varied skills contributed to shaping the breadth and depth of data collected.

Conclusion

This study emphasized the ways in which the presence and absence of family support shapes women’s ability and decisions to seek help in the face of IPV pre- and postresettlement to the United States. The findings point to family support as a key factor in helping women to pursue avenues of informal support and formal services. These findings strengthen the case for applying a social support lens to theory, practice, and research concerned with women’s help-seeking for IPV in the resettlement context. Recognizing and accounting for diminished access to immediate and extended family and the absence of social networks are paramount to further understandings of women’s help-seeking and ensuring meaningful access to services and support.

Footnotes

Acknowledgements

The project would not have been possible without the International Rescue Committee research team and language interpreters in the field—we thank them for their dedication and efforts. Our deepest appreciation to the research participants who shared with us their valuable time and tremendous insights. We thank the journal editors and reviewers for their valuable input.

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) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Office on Violence Against Women, U.S. Department of Justice (Grant Number: 2016-SI-AX-0004).

Author Biographies

Karin Wachter, PhD, MEd, is an assistant professor in the School of Social Work at Arizona State University. Her background is in international humanitarian assistance, and her research currently focuses on issues of violence against women and social support in forced migration.

Laurie Cook Heffron, PhD, LMSW, is an assistant professor at St. Edward’s University in Austin Texas. Her research spans issues of violence against women, immigration, detention, refugee resettlement, and human trafficking.

Jessica Dalpe, LMSW, is a Women’s Protection and Empowerment technical advisor at the International Rescue Committee. Her work focuses on generating and integrating evidence-based practices related to gender-based violence for U.S. resettlement programming with refugees.

References

Acevedo

M. J.

(2000). Battered immigrant Mexican women’s perspectives regarding abuse and help-seeking. Journal of Multicultural Social Work, 8, 243-282.

Adams

M. E.

Campbell

(2012). Being undocumented & intimate partner violence (IPV): Multiple vulnerabilities through the lens of feminist intersectionality. Retrieved from https://bit.ly/2QdlXLj

Ahrens

C. E.

Isas

Rios-Mandel

L. C.

Lopez

M. D. C.

(2010). Talking about interpersonal violence: Cultural influences on Latinas’ identification and disclosure of sexual assault and intimate partner violence. Psychological Trauma: Theory, Research, Practice, and Policy, 2, 284-295.

Ansara

D. L.

Hindin

M. J.

(2010). Formal and informal help-seeking associated with women’s and men’s experiences of intimate partner violence in Canada. Social Science & Medicine, 70, 1011-1018.

Barrett

B. J.

Pierre

M. S.

(2011). Variations in women’s help seeking in response to intimate partner violence: Findings from a Canadian population-based study. Violence Against Women, 17, 47-70.

Bauer

H. M.

Rodriguez

M. A.

Quiroga

S. S.

Flores-Ortiz

Y. G.

(2000). Barriers to health care for abused Latina and Asian immigrant women. Journal of Health Care for the Poor and Underserved, 11, 33-44.

Bhuyan

Velagapudi

(2013). From One “Dragon Sleigh” to Another: Advocating for Immigrant Women Facing Violence in Kansas. Affilia, 28, 65-78.

Campbell

Sefl

Wasco

S. M.

Ahrens

C. E.

(2004). Doing community research without a community: Creating safe space for rape survivors. American Journal of Community Psychology, 33, 253-261.

Cattaneo

L. B.

Stuewig

Goodman

L. A.

Kaltman

Dutton

M. A.

(2007). Longitudinal help seeking patterns among victims of intimate partner violence: The relationship between legal and extralegal services. American Journal of Orthopsychiatry, 77, 467-477.

10.

Coker

A. L.

Smith

P. H.

Thompson

M. P.

McKeown

R. E.

Bethea

Davis

K. E.

(2002). Social support protects against the negative effects of partner violence on mental health. Journal of Women’s Health & Gender-based Medicine, 11, 465-476.

11.

Coker

A. L.

Watkins

K. W.

Smith

P. H.

Brandt

H. M.

(2003). Social support reduces the impact of partner violence on health: Application of structural equation models. Preventive Medicine, 37, 259-267.

12.

Cook Heffron

Snyder

Wachter

Nsonwu

Busch-Armendariz

. (2016). “Something is Missing Here”: Weaving feminist theories into social work practice with refugees. In Wendt

Moulding

(Eds.), Contemporary feminisms in social work practice (pp. 166-180). New York, NY: Routledge.

13.

Crandall

Senturia

Sullivan

Shiu-Thornton

(2005). Latina survivors of domestic violence: Understanding through qualitative analysis. Hispanic Health Care International, 3, 179-187.

14.

Creswell

J. W.

(2013). Qualitative inquiry and research design: Choosing among five approaches. Thousand Oaks, CA: Sage Publications.

15.

Dutton

M. A.

Orloff

L. E.

Hass

G. A.

(2000). Characteristics of help-seeking behaviors, resources and service needs of battered immigrant Latinas: Legal and policy implications. Georgetown Journal on Poverty Law and Policy, 7, 245-305.

16.

Ellsberg

Heise

(2002). Bearing witness: Ethics in domestic violence research. The Lancet, 359, 1599-1604.

17.

Erez

Adelman

Gregory

(2009). Intersections of immigration and domestic violence: Voices of battered immigrant women. Feminist Criminology, 4, 32-56.

18.

Frias

S. M.

Angel

R. J.

(2005). The risk of partner violence among low-income Hispanic subgroups. Journal of Marriage and Family, 67, 552-564.

19.

Frye

Hosein

Waltermaurer

Blaney

Wilt

(2005). Femicide in New York City: 1990 to 1999. Homicide Studies, 9, 204-228.

20.

Fuchsel

C. L. M.

Murphy

S. B.

Dufresne

. (2012). Domestic violence, culture, and relationship dynamics among immigrant Mexican women. Affilia, 27(3), 263-274.

21.

Furman

Negi

Schatz

M. C. S.

Jones

(2008). Transnational social work: Using a wraparound model. Global Networks, 8, 496-503. doi:10.1111/j.1471-0374.2008.00236.x

22.

Garcia-Moreno

Jansen

H. A.

Ellsberg

Heise

Watts

C. H.

(2006). Prevalence of intimate partner violence: Findings from the WHO multi-country study on women’s health and domestic violence. The Lancet, 368, 1260-1269.

23.

Goodman

L. A.

Dutton

M. A.

Weinfurt

Vankos

(2005). Women’s resources and use of strategies as risk and protective factors for re-abuse over time. Violence Against Women, 11, 311-336.

24.

Gringeri

Wahab

Anderson-Nathe

(2010). What makes it feminist? Mapping the landscape of feminist social work research. Affilia, 25, 390-405.

25.

Guest

MacQueen

Namey

(2012). Applied thematic analysis. Thousand Oaks, CA: Sage.

26.

Guruge

Humphreys

(2009). Barriers affecting access to and use of formal social supports among abused immigrant women. Canadian Journal of Nursing Research, 41(3), 64-84.

27.

Kennedy

A. C.

Adams

Bybee

Campbell

Kubiak

S. P.

Sullivan

(2012). A model of sexually and physically victimized women’s process of attaining effective formal help over time: The role of social location, context, and intervention. American Journal of Community Psychology, 50, 217-228.

28.

Kiwanuka

(2008). The effect of migration on urban migrant women’s perceptions of domestic violence (Doctoral dissertation). Retrieved from https://bit.ly/2O0JsFQ

29.

Levine

Peffer

(2012). Quiet casualties: An analysis of U non-immigrant status of undocumented immigrant victims of intimate partner violence. International Journal of Public Administration, 35, 634-642.

30.

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.

31.

Messing

J. T.

Amanor-Boadu

Cavanaugh

C. E.

Glass

N. E.

Campbell

J. C.

(2013). Culturally competent intimate partner violence risk assessment: Adapting the danger assessment for immigrant women. Social Work Research, 37, 263-275.

32.

Mitchell

R. E.

Hodson

C. A.

(1983). Coping with domestic violence: Social support and psychological health among battered women. American Journal of Community Psychology, 11, 629-654.

33.

Mohanty

(2003). Feminism without borders: Decolonizing theory, practicing solidarity. Durham, NC: Duke University Press.

34.

Morrison

K. E.

Luchok

K. J.

Richter

D. L.

Parra-Medina

(2006). Factors influencing help-seeking from informal networks among African American victims of intimate partner violence. Journal of Interpersonal Violence, 21, 1493-1511.

35.

O’Mahony

Donnelly

(2010). Immigrant and refugee women’s post-partum depression help-seeking experiences and access to care: A review and analysis of the literature. Journal of Psychiatric and Mental Health Nursing, 17, 917-928.

36.

O’Campo

McDonnell

Gielen

Burke

Chen

(2002). Surviving physical and sexual abuse: What helps low income women? Patient Education and Counseling, 46, 205-212.

37.

Office of Refugee Resettlement. (2012). The refugee act. Retrieved from http://www.acf.hhs.gov/programs/orr/resource/the-refugee-act

38.

Office of Refugee Resettlement. (n.d.). Retrieved from https://www.acf.hhs.gov/orr/refugees

39.

Rodgers

B. L.

Cowles

K. V.

(1993). The qualitative research audit trail: A complex collection of documentation. Research in Nursing & Health, 16, 219-226. doi:10.1002/nur.4770160309

40.

Runner

Yoshihama

Novick

(2009). Intimate partner violence in immigrant and refugee communities: Challenges, promising practices and recommendations. Family violence prevention fund. Retrieved from https://bit.ly/1WrvmtD

41.

Saldaña

(2012). The coding manual for qualitative researchers (2nd ed.). Los Angeles, CA: Sage.

42.

Schiller

N. G.

Basch

Blanc-Szanton

(1992). Towards a definition of transnationalism. Annals of the New York Academy of Sciences, 645, 9-14.

43.

Sokoloff

Pearce

(2011). Intersections, immigration, and partner violence: A view from a new Gateway-Baltimore, Maryland. Women & Criminal Justice, 21, 250-266.

44.

Sylaska

K. M.

Edwards

K. M.

(2014). Disclosure of intimate partner violence to informal social support network members: A review of the literature. Trauma, Violence, & Abuse, 15, 3-21.

45.

Ullman

(2010). Talking about sexual assault: Society’s response to survivors (1st ed.). Washington, DC: American Psychological Association.

46.

United Nations High Commissioner for Refugees. (2011). UNHCR resettlement handbook. Geneva, Switzerland: Author. Retrieved from https://bit.ly/2CzrKYR

47.

United Nations High Commissioner for Refugees. ( 2018). Global trends: Forced displacement in 2017. Retrieved from https://www.refworld.org/docid/594aa38e0.html

48.

U.S. Department of State. (n.d.). Refugee admissions. Retrieved from https://www.state.gov/j/prm/ra/

49.

Adam

Wirtz

Pham

Rubenstein

Glass

. . . Singh

(2014). The prevalence of sexual violence among female refugees in complex humanitarian emergencies: A systematic review and meta-analysis. PLoS Currents, 18, Article 6.

50.

Wachter

Dalpe

Cook Heffron

(2019). Conceptualizations of domestic violence-related needs among women who resettled to the U.S. as refugees. Social Work Research.

51.

Wachter

Gulbas

L. E.

(2018). Social support under siege: An analysis of forced migration among women from the Democratic Republic of Congo. Social Science & Medicine, 208, 107-116.

52.

Wachter

Cook Heffron

Snyder

Nsonwu

Busch-Armendariz

(2016). Unsettled Integration: Pre- and post-migration factors in Congolese refugee women’s resettlement experiences in the United States. International Social Work, 59(6), 875-889.

53.

Wachter

Snyder

(2018). Centering subjectivities: Theoretical considerations for practice with women in forced migration. Affilia, 33(3), 395-409.

54.

Warrier

(2009). Culture and cultural competency in addressing intimate partner violence. In Mitchell

Anglin

(Eds.), Intimate partner violence: A health-based perspective (pp. 79-86). New York, NY: Oxford University Press.

55.

World Health Organization (29 November, 2017). Violence against women. Retrived from https://www.who.int/en/news-room/fact-sheets/detail/violence-against-women