Abstract
Survivors of intimate partner violence (IPV) and sexual assault (SA) faced increased violence, new safety risks, and reduced services access in the face of the COVID-19 pandemic. IPV and SA service providers have a critical role in safety planning and advocacy with survivors; however their patterns of working were dramatically impacted by changes brought on by the pandemic. Little is known about safety planning strategies and service adaptations employed in this context. Through semi-structured interviews with 33 service providers from across the United States, this study explores the experiences and perspectives of victim service agency staff with IPV and SA survivor safety and safety planning from March to December 2020. Qualitative data were analyzed using conventional content analysis. Four overarching themes related to survivor safety and safety planning emerged, including (1) “The violence is more severe, it’s more escalated,” describing an increase in the severity and frequency of violence; (2) “Perpetrating the violence through [technology],” describing a specific surge in technology based abuse (TBA) as the world shifted to virtual communication to facilitate social distancing; (3) “COVID-19 is now a tool in their toolbox,” describing the emergence of the COVID-19 pandemic and health guidance as a life generated risk that abusive partners used to further control and isolate their partner; and (4) “You just get real crafty,” highlighting the wide range of “work-arounds” and safety planning adaptations employed by victim service professionals trying to maintain services in a disrupted environment and in the face of evolving safety risks and increasing violence severity. These findings highlight the safety and safety planning challenges encountered as the COVID-19 pandemic unfolded and the many creative strategies employed by service providers to adapt in the moment.
Main Body
Data suggest that the extent and severity of interpersonal violence, including intimate partner violence (IPV), sexual assault (SA), human trafficking, and child abuse and neglect increased rapidly in the United States in the wake of the Coronavirus pandemic (Piquero et al., 2020, 2021; Wood et al., 2022a). Anti-violence hotlines across the country saw an increase in the use of hotline services (National Domestic Violence Hotline, 2020), with a marked uptick in chat and text-based engagement, which can be accessed by a survivor silently while in close proximity to an abusive individual (Kaukinen, 2020; McClay, 2021; NNEDV, 2020; Wood et al., 2020a). Survivors of interpersonal violence have faced additional threats within their homes along with the external dangers of a quickly evolving pandemic (Ravi et al., 2021; Wood et al., 2022a). Simultaneously, the service providers whose job it is to support and intervene in situations of interpersonal violence adapted to evolving work situations and new safety needs (Wood et al., 2020a). Quarantine and stay-at-home orders meant survivors were in close proximity to their abusive partner with diminished access to formal and informal supports. Understanding the safety concerns faced by survivors during the coronavirus pandemic and learning how service providers responded to reduce violence risk is critical to building communities free of interpersonal violence, and improving service responses in future public health emergencies. This study is among the first to assess changes in safety planning in the IPV and SA service sector to address risks in the context of the COVID-19 pandemic, reporting on findings from semi-structured interviews with 33 interpersonal violence intervention and prevention professionals from across the United States. Interviews focused on the abuse experiences of survivors and safety planning strategies employed by service providers and survivors together during the first 9 months of the pandemic response.
Background
The Centers for Disease Control and Prevention indicate that one in four women and one in seven men in the United States will experience sexual violence, physical violence, and/or stalking by an intimate partner during their lifetime, while one in three women and one in four men will experience sexual violence that includes physical contact (Breiding et al., 2014). These experiences lead to a wide range of serious physical and mental health impacts, as well as economic, educational, and intergenerational consequences (Campbell, 2002; Smith et al., 2018). Early data suggest that IPV rose during COVID-19, by some estimates by 8% or more (Piquero et al., 2021), exacerbated by decreased economic stability, prolonged exposure to abusive partners, reduced access to IPV services, and disruptions in formal and informal support networks (Nnawulezi & Hacskaylo, 2022; Wood et al., 2022a).
For survivors of violence, accessing support provided in community based, voluntary service agencies can increase safety and improve long-term physical and mental health outcomes (Ramsey et al., 2009; Rivas et al., 2019; Sullivan et al., 2018). Professionals in these agencies help survivors of violence address their current and future safety, focused on the needs and goals of the individual survivor and their family (Weintraub & Goodman, 2010; Sullivan & Goodman, 2019). A network of local agencies offer a variety of services including advocacy, hospital and legal accompaniment, shelter, counseling, legal aid, and economic support (Macy et al., 2009; NNEDV, 2020; Wilson, et al., 2015). These services often emphasize survivor-led, trauma-informed, and culturally relevant practices, which have been found to reduce isolation and restore interpersonal power (Nnaweluzi et al., 2018). Guided by these tenets, agencies implement low barrier and voluntary service models to increase participation in formal support systems by survivors of violence (Nnawulezi et al., 2018; Sullivan et al., 2018; Wilson et al., 2015; Wood et al., 2020b). A primary goal of these services is to help survivors of crime, particularly for survivors of SA and domestic violence, become safer from violence over the short and long term (Macy et al., 2009; Sullivan et al., 2018; Sullivan & Goodman, 2019)
Safety Planning
A central component of these services is collaborative work between a survivor and advocate to develop a “safety plan,” which is a personalized plan for how to deal with the immediate, individual risks faced by survivors of violence and their children, aiming to reduce the extent and impact of violence. This work is based in crisis and conservation of resource theories, which explain that after trauma, survivors face a complex set of health and social losses which can exacerbate and further entrench the losses brought on by the trauma. Swift intervention, such as safety planning and other services, is needed to stem the tide of losses and can interrupt spiraling negative outcomes (Sullivan et al., 2018). Advocates approach the tasks of safety planning as an effort to interrupt these negative outcomes. Safety planning may involve gathering essential items, working with informal supports like family and friends, developing strategies for action during violent episodes, addressing technology monitoring, and establishing connection with formal supports, such as law enforcement (Davies & Lyon, 2014; Messing et al., 2014). A safety plan can enhance survivors’ sense of safety and well-being, reduce harm from violence, and enhance wellbeing of survivors and their children (Davies, 2019; Davies & Lyon, 2014; Messing et al., 2014). Evidence demonstrates that comprehensive safety plans which are tailored to survivors’ specific needs and preferences can increase their utility, and ultimately the safety of the survivors they are designed to support (Hanson et al., 2019).
Historically, safety plans have been geared towards helping people leave violent situations, and have focused on safe escape strategies and accessing formal supports like law enforcement or shelter (Davies, 2019). A paradigm shift in the last decade has extended the focus of safety planning for those who do not or cannot plan to leave a potentially abusive situation, and those who chose not to engage with formal helping systems such as law enforce or child welfare due to histories of discrimination or oppression (Davies, 2019). This paradigm shift, “advocacy beyond leaving” (Davies, 2019) focuses on voluntary, culturally relevant, community, social, and interpersonal strategies to reduce risks in a relationship where IPV is present, rather than physical separation strategies. However, the evidence base for safety planning is still heavily focused on criminal justice and physical distance-driven approaches (Messing et al., 2014). This limits the applicability of traditional safety planning within the context of social distancing, where survivors have faced new safety challenges and increased internal and societal pressure to remain, at least temporarily, in abusive home environments in order to reduce disease spread or maintain children’s access to caregivers (Wood et al., 2022a).
Safety Planning Framework: Victim Defined Advocacy
Davies and Lyon (2014) outline the range of risks facing survivors of interpersonal violence in their service model approach, victim defined advocacy. Victim defined advocacy recognizes that survivors are constantly engaged in evaluating and planning for their own safety risks and needs, and that a central job of interpersonal violence service providers is to join survivors in their on-going safety planning, including strategies focused on advocacy beyond leaving (Davies & Lyon, 2014; Davies, 2019). Survivors and their families experience a wide range of life generated risks (factors such as such as experiences of racism, structural poverty, and health challenges that are external to the impacts of violence, but that are compounded by IPV). Survivors also face risks created explicitly by an abusive individual, termed batterer generated risks (i.e., physical or sexual violence), which work in combination to influence survivors’ ongoing safety planning. Risk assessment of both life and batterer generated risks help determine the types of interventions which will be effective. In line with conservation of resource theory, a victim defined advocacy approach focuses explicit attention to the ancillary resources a survivor might lose in the aftermath of violence (for example, access to a partner’s health insurance), and develops survivor-specific strategies for mitigating these losses. This framework also underscores that life generated risks impact and facilitate the abuse survivors face at the hands of their partner, suggesting that the COVID-19 pandemic may be an additional tool for an abusive person to use in perpetuating power and control. Finally, it highlights that survivors often approach victim service agencies for support with both batterer and life-generated risks (Davies & Lyon, 2014; Davies, 2019).
Current Study
Victims’ service providers play a critical role in addressing and reducing the risk of violence faced by survivors of IPV & SA. New life-generated risks, such as risks to health or economic security brought on by the COVID-19 pandemic, create additional safety concerns for survivors. Further, changes in the socio-cultural context of survivors’ lives brought on by the pandemic, including social distancing, economic disruption, and increased reliance on technology, necessarily require new approaches for promoting safety with survivors. However, to date, there is has been little examination of the way safety planning needs and approaches changed during the pandemic. The current study explores the experiences and perspectives of victim service agency staff with survivor safety and safety planning from March to December 2020 in the United States during the COVID-19 pandemic.
Methods
Data for this study were collected as part of a mixed methods project aiming to understand the experiences of IPV and SA survivors and service providers during the first 9 months of the pandemic response in the United States. An initial quantitative survey with separate pathways for survivors (n = 53) and IPV and SA service providers (n = 352) was fielded from April to June 2020, aiming to capture a quick snapshot of early safety and service experiences (see Wood et al., 2020a, 2022a). At the end of the survey, participants were asked if they would be willing to be re-contacted for a subsequent interview to be conducted via secure video conference or phone at a later date. The data for this study comes from those service provider interviews (n = 33).
Participants
Web-based survey respondents who provided consent to be contacted and identified as: (1) at least 18 years of age and (2) working in a staff role in an agency helping survivors of interpersonal violence during the first phase of the COVID-19 pandemic response (April-June 2020) were recruited to participate in qualitative interviews. A total of 33 service providers from across the United States participated in interviews between July and December 2020. They ranged in age from 28 to 65. Thirty participants identified as female, with others identifying as male and non-binary. Twenty identified as White, six as Hispanic/Latinx and others identified as Black or Asian. Participants worked in agencies focused on interpersonal violence, with the majority working in dual IPV/SA service agencies, and others working in single issue (IPV or SA) programs, human trafficking focused organizations, and child advocacy centers. Their job roles included survivor advocacy, housing or legal services, prevention education, and agency leadership (e.g., executive director). Participants came from 10 states across the United States, with the plurality coming from Texas.
Procedures
Interviews were conducted via ZOOM video conference or over the phone at a time of the participant’s choosing. Interviews were audio recorded, and lasted between 35 and 90 minutes. Two study team members, both PhD level social workers with experience in qualitative interviewing and victim services, conducted all the interviews. Participants provided verbal consent to participate and received a $25 gift card as a thank you for their time.
The semi-structured interview protocol included questions about participant demographics, personal experiences with the pandemic, client safety and service use during the pandemic, job task adaptations including safety planning, agency approach to social distancing and health guidance, and occupational stress. Example questions included the following: Thinking about your clients overall: How has their safety from violence, threats, stalking, or abuse changed since the coronavirus pandemic began? What strategies have you used to help clients address violence, threats, stalking, or abuse since the coronavirus pandemic began? How has this changed over time as the pandemic has unfolded? The study was approved by the institutional review board of the sponsoring universities prior to data collection.
Data Analysis
A qualitative content analysis approach was employed to organize, describe, and analyze the interview data (Elo & Kyngäs, 2008; Sandelowski, 2010). Audio recordings of the interviews were professionally transcribed verbatim, and these transcripts along with memos from the first and second authors documenting each interview were reflexively analyzed to identify patterns. Codes describing categories of data, such as data related to service adaptations brought on by the pandemic, experiences with survivor safety and safety planning and occupational stress, were developed by the first author with review from the second and third author. From this review, a second level of analysis entailed organizing these categories into a codebook outlining key domains developed from the dataset and refined by the research team. Data were then coded line by line by the first and second author, with meetings to discuss and review themes. The third author helped to address discrepancies in the coding. Memo-ing was a regular part of the coding process, and was used to define and name codes as they developed in the line-by-line coding process. Data analysis credibility steps included the use of multiple coders, thick description in data presentation, and verification of thematic saturation, when line-by-line coding of subsequent transcripts failed to develop new themes (Tracy, 2010). Themes are presented below.
Results
Service providers were unified in describing the COVID-19 pandemic as the cause of serious new safety challenges for survivors of interpersonal violence. Providers stressed that survivors faced new or evolving risks posed by abuse and violence at the same time that many of their previous strategies for addressing violence were suddenly less accessible or effective. Four major themes related to survivor safety and safety planning emerged, and each was named using the words of study participants. Themes are: (1) “The violence is more severe, it’s more escalated,” describing an increase in the severity and frequency of violence; (2) “Perpetrating the violence through [technology],” describing a surge in technology based abuse as the world shifted to virtual communication; (3) “COVID-19 is now a tool in their toolbox,” describing the emergence of the COVID-19 pandemic and public health guidance as a life generated risk that abusive partners used to further control and isolate their partner; and 4) “You just get real crafty,” highlighting the wide range of “work-arounds” and safety planning adaptations employed by victim service professionals to try to maintain services in a disrupted environment and in the face of evolving safety risks and increasing violence severity.
Theme 1: “The Violence is More Severe, its More Escalated”
Partly as a result of increased exposure to abusive individuals in the home, service providers overwhelmingly indicated that survivors experienced an overall increase in the severity and frequency of interpersonal violence during the pandemic. Importantly, service providers did not just highlight an increase in the number of victims they were seeing, but also an increase in the severity of violence. Several participants indicated that, because of COVID-19, survivors reported waiting longer to seek services, but when they did their situations were even more dire than before the pandemic. An IPV program supervisor interviewed in August, 2020 discussed violence increases: More strangulation. Battery that is more severe in nature… it seemed like it was related especially in the immediacy of the stay-at-home orders to being trapped there. Whereas if a survivor felt that the violence was escalating before, there were some options or some things they could do to try to separate themselves from the violence before it escalated to that degree, and those resources were not there during that stay-at-home orders, and so it fully escalated.
Several program leaders particularly focused in on an increase in IPV homicide and weapons related incidents in the early days of the pandemic. They shared: “Everything seems to be a lot more urgent, because the violence is more severe, it’s more escalated. Even in our small community, we’ve seen five DV homicides in the last 5 months;” (Program director, October, 2020), and “There’s been some really bad ones lately. We had one client where she was stabbed over 28 times. Somewhere between 20 to 30 times.” (IPV advocate, October, 2020).
Advocates also shared that they were seeing a wide range of abusive and violent tactics being used. One IPV advocate interviewed in November 2020 shared some of what they were hearing from clients calling their hotline: So that alone means that they’re being stalked, they’ve been sexually assaulted, as well as physically assaulted. They’re fleeing. Because I’ve got five right now that have actually had a gun waved in their face, and they fled the city they were living in. Some even fled the state they were in-… because they were literally threatened with a gun in their face… that they may have been stalked. I had not seen anything like it. The level of violence has really stepped up, and the SA, it’s more intense, it’s more physical, leaving behind much more mental anguish. It’s not just for sex anymore, or it’s not just guilt sex, it’s an actual full on assault from their partners.
One program advocate interviewed in November 2020 highlighted changes they were seeing in their lethality assessment scores, saying: It’s much more extreme, much more violent. There’s much stronger gun violence and threats, and literally wanting to take their lives. And you hear of that, but not every single case. And almost every case we have in shelter right now is that, that they are … We do what’s called a danger assessment, and they have to score at least a 14 right now during the pandemic, and they’re coming in with 30 s and 35 s.
Service providers attributed this escalation in severity and frequency of violence at the outset of the pandemic to a number of causes. Along with the social and interpersonal factors that contributed to violence risk pre-pandemic, increased social isolation, greater exposure to violent individuals in the home, reduced access to supports or violence reduction strategies, and increased stress and social strain were frequently cited as unique contributors to heightened levels of violence during the pandemic. As one agency leader shared in August, 2020: It seemed like it was related especially in the immediacy of the stay-at-home orders to being trapped there. Whereas if a survivor felt that the violence was escalating before, there were some options or some things they could do to try to separate themselves from the violence before it escalated to that degree, and those resources were not there during that stay-at-home orders, and so it fully escalated. So that’s something that my team has reported back to me that we’re definitely seeing more injury, more strangulation, more severe battery.
This increased exposure and reduced ability to escape from potentially escalating situations is matched with heightened stress for a range of reasons, including strain related to economic and health challenges. As an advocate shared in August, 2020: Then when you get kids on top of that or you get family members or you get poverty or you get all these. Or if so and so loses their job, that’s definitely been a factor. When abusers lose their job, sometimes then the violence ups because they feel less in control of their own environment, right? Abuse is about control seeking behavior, right? It’s about power. They’re like, “If I can’t provide for my family, if I can’t go out and do these things then I’m going to do these things in the home.”… I’d say violence has increased. Stress has increased. The other thing is people feel more out of control in general as a nation, as a world, and then I think there’s certain people who already are abusive. It’s going to naturally come out this way unfortunately.
Theme 2: “Perpetrating the Violence Through [Technology]”
Concerns about technology safety significantly impacted survivors and providers’ connections in the early pandemic response. Intimate partner violence advocates pointed to many situations where previously established connections with survivors living in the community were simply lost as threats to tech safety superseded connections that had been established. One advocate interviewed in October 2020 shared that she had several clients with who she had been working, who she initially lost touch with, saying: So, they may or may not have access to technology, or they may have access to technology but they so afraid that they don’t think that it’s safe to text or email. Another advocate interviewed in September 2020 noted that for many survivors, “it’s hard…to be on camera all the time and to have so much online when some of their safety depends on not having too much of an online footprint.”
These concerns were validated by the many examples of increasing technology based abuse (TBA) highlighted by service providers during the COVID response. Many advocates highlighted abusive partners taking the technology away from a partner or restricting/monitoring access to wi-fi or cellular data as a typical form of coercive control during the pandemic, compounding the isolating nature of social distancing by removing what for many people was the lone mechanism to maintain contacts outside the household. Service providers also shared significant narratives of complex and highly coercive tactics of TBA impacting the whole family. An advocate who worked with families remembered one case, where: He was the one responsible for paying the internet and he refused, so she had three or four, I think at that time she had four kids at home, and those kids she was having to shuttle them over to friend’s houses, so they could use the internet at the friend’s houses because he was in charge of the internet, and they lived on base, so that was the only internet provider that she could use, and he had locked her out of the account so only he had access, so even if she wanted to try to deal with that account in some way she wasn’t allowed. (October, 2020)
Along with the isolation of preventing and monitoring survivors’ access to technology in a socially distanced world, service providers also highlighted how harassment and verbal abuse shifted online in new and more intense ways in the era of COVID. One advocate interviewed in November 2020 noted “I definitely saw a lot more harassment through social media, phone calls, text messages…They’re still doing it in-person, but they’re perpetrating the violence even more so through harassment and stalking through the social media, the phone calls, the text messages.” Making the online spaces that survivors, and people in general, were turning for connection, comfort, and resources hostile and threatening provided another avenue for abusive partners to further isolation and disconnection.
Theme 3: “COVID now [is] a Tool in Their Toolbox”
Across interviews, service providers described challenges created by the COVID-19 pandemic not only as creating risks for survivor and provider health, but as creating new tools of coercion. Further, participants described the ways that the pandemic response and related societal changes created additional safety challenges or barriers for survivors, creating new risks, or exacerbating old ones. Increased isolation, and the social norming of isolation, was frequently discussed. Service providers highlighted the way it was used by abusive partners to further break down survivor resource access, and how abusive partners would justify their tactics of isolation as being aimed at reducing the spread of COVID. One agency leader shared: I think that offenders are using COVID now as a tool in their toolbox—that’s another way they can isolate a survivor. I think isolation is probably the biggest thing that COVID has brought out. (July 2020). This was further illustrated by several advocates who shared about specific ways that abusive partners used public health distancing guidelines to isolate their partners and inflict additional coercive control and abuse. One advocate described some of these tactics: Or if she works outside the home, he makes her sleep outside [claiming it is to prevent the spread of COVID]. He’ll lock the doors when she leaves and not let her in the house. Or if she doesn’t work outside the home, he’ll lock her in the house. We’ve had more than one situation, this is fairly common, where an offender will leave a weapon by the front door. He doesn’t have to say anything, all he’s doing is leaving a knife by the front door and that’s enough of a message that if you leave, you will be treated with this. So we’ve seen some of that also. Definitely offenders have been using the pandemic as a reason to fuel their power. (July 2020)
While another shared: We’ve had situations where an offender will make a survivor wash her hands until her hands bleed (Agency leader, July 2020). Other examples shared across interviews of abusive partners using COVID-19 as a justification for their coercive control include preventing survivors from taking walks in the name of social distancing, monitoring the car’s odometer, preventing travel, and making a survivor quit their job all with the argument that they are trying to prevent COVID-19 from coming home.
Changes in social patterns, economic situations, and service access that were precipitated by the COVID-19 pandemic also created a range of unanticipated new life generated risks that increased survivor’s risk for future violence. Resources lost due to the pandemic contributed to increased violence risk and played into the hands of abusive individuals. An advocate for survivors of trafficking shared in November 2020: People feel like they have less resources, so they’re now … Maybe people that wouldn’t have resorted to specific types of sex work maybe, are now getting to another level of sex work. People that hadn’t been involved in sex work, are now having to be involved in sex work. A lot of violence comes with the territory, unfortunately. I think that’s also something different, at least for human trafficking survivors.
Disruptions in other social systems also increased survivors’ vulnerability to violence. One agency leader felt that shifts in how their county was dealing with social distancing in the legal system was a factor in the increasing IPV homicide rates they saw over the summer: At the beginning of this homicide streak, there was a small handful of homicides at this point and a not small percentage of those were committed by guys who were out on bond. It didn’t even occur to me at the beginning of all this that not as many guys were going to be held pre-trial. There were going to be people out who wouldn’t normally be out. There were going to be people who got probation who normally wouldn’t get probation. Just to take the strain off of the criminal justice system. Because of that, we’ve seen increased violence in homes. (July 2020)
Theme 4: “You Just Get Real Crafty:” Staff Adapts to a COVID reality
Service providers employed a wide range of approaches and adaptations to meet immediate survivor safety needs in the wake of the COVID-19 pandemic. These changes had in common that they required flexibility and the ability to throw away previously held patterns or agency regulations about how and who advocates could engage with to address survivor safety and resource needs. Within this theme, two subthemes emerged, one addressing adaptations to service methods or activities, and the other highlighting adaptations to safety planning skills or strategies.
Service adaptations
Service providers were united in reflecting that the social disruptions caused by COVID-19 and the increasing severity of violence that they were seeing in their clientele, caused their agencies to shift established rules or patterns and create additional flexibility in what advocates could do for survivors. This was a response to recognizing that partnerships or strategies that may previously have been seen as too risky or difficulty were now “on the table” because of the extra circumstances. In October 2020, advocate counselor shared: One of the things was just being able to meet people when they called, and they’re like, “I need shelter,” but they don’t have any transportation, they don’t have any mass transportation. They really have a limited amount of time to talk, so it made us make better partnerships with people and redefine partnerships with people. We do a lot more transportation, like we don’t pick up at someone’s home because of the safety, but it made us troubleshoot things that had been barriers for a long time for our clients, and start troubleshooting them and saying, “How do we do this? How do we get these people here?” If that mother with three, four children calls me, and we’re not seeing those victims come to shelter, we’re not hearing from them near as much as other victims at this point, so if they do call us, we understand how important it is to meet them right then.
For many advocates, the model of service provision shifted from weekly or bi-monthly, in-person sessions to shorter, more frequent virtual service interactions focused on only the most pressing immediate crises. Rather than planning out the next several weeks of their safety journey, they were focused on the most emergent need, with an on-going understanding that situations were evolving and strategies discussed a few days ago may no longer be feasible or appropriate. An advocate shared about what they saw as some of the benefits of these service adaptations-reflecting that they were able to respond more quickly and have more frequent, if shorter, interactions with clients when they were providing mostly virtual services, rather than having to wait “for next weeks in person appointments” to get things done. They shared in October 2020: Well, the fact that I can get in touch with my clients way more often, the fact that I don’t get to see them in person as much weirdly enough it’s like we’re in touch more often. They send me emails and they know that I can reply right back when they need something, before it was a bit more of a process when you have to see someone in person, because you have to schedule a session in advance to get things done. But now it’s like, they send me an email, they request, I don’t know, a letter or something, and I’m like, okay, 10 minutes later here are your letters, and you’re good to go.
Service providers also shared the way that closures of programs from across a wide range of social services meant that they couldn’t rely on their “typical” slate of referrals and resources, meaning they needed to spend more time searching for effective safety strategies and resources. Changing resource availability from week to week, and limited access windows all contributed to an increase in creative problem solving and several adaptations to the overall model of service provision. One advocate shared her reflections on the first year of the pandemic, and the ways that it changed her approaches, in November, 2020: It’s taken a lot of extra maneuvering and elbow grease. But there are a lot of resources out there, we just have to really dig for them. We just had our tried and trues that we just go to and pull it out, and send them on their way, and with nothing open, we’ve had to find different avenues to make the therapy and the medical visits and their mental health medications … And transportation has been a concern. We don’t transport large amounts in the van anymore. So where we would normally take 10 clients down to sign up for a housing assessment, we don’t do that anymore. So our agency set up an account with Uber, and so we can Uber someone over there to go get that done. So it’s taken, collectively as an agency, for management and boots on the ground folks to just find new ways to make things work.
Similarly, another advocate reflected on altering her typical advocacy routine, leading to solutions that might actually be preferable for clients. She shared in November, 2020: We normally just type up a referral, and we send them to the building. The buildings are closed, and we can’t do that, so how can I get this person a pair of glasses? I went online, and I did a lot of research. I hunted, and I found one. I found one that we could actually do it all online, and they shipped the glasses right to her.
Advocates also noted the ways that shifts in service patterns and habits helped them think in new ways about reaching survivors who they hadn’t previously been serving. For many advocates, an increasing use of technology in service provision provided not only safety from COVID, but in-roads with new survivors, communities, and partners. Advocates shared about their increased engagement with a wide range of constituent communities, including leaders in culturally specific organizations, communities, and informal support networks, representatives of the legal system, and advocates in other service areas (e.g., Lesbian, Gay, Bisexual, & Transgender (LGBTQ) service centers, mental health centers) through video conferencing, (e.g., ZOOM). Advocates also highlighted texting and chat and text hotlines as important additions to their options for connecting with clients. One dual IPV/SA agency leader shared in October 2020: We’ve added Google Voice numbers that the advocates can call from, and allow to tell a victim, once they come in and stay and are a client or once they do an intake over the phone, which we never did before….We’ve never had texting before. Putting devices in the neighborhoods, especially of underserved communities, so like for us the immigrant population here, the African-American community, people that we feel like we’re not seeing those victims, as really placing a phone or a laptop or an iPad in the multicultural center, so that if they go there and they’re talking to somebody and making an outcry, they have a platform that they can just pick up and text a number or do a Zoom call or whatever.
Safety planning adaptations
In the face of increased interpersonal violence severity and an evolving risk profile, service providers also highlighted the way that survivors’ perceptions of the risks of leaving an abusive situation were impacted by the pandemic. Many service providers shared that survivors expressed fear that coming into shelter or moving out of a current living situation might expose them to COVID, creating what they perceived as a new barrier to overcome in the effort to engage clients in services. In the face of these new uncertainties and the evolving risks faced by survivors, it became clear through these interviews that old patterns of safety planning have necessarily shifted, with “distance focused” or “leaving centric” strategies like coming into shelter or moving in with other friends or family being sometimes de-emphasized in the face of new health risks, while strategies like de-escalation and mindfulness taking center stage. This has required increasingly individualized safety planning efforts to address each survivors’ unique risks and perceptions of both violence and COVID safety. An IPV and SA advocate in July 2020 shared: We have been trying to safety plan with victims, where they’re victims that probably would have previously left a situation but whether it be going to shelter or fearing the economic situation that they’re living right now…A lot of them are not willing to leave the situations for those reasons. We’ve been trying to safety plan and…educate them on the best way to prepare to leave in a dangerous situation. What documents to have gathered, what items to have stashed away in a bag, coming up with a code word to give your neighbor, teaching your kids to run across the street to so-and-so’s house if they hear a code word or yelling. Stuff like that. I would say there’s been a lot more safety planning.
To address these new emerging risks, victims’ service professionals from across the country were employing a whole range of new, and sometimes untested, strategies to try to maintain services or meet the needs of survivors in the context of constant disruption and heightened violence severity. One advocate shared that, in the context of COVID-19 and increasing safety risks, their agency was able to make partnerships that previously may have been considered too big a safety risk. Working with Uber or Lyft, or partnering with individuals in the community to address transportation needs became more frequent as other options dried up. As described by one service provider in October, 2020: We’ve done workarounds, we just got Uber and Lyft into the fray and we’ve used a lot, we have a local cab company, but really digging down and finding resources of people that if we say, “Hey, if we have this person and they need to be picked up, and they can get to the Dollar General, a public spot, can we do the turnover quicker?” Because the resources we’ve used in the past, the turnover has just taken a lot more time, planning, and the pandemic seems to push the envelope on that to say everything seems to be a lot more urgent, because the violence is more severe, it’s more escalated.
Another advocate noted in November 2020 that advocates and survivors in their agency strategized to use federal stimulus money to promote their safety from violence, sharing that: [In] April, May when the first round of stimulus checks hit, that helped survivors in [city] because they could pay for motels. They were a little but more liquid. When that ran out, unfortunately a lot of them were back.
Service providers in IPV service agencies underscored that psychoeducation about the safety risks posed by using technology to communicate, and safety planning to address those risks, became a central part of everyone’s work almost overnight. Where there may previously have been an individual within an agency who was the “tech go-to” person that rapidly became central to everyone’s work. Providers educated survivors on how to erase browser histories, use incognito browsers, and identify cookies. As one advocate in November 2020 shared, “[We talk about] deleting their browser history or making sure they’re somewhere private and using headphones and that no one is listening in and…then if someone is checking your emails or whatever else then to delete the [video] call history.” While this may not have been completely new, it had new urgency, as one advocate said: “You have to put that extra emphasis on making sure… that there’s no trail there.” The on-going nature of tech safety planning was reflected repeatedly in the experiences of service providers, noting the way that tech safety became more urgent and more quickly evolving in the context of the pandemic. Another advocate shared in August, 2020: We try to safety plan, so being that the abusers might be home or they’ve been more at home for more hours, we are still being creative in how we contact them, and also how we safety plan with them. So whatever is the safest way of communication, if you have a phone that is not safe, they’re not in a place where they’re alone or safe to talk, then we always advise that they either do something to make sure they’re safe before they call us, or just maintain a way of communication that’s the most safest for their entire time, or email instead of actually calling us. And we say there are limitations, right?
The risk of unwanted disclosure through virtual service provision doesn’t just extend to abusive partners finding out about IPV service use. Several service providers also highlighted other ways that confidentiality shifts in the virtual service world. For survivors living at home with family members who are unaware of their situation, or to whom they have not disclosed certain aspects of their identity, accessing services virtually created new perils. One campus-based advocate interviewed in October 2020 reflected on the challenges that younger survivors had reaching out for services while at home with their parents. They described some survivors who would tell them: “I share computers with my parents, and they might find out I’m going to counseling for a SA, and they don’t know about it.” A different campus-based advocate also commented on how survivors’ identities shape the safety of virtual help seeking: I’ve definitely seen a difference in survivor’s ability to access resources because of wherever they are home. So for my folks who are LGBTQ survivors, a lot of them have barriers to accessing resources cause they didn’t want parents to overhear conversations that may out them. Right. I had some students who didn’t want parents to know that that’s actually assaulted, so they couldn’t continue counseling. (November, 2020)
To address these emerging risks, service providers suggested that the first task for any virtual interaction was establishing a safety plan for the visit-how they would handle a person entering the room or overhearing the conversation. As one campus-based advocate noted in November 2020: We’ve also had certain students who struggled with finding privacy. So especially our queer students who may not be out to their family, for them to be able to figure out, “Where am I going to go do this 45 minute, hour where I can talk openly.” And we’ve also had definitely situations where perpetrator was also living with them. So similarly, especially if it was DV, how do we get them the privacy so they can be honest about what’s happening in the counseling session? So in some cases having to switch to phone and, “Oh I’m going to go take a walk.” And they’re talking to the counselor on the phone during their walk, which in some ways is just trading one privacy concern for another.
Discussion
As the coronavirus pandemic has unfolded, service providers working with survivors of IPV and SA have faced rapidly shifting working conditions and expectations while grappling with overwhelming service needs. Survivors faced safety challenges due to physical and emotional violence occurring in the context of increased social isolation, as well as new tactics of coercive control built around public health guidance and fear of the virus. These interviews with service providers highlight the ways that the pandemic and accompanying shifts in social structures heightened the severity and frequency of interpersonal violence, as well as contributed to an increase in TBA, and provided new avenues for an abusive partner to exert coercive control. They also shed light on how the pandemic, and related shifts in survivors’ assessments of their safety and choices related to staying in or leaving an abusive situation, required new ways of working. These shifts pushed advocates to try a wide range of new “work-arounds,” some of which will doubtless remain part of the advocacy toolkit.
As the pandemic unfolded, with new avenues for coercive control, increased family stress, more time spent at home, and limited access to previously useful supports or safety strategies, service providers bore witness to an explosion of new safety risks for survivors. Notably, interviews conducted over the summer of 2020 contained many of the most stark examples of increased violence severity, as compared to interviews occurring later into the fall. Quantitative research is needed to tease out the extent to which the proximity to the start of the pandemic may be linked to heightened violence. The context of social distancing required service providers to turn to strategies to support survivors who were in close proximity to an abusive individual. Advocacy beyond leaving strategies become more central when survivors face increased anxiety about leaving based strategies (Davies, 2019). Safety strategies like strengthening emotional coping skills, planning for immediate threats, and findings ways to access informal resources can enhance safety planning in the context of stay at home orders as well as when survivors have other reasons for choosing to stay with an abusive individual.
Conservation of Resource Theory, as applied to IPV and SA, teaches that after the trauma of interpersonal violence, additional complex losses across domains of well-being, including economic, physical, and metal health, can occur (Hobfoll, 2011; Sullivan et al., 2018; Wood et al., 2022b). In the face of the additional losses to health, economic security, and social connection brought by the pandemic, the risk of spiraling negative outcomes for survivors was heightened. The tasks of interpersonal violence service providers, then, became more crucial than ever, as they sought to interrupt the cycle and prevent further loss. In interpersonal violence intervention, this amelioration is typically achieved through advocacy to promote individual, relational, and social well-being, and the connection and alliance between a survivor and a service provider is crucial to a successful service outcome (Sullivan et al., 2018; Wood et al., 2022b). Previous studies highlight that effective survivor–advocate connection facilitates access to safety and supports, increasing family well-being and safety overall, and that a survivors’ perception of the quality of that connection may be more important than the actual amount of time spent on advocacy (Goodman et al., 2016; Sullivan et al., 2018; Wood et al., 2022b).
These interviews reveal new methods and strategies for achieving this connection, and ultimately stemming the tide of resource loss for survivors. Service providers talked about moving from less frequent, longer, and often in-person contact with survivors, to shorter, more frequent, technology facilitated engagement focused on immediate survivor needs and goals. These interactions allowed service providers to keep the focus on addressing immediate resource and safety needs, addressing resource loss both due to the pandemic and as a result of escalating violence. Further, in a service context in which their frequently used referrals might be restricted, closed, or shifting in availability from day to day, advocates who had previously relied on a fairly static set of referrals returned to what might be termed “old school advocacy.” To stem survivor resource loss, advocates hunted around, followed up on leads, tried creative solutions, and found ways to “make do” with what was available. This deep engagement in finding just the right referral or service could contribute to an increased sense of connection and support on the part of the survivor, as they witnesses the committed efforts of their service provider. Several service providers spoke with pride about their increased skills in this area, hinting at a potential long-term benefit to survivors seeking interpersonal violence services.
Implications for Practice & Policy
These findings underscore that the work of service providers addressing IPV and SA remains as important to survivor safety as ever. The tasks of advocacy, safety planning, and resource acquisition have been adapted to facilitate connection via technology and in the context of multiple unfolding crises. Increased funding, training, and agency support to expand strategies for service engagement, particularly via widening use of a range of information communication technologies, is critical for meeting safety needs in the context of social distancing. Training in the use of various virtual platforms and in the specifics of technology safety with survivors was frequently cited as a need. These adaptations will likely remain a fixture of services in an emerging “hybrid” post-pandemic context, and agency policy, funding, and evaluation frameworks need to adapt to match the flexibility shown by service providers and survivors. Ultimately, these interviews demonstrate connections between survivors and service providers can come in many forms. Future work should continue to examine the factors that influence the perceived quality of connection between a survivor and service provider in order to provide a wider variety of avenues for advocacy and safety planning services.
As service providers and public health officials plan for future wide-scale emergencies, they would benefit from keeping in mind several lessons from these interviews. As the pandemic began to unfold, not only did violence escalate in severity, but the avenues for coercive control available to an abusive partner also expanded. Public health plans and emergency funding streams need to be robust while including flexibility to support rapidly changing safety priorities. Planners should anticipate the need to make funding available to agencies to support safe, socially distanced housing (e.g., hotel stays or enhanced rapid rehousing voucher availability rather than shelters). Intimate partner violence and SA services should be included as first responders in emergency planning, ensuring access to supplies, emergency technology, and protective equipment. If public transit shuts down, funding for alternative routes to service access and safety could be prioritized. Supporting the ability of service agencies to quickly address economic and housing needs will help agencies implement pandemic-safe distancing strategies as well as further enhance survivor resource gain, and ultimately promote increased safety from violence.
Along with funding directly to agencies, governmental programs that put money in the hands of individual survivors had a critical role increasing safety from violence during the pandemic, and could be enhanced to provide even more benefit in future pandemics. These interviews demonstrate that stimulus funding and expanded unemployment were a boon for survivors, who used the dollars to obtain safe housing or address other pressing needs. However, the ongoing uncertainly in the length and amount of support created challenges, ultimately stymieing some survivors’ efforts to get safe as they wondered if it was a good idea to leave a violent situation if the funding that was financing their space was going to dry up.
Limitations
This study has several limitations to note. First, these interviews occurred only with U.S.-based service providers in interpersonal violence focused agencies. Future work should include interviews with survivors of violence who dealt with safety concerns during the pandemic, as well as survivors and service providers outside of the United States. Quantitative and longitudinal work is needed to understand if the observed shifts in safety and services maintains or changes over time. Further, the participants in this study were recruited based on their responses to a previous web-based survey, which may influence who ended up in our recruitment pool, including those with more confidence using technology and with active social media or e-mail presence.
Conclusion
In the wake of the COVID-19 pandemic, survivors of IPV and SA have faced new safety challenges while adapting to new modes of service delivery and safety planning. Service providers underscore the tightrope that survivors have been walking, balancing safety from escalating violence and coercion with safety from the virus. Survivors have faced a range of disruptions: to economic, physical, and emotional health, to service access, and to effective safety strategies. In future public health emergencies, plans should include a recognition of the immediate risk for increased violence frequency and severity, and the risk of an abusive partner using public health requirements as a facilitator of increased coercion in relationships. To support services in future pandemics, pandemic preparedness plans can include surge funding to IPV and SA agencies. This funding can support access to resources including personal protective equipment, flexible funding to meet survivor needs, and technology for providers, as well as strategies for expanding access to safe and socially distant housing options including access to hotel stays, rapid rehousing vouchers, and other innovative partnerships. Further, this funding can support focused public messaging about the increased risk for violence and the role of isolation and coercion in IPV. Finally, pandemic preparedness plans should consistently include in-person IPV and SA service agency staff as essential workers.
Service providers have worked diligently to adapt their modes of service and safety planning tactics to continue to meet the resource and safety needs of survivors. To entrench helpful strategies that were begun or accelerated during the pandemic, governmental and private funds are needed. Similarly, collaboration and communication between formal and informal community supports must be accelerated to meet the diverse needs of survivors. With continued monitoring and effective funding, helpful adaptations made to services during the COVID-19 pandemic, including increased access via technology and greater flexibility and collaboration between providers, can have a lasting positive impact on public health and survivor well-being.
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) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for this project was provided by the Social Science Research Council and Henry Luce Foundation.
