“A Community of Survivors”: A Grounded Theory of Organizational Support for Survivor-Advocates in Domestic Violence Agencies

Abstract

Half of today’s domestic violence (DV) advocates are survivors of intimate partner violence (IPV) or other forms of abuse. Yet, little is known about the experiences of those who are both survivors and advocates, especially regarding organizational relationships, policies, and culture, and how these factors shape well-being. This grounded theory study of 12 survivor-advocates identified three dimensions of organizational support that contribute survivor-advocates’ well-being: acknowledging their trauma-related needs, fostering belonging, and honoring strengths. In each case, these organizational factors contribute to well-being through the mechanism of validating their identities as survivors. Suggestions for organizations to better support survivor-advocates are discussed.

Keywords

domestic violence agencies vicarious trauma organizational support

From the beginning of the domestic violence (DV) movement, survivors of interpersonal abuse have played a central role (Schechter, 1982). Today, as many as half or more of DV advocates are survivors of intimate partner violence (IPV) or other forms of abuse (Slattery & Goodman, 2009; Wood, 2017). A growing body of research suggests that these survivor-advocates may be uniquely positioned to derive growth and meaning from the work that they do, and be more vulnerable to its emotional challenges (Frey et al., 2017; Kulkarni et al., 2013; Slattery & Goodman, 2009). Still, not enough is known about the unique perspective of being both a survivor and an advocate, especially with regard to how survivor-advocates experience their organizations and, in turn, how their organizations shape their well-being.

Using grounded theory, this study addressed this gap by exploring and developing a theory about how survivor-advocates experience their relationships with coworkers and their organizations’ policies and culture, and how each of these shape their well-being. The section “Literature Review” reviews existing research on survivor-advocates’ experience of workplace stress and organizational approaches to support well-being. The section “Method” builds a grounded theory to illustrate the process by which survivor-advocates’ organizational context shapes their well-being. Finally, the discussion integrates study findings with prior research and suggests how these results can be used to better support survivor-advocates in DV organizations. For the purposes of this study, a DV advocate is any direct service staff member working in an agency that serves IPV survivors, and a survivor-advocate is any advocate who has experienced some form of interpersonal abuse (e.g., IPV, sexual assault, childhood physical abuse).

Literature Review

Survivors were pioneers of the DV movement. The first shelters took the form of survivor-run safe houses, first in survivors’ own apartments and eventually in larger houses (MacFarquhar, 2019). Even as shelters became more formalized, anecdotal evidence suggests that many, if not most, advocates were themselves survivors of IPV, and that their identities as survivors infused their work, helping to create a sense of community and calling (Schechter, 1982). However, as the DV movement evolved from a sole focus on shelters to an expanded community-based response, debate regarding its mission and strategies gave rise to a tension between two approaches to the work, each with a distinct implication for the role of survivor-advocates (Schechter, 1982). Consistent with early movement philosophy, what we might call the social justice approach prioritizes transforming or dismantling oppressive social structures that undergird IPV and other forms of violence (Arnold & Ake, 2013). This approach views survivorship as a form of credibility among advocates taking an activist stance. However, the social service approach, which has come to dominate most DV organizations, prioritizes direct services to individual survivors, a hierarchical organizational structure, and maintaining emotional boundaries with clients (Lehrner & Allen, 2009; Wies, 2008). This approach more highly values professional training and views survivorship as a potential vulnerability rather than a strength.

Today, most DV programs embrace elements of both frameworks. Although the social service lens has come to dominate mainstream programs (Lehrner & Allen, 2009; Wies, 2008), a social justice approach—one that focuses on structural change and centers survivor-advocates—persists in programs that offer alternatives to mainstream DV services (Arnold & Ake, 2013). These tensions form the backdrop for the experience of DV advocates today.

The Emotional Impact of DV Advocacy: Workplace Stress and Well-Being

The emotional demands of DV advocacy pose significant challenges for all advocates, whether or not they are survivors. Advocacy can include crisis hotlines, community advocacy, support groups, counseling, and shelter services, as well as outreach, prevention, and social change work (Macy et al., 2009). Each of these roles involves advocates listening repeatedly to stories of violent victimization (Frey et al., 2017). Agencies vary in the amount of training and supervision available, leaving some advocates feeling underprepared and overwhelmed (Kulkarni et al., 2013; Slattery & Goodman, 2009). Furthermore, the work often takes place in organizational contexts characterized by high workloads, limited resources, demands from funders, relatively low salaries, and a normalization of constant crisis (Bemiller & Williams, 2011; Kulkarni et al., 2013). On a broader level, sociocultural forces that stigmatize survivors of violence and perpetuate other forms of identity-based oppression further compound the strain of advocacy work (Kulkarni et al., 2013). Given these emotionally taxing experiences and contexts, it is not surprising that DV advocates experience high rates of workplace stress, as described in the next subsection.

Workplace stress

The large body of research that describes workplace stress in helping professions encompasses the constructs of burnout, vicarious trauma, and secondary traumatic stress. Burnout consists of emotional exhaustion, decreased job motivation and commitment, depersonalization, and detachment (Bemiller & Williams, 2011; Maslach et al., 2001). These symptoms can lead to decreased job performance, increased turnover, depressive symptoms, and relationship problems (Maslach et al., 2001; Merchant & Whiting, 2015).

In contrast to burnout—a response to stressful work conditions generally—vicarious trauma and secondary traumatic stress are syndromes that arise specifically from prolonged empathic engagement with survivors of trauma (Hensel et al., 2015). Vicarious trauma emphasizes internal, cognitive changes in the helper (McCann & Pearlman, 1990), and secondary traumatic stress emphasizes behavioral and emotional symptoms (Figley & Ludick, 2017). Both include symptoms that mirror post-traumatic stress itself, such as intense distress and shock, intrusive re-experiencing of traumatic memories, or a shift in one’s belief system toward seeing the world as fundamentally unsafe (for a review, see Cohen & Collens, 2013). Evidence is mounting that a significant portion of DV advocates experience both of these syndromes. One recent study found that almost 50% of their sample of 148 DV advocates suffered from clinically significant secondary traumatic stress (Slattery & Goodman, 2009), and some qualitative studies of DV advocates have reported that all of their participants experienced some level of vicarious trauma (Cohen & Collens, 2013). Furthermore, recent meta-analyses suggest that survivor-advocates, as opposed to advocates who are not survivors, are at highest risk for vicarious trauma, though theoretical accounts of this link are underexplored (Hensel et al., 2015).

Burnout, secondary traumatic stress, and vicarious trauma each pose significant challenges to DV advocates. We will use the umbrella term workplace stress to refer to any and all negative responses to work conditions, including but not limited to vicarious trauma, secondary traumatic stress, and burnout.

Workplace well-being

Although working as a DV advocate poses threats to well-being, research has also identified ways that advocates can adapt to workplace stress, or even derive personal growth and benefits from their work. As an antithesis to burnout, the construct of work engagement describes a state of increased vigor, dedication, and absorption in work that is associated with increased job performance and satisfaction as well as personal well-being (Bakker et al., 2011). Although there is little research on work engagement specifically in DV advocacy, one study of 194 DV advocates identified a related process, called good soldiering, that describes how a sense of dedication to the mission of DV work was protective against burnout (Bemiller & Williams, 2011). A form of workplace well-being that is specific to trauma work is vicarious resilience, which refers to personal benefits and growth that can result from witnessing traumatized clients’ resilience and recovery (Frey et al., 2017). A number of studies suggest that working with survivors of trauma can deepen relationships, expand worldview (Cohen & Collens, 2013), and promote hope, self-awareness, and a deeper valuing of the helping role (Frey et al., 2017).

As noted above, research on workplace well-being in DV advocates generally, let alone in survivor-advocates, is scarce. However, one survey of 101 sexual assault and DV advocates (Jenkins et al., 2011) found that advocates who reported past experiences of IPV or sexual assault as part of their motivation for entering the field (i.e., survivor-advocates) were more likely to report positive changes due to the work, including increases in self-esteem, capacity for self-care, empowerment, and processing of their own trauma. Similarly, another recent study of a sample of 222 DV and sexual assault advocates found that advocates who are survivors were more likely to report vicarious resilience (Frey et al., 2017). This initial evidence that some survivor-advocates may be able to use their trauma history to forge greater well-being through their work raises the question of what types of organizational support contribute to reduced workplace stress and increased workplace well-being, especially considering that trauma history is also associated with increased workplace stress (Hensel et al., 2015). We turn next to research on how DV organizations support advocates generally before honing in on survivor-advocates.

Organizational Support in DV Agencies

Research over the past decade has explored organizational strategies for promoting workplace well-being among DV advocates. These include high-quality clinical supervision, trauma-informed training, support for self-care, a culture that openly acknowledges and destigmatizes vicarious trauma/secondary traumatic stress, and social support both within and outside of the workplace (Cohen & Collens, 2013; Hensel et al., 2015; Merchant & Whiting, 2015). In one recent survey of 142 advocates, participants listed supports available to them that included time off and mental health days as needed (Benuto et al., 2019). The survey of 148 survivors mentioned earlier (Slattery & Goodman, 2009) found that advocates who reported high levels of workplace social support reported lower secondary traumatic stress. These themes of a culture that prioritizes “connection, cooperation, flexibility, innovation, and self-care” (Merchant & Whiting, 2015, p. 475) have been echoed in other qualitative (Cohen & Collens, 2013) and quantitative research (Kulkarni et al., 2013).

Despite these advances, only a handful of studies have focused directly on survivor-advocates. This is a critical area for exploration, as so many advocates identify as survivors and their relationships within their organizations may be complicated by trauma symptoms and stigmatization of survivors. The next section reviews research on survivor-advocates to pinpoint the gap in our understanding of their experience of their organizations.

Survivor-advocates’ experience of organizational support

Some research on organizational support in DV organizations has hinted at specific organizational factors that may be especially important for survivor-advocates. Slattery and Goodman (2009) found that after controlling for workload, social support, and supervision quality, only perceptions of shared power—the degree to which agencies promote advocates’ autonomy and adherence to nonhierarchical structures—remained a significant protective factor against secondary traumatic stress. Critically, personal trauma history also continued to predict secondary traumatic stress even in the context of shared power, suggesting that survivor-advocates may have a more fraught experience of power dynamics in the workplace that makes it more difficult for them to reap its benefits (Slattery & Goodman, 2009).

A small handful of studies have focused on the experience of survivor-advocates in DV organizations. For example, one qualitative study found that survivor-advocates derived resilience in part by applying their experiences of survivorship to help others (Crann & Barata, 2019). Similarly, Wood (2017) described how survivor-advocates integrated their experiences of violence into their work in ways that increased their sense of competence as advocates. They did so by seeing advocacy as their “calling,” internally referencing their own healing journey to maintain their own sense of hope and empowerment, and making meaning of their clients’ recovery to further their own resilience. This study also found that survivor-advocates relied on coworker support to cope with the unique challenges they faced, but provided little detail about the kinds of coworker support that survivor-advocates find most helpful.

Although these two studies break new ground on survivor-advocates’ experiences of the relationship between their work and their recovery, neither focused in detail on survivor-advocates’ relationships with their coworkers or perceptions of their organizations. Such a focus is critical, given the history and continuing debate among DV organizations regarding the role of survivor-advocates and whether they should integrate their experiences into their work (Schechter, 1982). In addition, investigation of survivor-advocates’ experiences of their organizations may shed further light on why they are more likely to experience workplace stress (Hensel et al., 2015) and workplace well-being (Frey et al., 2017), and how their organizations can optimally support them in light of this tension. This study aimed to fill this gap by exploring survivor-advocates’ perceptions of how their organizational contexts shape their well-being. The next section describes the grounded theory methodology used to explore this question.

Method

This study used a grounded theory approach to construct a theory that explains survivor-advocates’ subjective experiences in a way that is meaningful, relevant, and useful for advocates and agencies (Charmaz, 2014). Grounded theory refers to an overall approach to research as well as specific methodologies that focus on developing rich concepts and categories that hew closely to the data, then synthesizing them into a coherent theoretical framework (Charmaz, 2014). This study utilized Charmaz’s (2014) constructivist grounded theory, which attends to implicit meanings in the data and the researcher’s role as an active participant in the process.

Sampling

Participants for this study were recruited from a small set of DV agencies in a major urban area of the northeastern United States through a targeted selection strategy using email and in-person solicitation. We obtained the Institutional Review Board’s (IRB) approval from our sponsoring institution prior to the beginning of the recruitment. Participants needed to be more than 18 years of age, should have been working in the field of DV for at least 6 months, and report having experienced interpersonal violence, including IPV (physical and emotional), sexual assault, childhood physical or sexual abuse, or childhood witnessing of violence. As we collected data, we directed recruitment toward increasing variation of program types and addressing specific gaps and emerging hypotheses, consistent with theoretical sampling (Charmaz, 2014). In particular, we sought to sample from sites with a wide range of organizational cultures, including some sites that were explicitly survivor-led and some more mainstream sites. Although we made a concerted effort to recruit participants working in both residential and nonresidential programs, only one participant who worked in a shelter responded to recruitment, and then was unable to schedule an interview. Recruitment ended when theoretical saturation was reached; that is, subsequent interviews no longer added to the development of existing concepts (Charmaz, 2014).

The final sample consisted of 12 survivor-advocates from nine DV programs. Six of them worked at mainstream community DV agencies, three worked at culturally specific antiviolence organizations, and three worked in domestic/sexual violence programs based in a hospital. Three of the participants provided exclusively individual advocacy, four provided a combination of direct service and outreach/education, two were program directors or supervisors, and one worked as a community organizer and individual advocate. Eight reported 5 or fewer years of experience in the field, one reported 8 months, and three reported 10 or more months. In total, 11 participants identified as women, and one identified as gender nonconforming. With regard to race/ethnicity, seven participants identified as White, two as Latino, one as Chinese, and two as mixed race. Four participants identified as Queer, four as heterosexual, two as lesbian, one as gay, and one as bisexual. Ages ranged from 25–58 years, with half the sample in the 25–28 years range, and half over the age of 35 years. Participants reported a variety of traumatic experiences. Eight participants reported some experience of IPV, seven reported a history of sexual assault, four reported a history of childhood sexual abuse, and three reported a history of childhood physical abuse. All participants came from community-based, as opposed to residential, programs.

Data Collection

Participants completed semi-structured interviews that we revised as data collection proceeded to develop emerging findings from prior interviews. The first author conducted all interviews (11 face-to-face, one over the phone). Questions focused on how participants experience workplace stress and well-being in the context of (a) their relationships (with clients, coworkers, and supervisors), and (b) their organization’s policies and culture. Questions were broadly stated (e.g., “What does it feel like to work in your organization?”) and were followed by more specific probes based on theoretical sampling (e.g., “What is the culture of your workplace with regard to self-care?”).

Data Analysis

Grounded theory emphasizes the development of theory across multiple levels of coding. The goal of the data analysis is to produce a set of concepts, hypotheses, and narratives that explain how participants interpret their experience, built up from an intimate understanding of participants’ subjectivity (Charmaz, 2014). Causal language is used throughout the data analysis when participants used causal language to describe their experience. Coding of interview transcripts occurred as data were collected, beginning with (a) open coding, which generates concepts and categories that serve as labels for chunks of similar data; (b) focused coding, which specifies relationships between and within concepts and categories; and (c) selective coding, which generates statements that identify theoretical relationships among the most central categories (Charmaz, 2014). Across each level of coding, we used the constant comparative method to develop the codes. Constant comparison involves comparing each new segment of data to existing data to identify similarities and differences between them, combine codes that have common meanings in the data, and identify the need for new codes (Charmaz, 2014). For example, early in the data analysis, multiple discrete codes such as “organizations proactively responding to staff trauma” and “organizations inviting staff to discuss personal trauma” were collapsed into the code “feeling that the organization creates space to discuss personal trauma” after constant comparison revealed that the data subsumed under each of these codes fit together. All transcripts were coded twice by the first author and a research assistant, and the resulting codes were regularly discussed and refined with the second author until we reached consensus.

We took numerous steps to ensure rigor and validity. Throughout the process, the first author wrote analytical memos to document his thinking about the emerging data and analytical decisions after each interview and throughout the coding of each transcript. The memos documented the first emergence of codes, questions regarding variations that a concept might exhibit across participants, and how codes related to other concepts and categories. For example, one memo contained the first author’s thoughts about how several early codes originally focused on “the political climate” might better fit in a category about stigmatization of survivors, a change that eventually made its way into the final analysis.

In addition, both authors took care to reflect on how their own personal experiences shaped their interpretation of the data (Charmaz, 2014). The first author has immediate family members who are survivors of IPV, some of which he witnessed. Both have worked in multiple clinical and research roles with survivors and DV advocates. We have deep admiration and respect for both groups and have witnessed the strength and fortitude that many of them bring to the challenges they face. This may ultimately have contributed to a tendency to devote excessive attention to participants’ positive experiences at the cost of exploring their experiences of stress and hardship. We attempted to balance this tendency by including probes for both positive and negative experiences and counterexamples throughout the interview protocol and by calling each other’s attention to the possibility of bias throughout the coding process. As a form of member checking, we sent the finished data analysis back to participants to allow them to give feedback on the theory. Four participants responded and expressed agreement with the results, although three offered amendments to their quotes to increase confidentiality or clarify their meaning.

Results

This study addressed the following research question:

Research Question 1 (RQ1): How do survivor-advocates’ experiences of their organizational context shape their workplace well-being?

It used a grounded theory approach to explore participants’ experience of organizational support in their relationships with coworkers as well as the overall organizational culture. Three main categories of the organizational context emerged as contributors to workplace well-being. These included the extent to which the organization (a) acknowledges survivors’ unique needs, (b) fosters a sense of belonging, and (c) honors survivor strengths. Each contributed to advocates’ well-being, which they described as engagement, motivation, fulfillment, and vitality at work; perceived ability to cope with the stress of their work; and personal growth and healing from the work. The more that organizations helped participants feel that their needs were acknowledged, that they belonged, and that their strengths were honored, the greater their workplace well-being.

Participants also emphasized that validation of survivorship was a critical path through which acknowledging needs, fostering belonging, and honoring strengths contributed to well-being. Although each of the categories independently contributed to well-being, participants felt even greater workplace well-being when they felt validated explicitly as survivors. Represented in Figure 1, each of the three categories has a direct link to workplace well-being, as well as an indirect link through validation of survivorship. The figure also lists the most frequent concepts that comprised each category, including both positive/validating and negative/invalidating factors. The next section describes these categories in detail. We used pseudonyms to disguise participants’ identities when quoting them. The following terms denote the numeric range of participants who described a given experience: “some” (2–4), “many” (5–7), and “most” (8 or more), a convention used in some qualitative research (Chang et al., 2009).

Figure 1.

Supportive contexts for survivor-advocates.

Acknowledging Survivors’ Unique Needs

Above all else, the degree to which organizations acknowledged needs related to survivorship was key to survivor-advocates’ well-being. Participants paid close attention to the ways that their organizations and coworkers responded to their stress and coping needs. When their organizations recognized, legitimized, and responded to their needs, they felt better able to cope with work stress and more engaged with the work. Notably, organizations varied in the extent to which they explicitly attributed participants’ needs to survivorship, and the extent to which such support was relegated to individual coworkers or created by the organization as a whole. The more that participants perceived their organizations as explicitly committed to supporting staff coping, and naming staff survivorship in that process, the more validated participants felt, contributing even more to well-being.

Actively encouraging self-care

Most participants who saw their organizations taking concrete steps to promote self-care and link it to mental health felt that this validated their own mental health needs. For some participants, this took the form of individual coworkers encouraging each other to engage in self-care as needed. Manda, a 26-year-old queer White woman, described it as follows:

I very much can be open about my boundaries. Like if I’ve had a really tough day, and I need to talk about it with a coworker, or I need to just leave, people are gonna understand that. And see that as me actually doing my own self-care. And I think that that’s great.

Manda felt more cared for and more able to care for herself because of the support and understanding her coworkers offered.

When participants felt that they could openly seek support specifically for feeling triggered, which more directly implicated their own survivorship, they experienced a further increase in well-being. Cassie, a 28-year-old White queer woman, stated that “we had enough of a relationship at that point that I felt comfortable saying ‘I got really triggered by this’,” when describing a particularly validating relationship in her organization.

Participants expressed even greater validation when their organizational leadership, rather than individual peers, took concrete steps to encourage self-care. Particularly useful practices included “mental health days,” recommending books about self-care, facilitating self-care goals and plans, and sending out newsletters about self-care. Sarah, a 26-year-old straight White woman, stated that she “never would’ve dreamt that my boss would be telling me to go home on days when I’m feeling the most burnt out” and that “it speaks to just how seriously” her agency takes self-care. By contrast, participants felt invalidated and unsupported when their workplaces trivialized self-care. As Manda, a 26-year-old White queer woman, put it:

I think I am more bothered by it when self-care is talked about in a very surface level way. That’s where I get an eye roll. It’s like, “Oh, go take a bath,” or like, “Go to a yoga class,” and for me, I think that’s like a band-aid. That’s not gonna do much in this work.

Creating space for discussing personal trauma

Beyond merely supporting self-care, many survivor-advocates also described the various ways their organization created space for them to discuss and process their trauma histories. Participants felt that this signified an organizational commitment to supporting survivor-advocates and recognition of how their needs might differ from those of non-survivors, which led to greater validation and workplace well-being. For example, Isabel described “team meetings where people openly talk about [trauma].” Cassie described her experience in supervision after being triggered by a coworker:

She’s just the type of person that any time you acknowledge any sort of feeling, she makes sure she creates space for those feelings. . . . She created the space where I felt comfortable disclosing more about my story.

Participants felt that having space to process the intersection of their prior trauma and their work reduced workplace stress, in part by demonstrating to them that their trauma history was a valid concern deserving of time and space in the organization. Of note, participants who were older and had more years of experience, especially those with supervisory roles, more commonly held a favorable outlook on being able to disclose survivorship in these spaces or even spoke of “proactively and explicitly creating” such spaces themselves. In the absence of these spaces, many participants, particularly those with less power in the organization, worried about being judged for divulging personal trauma histories to their colleagues. For example, Claudia, who works at an organization that openly prioritizes hiring survivors, described how trauma reactions that survivors might experience at work can be labeled as unprofessional:

There are meetings where things will be said and done, where your heart starts to race, you’re shaking, you actually have to get up from the room. And then you have to think about it, like how do I respond, because to have your experience as a survivor also not seen as professional, like if you cry in a meeting, or if you get upset and you respond with something that could be labeled as angry, but you’re just responding to something. A lot of these behaviors are not seen as professional.

Even though Claudia’s agency was explicitly survivor-led, she perceived some of her coworkers’ comments as stigmatizing of trauma survivors.

Fostering a Sense of Belonging for Survivors

In addition to the acknowledgment of survivor-advocates’ needs, a second major contributor to workplace well-being was the extent to which organizations fostered participants’ sense of belonging. When participants felt welcomed by and connected to their coworkers as part of an interdependent community, they felt more excited and engaged in the work. This sense of belonging inextricably links to the theme of the previous category in that participants who felt more belonging felt more able to seek support from their coworkers. Manda spoke of feeling able to be “more open about [my] boundaries” due to feeling more connected to her coworkers, and Sarah stated that “people on the team are out if they are survivors themselves,” which she attributed to her organization’s supportive stance toward self-care. However, fostering a sense belonging had value beyond merely encouraging coping, in that survivors saw it as a message that they were welcomed, safe, and among allies in their organization. This was increasingly true the more the participants perceived that survivors were explicitly welcomed in the organization. Several factors contributed to this sense of belonging, as described in the next subsection.

Sharing values about survivorship

First, many survivor-advocates described a sense of shared values as contributing to a sense of belonging. Two particular sets of values arose frequently. The first involved sharing a commitment to social change as central to DV work, often described as a social justice commitment. As Luis put it, “I know that walking through the doors [of my organization], that the people in the office are committed to ending oppression.” The second set of values involved a commitment to respecting and supporting survivors’ autonomy, described using terms such as survivor-defined or trauma-informed. Brittany, a 27-year-old White queer woman, described how these values shaped her relationships with her coworkers:

There are coworkers that I’m particularly close with that we align in how we envision this organization, and how we would like to see the work unfold, and where we would like to see it grow. And I think as coworkers, that has brought us closer together . . . some of our conversations about like, trauma-informed care, and what that means . . . it’s been great to have allies in these conversations about how we can do better for our clients.

The participants suggested that when their peers and organizational leaders held these sets of values, they sensed that their coworkers felt greater solidarity with survivors and empathy for the survivor experience. This led to a stronger sense of belonging in their organizations because participants felt more bonded with and able to trust their coworkers, which in turn helped them feel greater safety, engagement, and excitement at work.

By contrast, when advocates felt that their values clashed with the people they worked with, they felt less of a sense of community and more workplace stress. Often this clash reflected the fact that the DV program was part of a larger institution that did not adhere to the values of structural change or survivor-defined practice. Jessie, a 23-year-old queer White woman, described the hierarchical values of the institution that housed her DV program—values that interfered with her well-being despite her stronger connection to her more immediate coworkers:

Every once in a while, I am in a situation where I’m trying to advocate for the client, and I am feeling unheard by the rest of the team of psychiatrists and nurses and feeling like . . . in my role as an advocate, I don’t have a lot of power because of the hierarchy of the hospital. And that feels kind of triggering for me and also like, like feeling a huge burden of guilt that I wasn’t able to advocate good enough for my client.

Clashing values were even more evident when participants encountered judgmental or stigmatizing comments about survivors in their organization. Participants felt that such judgments were incompatible with trauma-informed, survivor-defined values, which subsequently made them feel erased or vulnerable. Isabel, a 41-year-old straight White, first generation immigrant cis-woman, described a “visceral reaction towards all different kind of judgments,” such as “when people judge people for not leaving their relationship.” As a survivor, her experience was that her coworkers were “passing judgment about not only that person, but about all of us that went through that experience.” Although Isabel’s coworkers were not passing judgment on her directly, their comments about clients had the effect of making her and potentially other survivor-advocates in their organization feel less belonging through a negative “visceral reaction” that detracted from her well-being.

Participants also noticed, in some colleagues, an underlying belief that survivors in need of support do not have the emotional capacity to support other trauma survivors. This often came up when hiring new advocates; Isabel described a policy of not hiring survivors “unless they’ve been out of the relationship for six months,” which she felt contributed to a culture of “them and us, them-victims and us-helpers.” For Isabelle, this implied that survivors and advocates are mutually exclusive groups, which she experienced as stigmatizing and exclusionary. Cassie described the way she herself had come to internalize this belief when she explained her struggle with whether “the fact that I am having these emotions make me not qualified to do this work or make it so I’m not gonna be as good at doing this work?” Whether by making them feel less included in their organization’s community, or by making them question their own value as advocates, participants experienced this notion of survivors being unfit to be advocates as particularly stigmatizing and detrimental to their well-being.

Experiences of feeling judged were compounded by additional identity-based oppression. Claudia, a 38-year-old queer Latina cis-woman, emphasized that judgments were often fueled by “White supremacy” and “misogyny,” and that her trauma reactions being labeled as anger were also a reaction to “when people of color get loud.” Thus, participants with multiple oppressed identities faced more numerous and complex challenges to feeling a sense of belonging.

Representing survivors within the organization

Although sharing values was often a necessary foundation for a sense of belonging, it was not always sufficient. Many participants identified a much clearer and unequivocal indicator that survivors belonged there: knowing there were other survivors working alongside them, which fostered even greater belonging. In some organizations, this manifested through the unspoken assumption that other staff have a trauma history, as Sarah described:

Not everyone on the team has outed themselves, at least not to me. That being said, I also just assume you’ve had at least some sort of experience by this point, just by the fact that you’ve been alive this long in a world in which people don’t always treat people so great. I think in general we’re all so supportive, regardless if you’re outed as a survivor or not.

Sarah’s assumption that she was not the only survivor on her team helped her feel more connected and cared for as a survivor herself. Other organizations more explicitly celebrated survivors as staff, which was associated with an even stronger sense of belonging. As Christine, a 53-year-old straight White woman, stated that there is a “camaraderie around sister survivors supporting each other in the work.” Luis described his workplace, which strongly encourages survivors to serve as advocates, as follows:

I can’t say this without a smile on my face. It’s like a place in which different communities can build one community. And I feel like that’s what we need. We need to build a community of survivors to understand that survivorship is an identity that has its own needs, and needs its own space. It’s just exciting to know that I’m going to come to work every day and have those conversations and learn more and have new experiences.

Across organizations, participants asserted that working alongside other survivors and having their own survivorship recognized helped them feel more engaged and supported at work.

Honoring Survivors’ Strengths

The third contextual factor that participants described as crucial to feeling validated by their organizations was the extent to which the organization honors survivor strengths. When organizations recognized and valued survivors’ strengths, participants felt that this sent the message that they were skilled, competent, and had something to offer to the work by virtue of their survivorship. This, in turn, increased their self-esteem, empowerment, and work engagement. Two ways that this was substantiated are described in the next subsection.

Valuing survivors’ expertise

Many participants described how meaningful it was when their organization elicited and valued the firsthand knowledge of trauma and recovery that survivors possess. Indeed, all participants believed that their survivorship enhanced their work in one way or another—as Jessie stated, “to do this work best, you have to have some sort of intimate knowledge of what it means to be a survivor.” Tasha, a 53-year-old Asian woman working in a community DV organization, said that she values having “a supervisor who is supportive of my out-of-the-box solutions,” which she attributes to the expertise she gained from her own recovery. Claudia described the validation and empowerment that come from her expertise being respected:

I think there’s attempts at shared power, folks really try as best they can to respect your knowledge you brought into this. There’s very much a respect for all kinds of knowledge, which I really love, as someone who doesn’t have a degree but has a lot of experience. It’s not condescending, they truly do take me as an expert in my own experience.

Notably, Claudia works in a survivor-led organization, where attention to survivor expertise is a priority. Luis also described his organization as “honoring the power that we have as survivors,” such as through meetings where “everyone’s voice is equally important.” Margaret, a 53-year-old straight White cis-woman, expressed her wish for what this might look like in her organization, which did not actively or explicitly value survivor strengths:

To know that that’s valued and acknowledged, that “You’re a survivor and we really value your input and your thoughts, because that’s a unique perspective.” Or if they said, “We’d also want your input when we’re writing up something that you’ve been through, if you’d like to share.” So just acknowledging that it has value, that it can be important.

The hypothetical examples Margaret provided illustrate her belief that if her own expertise were respected by her organization, she would feel more valued. Indeed, organizations characterized by strict hierarchy or stigmatizing beliefs about survivors, described above as detracting from a participants’ sense of belonging, also detracted from feeling that their strengths were honored.

Supporting the potential of disclosure

Participants felt that they could sometimes use careful disclosure of their survivor status or experience as a way to connect with clients or to otherwise use their experience in their work. In some agencies, participants who disclosed their survivorship to their supervisors were able to engage their supervisors in discussions about when and how to utilize their experiences to enhance the work. These supervisors recognized the strengths that can come with survivorship and supported their supervisees in utilizing them, which in turn helped survivor-advocates feel validated in their experience, supported by coworkers, and able to do quality work:

She was very validating. . . . I had so much anxiety; does the fact that I am having these emotions make me not qualified to do this work or make it so I’m not gonna be as good at doing this work? And she kind of helped me understand that it was something that I could use, it was this tool in my toolbox . . . being able to use it as something that helps you do better in the way that you’re showing up for people rather than creating this hindering or this limitation, which was my fear of what would it mean earlier on. (Cassie)

However, participants who worked in organizations that did not openly discuss survivorship imagined that this kind of supervision could be helpful, and they felt frustrated by its absence. Margaret explained:

When I’m introducing myself and talking about how long I’ve been with the agency and my skills, there’s part of me that would like to say, “And I am a survivor.” But I feel like that’s frowned upon. I would say it much more often if people said to me, “Yes, you should do that.”

Indeed, Margaret and others experienced their organizations as discouraging staff from openly discussing survivorship, as doing so was considered “taboo” or “frowned upon.” Margaret stated that it was

still very taboo for survivors to talk about being survivors, even in our workplace, even though it’s what we do . . . even though our job is to break the silence, there’s still a lot of forced silence in this field.

Participants experienced this silencing as delegitimizing the value of their survivorship. Beth, a 55-year-old White queer woman, who works in a larger institution, stated that “the instant you say [you’re a survivor], you lose a ton of power, even if you say it in your professional voice.” Specifically, Beth stated that disclosure can lead to being placed at “the bottom of the hierarchy” and that “any expertise, any credentials you have” lose their value in the eyes of coworkers. Thus, feeling free to share their survivorship contributed to participants’ sense of workplace well-being, while limitations on that freedom felt stifling or even threatening.

Discussion

The grounded theory presented above describes how workplace relationships and organizational culture contribute to survivor-advocates’ workplace well-being. The study generated a theory that highlights three focal points of organizational support for survivor-advocates, each of which could be instantiated on interpersonal and organizational levels (see Figure 1). Specifically, survivor-advocates’ well-being is dependent upon (a) the extent to which the organization acknowledges their mental health and survivorship needs, (b) fosters a sense of belonging, and (c) honors their experiences and strengths. Each of these factors contributes to workplace well-being directly. They also contribute indirectly through their influence on advocates’ experience of validation as survivors—a factor which itself contributes to workplace well-being. In other words, the more public and open the acknowledgment of the needs of survivor-advocates as survivors, the greater the sense of validation and corresponding sense of well-being. The next subsection discusses these findings in light of existing research and highlights their resonance with a trauma-informed approach to DV work.

A Trauma-Informed Approach to Organizational Support for Survivor-Advocates

Research on organizational support for the general population of DV advocates has identified key ingredients for improving workplace well-being, including encouraging self-care and attending to vicarious trauma or secondary traumatic stress (Cohen & Collens, 2013), as well as taking steps to ensure equitable distribution of work and allowing advocates to have time away from work to enhance coping (Benuto et al., 2019; Wachter et al., 2020). A few studies have pointed toward more specific forms of support that may be particularly helpful for survivor-advocates, including shared power (Slattery & Goodman, 2009), shared values (Kulkarni et al., 2013), and social support (Frey et al., 2017). However, research on survivor-advocates and their experience of organizational support remains scarce. This study helps fill that gap by shedding light on how particular forms of organizational support are helpful for survivor-advocates. Many of the themes that emerged from the study suggest that survivor-advocates benefit from an organizational approach that is trauma-informed not only with respect to survivors seeking services but also with respect to advocates, many of whom are also survivors.

Prior research has established the importance of generally educating staff about trauma, encouraging and supporting self-care, and normalizing vicarious trauma/secondary traumatic stress (Benuto et al., 2019; Cohen & Collens, 2013). The most prominent category that emerged from this study, acknowledging survivors’ unique needs, extends these principles to survivor-advocates by demonstrating the importance of organizational acknowledgment of advocates’ personal—not just vicarious—trauma. Interviewees repeatedly stressed how important it was for their coworkers to name and respond to the emotional challenges this work presented to them as survivors, especially feeling triggered. One mechanism that many of them mentioned was access to designated time and space for staff to discuss and process their personal trauma and its impact on their work. Offering such spaces, they felt, not only made explicit the deleterious effects of trauma work but also simultaneously recognized and legitimized the survivorship of staff. Explicitly naming and addressing the unique needs of advocates who are survivors thus represents a critical principle to uphold in a trauma-informed organization.

Similarly, the category of fostering a sense of belonging adds nuance to the literature on the importance of social support to workplace well-being. Participants named a sense of belonging—feeling accepted by and connected to coworkers—as critical. Previous findings that sharing the values of one’s organization promotes workplace well-being (Kulkarni et al., 2013; Merchant & Whiting, 2015) may be due to the sense of belonging that follows. In fact, this study identified specific values, especially regarding social justice and trauma-informed care, that were particularly important for survivor-advocates. Participants felt that coworkers who shared these values would be more accepting of them as survivors, increasing their sense of belonging. Thus, articulating and embodying a commitment to trauma-informed care may in itself help survivors within the organization feel more supported.

Finally, honoring survivor strengths was a prominent theme that complements and extends prior findings on the importance of shared power in workplace well-being. Previous research using quantitative measures has demonstrated the importance to advocates’ well-being of freedom to do their work in ways that worked best for them (Kulkarni et al., 2013). Consistent with this idea, participants in this study described how important it was for their organization to recognize the unique strengths they brought to DV work as survivors, such as using their survivor story to inform their work or using judicious self-disclosure to enhance client and advocate well-being (Wood, 2017). Furthermore, participants reported that feeling stifled or discouraged from using their unique strengths was detrimental to their well-being. Thus, this study helps make the case that survivor-advocates will feel most empowered in organizations that support them in using their survivorship as part of their advocate toolkit.

Finally, this study extends prior research by describing how organizational support can be at its most effective for survivor-advocates when it is enacted in a way that validates the survivor identity. Across each of the three categories of organizational support, the more explicit survivorship was named as a legitimate and valued part of what the advocate brought to the work, the more validated participants felt, leading to an even stronger sense of well-being. This draws further attention not just to what organizations can do to support workplace well-being, but also how they do it; survivor-advocates may benefit most when organizations offer support in a manner that openly validates and celebrates their survivor identity. These findings echo the principles of a trauma-informed approach in their focus on supporting coping, creating healing relationships, and highlighting strengths (Elliott et al., 2005). DV programs have taken great strides toward a trauma-informed approach, but within and beyond the field, trauma-informed care has focused on the needs of service seekers, with relatively less attention given to service providers—with a few notable exceptions, such as the Sanctuary Model (Bloom & Farragher, 2013; Mihelicova et al., 2019). This study makes a case for widening the scope of trauma-informed care to include all those involved in DV work. The next subsection suggests concrete ways for organizations to implement these findings.

Implications for Practice

More than half of advocates working in DV programs are themselves survivors of DV or some other type of interpersonal trauma (Hensel et al., 2015; Slattery & Goodman, 2009). Yet, as this study indicates, advocates often keep their survivorship hidden from colleagues and clients because they perceive that disclosing it would diminish their credibility or power in the organization. As a result, many survivor-advocates are unable to access the kind of support that would enable them to cope with vicarious trauma or develop vicarious resilience. As described next, this study begins to paint a picture of alternative practices that could contribute enormously to survivor-advocates’ well-being.

First and foremost, as participants made clear, DV organizations should foster an awareness and appreciation of the unique needs and strengths of survivor-advocates. This can be enacted on several levels in the organization. At the level of coworker relationships, organizations should develop systematic opportunities explicitly devoted to discussion of survivorship and how advocates’ own trauma histories might affect their work, such as through regular peer support groups or through retreats focused on workplace stress (Benuto et al., 2019; Bloom & Farragher, 2013). Such spaces could foster a sense of community and enable survivor-advocates to share knowledge and resources based on their own recovery stories. On the level of supervision, supervisors should make sure that survivor-advocates feel invited to share their survivorship when they choose to, such as by asking advocates about their motivation to enter the field, explicitly inviting them to discuss their trauma history, or even disclosing their own survivorship at appropriate times, if comfortable. Such discussions could help supervisors be more sensitive and proactive in supporting survivor-advocates, as described by participants.

At a broader level, organizations should determine whether they enact implicit or explicit policies or practices that stigmatize advocates’ survivorship, and then make efforts to transform them. For example, when evaluating new hires, organizations could take special care to handle advocates’ survivorship as a potential strength, provided adequate supports are in place, rather than an obvious sign of being “unready.” At the same time, programs need to redouble their efforts to encourage self-care and to create structures that allow it. Several participants, for instance, discussed flexible policies around taking “mental health days,” which is critical to note given a recent study that found this form of organizational support to be relatively rare compared with trainings, conferences, and counseling (Benuto et al., 2019). Organizations should consider how their policies around sick time can be shifted in this direction to the extent possible.

Relatedly, organizations might foster a greater sense of belonging for survivors by embracing and articulating values related to social justice and survivor-defined practice. These values and the practices that follow from them are not new; the introduction to this article discussed social justice and social service approaches to the work have together shaped the history of the movement (Arnold & Ake, 2013). However, the participants in this study clearly expressed appreciation and belonging when their organizations made commitments to fighting oppression, nonhierarchical structure, valuing lived experience, and other elements typically associated with social justice. To the extent possible, organizations should ensure that these values are reflected in their mission statement and practices.

Finally, the field as a whole should continue to develop advocate roles designed specifically for survivors. Several participants, especially those who worked in organizations that were more discouraging of disclosure, expressed a wish for greater flexibility in using their experiences to help others, reinforcing emerging research that documents survivor-advocates’ desire to integrate their personal experiences into their work and the benefits this might yield (Wood, 2017). Arnold and Ake (2013) review innovative survivor-specific roles that have been adopted by survivor-led organizations in recent years, including peer-to-peer outreach, leadership development, and community organizing models. These typically involve training survivors to engage other survivors within their community, with goals of raising awareness, preventing violence, or increasing activism (e.g., the promotora model; Serrata et al., 2016). Agencies could also begin to offer more opportunities to survivors who have received services to work in advocate roles, such as co-leading support groups or helping with intake and outreach.

Implications for Research

This study adds to a small but growing body of research illuminating the unique experience of being both an advocate and a survivor, and adds to a chorus of voices documenting the value of specific forms of organizational support for this group, as well as for advocates generally (Benuto et al., 2019; Cohen & Collens, 2013; Kulkarni et al., 2013; Wachter et al., 2020). Research focused on developing and testing specific models of support provision (e.g., the Sanctuary Model; Bloom & Farragher, 2013) is sorely needed.

But this study’s findings make clear that support for survivor-advocates cannot follow a one-size-fits-all template. Larger quantitative designs are needed to more systematically identify the needs of specific subgroups in a range of settings. Although this study’s use of theoretical sampling allowed some inferences about how the type of organization influenced participants’ experiences, there are other relevant dimensions that were beyond the scope of this project. For example, participants possessed a variety of different kinds of trauma history, including IPV, childhood sexual assault, and dating violence, as well as combinations of trauma types. Participants with different trauma histories and at different points in their recovery may have different experiences of organizational support. The same can be said with regard to race, gender, and other demographic variables. Research focusing on survivor-advocates in other fields (e.g., sexual assault, cancer survivors) would further sharpen and refine our understanding of being a survivor-advocate. The demographic homogeneity or diversity of the organization as a whole may be a critical influence on the extent to which survivor-advocates in that organization feel supported. Furthermore, this study did not include shelter advocates in its sample. A multiple case study design that compares types of organizations with varied staff demographic breakdowns could begin to shed light on what supports for what subgroups contribute most effectively to survivor-advocate well-being.

Limitations

The primary limitations of this study arose in the areas of recruitment and data analysis. Starting with recruitment, none of the participants worked primarily in a shelter or other residential settings. Thus, although this sample represents a wide range of community-based DV advocate roles and settings, it does not represent shelter advocates, who experience more frequent and intense contact with survivors in crisis (Macy et al., 2009). It is quite likely the case that participants who felt less strained by their work were more likely to volunteer to participate in this study, thus limiting perspectives on the organizational support needs of perhaps the most emotionally taxed survivor-advocates. Nonetheless, given the relative dearth of research on advocates who do not work in residential settings, these findings fill an important gap.

In addition, although a few participants had leadership or supervisory roles in this study, a more nuanced view of the tension between the needs of survivor-advocates and the ability of their organization to meet those needs would require a more directed effort to collect and triangulate data from people at all levels of the organization. Finally, turning to data analysis, although this sample was quite diverse, the analysis presented here focuses primarily on the survivor identity, rather than on other aspects of advocates’ intersecting identities. Future studies should examine how social location shapes survivor-advocates’ perceptions of organizational support.

Conclusion

Survivors helping other survivors was a hallmark of the early stages of the DV movement, and although advocates’ personal experiences of violence have more recently faded into the background, survivor-advocates continue to do a large portion of this vital work. As the DV field continues to incorporate trauma-informed and social justice approaches, new questions will arise about how survivor-advocates in diverse roles and settings experience their work, and how organizations can best support them. This study begins to answer some of those questions by illuminating the central role of validating and celebrating advocates’ survivor identity.

Footnotes

Acknowledgements

The authors extend their utmost gratitude to the many domestic violence and sexual assault agencies who helped them recruit participants for this study, and to the survivor-advocates who gave them their time and authenticity. The authors thank them for making this research possible and for all the work that they do to support survivors.

Declaration of Conflicting Interests

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

Funding

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

ORCID iD

Joshua M. Wilson

Author Biographies

Joshua M. Wilson is a staff psychologist at the Victims of Violence program at Cambridge Health Alliance. He completed his PhD at Boston College studying trauma-informed care in domestic violence programs. He completed his doctoral internship at Massachusetts Mental Health Center and postdoctoral fellowship at the Victims of Violence program. His clinical and research interests include trauma-informed care, resilience and post-traumatic growth, community-based approaches to mental health, and the intergenerational transmission of trauma.

Lisa A. Goodman is a clinical-community psychologist and professor of counseling psychology at Boston College. She uses a community-based participatory research approach to explore the unintended harms of systems designed to support intimate violence survivors, and how survivors use their social networks for healing and safety. Her research highlights the strengths and needs of marginalized survivors, including those from homeless; Black, Indigenous, and People of Color (BIPOC); and queer communities. She consults to multiple domestic violence organizations and is co-coordinator of the Domestic Violence Program Evaluation and Research Collaborative. She has received national awards for teaching and mentoring excellence, including the Elizabeth Hurlock Beckman Award.

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