Improving mental health therapy for people who have experienced intimate partner violence and housing instability: Advice from survivors

It is well documented that intimate partner violence and housing instability can profoundly impair survivors’ mental health, help-seeking efforts, and coping strategies. Few studies, however, focus on this population’s experiences in mental health therapy, and even fewer explore their thoughts on what therapists and survivors can do to facilitate a sustained, beneficial therapy experience. Informed by feminist therapy theory, this descriptive qualitative study addressed this gap by conducting phone interviews with intimate partner violence survivors who had a federal housing voucher (n = 21) recruited from a social work agency in a Mid-Atlantic U.S. city and a focus group with therapists employed by the agency (n = 3). We analyzed data using qualitative content analysis, involving a two-cycle coding process and constant comparison. Most of the participants were engaged in therapy at the time of the interview, and almost all had been in therapy previously. Participants’ advice for survivors coalesced into three main themes (i.e., “give it a try,” you need therapy to heal and move forward, and therapy is hard but worth it), as did their advice for therapists (i.e., “domestic violence is a deep subject” that requires specialized education, “follow the survivor,” and “have a holistic approach”). Findings suggest that supporting the mental health of survivors who have experienced housing instability requires increased access to low-cost, long-term therapy; use of survivor-defined, trauma-informed approaches; specialized training for therapists; and creative avenues to encourage survivor engagement in therapy. Social workers are uniquely positioned to advance these goals, given their person-in-environment approach and social justice orientation.