Running head: IPV: PREVENTION THROUGH EDUCATION Intimate Partner Violence: Prevention through Education Ernesto Guerrero ll California State University San Marcos Committee: Luis Terrazas, Ph.D., Chair Jacky Thomas, Ph.D. 1 IPV: PREVENTION THROUGH EDUCATION 2 Abstract Intimate Partner Violence (IPV) is one of the most serious problems on college and university campuses throughout the United States. Intimate Partner Violence is defined as physical, emotional, psychological, or sexual harm caused by a current or former partner or spouse but it is also used to describe dating violence. According to the U.S. Department of Justice, women who are at the greatest risk of becoming victims of IPV are between the ages of 18-24 years. Nineteen percent of college women have reported experiencing completed or attempted sexual assault since their freshman year of college, with the majority of those assaults coming from someone the victim knew. Various mental health issues are associated with intimate partner violence including, but not limited to: depression, posttraumatic stress disorder, low self-esteem, and substance use. Being the victim of intimate partner violence can also have severe consequences directly related to physical injury. The purpose of this capstone project was to explore the issues of IPV, and to write a grant proposal to fund an expert speaker on intimate partner violence to speak at California State University San Marcos via a partnership with the CSUSM Office of Arts and Lectures. Educating and raising awareness on intimate partner violence is a crucial step in the elimination and prevention of domestic violence. Keywords: Intimate partner violence, sexual assault, dating violence, domestic violence, depression, posttraumatic stress disorder, physical injury, education, prevention, victim, perpetrator IPV: PREVENTION THROUGH EDUCATION 3 Acknowledgments First and foremost, I would like to thank my mother, father, sisters, and girlfriend for supporting me and my decisions these past two years in the Masters of Social Work program. These past four months in particular were extremely difficult and without their encouragement and support, I would not have been as successful. My parents have been supporting me and my education for as long as I can remember and have always encouraged me to follow my dreams and for that I will always be grateful. I will also forever be grateful to my sisters for always supporting me and always allowing me to vent on my journey throughout the Master’s program. I would also like to thank my wonderful girlfriend because without her love and support, this journey would not have been possible. This program was a big part of my life the past two years and you being able to understand that and still support me 100% are something that I will never forget. I would also like to thank my peers and soon-to-be colleagues. We are the first cohort at California State University San Marcos to go through the social work program and I have learned so much from each and every one of you. I am grateful to have you guys in my life and hope that we continue this friendship we started two years ago. Lastly, I would like to thank my Chair, Dr. Luis Terrazas, Ph.D., and committee member, Dr. Jacky Thomas, Ph.D., for their guidance and encouragement throughout this process. Your hard work and dedication to ensure my success in this capstone project were unbelievable and I could not have asked for a better committee. Thank you for an amazing experience and I cannot wait to become colleagues as well. IPV: PREVENTION THROUGH EDUCATION 4 Table of Contents Abstract ........................................................................................................................................... 2 Acknowledgments........................................................................................................................... 3 Chapter 1. Introduction ................................................................................................................................ 6 Purpose of Project ................................................................................................................ 6 Definition of Terms.............................................................................................................. 7 2. Literature Review..................................................................................................................... 10 Risk Factors for Intimate Partner Violence ....................................................................... 10 Prior abuse history and trauma .......................................................................................... 10 Mental health ..................................................................................................................... 12 Depression ......................................................................................................................... 12 Posttraumatic stress disorder ............................................................................................. 13 Low self-esteem ................................................................................................................. 15 Substance use ..................................................................................................................... 16 Effects and Consequences ................................................................................................. 18 Physical injury ................................................................................................................... 18 Reproductive issues ........................................................................................................... 19 Prevention and Education .................................................................................................. 20 Conclusion ......................................................................................................................... 22 3. Methods.................................................................................................................................... 23 Project Selection ................................................................................................................ 23 Speaker Selection .............................................................................................................. 23 Submission Process ........................................................................................................... 24 Target Population .............................................................................................................. 24 Venue Selection ................................................................................................................. 25 Data Collection .................................................................................................................. 25 4. Grant Proposal ......................................................................................................................... 26 Executive Summary........................................................................................................... 26 Relationship to Funder’s Mission ...................................................................................... 26 Efforts Toward Policy ....................................................................................................... 27 Goals and Objectives ......................................................................................................... 29 IPV: PREVENTION THROUGH EDUCATION 5 Budget ................................................................................................................................ 30 Project Relevance .............................................................................................................. 30 5. Discussion ................................................................................................................................ 32 Limitations of Research ..................................................................................................... 32 Strengths of Research ........................................................................................................ 33 Further Research ................................................................................................................ 34 Social Work Relevance ..................................................................................................... 34 References ................................................................................................................................ 36 IPV: PREVENTION THROUGH EDUCATION 6 Intimate Partner Violence: Prevention through Education Chapter 1 Intimate partner violence is a serious public health problem that affects millions of people in America (Centers for Disease Control and Prevention (CDC), 2014). Research suggests there are certain risk factors people have that make them vulnerable and more likely to become victims of intimate partner violence (Wong & Mellor, 2013). Risk factors may be strong predictors of domestic violence; however, they may not necessarily be direct causes of intimate partner violence (Centers for Disease Control and Prevention (CDC), 2015-a). This means that some people can have some of the risk factors such as prior trauma, history of abuse, and mental health issues, and yet may not become victims of additional abuse. Perhaps the most important component related to this capstone project is the education and prevention section. According to Pomeroy et al. (2011), educating and raising awareness on intimate partner violence is a crucial step in the elimination and prevention of domestic violence. The following sections of the capstone project will explore the problem of intimate partner violence and give a better understanding of risk factors, consequences of intimate partner violence, and prevention and education strategies that can best eliminate this form of abuse. Purpose of Project The purpose of this project was to write a grant proposal to fund an expert speaker on intimate partner violence to speak at California State University San Marcos via a partnership with the CSUSM Office of Arts and Lectures department. The expert speaker would come to campus to raise awareness and educate students on several different components related to domestic and sexual assault. As the following chapters of this capstone project will explain in further detail, research shows that by raising awareness and educating college students through IPV: PREVENTION THROUGH EDUCATION 7 trainings and community outreach, students get a better understanding of what intimate partner violence is, how to prevent it, what signs to look for, and what options victims and perpetrators have to live better lives. The proposed speaker, Alyce LaViolette, LMFT, is considered an expert in the field of domestic violence, intimate partner violence, and sexual assault. It is anticipated that her presentation would be highly informative about these forms of violence and very motivating. It would also be very helpful for students who may be struggling with these types of abuse. Definition of Terms Intimate Partner Violence: The term Intimate Partner Violence involves physical, emotional, psychological, or sexual harm caused by a current or former partner or spouse (CDC, 2014). Domestic Violence: This can be defined as a pattern of abusive behaviors in any relationship that is used by one partner to gain or maintain power and control over another partner. Domestic violence can be categorized in many forms such as physical, sexual, emotional, economic, or psychological actions or threats of actions that influence another person. This includes behaviors such as intimidation, manipulation, humiliation, isolation, frightening, terrorizing, coercing, threatening, blaming, hurting, injuring, or wounding someone (U.S. Department of Justice, 2015). Teen Dating Violence: “The physical, sexual, psychological, or emotional violence within a dating relationship, including stalking.” It often occurs in person but can also be done electronically and might occur between a current or former dating partner (CDC, 2014, para. 1). IPV: PREVENTION THROUGH EDUCATION Sexual Assault: Sexual assault is any type of sexual contact or behavior that occurs without the explicit consent of the recipient. Some of the more common forms of sexual assault are activities such as forced sexual intercourse, forcible sodomy, child molestation, incest, fondling, and attempted rape (U.S. Department of Justice, 2015). Psychological/emotional violence: “This type of abuse involves trauma to the victim caused by acts, threats of acts, or coercive tactics. Psychological/emotional abuse can include, but is not limited to, humiliating the victim, controlling what the victim can and cannot do, withholding information from the victim, deliberately doing something to make the victim feel diminished or embarrassed, isolating the victim from friends and family, and denying the victim access to money or other basic resources. It is considered psychological/emotional violence when there has been prior physical or sexual violence or prior threat of physical or sexual violence” (Help Guide, 2015, p. 1). Intimidation: Intimidation tactics are designed to scare the victim into submission. Such tactics include making threatening looks or gestures, smashing things in front of the victim, destroying property, hurting pets, or putting weapons on display. The clear message is that if you do not obey, there will be violent consequences (Help Guide, 2015). Victim: This is a person who has been attacked, injured, robbed, or killed by someone else (Merriam-Webster’s, 2015). Perpetrator: Someone planning to produce, perform, or execute something likened to a crime (Merriam-Webster’s, 2015). 8 IPV: PREVENTION THROUGH EDUCATION 9 Posttraumatic Stress Disorder: “Posttraumatic Stress Disorder (PTSD) can occur after you have been through a traumatic event. A traumatic event is something terrible and scary that you see, hear about, or that happens to you,” such as: combat exposure, a sexual or physical assault, or a serious accident, among others (U.S. Department of Veterans Affairs, 2015, para. 3). Major Depressive Disorder: Severe symptoms of sadness that interfere with your ability to work, sleep, study, eat, and enjoy life. It is a problem when it affects your daily functioning. An episode, which lasts at least two weeks, can occur only once in a person’s lifetime, but more often, a person has several episodes (National Institute of Mental Health, 2015). Comorbid Condition: “When two disorders or illnesses occur in the same person, simultaneously or sequentially, they are described as comorbid. Comorbidity also implies interactions between the illnesses that affect the course and prognosis of both” (National Institute of Drug Abuse, 2015, para. 1). IPV: PREVENTION THROUGH EDUCATION 10 Chapter 2 Literature Review Intimate Partner Violence (IPV) is one of the biggest and most serious problems on college and university campuses throughout the United States (U.S. Department of Justice, 2014). The term Intimate Partner Violence involves physical, emotional, psychological, or sexual harm caused by a current or former partner or spouse (Centers for Disease Control and Prevention (CDC), 2015-b), but is also used to describe dating violence. According to the U.S. Department of Justice (2014), women who are at the greatest risk of becoming victims of IPV are between the ages of 18-24 years. For example, approximately 70% of all college students have reported that at some point in their life, they have been sexually coerced, meaning they were pressured or forced into having sex (Love is Respect, 2015). Nineteen percent of college women have also reported experiencing completed or attempted sexual assault since their freshman year of college, with the majority of those assaults coming from someone the victim knew (U.S. Department of Justice, 2014). The majority of these cases involve the female being the victim and male being the perpetrator; however, research also shows that men have also been victims of IPV where the female is the perpetrator (CDC, 2015-a). Risk Factors for Intimate Partner Violence Prior abuse history and trauma. Much of the current research has begun to explore the relationship between previous histories of sexual and physical abuse in childhood and experiencing intimate partner violence as an adult (National Center on Domestic Violence, 2011). According to the National Center on Domestic Violence (2011), it appears that women who have witnessed their mothers being abused are at a higher risk for being victims themselves of domestic violence compared to those who did not witness the same abuse. Similarly, the U.S. IPV: PREVENTION THROUGH EDUCATION 11 Department of Health and Human Services (2003) found that there is a co-occurrence between domestic violence and child maltreatment. It was also found that children who are exposed to domestic violence are at a greater risk for becoming victims themselves (U.S. Department of Health and Human Services, 2003). The National Institute of Justice (2011) also examined the relationship between child abuse and neglect and intimate partner violence. The findings stated that 45% of children who were in families involved in domestic violence experienced abuse throughout their lifetime (National Institute of Justice, 2011). Although longitudinal studies have not yet been done to determine the exact extent of risk that a child witnessing abuse becomes a perpetrator, Campbell and Lewandowski (1997) found it clear that the most consistent risk factor for men becoming abusive to their female partner was living in a household where they witnessed the trauma of their mother being abused by their father or mother’s partner. Similarly, the World Health Organization (WHO, 2006) reported that children who witnessed violence or threats of violence between parents were at greater risk for perpetrating violence in their relationships. The trauma of experiencing poor parenting as a child was also linked with perpetrating as an adult (CDC, 2015-b). The Centers for Disease Control and Prevention (2015-b) also found that in addition to experiencing poor parenting as a child, being physically disciplined was found to be related to perpetrating, although this was not always the case for each individual. However, not all research suggests that experiencing child abuse or witnessing domestic violence is a predictor to intimate partner violence. Edwards, Dixon, Gidycz, and Desai (2014) found that although experiencing childhood trauma may slightly increase the risk for IPV, violence coming from the family of origin does not clearly indicate an individual will perpetrate as an adult. Similarly, Whiting, Simmons, Havens, Smith, and Oka (2009) also found that much IPV: PREVENTION THROUGH EDUCATION 12 of the research that attempts to relate previous trauma in family violence and intimate partner violence as an adult is not consistent across the board. Although it is has been demonstrated that connections can be made between childhood abuse and being in a violent relationship as an adult, research does not make it clear enough to determine that these distinct processes actually lead to future violence (Whiting et al., 2009). Mental health. According to the U.S. Department of Justice (2014), some of the problems associated with consequences that follow IPV are, but are not limited to: depression, posttraumatic stress disorder, low self-esteem, and substance use. Similarly, Wong and Mellor (2013) found that in the one in four women who are likely to experience some form of intimate partner violence in their lifetime, a greater risk for developing posttraumatic stress disorder is a likely outcome. Depression. According to the World Health Organization (WHO, 2015-b), mental health issues are common among women who have suffered intimate partner violence. The strongest risk factor for identification of women who have been abused in one of the primary care settings was depressive symptoms (Campbell & Lewandowski, 1997). In a study regarding the mental health of IPV victims, the World Health Organization found that women who previously experienced physical or sexual abuse by a partner reported higher levels of depressive and emotional distress (WHO, 2015-b). Similarly, Devries et al. (2013) also found a relationship between depression and intimate partner violence. Their systematic review and meta-analysis of longitudinal studies examined physical and/or sexual intimate partner or dating violence among IPV victims with symptoms of depression, diagnosed major depressive disorder (MDD), dysthymia, mild depression, and suicide attempts (Devries et al., 2013). Through the research of 16 longitudinal studies previously conducted, Devries et al. found that women who suffered IPV: PREVENTION THROUGH EDUCATION 13 intimate partner violence were more likely to develop depression due to the violence. The second finding was that women who suffered from depression were at a higher risk for becoming victims of intimate partner violence compared to women who were not depressed (Devries et al., 2013). In regards to women, these findings were very important; however, the research was unable to conclude evidence for similar relationships among men with the same symptoms (Devries et al., 2013). This is not to say that men could not have similar results. Although the research was unable to determine the significance of the relationship between men and these symptoms, additional studies should be conducted to examine this issue further. Posttraumatic stress disorder. As previously mentioned, depressive symptoms among intimate partner violence victims are among the strongest risk factors found in research (Campbell & Lewandowski, 1997). However, posttraumatic stress disorder (PTSD) is also consistently found within the literature involving intimate partner violence (Nixon, Resick, & Nishith, 2004). The two most common comorbid mental health conditions related to intimate partner violence, PTSD and Major Depressive Disorder (MDD), are usually found to correlate with this form of abuse (Nixon et al., 2004). In regards to female victims of intimate partner violence, 50-75% of them suffer from PTSD and 54-68% of female victims are going through some type of major depressive disorder (Heru, 2007). Although both are found to be comorbid conditions within intimate partner violence, Nixon et al. stated that major depressive disorder was more severe among victims when PTSD was also present compared to when the victim only had MDD (Nixon et al., 2004). Research also found that one of the main reasons why posttraumatic stress disorder is so common in intimate partner violence is because victims are constantly living in fear of ongoing violence and experiencing physical assaults (Golding, 1999). IPV: PREVENTION THROUGH EDUCATION 14 Going through these extreme experiences has been shown to cause extreme stress and lead to posttraumatic stress disorder (Golding, 1999). It is worth noting that out of all the research found in this literature review, none of the information available could determine whether the mental health conditions and disorders were a result of intimate partner violence, or whether these conditions were present prior to the abuse. However, posttraumatic stress disorder is more likely to have been the result of intimate partner violence than other conditions (Heru, 2007). Something else worth noting is that those who experience or witness violence such as intimate partner violence or other forms of abuse are more likely to perpetrate violence as adults (Heru, 2007). This is found to be true for both males and females. Although the classic male perpetrator to female victim in intimate partner violence cases is most common, there are cases that involve the female being the perpetrator and the male being the victim (Heru, 2007). According to Williams, Ghandour, and Kub (2008), over seven percent of men report having been raped or physically assaulted at some point in their lifetime by a current or former partner. The U.S. Department of Veterans Affairs (2015) reports that intimate partner violence happens to everyone, regardless of gender, race, ethnicity, culture, or religion. In a study attempting to identify the most common feature of intimate partner violence related to PTSD, Pico-Alfonso (2005) found that the psychological component of intimate partner violence, rather than physical or sexual, was the strongest predictor of posttraumatic stress disorder. In this same study, it was not clear whether childhood abuse or violence was related to PTSD in women suffering from intimate partner violence (Pico-Alfonso, 2005). The latter was true for both the control group and experimental group. The U.S. Department of Veterans Affairs (2015) does not differentiate between the different components of Intimate IPV: PREVENTION THROUGH EDUCATION 15 Partner Violence but does conclude that women are more likely to develop PTSD when being victimized by their intimate partner. However, the study conducted by Pico-Alfonso had its limitations. It is unclear to the current writer of this literature review if the Pico-Alfonso study is generalizable to the overall population. Only 127 participants participated in the study and although they were all victims of intimate partner violence, they were women who were seeking help and wanted to get out of that relationship (Pico-Alfonso, 2005). According to the Domestic Violence Roundtable (DVR, 2015), most victims of domestic violence are unable to seek help because of fear of the perpetrator and also because they feel hopeless and responsible for the abuse (DVR, 2015). Perhaps the women in the study conducted by Pico-Alfonso were not the typical victims of intimate partner violence; therefore, the findings may not be generalizable to the entire intimate partner violence population. Low self-esteem. In addition to the previous mental health conditions, self-esteem also plays a role in intimate partner violence. Compared to children growing up in non-violent and non-abusive households, children who have experienced or witnessed abuse are at a higher risk for experiencing violence in their adult intimate relationships (Whiting et al., 2009). According to Whiting et al. (2009), “self-appraisals include perceptions and beliefs about one’s self and one’s relationships” (p. 640). Whiting et al. found that when children experience trauma due to physical or sexual abuse, they are more likely to have negative self-appraisals of themselves leading to low self-esteem. Similarly, the Centers for Disease Control and Prevention (2015-b) also found that low self-esteem is a common risk factor among adults who experience intimate partner violence. Although it can result from several different factors, research also shows that intimate partner violence can intensify low self-esteem and is a major concern for victims suffering from this form of abuse (Bradshaw, 2013). Similarly, the U.S. Department of Veterans IPV: PREVENTION THROUGH EDUCATION 16 Affairs (2015) also found that intimate partner violence and low self-esteem are related. Reach of Clay County (2015) also found that low self-esteem is one of the more common reasons why victims of intimate partner violence stay in the relationship. Whiting et al. (2009) found that adults who experienced both a history of childhood abuse and adult intimate partner violence reported significant damage to their self-esteem and a greater likelihood of mental and substance abuse disorders than were adults with no history of domestic violence. Specifically, adults who were experiencing intimate partner violence were also more likely to be more dependent on others, more enmeshed, and were insecure, which all result from having low self-esteem (Whiting et al., 2009). Substance use. Alcohol consumption is an extremely widespread issue among college and universities throughout the United States (National Institute on Health (NIH), 2015). College drinking not only affects the person drinking, but also affects the community within the university and families related to the drinker. Research shows that close to 2,000 college students between the ages of 18 and 24 years die each year from alcohol related deaths (NIH, 2015). Alcohol consumption plays a major role in domestic violence. Excessive alcohol use when intimate partner violence occurs is very common, with 45% of male perpetrators reporting having used alcohol and 20% usage being reported by women (Heru, 2007). The perpetrator in domestic violence cases is often under the influence of alcohol, which is sometimes the case for the victim as well (Heru, 2007). Also, victims of sexual abuse between the ages of 18 to 24 years old reported that alcohol played a role in their incidents (NIH, 2015). Across several studies, the identification of recent alcohol consumption by perpetrators has been routinely found (WHO, 2006). In a study designed to gather information from selfreport measures from college students, researchers found that alcohol problems are positively IPV: PREVENTION THROUGH EDUCATION 17 correlated with perpetration of hostile and sometimes violent behavior in the dating relationships of college students (Fossos, Neighbors, Kaysen, & Hove, 2008). Along with these findings, Fossos et al. (2008) concluded that the male perpetrators who reported intimate partner violence in their dating relationships also reported more of a problem with drinking alcohol compared to those who had not perpetrated violence. In the United States, 55% of intimate partner violence victims believed that their perpetrator had been drinking prior to their physical assault (WHO, 2006). This is not to say that the victims themselves did not have alcohol in their system at the time of the domestic assault. Research shows that victims oftentimes also have alcohol in their system but at much lower rates than those of the perpetrator (WHO, 2006). Drug use also plays a major role in domestic violence cases involving both the victim and perpetrator (El-Bassel, Gilbert, Wu, Go, & Hill, 2005). According to El-Bassel et al. (2005), over the past decade, intimate partner violence has emerged as a public health problem among women in drug treatment. According to the American Society of Addiction and Medicine (2015), substance abuse has been found to co-occur in 40-60% of intimate partner violence cases. Stuart, Temple, Follansbee, and Bucossi (2008) also found that drug use was a strong predictor for intimate partner violence among perpetrators. The main drugs that were reported in the Stuart et al. (2008) study as being related to intimate partner violence were marijuana, cocaine, and amphetamines, although others may also lead to IPV. The main goal of their study was to determine the role of drug use as it relates to intimate partner violence. Ultimately, Stuart el al. found that when the perpetrator and victim both used drugs, this was a stronger predictor for intimate partner violence. However, when only the victim used drugs, it did not lead to intimate partner violence (Stuart et al., 2008). It is important to note that although drugs and IPV: PREVENTION THROUGH EDUCATION 18 alcohol are predictors of intimate partner violence, drugs and alcohol can also be subsequent to intimate partner violence (American Society of Addiction and Medicine, 2015). Effects and Consequences Physical injury. As previously mentioned, intimate partner violence can happen to anyone (U.S. Department of Veterans Affairs, 2015). One in four women and one in 10 men have reported being in an abusive relationship (U.S. Department of Veterans Affairs, 2015). Being the victim of intimate partner violence can have severe consequences directly related to physical injury. According to the Centers for Disease Control and Prevention (2015-a), in 2010, 241 males and 1,095 females were murdered by an intimate partner. The American Psychological Association (2015) also found that 74% of all murder-suicides involved an intimate partner. When controlling for deaths in intimate partner violence, severe consequences are still found to be detrimental to the victim’s health, both long-term and immediate (Campbell et al., 2002). According to Campbell et al. (2002), the physical consequences of intimate partner violence still remain long after the abuse has ended. Some of the long-term consequences that victims are left with are chronic pain syndrome, chronic migraines and headaches, and cardiovascular diseases, just to name a few (CDC, 2015-a). This is a major issue because although the short-term, more obvious consequences are also detrimental to one’s health, the less obvious, more severe consequences often lead to long-term health issues (Campbell et al., 2002). Some of the more immediate consequences to intimate partner violence involve broken bones, black eyes, bruises, headaches, and knife wounds (CDC, 2015-a). Similarly, Campbell et al. (2002) found that the most common locations for injuries among battered women are the face, neck, upper torso, breast, or abdomen. IPV: PREVENTION THROUGH EDUCATION 19 Women who were victims of intimate partner violence had a 60% higher rate of experiencing headaches, back pain, vaginal infection, and digestive problems compared to women who never experienced this form of abuse (Campbell et al., 2002). These were the most common physical consequences women who were victims of domestic violence reported (Campbell et al., 2002). Reproductive issues. The Centers for Disease Control and Prevention (2015-a), found that women who experience intimate partner violence also experience reproductive issues related to the physical consequences. Some of the reproductive issues that women experience are, but are not limited to: gynecological disorders, sexual dysfunction, delayed prenatal care, pregnancy difficulties, and unplanned pregnancies (CDC, 2015-a). Similarly, Campbell et al. (2002) found that “among the women who experienced sexual abuse with or without physical abuse, 30 percent reported three or more GYN health problems compared with only eight percent of those who experienced physical abuse alone” (p. 360). Being pregnant while being the victim of intimate partner violence can be very dangerous. In addition to the risk factors previously mentioned, women who are pregnant while also victims of domestic violence are three times more likely to be killed by their partner than women who are not pregnant (Salihu, 2004). Furthermore, women who are not married are also three times more likely to be killed while pregnant compared to pregnant mothers who are married and suffering from domestic violence (Salihu, 2004). During the pregnancy, mothers who are victims of domestic abuse also have more problems during this time period. Some of the problems that are common for victims of abuse are low weight gain during pregnancy, kidney infections, and operative deliveries (Salihu, 2004). IPV: PREVENTION THROUGH EDUCATION 20 The devastation of intimate partner violence on soon-to-be mothers is also devastating because not only does the mother suffer the consequences of being the victim of physical assault, but her unborn child may also be directly affected by the abuse. According to Salihu (2004), fetal morbidities are all too common in mothers suffering from intimate partner violence. Babies who were in the womb while their mothers were victims of domestic violence are more likely to be born prematurely and also have birth defects (Salihu, 2004). These birth defects can range anywhere from low birth weight to small size for gestational age, and can also range in severity (Salihu, 2004). Similarly, the Centers for Disease Control and Prevention (2015-a) also found that children born into this type of violence often had low birth weight. Increased fetal deaths during pregnancy are also the result of domestic violence (Salihu, 2004). Babies are also affected in other ways. Intimate partner violence also affects breast-feeding postpartum (Sarkar, 2008). Prevention and Education Prevention and education on intimate partner violence is crucial in taking action against abuse. According to Refuge, Education, Advocacy, and Change (REACH, 2015), “preventing violence is ending violence” (p. 1). These are very strong words and it is believed that community education and leadership are building blocks to preventing dating and domestic violence (REACH, 2015). REACH is an organization that is committed to advancing the safety, healing, and empowerment of those who experience domestic and relationship violence through direct services and education while promoting social justice for individuals and families of all backgrounds (REACH, 2015). Community outreach and education are considered very important when raising awareness in this field because it gives individuals information, skills, and resources on dating and domestic violence (REACH, 2015). REACH also discusses the IPV: PREVENTION THROUGH EDUCATION 21 importance of explaining the dynamics of dating and domestic violence, completing screenings and referral strategies, and bystander intervention techniques that are helpful. This is important because many people know someone or have come across someone who has experienced intimate partner violence. With the techniques and education that REACH suggests, individuals would be better equipped to handle intimate partner violence experiences if they ever come across them again. REACH also talks about how Peers Against ViolencE (PAVE) is a program within their organization that is youth focused and very effective. PAVE engages youth and adults who support youth to learn about dating violence and healthy relationships and become active leaders in dating violence prevention (REACH, 2015). This is also effective when educating others because peers tend to listen more when their peers are the ones raising awareness. The PAVE education program “provides multi-session dating violence prevention education in schools and community settings while PAVE leadership development and PAVE summit programs build youth leadership skills” (REACH, 2015, p. 1). Research suggests that by raising awareness and educating college students on intimate partner violence, participants leave most educational trainings with greater knowledge and healthier attitudes towards this form of abuse (Pomeroy et al., 2004). Ismail, Berman, and WardGriffin (2007) also found that when conducting dialogic interviews with women, discussing their own violent relationships led to an opportunity to think critically about them (Ismail et al., 2007). The women came to a new understanding of their own intimate partner violence experience and had a greater awareness that they were not to blame for the violence happening in their relationships (Ismail et al., 2007). Although research has suggested that raising awareness and educating individuals on domestic violence can be beneficial to participants, Noughani and Mohtashami (2011) found that IPV: PREVENTION THROUGH EDUCATION 22 when determining the effect of teaching how to prevent domestic violence against females, raising awareness and education had no effect on domestic violence. This means that for some individuals, being educated on intimate partner violence had no effect on prevention. Similarly, Antle, Sullivan, Dryden, Karam, and Barbee (2011) also found that intensive education programs were not as effective as other methods of training and prevention of intimate partner violence. However, Antle et al. (2011) ultimately concluded in their study that a brief intervention training involving a pre- and post-test rather than educational programs, received results that indicated high levels of training satisfaction compared to the intensive education programs offered to students. Conclusion Overall, intimate partner violence is seen as a huge public health problem (WHO, 2015a). Not only is this an issue nationally, but students at California State University San Marcos are in need of this education so that they can better understand this issue. Over the past year, several sexual assaults have occurred on campus with the latest happening in March 2015 (CSUSM, 2015). Students need to know what the risk factors are and how to prevent this not only from happening on campus, but in their own lives outside of the campus environment as well. Although it is unclear whether the development of mental health issues are a direct result of intimate partner violence, research suggests that victims of domestic abuse are indeed at a greater risk for developing depression, substance abuse, low self-esteem, and PTSD. Research also shows being a victim of intimate partner violence has severe negative physical consequences that lead to poorer health outcomes. Through the proposed grant to bring in Ms. Alyce LaViolette as an expert speaker in the CSUSM Arts and Lectures Series, students have a better chance at better understanding, and ultimately ending, intimate partner violence. IPV: PREVENTION THROUGH EDUCATION 23 Chapter 3 Methods Project Selection The purpose of this capstone project was to apply for funding to bring in an expert speaker to raise awareness and educate students on intimate partner violence at California State University San Marcos (CSUSM, 2015). Intimate partner violence has become a serious public health issue and is affecting many people within the United States (CDC, 2015-b). The U.S. Department of Justice (2014) also agrees that intimate partner violence has become a serious public health issue and in addition has found that IPV has become a major issue on college and university campuses as well. This issue is particularly relevant to what has been happening on CSUSM’s campus. In the past year, there have been three sexual assault incidents: The perpetrator in all three situations was male. This is a serious issue that needs more attention on campus, which is why bringing in an expert speaker on this pressing issue would not only be useful, but may potentially change the lives of CSUSM students. Speaker Selection Through careful evaluation of potential expert speakers on intimate partner violence, Alyce LaViolette, Licensed Marriage and Family Therapist (LMFT), was ultimately chosen. A member of the writer’s committee agreed that Ms. LaViolette seemed like a good candidate but also recommended that more research be done to see if Ms. LaViolette was qualified to speak at CSUSM. After a 30 minute phone conversation with Ms. LaViolette and several hours of research on her credentials by committee members, Ms. LaViolette was selected as the intimate partner violence speaker at California State University San Marcos. However, this was still dependent on whether the grant would be awarded. It is important to note that before Ms. LaViolette was chosen, a previous speaker was also chosen to speak but upon further evaluation IPV: PREVENTION THROUGH EDUCATION 24 of credentials and background information, it was determined that the previous speaker was not aligned with CSUSM’s mission and values and was not the right fit to speak on this important issue. Submission Process The writer completed his undergraduate degree at CSUSM before entering the Master of Social Work program, and remembered attending several events on campus that featured multiple speakers on different topics. Through a particular colleague, the writer was able to get information regarding the Office of Arts and Lectures at CSUSM. Arts and Lectures offers funding for events on campus that will further the education of students. Each year, Arts and Lectures invites students to propose a series of 20-30 different events that will support student learning while educating the campus on important issues happening in the community. These events offer eye-opening perspectives on multiple topics by bringing in different guest speakers to educate students on important issues. These events include lectures across various fields, film screenings, dance and theatre performances, music concerts, book readings, and many more events. Once all proposals are submitted, Arts and Lectures committee members choose the events that they think would be in the best interests of the students. Participants who are approved are notified in late May, to early June, and would then act as liaisons between Arts and Lectures and guest speakers. Target Population This event will provide opportunities for outreach in the community because it will target and be open to college students on campus. Many of these students do not have access to this type of information other than what they learn in classes, and many do not even get that opportunity. This event will provide students at CSUSM the opportunity to learn from an expert IPV: PREVENTION THROUGH EDUCATION 25 in the field and will also allow students to ask questions that professors on campus may not have the answers to, or feel competent to address. This event will be extremely beneficial to students because the event will be free and accessible, and students will not need to travel to receive valuable information. The proposed speaker, Ms. LaViolette, would be meeting the students in their community, which is the campus at California State University San Marcos. If my proposal to invite Ms. LaViolette as a guest speaker is approved, then I will do everything in my power to make sure this event gets advertised properly. I will make and distribute flyers myself, along with the help of the Department of Social Work on campus. This is a great learning opportunity for students on campus and may also help particular students who are suffering in an abusive relationship. Venue Selection Arts and Lectures has several different venues to choose from depending on what equipment needs to be used and how many students will be attending. For the purpose of this event, the venue that was chosen was the main lecture room in Markstein Hall at CSUSM. It seats 240 people comfortably and will be more than sufficient to host Ms. LaViolette as a speaker. Data Collection Most of the information used in the literature review and grant proposal for this capstone project was found on PsycINFO and Google Scholar databases found in the CSUSM Kellogg Library. Other sources were found on government Web sites and from the CSUSM Web site. IPV: PREVENTION THROUGH EDUCATION 26 Chapter 4 Grant Proposal Executive Summary I propose bringing a guest speaker to the CSUSM campus to raise awareness and inform students on Intimate Partner Violence and sexual assault on college campuses, as this has become a major problem nationwide. The proposed speaker Alyce LaViolette, LMFT, is considered an expert in the field of domestic violence, intimate partner violence, and sexual assault. Her 1-2 hour presentation would be highly informative, detailing aspects and components of these forms of violence, and potentially helping individuals struggling with these types of abuse. In her presentations, Ms. LaViolette speaks not just about the victims of domestic assault, but also speaks about the perpetrators. She is known for her unique way of providing information and touching on sensitive topics. Each of her presentations is unique and her presentation at CSUSM will be tailored to issues happening on our campus. For the purpose of this event at CSUSM, Ms. LaViolette will provide resources, talk about risk factors, and also educate students on what constitutes intimate partner violence. Ms. LaViolette will also talk about how the female is not always the victim and how the male is not always the perpetrator, and vice versa. By the end of the event, students will have a better understanding of what intimate partner violence is, how to prevent it, what signs to look for, and what options victims and perpetrators have. Along with the educational component of intimate partner violence, Ms. LaViolette will provide handouts and discuss this form of abuse from different perspectives, leaving students able to apply the information they learned in their own lives. Relationship to Funder’s Mission “Arts and Lectures provides a diverse offering of artistic, cultural, and scholarly events all based on input and proposals from students, faculty, staff, administration, alumni, and IPV: PREVENTION THROUGH EDUCATION 27 community members” (CSUSM, 2015, para.1). Arts and Lectures main goal and mission are to support learning for students and the community while seeking to inspire and motivate at the same time (CSUSM, 2015). This event will definitely relate to the Arts and Lectures mission to “Inspire, Motivate, and Support Learning.” In regards to inspiring students, Ms. LaViolette will enhance the knowledge of students and enrich their learning experience because of her expertise in the field and unique way she delivers the information. Many students do not have the opportunity to get this type of information. Since this form of abuse is very common on college campuses, it would be extremely beneficial for students to learn information that would be in their best interests. As far as motivating students, Ms. LaViolette is an expert in provoking thoughtful and critical reflection through her lectures and presentations. Ms. LaViolette engages students on both intellectual and emotional levels and makes them think critically about what they are learning. She provides pertinent information from different perspectives that gets students thinking about their own experiences. Ms. LaViolette will definitely expand on the students understanding of the topic in ways that might not be possible without this event. Efforts Toward Policy According to California Legislative Information (2014), Senate Bill Number 967 Student Safety: Sexual Assault, which took effect January 1, 2015, would require the governing boards of each community college district, the Trustees of the California State University, the Regents of the University of California, and the governing boards of independent postsecondary institutions to adopt policies concerning sexual assault, domestic violence, dating violence, and stalking that include certain elements, including an affirmative consent standard in the determination of whether consent was given by a complainant and to ensure that students, faculty, and staff who IPV: PREVENTION THROUGH EDUCATION 28 are victims of sexual assault on the grounds or facilities of their institutions receive treatment and information, including a description of on-campus and off-campus resources. (California Legislative Information, 2014, para. 2) California State University San Marcos has an executive order that governs policy. The Executive Order 1097 was implemented in June of 2014 before Senate Bill 967 was put in place on January 1, 2015. Each CSU is required to have attorneys who are responsible for the policy components of education. CSUSM does not have an in-house attorney as do larger CSU campuses, but we do have one housed in the CSU Chancellor’s Office to review new policies to make sure the University is aligned with current legislation. All California State Universities abide by the same policies. CSUSM’s attorney found that Executive Order 1097 on campus was already aligned with Senate Bill 967 and no changes needed to be made; however, the executive order is reviewed and updated each year (CSUSM, 2013). To ensure student safety, all new incoming students are required to complete an online training on sexual assault and be able to pass by a certain percentage or they will not be admitted on campus. Each staff and faculty member at California State University San Marcos is a mandated reporter (CSUSM, 2013). If someone comes forward and reports sexual assault or some form of dating violence, the report needs to be made to the Title IX Coordinator in the CSUSM Division of Student Affairs. The case is reviewed by a Title IX investigator and if a crime did occur, the University will conduct a University investigation; however, this is not the same as a criminal investigation. The police do not get involved unless the victim wants to press charges. It all depends on what the victim wants to do and the case is kept confidential unless legal action needs to take place. Student affairs staff members are obligated to refer the victim to police. But student affairs staff themselves cannot go to police with information due to confidentiality. IPV: PREVENTION THROUGH EDUCATION 29 California State University San Marcos is making an effort to mandate all staff and faculty to take online sexual assault trainings each year to educate on this form of abuse. However, this type of mandate needs to go through unions that represent staff and faculty before the University can approve such training. For now, CSUSM can only offer this training as an option for staff and faculty before it becomes an official mandate. Goals and Objectives California State University San Marcos believes that students should be active participants in the learning process. During her presentations, Ms. LaViolette would make it an interactive experience by engaging the students and making them think critically about their own experiences. California State University San Marcos also wants its students to gain the knowledge, skills, competencies, and experiences needed to reach their full potential. By bringing in Ms. LaViolette to raise awareness and educate students on intimate partner violence and sexual assault, students are strengthening their skills and competencies in an area that is crucial and relevant to their environment. This event will also be innovative because Ms. LaViolette will tailor the information in a way that will best meet the needs of the students. She will teach students how to apply the knowledge they learn to their own experiences within their lives. The overall goal of this grant proposal is to have a better informed campus community regarding intimate partner violence at California State University San Marcos. In order to meet this goal, there will be two objectives: bringing in a guest speaker and conducting public relations. The first objective is to bring an expert speaker on intimate partner violence to California State University San Marcos (CSUSM) in the fall of 2015. The second objective is IPV: PREVENTION THROUGH EDUCATION 30 regarding public relations. This event will be advertised through social media, flyers, e-mails, and posters at least two months before the event takes place in the fall of 2015. Budget For the purpose of this grant proposal, a maximum grant of $2,000 dollars will be awarded to the chosen events by CSUSM Arts and Lectures. When speaking with Ms. LaViolette, she stated that her fee was $3,000 dollars. When the writer told her that the maximum amount that could be given to guest speakers was $2,000 dollars, she stated that she would work on her price with CSUSM and lower her fee to the maximum amount because she felt strongly about educating campuses on domestic violence. Arts and Lectures provides an extra $300 dollars to candidates needing additional technical support. This will not be necessary for this event. The $2,000 dollars will be sufficient and will cover the costs of the guest speaker. Should this grant proposal be accepted by Arts and Lectures, funding for advertising the event will not be requested. The writer will print the flyers and also advertise on social media to get the word out. The writer will also seek help from the social work department on campus to help spread the word and possibly help distribute flyers. This will not be considered an additional cost. In total, the guest speaker will receive her requested fee of $2,000 dollars. Project Relevance It is crucial for a speaker to come to California State University San Marcos (CSUSM) and educate the students on this pressing issue, especially given rates of interpersonal violence among college students. According to REACH (2015), trainings should involve speakers to talk about specific personal experiences in dating and domestic violence, or talk about the impact of abuse and the role of the community in supporting survivors. Ms. LaViolette is more than qualified to help the students at CSUSM get a better understanding of this type of abuse. She has IPV: PREVENTION THROUGH EDUCATION 31 been working with battered women since 1978, first as an advocate at WomenShelter in Long Beach, California, and then in private practice in Long Beach. She has written and published articles on the impact of domestic violence on women. Ms. LaViolette will enhance the knowledge of students and enrich their learning experience because of her expertise in the field and unique way she delivers the information. Many students do not have the opportunity to get this type of education during classes and since this form of abuse is very common on college campuses, it would be extremely beneficial for students to learn information that would be in their best interests. By bringing in Ms. LaViolette to raise awareness and educate students on intimate partner violence and sexual assault, students are strengthening their knowledge, skills, and competencies in an area that is crucial and relevant to their personal and community wellbeing. IPV: PREVENTION THROUGH EDUCATION 32 Chapter 5 Discussion Limitations of Research The research that was examined for this capstone project regarding intimate partner violence had limitations that were consistent across studies. One limitation that the research had was regarding the prior history of abuse that victims of domestic abuse endured as well as the trauma they experienced in the past. The research did not provide much information on how long these victims were exposed to prior trauma experiences. It would have been important to know if most of the victims had experienced trauma briefly, for more days than not, or if their trauma had been consistent throughout their childhood and adolescent years. The research only talked about previously experiencing a history of trauma in the past. More information about the extent of prior trauma and more in depth screenings about the trauma would have provided more useful information. The second limitation to the research was that although some studies found that males are also victims of intimate partner violence, not enough research has been done to appropriately generalize to other populations. Hardly any research gives demographics on male victims either. Most research on female victims is thorough and generalizable. The research also does not specify if men’s experience of past violence was traumatic for them in the same way that it was for women. Everyone has a different perspective on experiencing violence in the home and not enough information was given as to what extent it affected male victims of intimate partner violence. The research only talked about males witnessing their mothers getting abused by their fathers and how that can lead to becoming a perpetrator themselves and about the boys who were being physically abused as children potentially becoming perpetrators. No other form of trauma, abuse, or length of abuse was reported in the research on males. IPV: PREVENTION THROUGH EDUCATION 33 The third limitation of the research in this capstone project was that each source of information regarding intimate partner violence in this project stated at some point in the literature that not enough information was known to be able to conclude that experiencing trauma and abuse as a child was directly responsible for experiencing IPV as an adult. The literature was careful in stating that victims with a previous history of trauma and abuse were more likely and had a higher risk of becoming victims or perpetrators as adults compared to people who did not have the same experience, but the causation was not definite. Perhaps more research needs to be done in order to be able to say what exactly causes a person to become a victim or perpetrator of intimate partner violence. The last limitation of the research was that not enough attention has been given to prevention and education strategies for ending intimate partner violence. More research needs to be done to determine better ways to help victims prevent this from happening or continuing to happen. This is not to say that research has not been done or that organizations have not been created to be involved in the prevention or educational component of intimate partner violence. The writer is merely saying that more research needs to be done regarding preventative measures. Strengths of Research The research also had strengths. One of the main strengths of the research was that it was mostly consistent across studies. Although also mentioned as a limitation, the research does not make it clear enough to determine that these distinct processes actually lead to future violence. Research has been demonstrated across studies that connections can in fact be made between childhood abuses and being in a violent relationship as an adult, but the nature of that IPV: PREVENTION THROUGH EDUCATION 34 relationship is still not clear and more information needs to be collected and further research needs to be completed to make a better distinction. Further Research Further research is definitely needed regarding intimate partner violence. Health care professionals need to do more in order to appropriately screen potential victims of intimate partner violence. Many victims do not want to speak up or are possibly afraid to do so. Most of the time health care professionals are only screening victims of intimate partner violence when they see the physical consequences of the abuse. This is good but health care professionals can potentially miss the victims who suffer from health issues related to intimate partner violence as described in the literature review section of this capstone project. Further research also needs to be done regarding men as victims. What causes men to become victims of intimate partner violence? Does it relate to the same experiences as women? Would the findings be as significant as the findings regarding women? These are some of the questions that need to be answered to get a better understanding of these phenomena. Social Work Relevance The issue of intimate partner violence has great relevance to those working in the field of social work. Our professional code of ethics states: “Fundamental to social work is attention to the environmental forces that create, contribute to, and address problems in living (National Association of Social Workers (NASW) 2008, Preamble, para. 1). Domestic violence definitely falls under this category of being a problem in living for people suffering from this form of abuse. Social workers have been strong supporters of victims of abuse and have been working with them for many years in a variety of settings (NASW, 2008). Social work professionals deal directly with victims of interpersonal abuse in settings that serve people suffering from IPV: PREVENTION THROUGH EDUCATION 35 homelessness, depression, PTSD, anxiety, and substance abuse (NASW, 2008), as well as in shelters and programs targeted specifically to interpersonal violence. But social workers also attempt to address the macro-level attitudes and beliefs that create climates where such violence is accepted. Social workers participate in a variety of professional activities that may include “direct practice, community organizing, supervision, consultation, administration, advocacy, social and political action, policy development and implementation, education, and research and evaluation” (NASW, 2008, Preamble, para. 2). The purpose of this capstone project to bring in an expert speaker on intimate partner violence to educate students in the CSUSM community is in line with social work’s unique purpose, values, and perspectives. The expert speaker would raise awareness and educate students in a broad way on the issue of intimate partner violence, while also providing specific information regarding risks, effects, and resources for victims in the community. IPV: PREVENTION THROUGH EDUCATION 36 References American Society of Addiction Medicine. (2014). Intimate partner violence and co-occurring substance abuse/addiction. 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