Measuring Domestic Violence Service Providers Attitudes: The Development of the Survivor-Centered Care Scale (SCCS)

Purpose: In the domestic violence (DV) field, survivor-centered models have been identified as best practice for promoting empowerment, individualized services, and culturally centered care.  Collectively these models call for service delivery that is characterized by client choice, survivor voice, partnership, service individuation, support, and a larger systems orientation. Service providers’ attitudes appear to greatly influence their ability to implement survivor-centered care; however, there are currently no instruments that measure these attitudes among domestic violence service providers. This pilot study reports on efforts to develop such a measure.

Methods: A convenience sample of DV service providers (n=236) were recruited from two-statewide list-servs in the south and southwest regions of the US. Participants completed a web survey of 160 standardized and researcher developed items, including 28 items reflecting aspects of survivor-centered care; these were scored on a 5-point Likert scale. Sample items included: All survivors need counseling; Survivors play the victim card too much.

Analysis: Principal axis factor analysis was conducted in SPSS to identify underlying factor structure. Only items that loaded onto one factor and with factor loadings > .40 and < .90 were retained.  Items not meeting these criteria were removed, reducing the original scale from 28 to 14 items. Bivariate correlations were conducted to examine the relationship between the final scale and key service provider characteristics, including demographic, individual worker, and organizational factors. A hierarchical regression with individual, organizational, and worker wellness variables was also entered in three blocks with SCCS as the dependent variable.

Results: A single factor solution was supported that explained 17.1% of the variance.  Additional analyses found no other solutions that contributed to explained variance. The final Survivor-Centered Services Care Scale (SCCS) yielded a Cronbach’s alpha of .76. The SCCS had some significant relationships with service provider characteristics that were congruent with the established literature. For example, SCCS was significantly associated with higher educational level; greater number of months working in DV; quality supervision; working in a stand-alone DV agency; feeling a sense of control/autonomy over one’s work; sharing in the values/mission of one’s organization; and higher levels of compassion satisfaction defined as experiencing one’s work as meaningful. SCCS had significant negative associations with hours spent working with DV victims per week and working in a governmental or public agency, such as law enforcement or income support services. The final regression model accounted for 25% of the variance with significant relationships between individual worker and organizational characteristics blocks, but not with worker wellness characteristics.

Conclusions: Despite study limitations, the SCCS offers a useful first step towards the measurement of DV service providers’ attitudes towards survivor-centered care.  Initial findings suggest that these attitudes are related to education, supervision, and embracing the organizational mission and values. Investment in staff development may offer opportunities to enhance SCCS and thus more effective implementation of DV best practice models.  More research is necessary to validate the SCCS, as well as more directly connect service provider attitudes and survivor-centered care with positive client outcomes.