Toward a Theory of Help-Seeking Behavior

Background and Purpose: African American women disproportionately experience intimate partner violence (IPV)-related homicide due, in part, to the racial discrimination they experience during their help-seeking (Petrosky, et. al, 2017; Waller, 2021). Fundamental to improving their outcomes is understanding how they navigate their sociopolitical barriers to secure urgent aid. This study employed constructivist grounded theory methodology to develop a model that explains the psychosocial processes of help-seeking among a vastly understudied, difficult-to-reach, marginalized population of African American women IPV survivors when they are seeking a solution to their abuse. The primary goal of this study was to explain how survivors’ cognitive evaluations of available services and supports inform their help-seeking process.

Methods: Thirty in-depth, semi-structured interviews were conducted with women who have experienced a violent episode within the previous year. Purposive and snowball sampling methods were employed. Survivors who were seeking assistance from the domestic violence service provision system and/or domestic violence ministries at their church participated in the study. Data was collected during one 60-120-minute, face-to-face interview between July and October 2019. Interviews were conducted in a private office where participants could speak freely. To further ensure survivors’ confidentiality, a Certificate of Confidentiality (CoC) was obtained from the NIH. To avoid the risk of coercion, audio recordings commenced upon obtaining participants’ approval. The Transtheoretical Model of Change (TTM), Intersectionality Theory and Agency framework were utilized as sensitizing concepts to develop an emergent theory. Data was triangulated via demographic surveys, semi-structured interviews and field notes. All eight techniques were employed to establish trustworthiness. Dedoose was utilized for data management.

Results: Findings suggest that survivors believe “there is no help.” They further noted they had to be self-reliant although they were currently securing assistance from providers. Participants also stated that they believed that “he’s going to kill me” because providers neglected to fully assist them. Survivors shared the ways that the murders of unarmed Black men and women informed their help-seeking process and deteriorated their trust in the domestic violence service provision system. The Theory of Help Seeking Behavior emerged from the data. This theory postulates that survivors’ social context, specifically their experiences with racism, racial discrimination and systemic racism, inform their perceptions about which supports were really available to them as African American women. This theory includes three constructs: 1. Social context; 2. Beliefs; and 3. Agency.

Conclusions and Implications: To our knowledge, this is the first theory that seeks to provide a comprehensive understanding of African American IPV survivors’ help-seeking process. Findings suggest that adverse proximal and distal interactions with providers within the domestic violence service provision system informed their evaluations about which services and supports were readily available to them. There is an immediate need to develop interventions in an effort to reduce the IPV-related homicide rates among this vulnerable population of IPV survivors. The Theory of Help-Seeking Behavior informs the way African American women survivors navigate barriers unique to their positionality and is an initial step to developing culturally-informed, comprehensive interventions designed to meet their nuanced needs.