Centering the Voices of Black Women Survivors: Introducing Sarah Waller’s Help-Seeking Model

Background and Purpose: Black 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 a series of 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 Black women IPV survivors when they are seeking a solution to their abuse. The primary goal of this study was to identify survivors’ nuanced 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. 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. Sarah Waller’s Help-Seeking Model emerged from the data and includes nine phases: (1) Awareness, (2) Acknowledgment, (3) Assessment, (4) Enough, (5) Enlist, (6) Escalate, (7) Reject, (8) Resolve, and (9) Restoration. This is the first theory that identifies how this vulnerable and underserved population’s mental health and social support-seeking process is partially mediated by mistrust of law enforcement, disappointment in linkage to care and services, fear of death, and willingness to survive.

Conclusions and Implications: To our knowledge, this is the first theory that seeks to provide a nuanced understanding of Black women 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 to reduce the IPV-related homicide rates among this vulnerable population of IPV survivors. Sarah Waller’s Help-Seeing Model informs the ways that Black women survivors navigate barriers unique to their social context and is an initial step to developing culturally informed, comprehensive interventions designed to meet their specific needs.