The recovery of valued occupations after intimate partner violence: A scoping review analysis using the Person Environment Occupation Performance model and an occupational justice lens

Abstract

Introduction

Intimate partner violence has enduring impacts that persist well beyond the cessation of abuse. Recovery and healing, though recognised as a priority in the Australian Government's national policy, has received less research attention compared with prevention, early intervention, and response. Survivors experience interruptions to their occupations during abuse and face occupational injustice. There is limited understanding of how these occupations recover and whether occupational justice is restored during the recovery phase.

Methods

This scoping review aimed to (1) identify occupational focus and gaps in literature during IPV recovery and healing; (2) analyse person and environmental barriers and enablers associated with survivors' occupational recovery; and (3) examine restoration of occupational justice during recovery. The review followed the PRISMA‐ScR Checklist for screening and data extraction. Comprehensive searches of databases and grey literature were conducted. The Person Environment Occupational Performance model guided keyword selection and data synthesis. There was no consumer or community involvement included.

Results

Twenty articles were reviewed, with findings primarily centred on paid employment, reflecting the research focus on this productive occupation. Parenting and ongoing education were also examined. Barriers to occupational recovery included physical health impacts, ongoing trauma, depression and anxiety, limited social supports, discrimination, ongoing coercive control, and restricted access to housing, transport, and childcare. These results were then interpreted through an occupational justice lens, including the persisting limit to choice and control in occupations for survivors, which results in continued occupational injustices.

Conclusion

The review highlighted some of the complex person and environment factors affecting occupational recovery for women after IPV, particularly regarding access to meaningful paid employment. The findings underscore the need for both individualised support and broader systemic changes to achieve occupational justice and promote meaningful recovery. Further research is recommended to explore barriers and enablers beyond employment within the Australian context.

Plain English Summary

This paper explores how women recover and rebuild their lives after experiencing intimate partner violence. Intimate partner violence is harmful behaviour from a current or former partner. It can affect a survivor's health, confidence, ability to work, and other everyday activities. This study reviewed 20 research papers published between 2005 and 2025 that researched returning to important everyday activities and roles after experiencing intimate partner violence. The results showed that survivors face many challenges after experiencing intimate partner violence. These include personal factors, such as low self‐confidence, as well as practical problems like limited job opportunities and lack of social and community support. Having a job that feels important and worthwhile can help survivors rebuild their lives to move forward. However, finding and keeping work can be difficult when survivors do not have access to safe housing, affordable childcare, or supportive workplaces. The research suggests that survivors need different kinds of support to help them recover, based on their unique needs. This may include help to build work skills, accessible childcare, and strong community support. The study shows that both personal and broader social factors play a role in recovery after intimate partner violence. The findings highlight the need for action from individuals, services, communities, and governments. More research is needed because this study focused mainly on paid work and does not cover other parts of recovery.

Key Points for Occupational Therapy.

• The PEOP model helps to analyse factors impacting occupational recovery after experiencing intimate partner violence.

• Engagement in meaningful occupations could help support recovery after experiencing intimate partner violence.

• Occupational therapists can support through addressing individualised supports and the systemic barriers impacting engagement in meaningful occupations.

1. INTRODUCTION

Intimate partner violence (IPV), also referred to as domestic violence and abuse, involves behaviour perpetrated by a current or former intimate partner that causes physical, sexual or psychological harm (World Health Organisation [WHO], 2024). IPV is characterised by the exertion of power and control over an intimate partner (Australian Institute of Health and Welfare [AIHW], 2023). WHO reports that a quarter of women aged 15–49 years have been subjected to IPV in their lifetime, and similarly, in Australia, 23% of women and 7% of men have experienced physical or sexual violence within an intimate relationship since the age of 15 (Australian Bureau of Statistics [ABS], 2023; WHO, 2024). In 2011, IPV was identified as the leading cause of illness, disability, and premature death among women aged 18–44 in Australia (Webster, 2016). Violence against women and children in Australia cost an estimated $22 billion in 2015–2016 (KPMG, 2016), a figure that has likely risen since.

The long‐term impacts of IPV include increased risk of homelessness, poor physical and mental health, substance misuse, self‐harm and suicide, hospitalisations, and increased risk of being a victim of abuse in future relationships (AIHW, 2019; Australia's National Research Organisation for Women's Safety [ANROWS], 2019; WHO, 2012). The Australian Longitudinal Study on Women's Health (ALSWH) found that domestic violence was linked to persistent poor physical health, ongoing bodily pain, and long‐term mental health issues in women, many years after the abuse ended (ALSWH, 2020). Post‐separation abuse is common, manifesting as power and control exercised by the perpetrator, particularly in co‐parenting situations (Spearman et al., 2023). This can include interference with legal proceedings, custody arrangements, and employment opportunities, often resulting in less safe and sometimes fatal circumstances and significant economic hardship for survivors (Spearman et al., 2023).

Occupational therapists promote a person, group, or community's health and wellbeing through participation in meaningful occupation (World Federation of Occupational Therapists [WFOT], 2025). The term ‘occupation’ encompasses much more than paid employment; it is described as the unique everyday activities a person needs, wants, and is expected to do (Christiansen & Townsend, 2010; WFOT, 2025). Occupations provide meaning and are central to wellbeing and human existence (Hammell, 2023; Wilcock, 1993). ‘An occupational perspective includes examining what individuals do every day on their own and collectively; how people live and seek identity; how people organize their habits, routines, and choices to promote health; and how systems support (or do not support) the occupations people want or need to do to be healthy’ (Whiteford & Townsend, 2011, p. 67). Taking these definitions into account, occupations encompass the activities undertaken to fulfil various roles, such as those associated with being a parent, friend, family member, partner, or employee. They include the things a person does to keep themselves healthy, such as attending medical appointments, exercising, eating, and bathing. They also include what a person does for fun and how they use their leisure and recreational time. These examples are not exhaustive.

The WFOT Position Statement on Occupational Therapy and Human Rights asserts that occupational justice requires recognition of every individual's right to choose and freely engage in meaningful occupations (WFOT, 2019). Ensuring these rights involves ‘addressing the capabilities, opportunities, and freedom of choice for individuals, communities and populations to participate in society’ (WFOT, 2019, p. 1). Violations of these rights constitute abuses of human rights and represent forms of occupational injustice. Occupational justice discourse gained momentum in the early 2000s (Stadnyk et al., 2010; Townsend & Wilcock, 2004), and the foundational definition remains highly relevant. An occupational justice perspective focuses on ‘what meaningful and purposeful occupations (tasks and activities) people want to do, need to do, and can do considering their personal and situational circumstances’ (Stadnyk et al., 2010, p. 331). Occupational injustice arises when external factors restrict or disrupt an individual's freedom to engage in desired occupations, which may include through restriction, segregation, or exploitation, negatively affecting health and wellbeing (Hocking, 2017; Townsend & Wilcock, 2004). This perspective encourages occupational therapists to consider structural and power relations operating at micro (individual), meso (organisational), and macro (policy) levels that may create barriers to participation for individuals and groups (Bailliard et al., 2020). As a profession concerned with health, wellbeing, and participation across individual, organisational, and systems levels, occupational therapy is fundamentally rooted in justice (Bailliard et al., 2020). Townsend and Wilcock (2004) conceptualised occupational injustice through four interrelated forms: occupational deprivation, occupational alienation, occupational marginalisation, and occupational imbalance.

People experiencing IPV encounter significant occupational injustice due to patterns of power and control that restrict their ability to engage in meaningful occupations (Smith & Hilton, 2008). Occupational disruptions commonly occur across employment, education, health‐promoting activities, parenting, and social activities (Ballan & Freyer, 2020; Javaherian‐Dysinger et al., 2016). Daily routines may become centred on safety and survival rather than personal choice and meaning. Activities may be dictated by an abusive partner or undertaken to minimise risk and maintain safety, whereas opportunities to participate in valued occupations may be restricted or withheld (Smith & Hilton, 2008). Such experiences can contribute to occupational alienation, marginalisation, and deprivation (Javaherian‐Dysinger & Underwood, 2017; Townsend & Wilcock, 2004; VanLeit et al., 2006). To date, some but limited research has examined occupational injustices during periods of abuse. However, even less attention has been given to the possibility that occupational injustice may persist beyond the abusive relationship itself. Following the cessation of abuse, individuals may continue to encounter social, economic, institutional, and other environmental barriers that limit their participation in meaningful occupations, allowing occupational injustices to continue.

Despite the potential for occupational injustice to persist after abuse, interventions aimed at improving survivors' occupational participation have typically focused on developing individual capabilities, such as work readiness and parenting skills. However, taking an occupational justice perspective would provide an evaluation of the external forces impacting engagement and performance. For example, VanLeit et al. (2006) argued that systemic environmental barriers such as poor public transport and expensive childcare were larger barriers than any person's capabilities of the participants in their study of women who were homeless. This is echoed by Hammell and Iwama (2012), who advocated that health and wellbeing cannot be reached by solely addressing individual abilities, but also by addressing external factors or the ‘conditions of people's lives’ (p. 385). Hammell (2023) further reinforces this, that if we focus solely on an individual being responsible for their own accomplishment, we lose sight of the broader structural inequalities that exist and are creating larger occupational barriers. We hypothesise that similar external factors create barriers for survivors as they recover from an experience of IPV, and that these should be recognised and prioritised to further their occupational opportunities and support occupational justice.

The Person Environment Occupational Performance (PEOP) model encourages consideration of the factors shaping occupational participation, including social, cultural, and policy influences (Baum et al., 2015). It has been used as an organising framework in emerging areas of occupational therapy research, including social prescribing for loneliness and sexuality and intimacy (Bass et al., 2024). Given the limited occupational therapy literature examining IPV recovery and healing, the PEOP model was selected to identify and organise the factors shaping survivors' occupational recovery. Although occupational justice has not commonly been used alongside the PEOP model in research (Bass et al., 2024), using them together offers complementary perspectives. The PEOP model provides a structure for analysing the influences on occupational participation, whereas occupational justice enables critical interpretation of whether the identified barriers reflect inequities in opportunities, choice, and control over meaningful occupations.

The recovery and healing stage, which follows the crisis response stage for survivors of IPV (Commonwealth of Australia, 2022), has been chosen as the focus of this study. IPV is a complex and urgent issue throughout Australia and internationally, with prevention and the immediate safety of survivors being a priority. Recovery and healing was added as one of the four priority areas acknowledged in the updated National Plan to End Violence against Women and Children 2022‐2032, Australia's overarching policy strategy to address domestic, family and sexual violence (Commonwealth of Australia, 2022). However, research examining survivors' longer‐term recovery after leaving an abusive partner remains limited (Carman et al., 2023).

This study aimed to examine the current evidence regarding how IPV survivors are supported to participate in their chosen occupations during the recovery stage, hereafter referred to as occupational recovery. Further, it aimed to identify the factors that influence occupational recovery, including individual and environmental enablers and barriers. In addition, the research was interpreted through an occupational justice lens, which considers occupational choice and control as integral to the occupational recovery stage. Specific objectives that guided this study were:

1. To highlight the occupational focus and gaps in literature centring on the recovery and healing stage after IPV.

2. To analyse the person and environmental barriers and enablers associated with IPV survivors' occupational recovery and healing.

3. To identify if there are ways in which occupational justice is restored during the recovery and healing stage after experiencing IPV.

2. METHODS

A scoping review was conducted to address the study aims, following the first five steps of Arksey and O'Malley's methods (Arksey & O'Malley, 2005). In addition, the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) checklist was integrated into the process to strengthen the quality and transparency of the review (Tricco et al., 2018). A protocol was developed prior to the search; however, it was not registered.

2.1. Eligibility criteria

Inclusion criteria included: English‐language studies from the last 20 years (2005–2025), involving adults (≥18 years) with IPV experience, addressing occupation as an outcome, and focusing on post‐abuse recovery and healing experiences. We excluded studies focused on perpetrators, child experiences, and isolated sexual assault, such as rape outside an intimate relationship, to ensure a focus on IPV survivors. Most studies conducted in shelter settings were excluded as they focused on crisis support rather than on longer‐term recovery and healing. Literature reviews were excluded, but their reference lists were screened for relevant papers.

2.2. Information sources and search strategy

Relevant studies were identified from searching electronic databases (Medline, CINAHL, ProQuest Central, Scopus/Web of Science, and PsycINFO), reviewing reference lists, hand searching of occupational therapy and science journals, and searching relevant websites, and Australian grey literature (e.g., ANROWS, Australian Institute of Family Studies [AIFS], Australian Institute of Health and Welfare [AIHW], and ALSWH websites). All searches were conducted in May 2025.

Search strategies reflected two main search concepts—IPV and occupation. The PEOP model was used to develop keywords relevant to occupational justice and occupational therapy. Depending on the database, relevant MeSH terms and keywords were added to each of the search strategies. A full list of keywords and MeSH terms developed for Medline is provided in Table 1. Searches were limited to English‐language papers, publications between 2005 and 2025, and excluded any literature reviews when the database functionality allowed for it. Grey literature sources were searched using the same core keyword combinations developed for the database searches, with keywords adapted to suit website search functions. Reference lists of key reports and policy documents were also hand‐searched to identify additional relevant sources. Grey literature searches were limited to publications between 2005 and 2025.

TABLE 1.

Keywords and MESH terms developed for Medline search.

	IPV	Occupation
Keywords	(‘domestic violence’ or ‘intimate partner violence’ or ‘family violence’ or ‘family domestic violence’ or IPV or ‘relationship violence’ or ‘gender based violence’ or ‘spous* abuse’ or ‘battered women’ or ‘interperson* abus*’).Ti,Ab. MESH Domestic violence/or spouse abuse/or gender‐based violence/ or intimate partner violence/or battered women/	(occupation* or ‘activities of daily living’ or ‘instrumental activities of daily living’ or sleep or ‘living skills’ or employ* or productivity or leisure).Ti,Ab. MESH ‘Activities of daily living’/or employment/or occupations/or leisure activities/or self‐care/or education/or social inclusion/or social networking/or sleep/

2.3. Selection of sources of evidence

Duplicates were removed, and titles were screened in Rayyan (Ouzzani et al., 2016). Covidence systematic review software (Veritas Health Innovation, 2025) was used by reviewers to facilitate abstract and full‐text screening. The first author screened all titles, abstracts, and full texts. A second reviewer screened 30% of abstracts and all full texts. The collaboration process was tracked in Covidence. Disagreements about inclusion were discussed until consensus was reached by both reviewers. All authors reviewed and approved the final sample of papers.

Records identified for full‐text screening were reviewed by all authors and the second reviewer to ensure they met the inclusion criteria.

2.4. Data charting

Excel was used to chart author, year, country/setting, aims, design, population, outcomes/tools, and sample characteristics for each included study. Consistent with the PEOP model, key findings of each paper were mapped and deductively coded to the domains of occupation, person, and environment enablers or barriers using the model headings (Baum et al., 2015). Person factors were categorised into cognition, psychological, physiological, sensory, motor, and spirituality domains. Similarly, environment factors were categorised into culture, social determinants, social support and social capital, education and policy, physical and natural, and assistive technology. Occupations were coded into activities, tasks, or roles, as well as self‐care, leisure and productivity. The extraction and charting of data was completed by the first author, and all processes were overseen by the other authors.

2.5. Synthesis of results

Synthesis and reporting of results included an analysis using the domains from the PEOP model. Data extracted from included studies were grouped within PEOP domains and systematically compared to identify patterns, commonalities, and points of divergence across the literature. This process supported synthesis relevant to research questions one and two. To address the third research question, a second analytical process was undertaken. Findings synthesised using the PEOP model were then re‐examined through an occupational justice lens, with particular attention to issues of choice, control and access to meaningful occupations. Concepts of occupational injustice, including occupational imbalance, occupational marginalisation, occupational deprivation, and occupational alienation, were coded to interpret occupational injustices occurring during the recovery and healing stage (Townsend & Wilcock, 2004).

2.6. Author positionality statement

All authors have research and practice interests in the family and domestic violence and abuse field in Australia. With backgrounds in allied health and academia, the authors approach this work from perspectives that value participation, social justice, and human rights. These perspectives informed the focus on occupation and participation as important aspects of recovery and may have influenced the research questions considered important and the interpretation of the findings. While striving for objectivity, the authors acknowledge that their professional experiences inevitably shape their interpretations. To minimise potential bias, the authors engaged in ongoing reflexive discussion throughout the review process and sought to ground their interpretations in the evidence presented across included studies, with the aim of ensuring that the findings reflected the experiences reported by survivors of IPV.

3. RESULTS

After duplicates were removed, a total of 5449 titles and 558 abstracts were screened, resulting in 144 full texts retrieved and reviewed. Reasons for exclusion after reviewing the full texts are included in the PRISMA chart (Figure 1). A total of 20 articles were included in the final sample of papers.

FIGURE 1.

PRISMA 2020 flow diagram used for scoping review.

3.1. Study characteristics

Each study was mapped to record the setting, aims, design, outcomes, and results related to the research question (Table 2). Two papers each originated from Canada and Australia; one paper each was from England, Denmark, Sierra Leone, Sweden, and Mongolia and Hungary. The remaining 11 papers were from the USA. Publication years ranged from 2005 to 2024, with eight papers published within the last 5 years. Three studies were written by authors who included occupational therapy scholars using qualitative interviews or surveys (Cordier et al., 2023; Helfrich et al., 2006; Njelesani et al., 2021); the remainder were from fields, including psychology, social work, nursing, or employment counselling. Fifteen studies collected most of their data through interviews, and qualitative methods were employed in 13 papers, primarily using semi‐structured interviews in community settings, often with participants recruited through community domestic violence organisations. Four papers employed longitudinal designs to examine employment stability, mental health outcomes, and duration of IPV, offering some insight into employment trajectories over time (Adams et al., 2012; Adams et al., 2013; Helfrich et al., 2006; Staggs & Riger, 2005). Formal assessments were used in some papers to capture physical and mental health outcomes, IPV duration or type, and employment stability or job skills. Sample sizes ranged from one paper covering two case studies (Chronister et al., 2012) to 3429 participants in a cross‐sectional survey (Bonomi et al., 2006). All participants were women over 18 years who had experienced IPV, whose relationships had ended, some relatively recently (less than 12 months), others many years ago; with one study's participants being separated from their abusive partner anywhere from 1 to 15 years prior (Amarsanaa et al., 2023). Low income was commonly reported in demographic data.

TABLE 2.

Summary of included papers.

Authors	Country	Aims of study	Methodology and methods	Sample	Occupational factor/s	Person factor/s (B = barrier, E = enabler)	Environment factor/s (B = barrier, E = enabler)
Adams et al., 2012	USA	(1) To what extent does IPV negatively affect the job stability and economic wellbeing of low‐income women; (2) to what extent does job stability explain the association between IPV and reduced economic wellbeing; and (3) if IPV does negatively affect women's job stability and economic wellbeing, how long do the effects last after the abuse ends?	Quantitative. Longitudinal cohort study	503 welfare recipients: IPV ended < 3 years ago (N = 67) IPV ended 3–5 years ago (N = 61)	Paid employment	n/a	Social determinants (B)
Adams et al., 2013	USA	Investigate the extent to which job stability mediates the relationship between IPV and adverse mental health symptoms in low‐income women	Quantitative. Longitudinal cohort study	503 welfare recipients: IPV ended < 3 year ago (N = 67) IPV ended 3–5 years ago (N = 61)	Paid employment	Psychological (B)	Social determinants (B)
Amarsanaa et al., 2023	Mongolia and Hungary	Compare posttraumatic growth of Mongolian and Hungarian survivors of intimate partner violence	Qualitative; interviews	15 female IPV survivors: 10 Mongolian and 5 Hungarian women	Education, skill acquisition (e.g., new language and driver's licence), housing, paid employment, mothering, volunteering (e.g., advocating for change and helping other survivors)	Psychological (E), spiritual (E), cognition (E)	Social support (E), cultural (B)
Bonomi et al., 2006	USA	Describe the relationship between women's health and their exposure to IPV by examining: Timing of IPV, type of IPV, duration of IPV	Quantitative; cross‐sectional/population level survey	3429 women in the community randomly sampled from a health group cooperative	Volunteering, social functioning (e.g., visiting friends), paid employment, involvement in risky behaviours	Psychological (B), cognition (B), physical (E)	Social support (B)
Broughton et al., 2024	Canada	To explore the priorities of women mothering children in the context of IPV and to understand what shapes those priorities	Qualitative, interviews	20 female IPV survivors	Mothering, paid employment, housing	Psychological (B), physical (E)	Culture (B), social determinants (B), social support (B), education & policy (B & E)
Chronister et al., 2012	USA	Describe the structure and implementation of career counselling services for IPV survivors, and the diverse career development concerns, supports, and barriers that survivors encounter	Qualitative, case studies	2 female IPV survivors—only extracted information from one case study that met inclusion criteria	Paid employment	Psychological (B), spirituality (E)	Culture (B), education & policy (B), social supports (E & B)
Chronister et al., 2018	USA	Provide demographic information about partner violence survivors who accessed individual career counselling services; identify their individual counselling needs, career barriers, and service satisfaction; and examine group differences in the survivors' counselling needs, barriers, and service satisfaction	Quantitative; survey	71 female survivors of IPV	Paid employment.	Psychological (B), physical (B)	Social determinants (B), social support (B), education and policy (B), culture (B)
Cordier et al., 2023	Australia	Illustrate the long shadow cast by IPV and identify factors associated with women's health status, housing, and economic and social outcomes of women who experienced IPV	Quantitative; cross‐sectional survey	658 female IPV survivors	Paid employment	Physical (B), cognition (B), psychological (B)	Social support (B)
Cort & Cline, 2017	England	Explore the views of women who have experienced IPV to gain a greater understanding of the impact of abuse on their role and identity as a mother	Qualitative; interviews	7 female IPV survivors	Mothering	Spirituality (E), psychological (B)	Culture (B), social determinants (B), social support (B & E), education and policy (B)
Duffy, 2015	Canada	Explore and describe single mothers' transitions to a sustainable livelihood after leaving an abusive partner	Qualitative; interviews and photovoice	20 female IPV survivors	Mothering, paid employment, livelihood strategies (e.g., making and selling crafts, renting spaces in their homes, bartering for goods and services), education, health management	Psychological (B & E), cognitive (E)	Culture (B), social determinants (B), social support (B & E), physical (E)
Helfrich et al., 2006	USA	Understand the meaning and development of identity in the worker role for women with disabilities who were transitioning from domestic violence shelters into the community over the course of 2 years	Qualitative. Two‐year longitudinal interviews	7 female IPV survivors with disabilities	Paid employment, mothering	Psychological (B), physical (B), sensory (B), cognitive (B)	Culture (B), education and policy (E)
Henze‐Pedersen & Poulsen, 2024	Denmark	The role of home in the recovery process of women and children subjected to violence	Qualitative; interviews	Study 1: Did not meet inclusion criteria. Study 2: 14 female IPV survivors	Mothering, homemaking, social functioning	Psychological (B)	Culture (B), social determinants (B), social support (B), education and policy (B)
Humphreys et al., 2011	USA	Describe the occurrence of chronic pain and to evaluate the differences in pain characteristics and IPV between women who reported mild compared with moderate to severe chronic pain	Quantitative; cross‐sectional questionnaire	84 female IPV survivors	Paid employment, education, general activity, general functioning (e.g., general activity, mood, walking, normal work, relationships with others, sleep, and enjoyment in life)	Psychological (B), physical (B)	Social support (B)
Lantrip et al., 2015	USA	Investigate the impact of partner violence on women's career development at different stages of IPV survival	Qualitative; case studies, interviews	4 female IPV survivors	Paid employment, mothering	Psychological (B), physical (B), cognitive (B)	Culture (B), social determinants (B), social support (B & E), education and policy (E)
Njelesani et al., 2021	Sierra Leone	To explore accounts of navigating intimate relationships from women with disabilities in Sierra Leone	Qualitative; interviews	13 female IPV survivors with disabilities	Mothering, social functioning	Physical (B)	Culture (B), education and policy (B & E), social support (B & E)
Staggs & Riger, 2005	USA	To examine how abuse history directly affects health and employment and explore the indirect effects of abuse	Quantitative; longitudinal interviews	1072 women receiving welfare: Past only (abuse before but not during the study, n = 159)	Paid employment	Physical (B), psychological (B)	Culture (B), social determinants (B), social support (B)
Tarshis et al., 2022	USA	Compare perspectives on economic empowerment in the context of employment seeking among IPV survivors and service providers specialising in IPV‐related trauma	Qualitative; interviews	16 female IPV survivors	Paid employment	Psychological (E), cognition (E)	Social support (B), education & policy (B), culture (B), social determinants (B)
Tarshis, 2022	USA	To understand how IPV and experiences of oppression relate to employment‐seeking	Qualitative; interviews	16 female IPV survivors	Paid employment, education	Psychological (B & E), spiritual (E)	Social determinants (B), social support (B & E), cultural (B), education & policy (B & E)
Ulmestig & Eriksson, 2017	Sweden	How do survivors describe their financial vulnerability after leaving abusive partners? How is the survivors' vulnerability handled within the social assistance system, and how are their needs recognised? How do survivors' backgrounds intersect with their needs getting recognised?	Qualitative; interviews	13 female IPV survivors	Survival‐based occupations	n/a	Social determinants (B & E), social support (B & E), education & policy (B & E)
Wills & Fitts, 2024	Australia	To gain insight into Indigenous women's perceptions of TBI, how they have managed their TBI symptoms and their decision‐making processes surrounding healthcare access and engagement	Qualitative; interviews and focus groups	18 female IPV survivors with TBI	Health management, general ADLs, social and spiritual occupations, leisure	Cognitive (B), psychological (B), physical (B, spirituality (E)	Social support (E & B), social determinants (B), education and policy (B), culture (E & B)

3.2. Occupational focus of studies

The main occupation represented was the productive occupation of paid employment and the worker role (15 papers). This included seeking, gaining, and keeping paid work, and the number of hours worked. The mothering role was discussed in eight papers, and other general daily functioning was featured in five papers (e.g., attending appointments for themselves or their children). Learning new skills (e.g., studying and getting a driver's licence) and social functioning appeared in a small number of papers. Survival occupations were discussed in two papers, which included spending time on activities due to lack of resources such as finding lower priced goods and services or completing tasks to increase income (Ulmestig & Eriksson, 2017), making and selling crafts, and renting spaces in their homes (Duffy, 2015). All papers focused on an environmental or person factor (or both) alongside their research into one or more types of occupations. These findings are discussed in the following paragraphs arranged by PEOP model domains. There was overlap between the domains of the PEOP model, and some enablers and barriers did not fit neatly within a single category. Furthermore, factors identified as enablers in some studies or for some participants were reported as barriers in others. To minimise repetition, each factor is reported once and has been assigned to the PEOP domain that provided the best conceptual fit. No papers explicitly discussed occupational justice in the recovery and healing stage of IPV.

3.3. Barriers to occupational recovery—Person factors

Person factors were extracted according to the PEOP model subdomains described in the methods above. Physiological, cognitive, psychological, and spiritual enablers and barriers to participating in occupations were identified in the included papers.

3.3.1. Physiological and cognition

Long‐term physiological factors, including pain, poor sleep, and the impact of acquiring a traumatic brain injury during IPV, were highlighted as barriers to participation in occupations in several papers. Wills and Fitts (2024) investigated participants who sustained traumatic brain injuries during IPV. The study found that cognitive and motor issues, including impaired balance, coordination, slurred or jumbled speech, and headaches, affected participants' social and spiritual engagement. This was echoed by Lantrip et al. (2015) and Cordier et al. (2023), with participants reporting that head injuries negatively affected their memory, ability to focus, and other cognitive functioning, which in turn hindered their ability to perform and confidence to complete certain jobs. Humphreys et al. (2011) reported that chronic pain was experienced by 77% of women in their study, and adversely impacted participants' employment status, relationships with others, sleep, and enjoyment in life.

3.3.2. Psychological

Factors in this domain were common among the included papers, including those raised by Adams et al. (2013) who linked women's job instability to higher levels of anxiety, with the correlation persisting 3 years post‐IPV. Bonomi et al. (2006) highlighted that women with past IPV were at increased risk of depressive symptoms and had lower social functioning scores. Additional psychological barriers to employment were reported in several studies (Broughton et al., 2024; Chronister et al., 2012; Chronister et al., 2018; Cordier et al., 2023; Lantrip et al., 2015; Tarshis, 2022). Lantrip et al. (2015) reported that PTSD symptoms, including paranoia, avoiding triggering stimuli, and flashbacks, inhibited participants' ability to engage in job searches and complete work and career‐related tasks. In a study of 16 women who were actively seeking employment or recently employed, Tarshis et al. (2022) reported that the ongoing psychological distress from their IPV experience meant that they needed time to recover and heal from their abuse, which impacted their work attainment.

Psychological factors were also linked to the mothering role. Cort and Cline (2017) reported that IPV negatively impacted participants' thoughts in relation to themselves and their ability to cope as a mother; as did Broughton et al. (2024), who reported that depression and anxiety symptoms, fears, poor self‐confidence, and PTSD symptoms impacted the mother role, including participants' sense of fulfilment from this role. Wills and Fitts (2024) reported that for a group of 15 Aboriginal Australians living remotely, mood and personality changes and trauma symptoms after IPV meant participants were more likely to stay home and miss out on important cultural practices such as yarning.

3.4. Barriers to occupational recovery—Environmental factors

Environmental factors were extracted according to the PEOP model subdomains, with education and policy, culture, social determinants, and social support and social capital being areas discussed by the included papers. Gender expectations, discrimination, limited social support, cultural norms, structural inequalities, ongoing coercive control, lack of accessible child care, financial barriers, and restrictive welfare policies emerged as some of the obstacles to occupational engagement and recovery across the included studies.

3.4.1. Education and policy

Adams et al. (2012) reported that unstable income and employment were frequent among women who had experienced IPV within the past 3 years, resulting in fewer employment benefits (sick leave, retirement, paid vacation, and health insurance), and more financial hardships such as inadequate housing, food, and financial insecurity (which is linked with social determinants). Although government assistance allowed some women the financial means to stay home to care for their children, it also created economic difficulties and work restrictions (Broughton et al., 2024), as well as feelings of discrimination when applying for work (Staggs & Riger, 2005). Limited access to affordable childcare often restricted women's employment opportunities (Broughton et al., 2024; Chronister et al., 2012; Chronister et al., 2018; Tarshis, 2022). Employment support programs frequently operated under strict regulations and policies, limiting women's ability to address their individual needs (Tarshis et al., 2022). Legal and public welfare assistance requirements created time constraints that interfered with work (Tarshis, 2022), and people from immigrant backgrounds experienced rigid immigration work visa policies that impacted their ability to secure a stable job (Chronister et al., 2012; Tarshis, 2022; Ulmestig & Eriksson, 2017). Any Education‐based barriers to occupational recovery were not highlighted by the included studies.

3.4.2. Culture

Attitudes, including gendered expectations that placed a priority on motherhood before career aspirations, impacted employment outcomes for some survivors (Broughton et al., 2024; Cort & Cline, 2017; Lantrip et al., 2015; Njelesani et al., 2021). Further structural inequalities such as classism, racism, intersectionality, and discrimination were also noted as barriers to gaining employment (Broughton et al., 2024; Chronister et al., 2018; Tarshis, 2022; Tarshis et al., 2022). Disability‐related ableism was reported to be a barrier for employment (Helfrich et al., 2006) and in the mothering role (Njelesani et al., 2021), as well as age discrimination from employers, which impacted job attainment for women aged 45 years and above (Lantrip et al., 2015). Women often felt blamed for their IPV experience or for leaving abusive relationships, which was linked to both employment prospects and their social relationships (Cort & Cline, 2017; Duffy, 2015). Ulmestig and Eriksson (2017), Tarshis et al. (2022), and Chronister et al. (2012) reported that people from immigrant backgrounds encountered language barriers and anti‐immigrant attitudes when searching for employment. Wills and Fitts (2024) reported ‘mother blaming’ from professionals, and fear related to involvement of government systems such as child protection. A study based across Hungary and Mongolia reported patriarchal societies, traditional gender norms, and acceptance and normalisation of IPV, especially in Mongolia, impacted how a person returns to their occupations after experiencing IPV, including finding employment and caring for their children (Amarsanaa et al., 2023).

3.4.3. Social determinants

All studies included participants with a history of experiencing IPV, highlighting a shared social determinant. Barriers to gaining employment and challenges with motherhood have been linked to low income; at times as a result of debt incurred by a former partner or ongoing legal costs that affected survivors (Lantrip et al., 2015; Ulmestig & Eriksson, 2017). Barriers such as insufficient funds for childcare, limited access to safe and affordable housing, stigma associated with low income and poor housing, and problems with accessing transportation created barriers to gaining and sustaining paid employment (Broughton et al., 2024; Duffy, 2015; Tarshis, 2022; Wills & Fitts, 2024). Lack of financial resources was also identified as a barrier for women pursuing goals of going to school or starting their own business (Chronister et al., 2018; Tarshis, 2022), and for women setting up a new home (Henze‐Pedersen & Poulsen, 2024; Tarshis, 2022). These barriers made the need for employment (even low‐paying work) urgent, impacting women's ability to pursue longer term career goals (Lantrip et al., 2015). Tarshis et al. (2022) raised the context of past emotional abuse as impacting women's vulnerability to exploitation, such as when negotiating salary and navigating coworker relationships.

3.4.4. Social support and social capital

Solo parenting with no assistance and at times interference from their children's fathers created challenges for women in both seeking employment and in the mothering role (Broughton et al., 2024). Limited social supports resulting from fleeing IPV contributed to personal and professional barriers, particularly regarding job networking (Chronister et al., 2012; Tarshis, 2022; Ulmestig & Eriksson, 2017). Additionally, coercive control often led to social withdrawal, which affected community engagement in the recovery stage (Cort & Cline, 2017; Lantrip et al., 2015) and hindered women's ability to establish themselves in new communities (Henze‐Pedersen & Poulsen, 2024). This would result in a survivor's inability to increase social capital. Although faith communities were identified as important and supportive for some, others reported experiencing judgmental attitudes, which reduced their social support and social capital (Duffy, 2015).

3.5. Enablers to occupational recovery—Person factors

3.5.1. Psychological

Several psychological factors were identified as enablers to occupational recovery in the included papers. These include self‐confidence, assertiveness, bravery, and optimism (Amarsanaa et al., 2023). Improved mental health, along with the development of personal motivation and self‐esteem, was shown to support women when they were seeking employment (Tarshis, 2022). Additionally, self‐reliance and personal strength were identified as factors supporting women to feel empowered after experiencing IPV (Tarshis et al., 2022).

3.5.2. Cognition

Factors, including strong organisational skills, were identified as supportive for the parenting role (Duffy, 2015). Increasing knowledge through further education contributed to improved employability and empowerment (Tarshis et al., 2022; Ulmestig & Eriksson, 2017). Learning new things provided survivors with a sense of independence and liberation, such as learning a new language, career improvement, and caring for children (Amarsanaa et al., 2023).

3.5.3. Spirituality

This was reported in some studies as an enabler for occupational recovery. Having faith and a spiritual or religious connection through attending a church was described as empowering and helped some women feel part of a community (Amarsanaa et al., 2023; Tarshis, 2022). Personal growth since leaving an abusive partner, as well as retelling stories and participating in cultural yarning, were also identified as important for healing (Duffy, 2015; Wills & Fitts, 2024).

3.6. Enablers to occupational recovery—Environment factors

3.6.1. Social support and social capital

Social support and social capital were referenced in several studies as enablers for occupational engagement, particularly for seeking employment. For example, friends and family supported with childcare when women left an abusive partner in search of safety (Duffy, 2015). Social capital, including peer support, sharing experiences, and gaining friendships through community programs as well as via a workplace, was vital to help foster a sense of community that supported ongoing employment (Tarshis, 2022; Tarshis et al., 2022). In one study, social support and increased social capital were also gained through recreational activity groups, such as dancing, yoga, or hiking (Amarsanaa et al., 2023). Older children were identified as enablers to their mothers when seeking employment, such as helping write resumes (Lantrip et al., 2015), as well as with other activities of daily living and financial assistance for women with a disability (Helfrich et al., 2006; Njelesani et al., 2021).

3.6.2. Education and policy

Formal support from women's employment organisations and community agencies, such as training on resume writing, online job searching, and role‐plays of conversations with potential employers, was reported as valuable for supporting employment readiness (Chronister et al., 2012; Duffy, 2015). Furthermore, IPV organisations that offer professional clothing, employment placement programs, childcare assistance, and trauma‐informed counselling and mentor services supported women in securing employment (Tarshis, 2022).

One study from the USA reported that welfare supports such as disability pensions or unemployment benefits allowed women to choose not to work and care full‐time for their children at home, which was valued more highly by some women than seeking employment (Helfrich et al., 2006). They identified success and independence within other areas as having greater overall importance than paid employment (Helfrich et al., 2006). This was the only study that reported that paid employment was not the aim of recovery for all participants. Public housing was also reported as an enabler to recovery and women's independence (Lantrip et al., 2015; Njelesani et al., 2021). In a study from Sweden, social assistance payments were reported as crucial for survivors of IPV; however, this often wasn't enough to cover all expenses, so the social support offered by family and friends was just as necessary (Ulmestig & Eriksson, 2017).

3.6.3. Culture

Cultural factors were viewed as supportive for participants in regional Australia, such as being part of an Indigenous culture that values yarning, sharing stories, and supporting each other, including help with shopping, paying bills, washing clothes, cooking, and offering a place to live after experiencing IPV (Wills & Fitts, 2024).

4. DISCUSSION

4.1. Dominant focus of the review

This scoping review reported the interplay of person and environmental enablers and barriers associated with occupational recovery for women who have experienced IPV. Many of the included studies centred on employment as the main outcome, skewing the results of this review toward paid work. Although work and income are often seen as success indicators in capitalist societies, they represent just one dimension of occupational recovery after IPV, and broader research gaps remain. The examples of environmental factors raised in this review showed that larger barriers for women who have experienced IPV tend to fall outside their personal capacities. This highlights the need to address broader external and systemic factors, and the structural contexts where women are living, to support survivors during the recovery stage. By moving beyond goals focused solely on building survivors' individual capacity, this perspective supports occupational justice practice (Bailliard et al., 2020).

4.2. Occupational justice lens

Although the included papers do not explicitly address occupational justice for survivors of IPV, the findings can be interpreted within this framework. Heightened awareness of injustices is recognised as an essential step toward social change and in the promotion of human rights and justice, aligning with methodologies discussed in occupational therapy literature focused on underrepresented populations (Benjamin‐Thomas & Rudman, 2018). An occupational justice application of the results is discussed in the following paragraphs, with occupational justice viewed as being able to exercise choice and control over what occupations a person engages in and how they choose to spend their time.

4.2.1. Enablers and barriers to restoring occupational justice

Across the included papers, there was evidence that some women experienced enablers that supported the restoration of occupational justice, particularly through increased choice and control in employment. For example, some participants acquired new skills, pursued personal aspirations, and secured employment that positively influenced their self‐esteem and wellbeing (Amarsanaa et al., 2023; Tarshis, 2022). However, several larger longitudinal studies did not examine choice or control as outcomes, instead focusing solely on job stability or employment status (Adams et al., 2012; Adams et al., 2013; Staggs & Riger, 2005). In the absence of attention to job satisfaction or autonomy, occupational justice cannot be assumed within the findings of these papers. Smaller studies that explored employment experiences in greater depth demonstrated that many women continued to face limits to choice and control during the recovery stage. Women who had experienced IPV frequently entered employment that did not align with their skills, interests, or aspirations, and reported limited influence over their career trajectories (Cordier et al., 2023; Lantrip et al., 2015; Tarshis et al., 2022; Ulmestig & Eriksson, 2017). At a meso (organisation) level, employment support programs often prioritised rapid workforce entry over meaningful or suitable roles, further constraining women's autonomy (Tarshis et al., 2022). Additionally, factors such as ongoing financial vulnerability because of IPV (Ulmestig & Eriksson, 2017), lack of affordable childcare and transport (Broughton et al., 2024; Chronister et al., 2018), and inadequate social or informal supports limited survivors' choices for meaningful work and recreation.

Experiences of discrimination further constrained women's choice and control in employment seeking and maintaining a job, contributing to ongoing forms of occupational injustice (Chronister et al., 2018; Tarshis, 2022; Townsend & Wilcock, 2004). At a macro or system‐level, factors, including the lack of responsive supports for women with disabilities or those from minority backgrounds, limited recognition and diagnosis of traumatic brain injury, and fear of engaging with government systems, further restricted the occupations women were able to engage in (Wills & Fitts, 2024). These findings align with previous research that highlighted the occupational injustice among women with disabilities who were experiencing IPV (e.g., Ballan & Freyer, 2020). However, the findings of the current review demonstrated that occupational injustice can persist even after the abuse has ended, as survivors continue to navigate systemic barriers that follow them beyond the immediate period of violence. This reflects experiences of occupational marginalisation, characterised by restricted access to meaningful occupations, limited choice, and exclusion shaped by social norms, institutional expectations, and structural constraints (Durocher et al., 2014; Hammell, 2008; Townsend & Wilcock, 2004).

Being forced to participate in certain activities, or lack of opportunity to participate in meaningful occupations, also restricts choice and control (Galvaan, 2012; Hocking, 2012). Galvaan (2012) argues that marginalised groups can lack the power to pursue their preferred occupations due to socio‐economic and political influences. This was evident when participants needed to prioritise survival activities over others due to lack of resources (Duffy, 2015; Ulmestig & Eriksson, 2017). Limited childcare options or social support, and the demands of single parenting further restricted access to work or educational opportunities, making these opportunities inaccessible for mothers after experiencing IPV. As a result, mothers often had limited time and opportunity to engage in occupations that supported healing and wellbeing. Not having access to these activities can lead to occupational alienation, where individuals are forced to participate in activities they find meaningless and unrewarding (Durocher et al., 2014; Townsend & Wilcock, 2004), and occupational imbalance, where time and energy are disproportionately devoted to one aspect of life at the expense of others (Townsend & Wilcock, 2004).

4.3. Implications for research, policy, and practice

Further research is needed to examine the systemic barriers and enablers that impact occupational recovery in an Australian context, particularly beyond paid employment and following separation from an abusive partner. Such research should investigate the environmental factors that facilitate or hinder re‐engagement in valued occupations, as well as strategies to support occupational recovery and restore occupational justice. Findings from this work could support the integration of occupation‐focused approaches within Australian IPV recovery frameworks and policies. As this current research has shown that policies can either enable or constrain occupational recovery, advocating for policy change that promotes engagement in meaningful occupations represents an important form of occupational justice practice and human rights at the macro level (Bailliard et al., 2020).

An important consideration not explicitly addressed within the PEOP model is intersectionality. Findings from this review suggest that cultural, social, and policy‐related environmental factors may differentially shape occupational recovery depending on individuals' intersecting identities. For example, sexism, racism, ageism, ableism, and xenophobia were identified as barriers to occupational recovery in this review. Future research should consider how intersectionality shapes experiences of occupational injustice and occupational recovery following IPV.

Participation in meaningful occupations could help support a survivor's recovery and healing after experiencing IPV. Any supports that are offered, including employment supports, need to be individualised and prioritise meaning for the survivor, not just quick job placement. Occupational therapists have a role in facilitating survivors' reengagement with their chosen valued occupations by addressing not only the provision of individual supports, but also identifying and working to overcome the broader systemic barriers affecting survivors' participation. This would in turn promote occupational justice and human rights for survivors recovering from IPV.

At the micro level, occupational therapists should be attuned to personal biases that may unintentionally impose goals or priorities on survivors. Occupational justice practice would include supporting survivors to identify and pursue occupations that are meaningful to them, while also advocating for, or fostering self‐advocacy skills (Bailliard et al., 2020). For example, occupational therapists may support survivors to advocate for workplace flexibility when childcare responsibilities create barriers to participation in the workplace.

4.4. Study limitations

Certain limitations of this scoping review should be acknowledged. Firstly, only English studies were included, which may affect why some countries are not represented and limits the generalisability of the results to other countries. Secondly, as the timing of the past IPV experience varied greatly between and within studies, we cannot comment on time being a factor that supports healing and recovery. Lastly, in this scoping review, we tried to apply an occupational therapy framework to findings derived from studies outside the field of occupational therapy. In doing so, we sought to interpret and synthesise the evidence through an occupational lens, aiming to highlight how diverse personal and environmental factors impact women's opportunities for meaningful occupational engagement and recovery following IPV. However, no studies aligned perfectly with an occupational therapy framework, and variations in terminology between disciplines were seen, so there are likely to be gaps in the research.

5. CONCLUSIONS

This scoping review reported the interplay of person and environmental enablers and barriers associated with occupational recovery for women who have experienced IPV, with a strong focus on gaining and maintaining paid employment. Although some personal factors such as individual resiliency and physical health are important to support gaining and keeping a job, broader environmental factors such as limited access to meaningful employment, inadequate childcare and social supports, experiences of discrimination and social expectations and attitudes, lack of tailored supports, and restricted financial resources play significant roles in shaping occupational opportunities and outcomes for women after experiencing IPV. These barriers mean that occupational injustices, including lack of choice and control into a person's occupations, can continue into the recovery stage and potentially impact the healing process.

AUTHOR CONTRIBUTIONS

B.S. was primarily responsible for coordinating, conducting, and writing up the study. L.P., L.T., R.W., and B.S. developed the search strategy. The screening and extraction processes were coordinated by B.S., with ongoing support provided by L.P. and R.W. All other authors contributed extensive feedback and revisions during the draft stages. All authors reviewed the final manuscript and approved its submission for publication.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflicts of interest.

Safe, B. , Parsons, L. , Waters, R. , Timms, L. , & Chung, D. (2026). The recovery of valued occupations after intimate partner violence: A scoping review analysis using the Person Environment Occupation Performance model and an occupational justice lens. Australian Occupational Therapy Journal, 73(5), e70124. 10.1111/1440-1630.70124

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.