Impact of Sources of Strengths on Coping and Safety of Immigrant Survivors of Intimate Partner Violence

Abstract

Intimate partner violence (IPV) is a national and international public health and human rights concern. Immigrant women are disproportionately affected by IPV that includes homicides. This study explored the perspectives of survivors of IPV, who are immigrants to the United States, regarding their sources of strength that enhance their safety and promote coping in abusive relationships. Data for this qualitative study were collected from ethnically diverse immigrant women residing in Massachusetts, Arizona, Virginia, Washington, D.C., New York, Minnesota, and California, using purposive and snowball sampling techniques. Eighty-three in-depth interviews were conducted with adult immigrant survivors of IPV who self-identified as Asian (n = 30), Latina (n = 30), and African (n = 23). Data were analyzed using thematic analysis. Women identified both external (e.g., community support, support from social service agencies) and internal (e.g., optimism, faith, beliefs) sources of strength. The study highlights how these sources can adequately address needs of survivors and offers areas for improvement in services for survivors. The findings are informative for practitioners serving immigrant survivors of IPV in legal, social service, and physical and mental health settings.

More than 44.5 million immigrants resided in the United States in 2017, approximately 52% of whom were women (Zong et al., 2019). Intimate partner violence (IPV) against women is a significant global and national public health problem, with one third of women who have been in a relationship experiencing physical and/or sexual violence by their intimate partner during their lifetime (Devries et al., 2013). Immigrant women in the United States are disproportionately affected by IPV and severe IPV including homicide (Frye et al., 2005; Sabri, Campbell, & Messing, 2018). The lifetime prevalence of IPV in community-based studies among immigrant women in the United States range from 24% to 60% (Y. Lee & Hadeed, 2009; Raj & Silverman, 2002; Yoshioka et al., 2000).

An intersectional perspective—the idea that multiple marginalized identities and characteristics of an individual interact to shape their social experiences—includes an assessment of how not only gender but how minority race/ethnicity, religion, and immigration status may interact to shape women’s safety and health (Ahmad et al., 2013; Sabri et al., 2019; Sabri & Granger, 2018). Immigrant women may be adjusting to a new culture and health and justice system in the United States, while at the same time experiencing structural disadvantage and discrimination when interacting with these systems to promote their safety (Orloff et al., 2003; Shavers et al., 2012). While the concept of acculturation, arising from social psychology, and intersectionality, arising from critical race theory, come from fundamentally different and potentially contradictory theoretical perspectives, employing ecological system theory (Bronfenbrenner, 1992) can help to highlight how factors at multiple levels of the environment work in concert to shape immigrant women’s safety. For instance, their experiences of social isolation associated with immigration to a new setting at the microlevel, together with the experience of structural factors such as economic barriers and potentially restrictive norms about the roles of women in families and community, can all simultaneously increase vulnerability to IPV (Sabri, Nnawulezi et al., 2018). Studies have shown that there are a number of factors unique to immigrant populations (e.g., lack of connection with family of origin, low familiarity with laws, and rights in new country), which were found to elevate this populations’ vulnerability to IPV (Bauer et al., 2000; Denham et al., 2007; Firestone et al., 2003; Mindlin et al., 2011).

This study explored (a) what internal and external sources of strengths could address IPV among immigrant populations and (b) how immigrant survivors’ sources of strengths influence their safety and coping with abuse? Despite immigrant women’s experiences of IPV within a context of intersectional disadvantage (Turan et al., 2019), internal and external sources of strength can promote resilience or influence their ability to deal with their abusive relationships. Notably, intersectionality theory also points to the importance of taking a strengths-based approach and examining the possible sources of resilience that lie at the intersection of multiple marginalized identities (Turan et al., 2019). Resilience is a dynamic process in which environmental, psychological, and social factors interact to enable a person, at any stage of life, to recover from adverse life experiences (Sabri et al., 2019). These factors, or sources of strength, can be found at the cultural, community, relationship, and individual/survivor levels (Njie-Carr et al., 2020; Sabri, Simonet, & Campbell, 2018). For instance, supportive family and friends, religion, education, empowerment, and safety strategies were identified as sources of strengths for South Asian immigrant survivors of IPV (Sabri, Simonet, & Campbell, 2018). Among Latina immigrant survivors, love of children and economic and emotional support of family and friends helped survivors move on from abuse, despite facing many adversities, including difficulties seeking help (Silva-Martinez, 2017).

Immigrant women face significant obstacles to help seeking and engaging in domestic violence services including language barriers, immigration status, and amount of time in the United States (Messing et al., 2013; Postmus et al., 2014; Raj & Silverman, 2002; Vidales, 2010). Survivors seek help from formal and informal systems, as well as engage in multiple coping strategies to protect themselves and their loved ones, often increasing help seeking efforts as violence becomes more severe (Hamby, 2014). Women utilize coping strategies such as acceptance or minimization of the abuse, behavioral distractions, future orientation, seeking informal and family support, using prayer, and having faith in God, divine retribution, and in their ability to survive.

Knowledge of available services and help seeking empower survivors (Ting, 2010). The majority of help seeking research, however, has focused on women’s utilization of formal services (Anyikwa, 2015; Durfee & Messing, 2012; Flicker et al., 2011; Lipsky et al., 2006; Nurius et al., 2011). Yet, women seek help in multiple ways that reflect their individual characteristics (including immigration status), relational histories, sociocultural positionality, and economic factors (Cho et al., 2017; Liang et al., 2005). A nascent body of research that examines patterns of help seeking among IPV survivors (Ben-Porat, 2017; Cheng et al., 2020; Hanson et al., 2019) further reiterates differences across women’s responses to IPV. For instance, in a study, women who substantially used welfare and criminal justice services were those who were employed, experienced severe emotional distress and severe IPV, and desired to end the relationship or to have the abuser removed from home (Ben-Porat, 2017). Regardless of the differences in patterns of help seeking, the use of sources of strengths such as will power and determination, family and community support, available services, and laws and regulations protecting survivors of IPV can help address IPV and protect women from future abuse (Sabri et al., 2018; Sabri et al., 2019).

Drawing from the resilience or the strengths perspective (M. Lee, 2007; Saleebey, 1996; Slabbert, 2014), this study explored external and individual sources of strength among diverse groups of immigrant survivors and examined how these sources influenced their safety and coping with abuse. The strengths perspective refers to building on survivor’s hidden strengths and competencies, focusing on what they can do rather than on what they cannot do (M. Lee, 2007). The assessment and intervention process involve discovering and exploring survivors’ strengths in dealing with their IPV and how these strengths may be used to improve their situation (Slabbert, 2014). The strengths-based perspective can be used to build on the natural abilities of immigrant survivors as well as understanding how aspects of their communities and cultures may be drawn upon for support and strength (Sabri, Simonet, & Campbell, 2018). Practitioners can reflect on protective actions that the immigrant survivor has taken and how to capitalize on their strengths. While prior research has focused on risk factors only or resilience factors in only some groups of survivors, studies have not examined sources of strengths and their variations among diverse groups of immigrant survivors. With the growing immigrant populations in the United States, practitioners are more likely to encounter survivors from diverse countries of origin and would need to provide culturally informed safety planning services. Identifying sources of strengths and their roles in women’s safety or coping can be useful for the development of intervention strategies for immigrant survivors of IPV in the United States.

Method

Participants and Eligibility

Data were collected from 83 immigrant IPV survivors who self-identified as Asian (n = 30), Latina (n = 30), or African (n = 23) and were first- or second-generation immigrants. Women were eligible if they were over the age of 18, had experienced IPV in the past 2 years, and self-identified as an immigrant from Asia, Latin America, or Africa. They were recruited from multiple regions in the United States: Massachusetts, New York, Arizona, Virginia, Washington, D.C., Minnesota, and California. The sample size of 83 women was adequate to reach data saturation in each group (n = 30: Asians, n = 30: Latinas, and n = 23: Africans). A sample size of less than 16 participants is adequate for homogenous groups and 20–40 participants for heterogeneous groups (Hagaman & Wutich, 2017).

Women represented six Asian cultural groups from India, Philippines, Pakistan, Laos, Thailand, and Hmong; nine Latina groups from Mexico, Jamaica, Dominican Republic, Puerto Rico, El Salvador, Honduras, Peru, Guatemala, and Colombia; and eight African groups from Democratic Republic of Congo, Rwanda, Burundi, Nigeria, Uganda, Somalia, Kenya, and Ethiopia. Women were on average 37.1 years old (SD = 10.9). Except for the two second-generation immigrants, they had been in the United States for an average of 9 years (SD = 8.8). More than half (61.5%, n = 72) were employed at the time of the interview; the remainder of the women either were unemployed or did not specify their employment status. Most women in the sample were mothers (82.5%, n = 71), with an average of 2.5 children. Participants reported time apart from their partners varied from 2 months to several years.

Procedures

Using purposive and snowball sampling, participants were recruited using multiple strategies including flyers posted at organizations serving immigrant survivors as well as locations where immigrant women were expected to congregate (e.g., mosques, churches, events, and meetings), word of mouth, and meetings with community collaborators. Interviews were conducted by four trained members of the research team using a demographic sheet and a semistructured interview guide. The questions focused on living situations, survivors’ perceptions of what was expected of them as women in their communities, their relationship experiences, perceived risk and protective factors for IPV, how they help themselves safe, and perceptions of safety planning interventions. For instance, survivors were asked: What are some of your characteristics that have helped you as a survivor? How did you use these strengths to your advantage? Women were given the option to decide on an interview location that they thought was safe and convenient. The interviews were conducted using a demographic sheet and a semistructured interview guide. The interviews lasted approximately 2–2.5 hr depending on whether an interpreter was used. Women were compensated US$25 for participation in in-depth interviews and $10 for travel. All interviews were audio-recorded using digital recorders with interviewers also taking field notes. Data were transcribed using professional transcription services. All study procedures were approved by the institutional review boards at the home institutions of the investigators.

Analysis

Data were analyzed using a thematic analysis procedure (Braun & Clarke, 2006). The analysis involved coding and classifying data according to broad domains of interest (e.g., external sources of support) and in vivo coding of content within these broad domains. Data were coded by three trained members of the research team. The members agreed to the content and meaning of each code. Codes were then aggregated into themes and subthemes. Trustworthiness was established by maintaining an audit trail through detailed notes of research activities, recording of thoughts and experiences, regular debriefing sessions among team members, and analytic triangulation with more than one coder.

Findings

In our analysis, immigrant women identified both external and internal sources of strengths. The external sources of strength referred to support received in immigrant survivors’ interpersonal (e.g., support from children and friends) and community (e.g., availability of culturally informed services) contexts. External sources of strengths, in this study, included informal and formal sources of support. The informal sources of support were community support and social connectedness, friends, neighbors, and family. The formal sources of support were social service and health care organizations and police and the legal system.

Internal sources of strengths, in this study, referred to factors at the individual level. The individual-level factors include women’s individual attributes, abilities, or their use of adaptive coping strategies (i.e., cognitive and behavioral efforts to manage their stressful circumstances; Lazarus & Folkman, 1984) such as engaging in self-care practices for emotional well-being, keeping calm, and being hopeful. The internal sources of strengths for immigrant survivors were found to be faith and belief, acculturation, and personal characteristics such as continued optimism or positivity about life; having hope; being strong, determined, and willing to stand up to life situations; not hesitating to ask for help; having a “fighting spirit”; taking steps to address abuse; and being calm.

While women in our sample differed in their cultural backgrounds and countries of origin, we found more similarities than differences in their reported external and internal sources of strength. For instance, women from all regions described community, friends, neighbors, family members, and religious institutions as their sources of strengths. There were, however, some variations in experiences and in culturally specific sources of strengths. For instance, more women from Asia and Latin America reported positive experiences with the police and the legal system than women from Africa. Among culturally specific sources of strengths, African women discussed receiving help from elders in the community, and having an advocate from the same cultural background was reported as an external source of strength by Hmong women.

External Sources of Strengths

Informal sources

Social connectedness and community support.

Almost half of women from Asia or Latin America described their communities as a source of help and support and described a sense of inclusion and safety arising from membership in different informal and formal community groups.

When you’re involved in your community, you feel like you have a lot of people to help you. If you are inside the house, like what I did before. I didn’t have a choice at the time. I felt like nobody’s going to help me. I didn’t have friends. Now I’m involved in an organization where they help domestic violence victims and human trafficking. It just feels good, because I feel like I have a family here. I’m not alone. Having community, friends, surrounded by good people… makes you feel like you can do anything. Someone will back you up. (Filipina survivor)

Community was also a resource for connectedness and support for seven African survivors. For instance, elders in the community played an important role in resolving instances of abuse: “There is a Burundian community called Baho..... these are people … who … help them to resolve their problems without involving the law enforcement” (Great Lakes Region survivor). Another African woman described the important role of this type of support, although elders were ineffective in stopping her husband’s behavior and she said they simply took his side:

It would be good if there is an in-between. [In the U.S.] it’s more of that the law is enforced. From the culture I come from, the elderly … can sit in between and try to solve the issues. It would be good if there is a way of having such kind of intervention before letting the man go to prison and the woman maybe in a shelter. (Ethiopian survivor)

Friends.

Almost one fourth of women described friends as a source of advice, emotional support via listening to the woman, discussing their problems, and knowing that there is someone who would be there for them if and when they called. The quality of nonjudgment was emphasized. In two cases, women from Latin America explained that they had friends who encouraged them to move forward and offered a safe place to stay.

I have friends that have tried to help me move forward, and they’ve been able to support me in the most difficult times..... My friend said that if I had the strength to leave him, not to worry, that I could depend on her, no matter what, and she would help me get through it. (Central American survivor)

When specified, friends were most often talked about in the context of work and church by Latin American and Asian women. Women from Africa also echoed thoughts about the importance of community and friends from places such as work or church.

Neighbors.

Neighbors were mentioned as an important resource by one fifth of women in the study, which included women from all regions. For some women, the neighbors provided tangible support including a safe space to flee to or stay and simply a presence that the women knew noticed the abuse. For others, neighbors provided referrals to available services or even contacted the police for them in times of danger. Several Asian women mentioned that the neighbors would at times intervene by calling the police (in two cases) or by talking to the partner (in one case).

Then he left the house, and then I grabbed my daughter and went straight to my neighbor. I slept over at my neighbor’s house. My neighbor helped me to call the police. Then, the police wrote the report, and then they took me to the hospital. Then, they arrested my husband. (Filipina survivor)

For an African woman, having a supportive neighbor had a dramatic impact in preventing her from harming herself. Having gotten to a point of feeling like the only way out of her abusive situation was taking her own life, her neighbor promised to look after her if she promised not to take her life. The woman explained that “she was my hero. She rescued me.” She also explained that going to the neighbors just to “sit there” and have people give her advice was very helpful.

Family.

Regarding family, 12 women in the study that included women from all regions discussed their children as being a source of strength or reason for leaving. At times, children were able to connect their mother to resources through their school or, more commonly, were a source of encouragement or support for a woman to leave her relationship:

One night I remember [my daughter] said, “Mom”—we can do it. I’ll go get a job. … I remember one Christmas Eve night I gave her $60 and she took it and bought 3 stress candles for me. She bought perfume … and even that didn’t make me happy, but the fact that she spent all her money. I was saying “she loves me so much, and I’m putting this man in front of her, it’s time for me to let him go.” (Caribbean survivor)

For one fifth of women in the study, the influence of children was less about their own safety in the present moment, and more about how witnessing abuse could shape their children’s ideas and behaviors, as they grew into adults with their own intimate relationships. As explained by one woman,

When my little one was born, I started thinking about it, I said, “Okay, if I keep raising this girl in this house, she’s going to think that this is how women live.” That’s not the legacy I want to leave for my daughter … just by looking at her, it makes me feel like I have a reason to keep fighting and living. (Congolese survivor)

In addition, two Hmong women found that having their children nearby kept them safe from abuse. Alternatively, partners’ threats about keeping a woman from her children or concerns about providing for their children were expressed by some women as limiting their ability to leave. Of note, the influences of culture and family could come into conflict with one another.

I think the inner strength of it was really doing it for my daughters … setting an example saying you don’t have to live the life that I did. That you’re not like your father, that you’re different, that you can be strong. At the same time, even though I feel like being divorced means that I’m not a good role model for all the young girls that I work with. I think at the same time it also makes me feel like I can also be a role model for them. Saying that we can be strong, Hmong women. We don’t have to put up with men mistreating us. (Hmong survivor)

Family members, especially among Latin American women, were said to denormalize abuse, encourage, and reassure a woman in her decisions about leaving a relationship or staying safe, pick them up when needed, make referrals to care, and even just provide a safe space to go to when they needed it. Ten women from different regions discussed their mothers as an important source of support, for example, one Latin American woman described “my mom, even though she lives in the Dominican Republic. She’s 86 years old. She’d always give me words that were positive. Give me the strength” (Caribbean survivor).

Latin American women discussed a larger variety of family members (e.g., grandmother, sister, cousin) as supporting them and intervening to assist them when experiencing violence as compared to the Asian and African women. One woman even discussed receiving support from their partner’s family as demonstrated in the following quote:

[His grandmother] used to tell me, “You should leave him. You should leave my grandson because you and him, you guys never going to be happy together. He’s not the man for you.” (Mexican survivor)

Yet, women’s understandings of how other members of the family aided or hindered their ability to stay safe were far more mixed than responses about children. At least one woman from Africa said she had no support from her family, and two others said that they had no family on which to rely. A Hmong woman also pointed out that sometimes family members were limited in what they could do because they feared the abuser.

Religious institutions.

Religious institutions such as churches and mosques were described as helpful resources by one fifth of women in the study. Particularly for women from Congo, the church was viewed as an institution with a role to play in resolving their situation. As such, it was common for women from Africa to try some sort of counseling through religious institutions when the abuse occurred. Two African women described their church telling the man that his behavior was unacceptable. For instance,

The church was my only refuge. … I tried to sit him [abusive partner] down and call the pastors and people from my church. I told them about this behavior. They told him, “Your behavior [will] tear apart your family … you need to stop.” (Congolese survivor)

However, three women found that religious institutions were not effective in stopping the abuse, or in some cases, those religious leaders or the community would side with the husband or fail to meaningfully intervene. Several women from Asia and Latin America did describe other ways that the church supported them, similar to African women. For instance, an Indian woman described her pastor connecting her to domestic violence service providers, and a Latin American woman said her pastor would pick her up when needed.

Formal sources

Social service and health care organizations.

In general, more than half of the women which included immigrant women from each region described positive experiences with formal support services for women experiencing IPV. Health providers, therapists, caseworkers, social workers, or counselors were all described as people who could be trusted and had, or could, help women experiencing abuse. One woman from Congo said her community health clinic is “why I’m still walking around” (Congolese survivor). Domestic violence organizations were thought to provide important information about the legal system, women’s rights, and other resources for assistance, but women also described few tangible impacts of these services on their lives:

They [organization] made me feel like, “Okay, so there’s people who actually care about me, who can look after me and protect me.” They made me feel safer. I felt more secure, because I felt like even if something happened to me, these people already know what’s going on, so they’ll seek justice for me … every time something happened to me, I knew I had to go to them and talk to them. (Congolese survivor)

Some participants expressed a view that many services are available to women in the United States experiencing IPV, and the broad nature of the support that these organizations provide was emphasized. For instance, one woman reached out to a nonprofit when she began to feel like the abuse she was experiencing could be fatal; she explained,

[The nonprofit] provided me a shelter … a home to make sure that I was safe, and my daughter too. They provided me food. They provided me classes where I learned how to find a job. At that time, I didn’t have a job. Then, I started a job. I was working at the hotel. Then, they provided me a daycare while I was working, and they were watching my kid for free. … It’s also good that the police were involved. Don’t be afraid of talking. … You have to remember, we’re all even. It can be your husband. It can be your father, your mother, or anyone that’s abusing you. The main thing here is your life is only one, and you have to protect yourself, especially when you have kids. (Filipina survivor)

Many women commented on how much they appreciated follow-up from organizations and that service providers would take initiative to reach out to them. As one Hmong woman described: Having them [service providers] call me randomly—and saying, “I understand that you were victimized. How can I help you?” that helped a lot (Hmong survivor). Another survivor described an ongoing relationship with her social worker: “The social worker still looks out for me and wants to know how the situation is. She still asks for me and wants to look out for me. She follows up, and that’s been really great” (Caribbean survivor).

Police and the legal system.

One fourth of women in the study described police as a helpful resource. Five women, however, reported negative experiences with the police, and seven reported being afraid of calling the police. In general, women from Latin America and Asia were more positive than African women about the police and legal system, describing them as a helpful resource. As one woman explained:

I remember, I was shaking at that time and one policeman helped me and gave me water … tried to calm me and talk to me, like, “Everything’s okay now, you’re safe now. We’re here to help you.” They’re really, really nice. They even sent me to my sister’s house, because I didn’t know what to do. They asked me if I have siblings here and then I was like, “Yes, she’s working right now, so I can’t call her, but I know she is at work.” Then the sheriff sent me to my sister’s workplace. (Filipina survivor)

Another Filipina woman said that the appearance of the police when she called them “made me feel powerful.” These sentiments were not universal, however, with one Latin American woman and one Indian woman describing being afraid to call the police, more in line with statements from five African women. Four women from Africa described that it was culturally unacceptable to involve the police in instances of IPV and that doing so could cause them to be ostracized. For example, one woman explained that if she had involved the police and it resulted in her husband being imprisoned, her community would have blamed her for this. The results of these interactions were mixed and ranged from police being described as a source of rescue to having issued restraining orders that were ultimately ineffective.

He called the police when we were breaking up. The police said, “get the hell out the man house.” Even when they saw that I didn’t do anything wrong, and he was even acting violent in front of them—all the police said was, “Back off, leave her alone.” Even then, the police said, “You know you’re a strong man to be putting up with this crap.” (Jamaican survivor)

Internal Sources of Strengths

Religious faith and beliefs.

Almost one third of women in the study which included women from across all regions discussed religion as a source of support; however, the way that religion was discussed varied somewhat by region. Although the religions practiced by women varied by ethnicity, many women from Latin America and Asia emphasized faith, belief, and prayer as aspects of spiritual life that were important in helping them feel safe or survive the abuse. In at least one case, faith was described as a last resort or something that was always available to a woman even when nothing else was.

[Talking about another survivor she knew] She said some of her barriers were that she really felt like nobody could protect her, and so she depended on her faith and belief, and she prayed, often, to her ancestors to protect her and just to keep her safe. She felt like she couldn’t go anywhere else, and she depended on her faith to protect her. (Hmong survivor)

The fellowship that the church provided was also described by several Latin American women and a Filipina woman as important:

I think it’s a good thing to be surrounded—you have to be surrounded by good people around you. Make sure that you have good friends. If you have the same beliefs, that’s very important. You have to be also involved in the community like me. I actually went to my church I volunteer. I asked them, “Hey, I want to be involved. I want to help here. … It feels good. It’s helping me to feel safer. (Filipina survivor)

Acculturation.

Acculturation in this study refers to women adopting the American cultural values, with or without retaining their heritage culture (referred to as integration/biculturalism or assimilation, respectively; Berry, 1980; Schwartz et al., 2010). In the process of acculturation, an immigrant woman may adopt some (or all) aspects of the U.S. culture and retains some (or all) aspects of the cultures of their countries of origin (Sabri, Simonet, & Campbell, 2018; Sam & Berry, 2010; Schwartz et al., 2015). For abused immigrant women, this may include the adoption of egalitarian gender role beliefs, assertion of rights in relationships, gaining awareness and knowledge of resources, and seeking help to address abuse in their lives (Sabri, Simonet, & Campbell, 2018).

Seventeen percent of women in the study who belonged to Asian and Latin American regions described the United States as a place of greater empowerment, freedom, and ultimately safety for women. Generally, as Asian women adopted values more in line with Western culture, they were better able to discover and utilize services around them,

The more that people are comfortable with being here in this country, they will leam that there are laws in the country to protect you, and if you ever feel in danger, that you could go to the police so that they can protect you from being killed. … The more acculturated you are here in this country, the more you understand that there are a number of organizations, anything from addressing just health to safety to your mental health state and things like that. … That helps to keep you safe. (Hmong survivor)

Beyond access to services, one woman from the Philippines described that “the culture [in the U.S. is very empowering for women” and that “that helped me tremendously. … It has really affected me in a way that I know now how to fight and not just be passive and to be tolerating of his actions.” Many women explained that they would still be undergoing abuse from their partners if they had remained in their home countries,

I think [adapting to American culture] has helped me a lot. If I were to be in my country, I would still be with him. I would be begging him to come back to me … [There] society tolerates more, “It’s fine. He was drunk; nothing happened. She’s okay.” It’s different. Here, it’s a big deal. (Central American survivor)

While almost one fifth women from Africa also recognized increased freedom in the United States, one woman explained that in some ways, this freedom served to exacerbate her risk when it was perceived as a threat by the abuser.

Because the culture [between the United States and Somalia] is very different, and because of religion, if the husband is used to you having the Somali culture, your change can create a lot of risk. It’s possible that he kills her because now they’re not in the same culture, and he won’t be getting what he is used to getting from that. (Somalian survivor)

Personal characteristics.

Despite the enormous challenges survivors experienced, slightly less than one fourth of them reported internal strengths such as being strong, determined, patient, and willing to stand up to any situation; ability to access resources; having a positive personality; being social; not being afraid easily; and being calm. Women, particularly women from Asia, talked about several important personal characteristics that helped them survive and persevere in the context of abuse. One quality that was emphasized was a continued optimism or positivity about life despite (or even in response to) their circumstances:

I’m a very positive person. No matter how hard life was I always see the good thing. I think a lot of it has to do with my life too as a little child escaping through war and suffering. I lived in a refugee camp for 5 years and seeing so much violence, seeing so much about what people had to go through. I think I was just always in a surviving mode. Just thinking, “This is better than what it used to be.” Or something like, “I need to do what I need to do to survive.” (Hmong survivor)

The inner strength to survive, persevere, and achieve was discussed by women from other regions as well (i.e., Ethiopia, India). A Filipina woman described inner strength by saying:

You can tap your untapped potential, and that’s being unique for you as a survivor. Otherwise, you tend to be lenient about knowing your strengths. You may have taken yourself for granted and you may not have discovered that actually you have that inside of you. That’s one thing for me to be thankful for. (Filipina survivor)

This same woman also emphasized being resourceful and creative, while others emphasized both a desire not to be a burden on anyone but also being unafraid to ask for help. Among African women, in particular, avoidance and acquiescence to a partner until she was ready to leave, and sometimes after (i.e., trying to maintain no contact, not seeking child support), were important safety strategies as well. Women used multiple safety strategies such as seeking help, building safety circles, avoiding confrontation, keeping calm and quiet, and making an escape plan.

Discussion

This study focused on sources of strength among immigrant survivors of IPV using qualitative data collected from diverse groups of immigrant women living in the United States. Findings highlight sources of strengths that survivors used to achieve safety from an abuser and for coping with abuse. Despite extreme challenges related to being immigrant women in abusive relationships, women utilized numerous sources of both external and internal strengths, which protected them from the negative impact of IPV.

Consistent with research on other groups of women who have experienced abuse (Davis, 2002; Fowler & Hill, 2004; Sabri et al., 2016), immigrant women’s external sources of strengths came from support in their communities, including from family and friends. Tight-knit immigrant communities can be a barrier to women accessing IPV resources or leaving their partner, secondary to cultural expectations (Njie-Carr et al., 2020; Uehling et al., 2011). However, for the women in this study, informal sources of support such as family and friends were a source of strength for many, as they sought relief from IPV experienced at home. This type of support may be augmented or fostered by acculturation to the United States and increased use of Western resources for support (Njie-Carr et al., 2020; Yoshioka & Choi, 2005). Evidence shows that having high levels of both acculturation and enculturation (i.e., degree to which a person from a minority group functions and interacts competently within her minority culture), referred to as bicultural competence, can be protective for individuals from minority groups (Delgado-Romero et al., 2004), which may include immigrant women survivors of IPV.

Similar to other studies, the women’s time in the United States and their comfort navigating the system allowed survivors to feel more empowered and independent, helping to shift power dynamics within intimate relationships (Uehling et al., 2011). In our study, the specific role that each of the informal sources played varied among immigrant women. For some immigrant women, family was only able to provide emotional support whereas a neighbor or a community elder was able to provide a place of safety. Reasons such as accessibility of family members and cultural expectations related to marriage prevented some women from utilizing family as a source of physical safety. Practitioners should be intentional about understanding nuances within the survivor’s network to better identify who can provide needed support as well as considering individual and cultural differences when creating safety plans and organizing resources.

Women in this study reported social service organizations such as domestic violence support services were external sources of strength. Responses to the police and the legal system were more mixed with some women finding them a reliable resource that allowed them to feel “powerful” while others (particularly African women) identified the legal system response as unhelpful. While certain norms (e.g., IPV is a private affair) may hinder women from reporting abuse at home or seeking domestic violence services (Yoshioka & Choi, 2005), for women in our study, the interconnectedness of services and the broad range of available services were helpful. Overall, women spoke highly of their experience with domestic violence support services, shelters, and police, although some stated that it was culturally unacceptable to contact the police or a domestic violence support service. Some women felt that religious leaders or elders in their community would be better suited and more culturally acceptable to mitigate IPV, while others did not find utility within this practice. Practitioners must account for the cultural barriers that exist for women seeking help from the legal system or domestic violence support services and tailor safety plans to accommodate these needs. Additionally, our study suggests that identifying and forming partnerships with religious leaders and community leaders or elders may be helpful when creating safety plans and can be considered within the larger domestic violence network. Agencies should also be encouraged to consider the diverse cultural needs across the immigrant population and to accommodate these needs on an individual basis rather than expecting all immigrant women to react to informal and formal supports in the same manner.

Women shared multiple internal strengths that helped them cope with their abusive situations. Adversarial growth, positive experiences or growth that develops from trauma or adversity (Linley & Joseph, 2004), was described powerfully by women in our study and was connected to the immigrant experience. One woman described that having already fled war and violence from her home country allowed her to view herself as a survivor. Many immigrant women expressed similar feelings and that having gone through significant adversity in the past provided them internal strength to cope with an abusive relationship in the present. Cultural accounts of survival are described as “extremely important sources of strength” according to the strengths perspective. The amount of adversity that immigrant women have already experienced may or may not be perceived to be far worse than their experiences of IPV. The sense of survivorship that women identify as unique to their immigrant experience was clearly a source of strength for overcoming challenges related to being in an abusive relationship. Historically, underrepresented minorities, including immigrants, have found solace and a source of inner strength through their faith and beliefs (Ahmad et al., 2013; Katerndahl et al., 2015; Njie-Carr et al., 2012; Sabri, Simonet, & Campbell, 2018).

One of the most important personal strengths was women’s ability to stay strong in efforts to protect their children. Repeatedly, we hear women discuss the different strategies they used to survive the abuse for the sake of “my children.” Mothers’ inclination to shield their children is warranted, given the plethora of literature substantiating heightened risk of children vulnerabilities as adult victims or perpetrators after exposure to violence as children (Capaldi et al., 2012; Jung et al., 2019; Njie-Carr, 2014). Capaldi et al. (2012) conducted a review and found a strong association between childhood exposure to violence and adult victimization and perpetrator tendencies. These results present important implications for primary prevention efforts such as implementing abuse prevention strategies at schools.

In our study, we found the unique contribution of acculturation as an internal source of strength. Although acculturation can place women at risk of IPV when it is seen as a threat to male power in a relationship, it can also serve a protective role (Sabri et al., 2018). Women described that becoming knowledgeable about the available resources in the United States and how to access them was helpful. A sense of empowerment is described from the strengths perspective as one’s ability to “free themselves” from the “restraints” of “conflict and tension.” Immigrant women in the study gained their sense of empowerment and self-confidence through their acculturation and adjustment to life in the United States. In assessing resilience in young refugees, acculturation has been described as an aid to “gaining social acceptance and strengthening their sense of self” (Sleijpen et al., 2016). Similar sentiments were expressed in this study, where women felt the strength and a sense of freedom to leave their abusive partner and sought help after gaining knowledge of the U.S. resources and being comfortable accessing them. Combined with adversarial growth tied to the immigrant experience described by women in our study, acculturating and learning different systems in the United States may have empowered them to reevaluate their relationship, resources, and consider their individual needs. Of note, we cannot disentangle the influence of acculturation in terms of adopting new or shifting certain values, such as acceptability of violence, from the potential strength building that may occur as women learn to overcome or deal with structural barriers to access of resources within the United States that are shaped by different axes of oppression related to language, documentation status, and xenophobia. Future research should also examine in greater detail how interacting structural forces and women’s ability to resist or navigate those barriers may build unique strengths in keeping with idea arising from intersectionality theory, moving beyond an individual-level focus on acculturation.

For practitioners and researchers interested in intervening in IPV among immigrant women, a key consideration is the impact of these sources of strength within the context of their familial, local, and diasporic communities (Asay et al., 2016). Several women described their experiences in relation to these community-level frames, and it is imperative that professionals who interact or study their relationships understand the greater ecological forces that inform their sources of strength and that the analysis of their intimate partner relationships be mindful of this social context. For example, the pervasive acceptance of societal norms that view women as subservient and men as dominant in immigrant populations could discourage women from seeking help and negatively impact practitioners’ efforts in working with these groups. Therefore, it is important that practitioners strategically consider these factors that could present difficulties and creatively incorporate them into their interventions for safe care. It is clear from this qualitative study that the perception and impact of sources of internal and external sources of strength varied in a diverse set of immigrant women.

In a grounded theory analysis (Njie-Carr et al., 2020), the interplay between strengths and risks that fueled and facilitated women’s resilience was conceptualized in an engendering resilience to survive (ERS) model. For example, women staying in marriages to preserve traditional roles and gender norms and expectations contributed to their heightened risk of abuse and barriers to seeking services and resources. The ERS model posits that as immigrant women got more acculturated, their self-confidence improved, and they sought the needed help (Njie-Carr et al., 2020). Factoring these barriers in the context of women’s strengths is important for a holistic approach to safety interventions for immigrant women survivors. As many of the women in this study had already left their abusive partners and were willing to discuss their abuse with researchers, it may be that their high levels of acculturation, reliance on services, and descriptions of their support networks are unique. Research is needed to investigate how these impacts translate to greater health outcomes and utilizing the ERS model would provide a framework for future studies on risks and strengths across levels of acculturation to provide unique supports for immigrant women. More importantly, practitioners must be mindful when creating safety plans for this cohort, as each culture and individual views these sources of strength differently and may respond in different ways.

The limitations of this research should be acknowledged. The study included only certain groups of immigrant women and not immigrant women from other regions of the world. The findings, therefore, may not be generalizable to immigrants from other countries. However, immigration-related stressors and sources of strengths identified in the study may be common for immigrant survivors from other regions. This study is based on self-report and is therefore limited by retrospective bias and women’s willingness to share their perspectives and experiences. Further, we did not ask women about their immigration status. The perspectives and experiences of immigrant women who are undocumented or on a dependent visa may be different from those who are legal or have an independent visa status. Despite the limitations, this study is an important contribution to the literature with its focus on sources of strengths among diverse groups of immigrant survivors. The findings can be used to provide culturally informed strengths-based assessments and interventions to immigrant survivors of IPV.

Biography

Bushra Sabri, MSW, PhD, is an assistant professor at Johns Hopkins University School of Nursing. She has led or co-led multiple research projects focusing on risk factors and health outcomes of interpersonal violence across the lifespan. Her current research focuses on development and testing of trauma-informed culturally tailored interventions for survivors of gender-based violence from diverse racial and ethnic backgrounds.

Karissa Avignon, BA, is a graduate in public health studies from Johns Hopkins University. She is currently a Public Health Associate in Research and Evaluation with the National Association of County and City Health Officials (NACCHO) as a CDC PHAP fellow. Her research interests include maternal health, health inequities, occupational health, injury and violence prevention, and immigrant populations.

Sarah Murray, PhD, is assistant professor at Bloomberg School of Public Health, Johns Hopkins University. Her major focus of research has been the rigorous evaluation of interventions designed to treat mental disorders and distress for survivors of torture and conflict-related violence in diverse global settings.

Veronica P. S. Njie-Carr, PhD, is an associate professor in the School of Nursing at the University of Maryland, Baltimore. Her research interests and scholarly activities address global health, HIV-related disparities, and intimate partner violence. She is committed to finding solutions to contribute to eliminating health disparities and propagating health equity.

Anna Marie Young, MPH, is the MD candidate at Johns Hopkins University School of Medicine and a graduate in public health from Bloomberg School of Public Health, Johns Hopkins University.

Amelia Noor-Oshiro, MPH, is the doctoral candidate at Johns Hopkins Bloomberg School of Public Health, Department of Health, Behaviour & Society. Her research focuses on reducing mental health disparities among early adults who identify with multiple stigmatized groups.

Joyell Arscott, PhD, is a HIV Epidemiology post-doctoral fellow at The Johns Hopkins Bloomberg School of Public Health. Her research examines the historical impact of social, structural, and institutional factors that contribute to the health inequities in marginalized populations, the impact of cumulative trauma on HIV risk and sexual decision-making for young adults and adults from underserved communities.

Jill Messing, MSW, PhD, is an associate professor in the School of Social Work, Arizona State University. Her expertise includes intimate partner violence, domestic violence homicide/femicides, risk assessment, and interventions for survivors of intimate partner violence, and criminal justice-social service collaborations.

Jacquelyn C. Campbell, PhD, is the Anna D. Wolf Chair and professor at the Johns Hopkins University School of Nursing. She has 30 years of experience in the area of violence against women with multiple studies of health consequences of intimate partner violence (IPV), as well as developing and testing culturally appropriate interventions for victims of IPV.