Social Work Education and Intimate Partner Violence: How Prepared Are Recent Master of Social Work Graduates? Dante M. de Tablan, MSW School of Social Work University of Maryland, Baltimore Abstract The prevalence of intimate partner violence requires that social workers be prepared and able to respond; however, research shows that social workers receive limited education about IPV. Results from a cross-sectional survey of 228 recent MSW graduates show that those who graduated more recently feel less prepared and less knowledgeable about IPV than those who graduated earlier. Multiple linear regression analyses indicated that age, graduation year, field placement, seminars outside the MSW program, topics in the MSW program and post-MSW training predicted perceived preparedness. Graduation year, seminars outside the MSW program, topics in the MSW program and training post-MSW predicted perceived knowledge. Only race and social work licensure predicted actual IPV knowledge. Implications in educating social workers in Southeast Asia will be discussed including expanding educational exposure to IPV, and examining the role of race and cross-cultural responsiveness by the social worker vis-à-vis the IPV victim may assist recent MSW graduates to become well-informed and better equipped to respond effectively. Background Intimate Partner Violence (IPV) – coercive or aggressive behaviors committed by a current or former spouse, partner, girlfriend, or boyfriend, dating, or sexual partners against an intimate partner Four Types: sexual violence, physical violence, stalking, and psychological aggression Background Reported IPV rates among women vary widely from 15% to 71% according to a World Health Organization study (Ellsberg et al., 2008). The U.S. Centers for Disease Control and Prevention (CDC, 2014) reported that in 2010, one in four women have experienced intimate partner violence (IPV), while one in seven men experienced the same. Background In Vietnam, nearly a third (31.5%) of women have experienced physical violence from their intimate partners (Yount et al., 2014). In Indonesia, IPV prevalence is estimated at < 1% of cases reported by service providers to the National Commission on Violence Against Women (Iskandar et al., 2015). In the Philippines, 13% of the women in Hindin & Adair’s (2002) sample reported IPV. Literature Review In Black et al.’s study, MSW students were underprepared to deal with IPV as a whole, and a greater educational focus on IPV as complex construct is required (2010). Through a qualitative survey research design, Black et al. (2010) examined the thoughts about IPV among social work students and found that the 124 students in the sample were more likely to focus on individual and interpersonal relationships as a response to a domestic violence scenario, rather than the power and control aspects of the IPV relationship. Literature Review Collins and Dressler (2008) sought to compare social workers’ and anthropology students’ cultural models of the causes of domestic violence. Using a qualitative design, the cultural beliefs of the causes of IPV were examined among 64 MSW students and 16 anthropology students. The authors found that while there was consensus in both groups relating to the cultural causes of IPV, the social work students had a more nuanced understanding of the causes of IPV (Collins and Dressler, 2008). Literature Review Cann et al. (2001) in examining attitudes, knowledge, and levels of detection towards domestic violence in the United Kingdom, found that women, nurses, and mental health workers had significantly more knowledge and greater sensitivity towards IPV victims than other health workers. Literature Review Kanno et al. (2010) identified that MSW field placement experiences have a significant role in the education of students. Students are required to work in the field for 900 hours and there is some evidence that students often enter their placements with apprehension, stress, anxiety, with unclear expectations, and negative emotions that may well interfere with effective learning (Barlow & Hall, 2004; Barlow et al, 2006; Gelman, 2004; Rompf, Royse, & Dhooper, 1993). The student may enter the field with low confidence, role confusion or conflict, and undergo emotional stress (Gelman, 2004). In the absence of adequate preparation, the student may enter the field with apprehension and anxiety and become at risk for burnout. Research Questions Are more recent graduates in a Master of Social Work program better prepared regarding IPV than those who graduated earlier? Are later graduates in a Master of Social Work program more knowledgeable regarding IPV than those who graduated earlier? What demographic, student background and educational factors predict increased preparedness and greater knowledge among recent MSW graduates regarding IPV? Method Procedures Designed as a cross-sectional study, a one-time survey was administered in spring 2014 to recent MSW graduates from an accredited university in the Mid-Atlantic region of the United States. Participants were sent an introduction e-mail announcing the study and the opportunity to participate. A follow-up email was sent later that invited participation and provided a link where the survey can be completed. Two follow up reminders were sent to nonresponders, one three days after the initial link and one a week after the initial invitation. The reminder e-mail included a direct link to the survey (Dillman, Smyth, & Christian, 2009). Survey data were kept confidential but responses were tracked to enable follow up mail surveys to non-responders. The mailing included a letter describing the study and a self addressed stamped return envelope. Mailed surveys did not include a link to the online version as researchers have found this complicates the response and actually decreases the response rate to paper surveys (Medway and Fulton, 2012). No financial or gift incentives were used for survey participation. Participants Of the 1,758 surveys that were distributed to MSW graduates from 2008 to 2013 via email, 156 were completed, yielding a response rate of 8.9%. Of the remaining 1,602 participants who did not respond to the online survey, 1,000 individuals were randomly selected to receive a paper survey. Of those 1000, 155 were undeliverable. For the remaining 845, 111 were received, yielding a 13.14% response rate. Of the 267 total surveys received, two surveys were excluded for non-graduation from the particular school, along with 11 survey respondents who opened the survey but did not fill out the questionnaire as well as 26 who did not complete the IPV subscales, leaving a sample size for analysis of 228. A power analysis was performed using G*Power (Version 3) indicating that this study needed at least 83 cases for 11 predictors to achieve power at 0.95. Missing Data Missing data. An SPSS (Version 22) analysis showed that all 14 variables (3 dependent variables and 11 independent variables) used in this study had missing data. Analysis further showed missing value patterns. Nearly 10% of survey respondents skipped or stopped at the IPV portion of the questionnaire, which is near the end of the survey questionnaire. Casewise deletion was applied to cases with missing responses on IPV subscales (n=26). Dependent Variables Actual knowledge of IPV was measured through five multiple choice test questions that were selected from the adapted PREMIS. The multiple choices listed in each of the five questions were transformed into a total of 17 recoded variables. A total mean score was computed to arrive at an Actual Knowledge score. While no Cronbach alpha was reported, observed alpha was .79. Perceived knowledge was measured using the Perceived Knowledge subscale from the adapted PREMIS, which ranges from 1 (“Nothing”) to 7 (“Very much”) in having knowledge of IPV. This subscale demonstrated high internal consistency with a reported Cronbach's Alpha = .97 and an observed ∝ = .94). The 16 items were transformed by computing the mean total score. Perceived preparedness was measured using the Perceived Preparedness subscale from the adapted PREMIS that ranges from 1 (“Not prepared”) to 7 (“Quite well prepared”) and also demonstrated high reliability in Connor et al.’s study (Cronbach Alpha = .97, and an observed ∝ = .96). Twelve items were transformed to compute the total mean score. 11 Independent Variables Gender was recoded as “female” and “not female,” collapsing “male” and “transgender” into the latter. Race was recoded as “White” and “non-White.” Age was a continuous variable. Date of graduation was recoded as dichotomous “Less recent” for 2008-2010 graduates, and “More recent” for 2011-2013 graduates. Licensure was coded as dichotomous “Yes/No” responses. Both personal experience and witness with IPV were dichotomous “Yes/No” questions while the three educational exposure questions were also coded as dichotomous “Yes/No” responses. The four aspects of educational exposure which consists of (a) having had an academic field placement in the area of IPV, (b) taking an IPV course or training outside the master of social work program, (c) having enrolled in a Master of Social Work program that covered topics in IPV, and (d) training post-MSW program, were coded as dichotomous “Yes/No” responses. Data Analysis Univariate statistics. The frequencies and percentages of the characteristics of the sample were reported. Gender, race, age, year of graduation, licensure, personal experience of IPV, personal witness to IPV, IPV-related field placement, IPV seminars outside the MSW program, IPV topics in the MSW program and training post-MSW program were analyzed. Bivariate statistics. Less recent MSW graduates (2008-2010) were compared to more recent MSW graduates (2011-2013). This categorization coincided with the State of Maryland’s StateStat Plan, which made IPV a State-level priority after 2010. The MSW graduates’ scores on IPV Perceived Preparedness scale, Perceived Knowledge scale, and Knowledge scale of the PREMIS Questionnaire were compared. Effect size was determined by partial eta squared. Multivariate analysis. Each of the characteristics of the sample were included in three multiple linear regression analyses to determine: (a) if the bivariate result comparing more recent MSW graduates’ preparedness, perceived knowledge and actual knowledge of IPV remained the same after controlling for other factors, to those who graduated earlier, and (b) which factors predicted increased preparedness, perceived knowledge and actual knowledge regarding IPV. Table 1. Sample Characteristics of Recent MSW Graduates (N = 228) Demographic Factors N % Female 205 89.9 White 170 74.6 2008 – 2010 Graduates 97 42.5 2010 – 2013 Graduates 131 57.5 Licensed 200 88.1 Experienced IPV 69 39.5 Witnessed IPV 82 36.1 Field Placement 19 8.5 Seminars outside MSW 49 21.9 Topics in MSW Program 87 38.2 Training Post-MSW 87 38.2 Note. MSW = Master of Social Work degree IPV = Intimate Partner Violence Table 2. Perceived Preparedness, Perceived Knowledge, and Actual Knowledge of IPV Among Recent MSW Graduates 2008-2010 2011-2013 M SD n M SD n F df p η2 d Perceived Preparedness 5.17 1.19 92 4.63 1.26 125 10.04 1,215 .002* .04 .45 Perceived Knowledge 4.94 1.21 90 4.44 1.24 124 8.61 1,212 .004* .04 .41 .72 0.16 97 .74 0.18 131 0.79 1,226 .376 .00 -.12 Variables Actual Knowledge p <.01* Table 3. Linear Regression Analysis of IPV Perceived Preparedness and Knowledge, and Actual Knowledge of Recent MSW Graduates Perceived Preparedness Variable Perceived Knowledge Actual Knowledge B P 95%CI B P 95%CI B P 95%CI Gender -0.140 0.59 -0.14, 0.26 -0.143 0.59 -0.14, 0.27 0.045 0.26 -0.03, 0.12 Race -0.072 0.69 -0.07, 0.18 -0.136 0.46 00.14, 0.18 -0.081 0.003** -0.13, -0.03 Age -0.026 0.01* -0.26, 0.01 -0.014 0.16 -0.52, 0.17 0.001 0.70 -0.00, 0.00 Graduate Year -0.689 0.000*** -0.69, 0.17 -0.515 0.002** -0.52, 0.17 0.036 0.15 -0.01, 0.08 Licensure 0.218 0.39 -0.22, 0.25 0.108 0.66 0.11, 0.25 0.194 0.012* 0.02, 0.17 Experienced IPV 0.220 0.19 0.22, 0.17 0.206 0.23 0.21, 0.17 0.037 0.16 -0.01, 0.09 Witnessed IPV 0.051 0.76 0.05, 0.171 0.028 0.87 0.03, 0.17 -0.014 0.58 -0.06,0.041 Field Placement 0.581 0.04* 0.58, 0.29 0.562 0.006** 0.56, 029 0.024 0.57 -0.06, 0.11 Seminars nonMSW 0.443 0.03* 0.44, 0.21 0.561 0.006** 0.56, 020 -0.041 0.18 -0.10, 0.02 Topics in MSW 0.682 0.000*** 0.36, 1.01 0.682 0.000*** 0.36, 1.01 0.013 0.60 -0.04, 0.06 Training PostMSW 0.652 0.000*** 0.32, 0.98 0.667 0.000*** 0.33, 1.00 0.042 0.10 -0.01, 0.09 Discussion Field internships have always been one of the key pillars of social work education. Identifying IPV-related agency field placements that are open to learning, developing field supervisors by providing field supervision training, and incentivizing field supervision through engagement of practitioners are some of the capacity building opportunities to explore. Students tend to give immediate feedback as to the efficacy of the field placement experience. Strategically invest in one or two local IPV-related agencies that can provide first-rate experiences for students and field supervisors alike. Consider international internships that will also offer much needed crosscultural appreciation of program and practice. Develop agency practitioners into effective field supervisors by providing continuing feedback, training, and guidance. Engaging field supervisors to become clinical faculty adds resource and strengthens the social work professional network. Discussion The students’ perceived preparedness in, and knowledge of IPV may be further enhanced by seminars outside the MSW and BSSW programs. Encouraging and incentivizing students to attend in-service trainings sponsored by NGOs, will inform students of the importance and urgency of the work. They will hear directly from practitioners the daily challenges in engaging and serving IPV victims. Organizing workshops, whether student-led or faculty-led will yield many benefits including greater appreciation in organizing and scheduling workshop presenters and participants while learning the many facets of IPV. Student and faculty attendance at conferences through scholarships and funded student and faculty support may further enhance preparedness and knowledge of IPV. Discussion Regarding IPV Topics in the MSW or BSSW program: incorporate IPV-related case studies, expert guest speakers, and collaborative student projects. Harvard Business School and the Harvard School of Education primarily utilize case studies to train professionals. Case studies encourage inductive discussions among students with diverse backgrounds and experiences. Teachers can capitalize on the growing experience of the program participants. As more second career individuals enter the social work profession, they bring a wealth of knowledge, competencies, and experience which need to be harnessed, developed, and deployed. Field experts can provide a deeper perspective, and a new professional alliance, not to mention a welcome respite your the teacher and students. Collaborative student projects although messy at times, can maximize the research and learning capacity of its members, benefiting the class as a whole. Discussion Finally, continuing education after the MSW or BSSW program can enrich their knowledge and nourish the new social work professional’s appreciation of colleagues. Encouraging new graduates to pursue licensure, if available in the country, can improve not only their knowledge of IPV but will boost their professional identity as well. However, if licensure is not yet established by the appropriate credentialing institutions, providing support to graduates by informing them of education and employment opportunities is a sensible recourse. Include taking an IPV courses as a requirement in licensure renewal. California and Florida are the only two states that require social work licensees to complete IPV courses to for renewal. Discussion Perceived Preparedness and Perceived Knowledge may be related to social worker self-efficacy in addressing IPV. Osteen et al’s (2014) study on social work student preparedness in assisting clients at risk of suicide may provide parallel lessons for MSW graduates and their ability to address IPV. Since there is no commonly accepted IPV Actual Knowledge Subscale, strengthening social worker self-efficacy offers a foundation to build on. Cross-cultural exchanges of social work practice and philosophy may increase our combined repertoire of IPV interventions. The strength of clinical social work practice in the United States, if translated to Southeast Asia may benefit individual and family interventions for IPV victims in Southeast Asia. Conversely, feminist and community-level interventions, which tend to dominate social work and community development efforts in the Asia-Pacific region may balance out the IPV interventions dominated by behavioral and psychotherapeutic modalities most prevalent in the United States. Discussion Since race is a significant predictor in determining actual knowledge of IPV, i.e., as a social work graduate’s race changes from White to Non-White, one can predict a 3% decrease in actual knowledge of IPV. Therefore, investing in cross-cultural training regarding intimate partner violence can identify multiple cultural factors that can affect IPV knowledge. These include shame, embarrassment, providers not asking about IPV, religious beliefs, language barriers, settings for self-disclosure, and forced silence or by choice (Montalvo-Liendo, 2008), especially within non-White groups. The need to establish trust in a compassionate and supportive environment, as well as to listen attentively and without judgment are some of the prerequisites to effectively intervene with women from Asian, Hawaiian, Japanese, and Latino backgrounds; and especially among Filipinas, counselors of the same background is most helpful (Montalvo-Liendo, 2008). Acquiring a nuanced understanding of these aspects can greatly enhance social worker knowledge regarding IPV vis-à-vis various racial groups. Strengths The present study has a number of strengths and limitations. Since there is limited research on IPV and IPV intervention in social work (Black, Weisz & Bennett, 2010; Connor, et al., 2012; Nouer, et al., 2012), this current study adds to this developing field. At present, this is one of a few identified investigations that report perceptions, preparedness and knowledge regarding intimate partner violence among recent MSW graduates. Another strength of this study is its use of tested and recognized measures of perceptions, preparedness and knowledge on IPV adapted from the Provider Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool published by Short, et al. (2006). In addition, statistical power was addressed given the sample size (N = 228). Limitations Only recent graduates from one urban school of social work in the Mid-Atlantic region of the United States were surveyed in this study. Therefore, results of this investigation cannot be generalized to other graduates of master level programs of social work. Nearly 10% of surveys (26) were not included in the final sample because they lacked responses on the IPV subscales, thus rendering them incomplete. It was unclear if survey respondents stopped because they did not know the material. Nevertheless, it is difficult to extrapolate conclusions from this occurrence. In addition, because certain items from PREMIS were not included in this study, e.g., additional Actual Knowledge items, estimation of IPV training hours before graduate school, and alcohol consumption and other substances as a predictor of IPV, explication of the constructs may be inadequate thereby underrepresenting the characteristics of the constructs presented here (Shadish, Cook & Campbell, 2002). A possible threat to internal validity can be an event related to intimate partner violence during the time of the survey (Shadish, et al., 2002). Media coverage was extensive particularly in the team’s home city and state where the subject school of social work is located An ANOVA showed no difference in Perceived Preparedness and Perceived Knowledge scores; but did yield a statistically significant difference in Actual Knowledge scores between those who responded online (M = .76, SD = .13, N = 107) compared to those who responded by paper survey (M = .71, SD = .20, N = 121). In addition, this cross-sectional study only allows for a one-time examination of the relationships of variables included in the study and cannot be observed as they change overtime. Conclusion IPV is a cross-cutting issue that touches child and family welfare, family counseling services, the criminal justice system, mental health, addiction interventions, medical systems, income assistance programs, gerontology and disability services, and community-based services (Arseneault, Steward & Miller, 2013). Given this charge, it is vital that social workers are properly trained, are adequately knowledgeable and possess the skills to interact effectively with victims of IPV and their families. This present investigation demonstrated the importance of IPV-related field placement, IPV topics in the MSW coursework, additional IPV seminars outside the MSW program and continuing IPV-related training after graduation, in predicting preparation and knowledge. These aspects of social work education provide the necessary underpinning to critically examine past and current practices and their theoretical bases, while developing multifaceted approaches and correct methods for gathering valid and reliable data” (Colarossi, 2005, pp. 151-152). 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