You deserve better: improving services for domestic abuse survivors and their providers by using experience-based co-design

Gander-Zaucker, Shoshana (2022). You deserve better: improving services for domestic abuse survivors and their providers by using experience-based co-design. University of Birmingham. Ph.D.

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Abstract

Background: Survivors of domestic abuse may be reluctant to seek help from the police. When they do, they may be dissatisfied with the response. Survivors may be at increased risk if the police are not engaged with them and providing appropriate responses.

Aims and Structure: This thesis examines this issue of help-seeking and reports on an innovative project which aimed to improve services for domestic abuse survivors and their service-providers. It engaged survivors, police employees, IDVAs (Independent Domestic Violence Advisors) in an Experience-Based Co-Design (EBCD) process. EBCD is a collaborative approach to service improvement, widely used in healthcare, but new to the policing context.

The first component of the thesis covers the EBCD project that this thesis is based on. It examines the potential of EBCD as an approach to service improvement in the context of policing. The second component of the thesis reports in greater detail on two in-depth interview studies. One of these explores the help-seeking experiences of domestic abuse survivors. The other reports on the understandings of police employees and IDVAs, regarding the issues arising in providing a help-seeking pathway for survivors. Thus, these chapters explore in greater depth the insights from the research phase of the EBCD project.

Findings: After a Reflexive Thematic Analysis of the interviews with six domestic abuse survivors, two sets of themes were developed. The first set relates to the experience of suffering from domestic abuse: Relationships are Dynamic; Domestic Abuse Has Accumulative and Sustained Consequences; Survivors Make Sense of Their Experiences in the Context of Other People’s Expectations. The second set of themes are related to the help-seeking experiences of domestic abuse survivors from the police and the domestic abuse organizations: The Importance of Being Understood, Believed, and Cared For; It Is Important That There Is Good Communication Between the Survivor and Formal Services; Survivors Want a Victim-Centred, Rapid, and Meaningful Response; Specific Circumstances Sometimes Influence Opportunities for Help-Seeking.

Following Template Analysis of the interviews with 23 police employees and four IDVAs, the following themes were identified: Domestic Abuse Is Varied. Therefore, Tailored, Meaningful, and Rapid Responses Should Be Provided; Satisfaction of Domestic Abuse Survivors with Services Provided by the Police and IDVAs is Varied; Supporting Domestic Abuse Survivors Can Be Dangerous, Challenging, Relentless, and Psychologically Taxing with Little Support Available, but Worthwhile.

Conclusions: Together these findings suggest that, while there are some important areas of difference, there is considerable agreement between stakeholders on what a poor response to help-seeking looks like, and what problems need to be addressed to improve service responses. The thesis draws on different theoretical models to interpret these findings and brings these theories together into a single integrated model. It also examines the potential acceptability and utility of EBCD for further implantation in domestic abuse contexts and makes recommendations for services.

EBCD has not been used with victims in a policing setting before. The thesis adds to knowledge in two ways. First, it demonstrates that EBCD can be implemented in this setting, with domestic abuse survivors. Second, it proposes an integrated theoretical model to explain survivors’ help-seeking behaviours. This thesis argues that EBCD has considerable potential for use in this context and identifies several areas where insights from this project could be used to improve the future viability of any such initiatives. Improved domestic abuse services will benefit survivors, their service-providers, and the wider community.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):