Parallel Proccesses 1 IRB

Understanding parallel processes in family violence work: A phenomological exploration of Asian community based workers Project Description General Description Intimate partner violence (IPV) has been recognized as a public health issue that has far reaching consequences in immigrant and refugee communities. In response, stakeholders, experts, legislators and federal and local agencies identify a dire need for culturally responsive service delivery. This manifests in a demand for organizations to hire culturally relevant and linguistically capable practitioners to provide services for immigrant women and their children who experience IPV. It is not uncommon for many of the practitioners to experience some of the same stressors and risk factors faced by these women: acculturation stress, immigration related challenges, and exposure to past violence or trauma, yet research into ethnic, race, and linguistic case matching often focuses only on client and case outcomes. The proposed study aims to examine the effects of ethnic and race and linguistic case matching on practitioner well-being and explore implications such effects may have on the work. Findings from this study will have significant implications for and help to inform best practices relative to organizational cultural responsiveness, cross cultural intervention, and workplace safety. There are three research questions that will guide this proposed research: 1) Is there a parallel process that exists between Asian practitioners and their Asian clients in the context of IPV related work? 2) If so, what does it entail? 3) How do workers draw on the parallels to inform their work? This qualitative phenomenological study is rooted in principles of community based participatory research in that the questions and focus of the study was initiated by and derives directly from consultation and training work this researcher was approached to do with two agencies in the field of family violence work (Department of Children and Families, and the Asian Task Force Against Domestic Violence). Specifically the interest in worker-organization driven models of culturally relevant work relative to IPV stems directly from a joint agency initiative to facilitate dialogues about best practice. Moreover, the questions that comprise the structured interview guide have evolved from over two years of direct work with staff in these agencies at different points in time where these themes were first identified and repeatedly surfaced. As such, this study will employ individual in-depth interviews with participants and focus groups among participants as the primary methods of data collection to gain a deeper and more systematic inquiry into these very themes that have emerged repeatedly within the daily practice of these workers over the last couple of years. The rationale for employing both methods of qualitative analysis in one study lies in the subtle yet distinct objectives underlying the proposed research questions. On the one hand, participants will be asked to identify detailed perceptions, opinions, beliefs, and attitudes about what it is like working with Asian women and their families in the context of intimate partner violence. An assumption embedded in this discourse is that particular inquiry might stir up practitioner accounts of exposure to violence (e.g. war related, racism), acculturation stress, or immigration driven anxiety similar to the experiences of their clients. Facilitating such a dialogue in a private and confidential manner is an ethical, responsible, and thoughtful way to collect the necessary associated data (Padgett, 2008). On the other hand, participants will also be asked to identify ways in which they draw on possible parallels with clients to inform and execute the work. In this context, providing participants with an environment that enables brainstorming, and interaction with others who may also be experiencing similar professional challenges will allow the participants to explore all of the possibilities of practice in an in-depth way, offering a rich array of responses for later analysis (Royse, Thyer, & Padgett, 2009).

Authored by Tien Ung, PhD, LICSW

Parallel Proccesses 2 IRB

Significance of Study Intimate partner violence (IPV) among immigrant communities has been hailed as a major public health issue. In recent years, there has been growing recognition that effective responses to intimate partner violence among immigrant and refugee communities requires culturally responsive interventions and legislation (Bhuyan & Senturia, 2005; Conyers Jr., 2007; Raj & Silverman, 2002; U.S. Public Health Service, 2000). In part, this stems from an evolving understanding that issues related to culture, legal immigrant status, and acculturation contribute to risks that survivors of IPV face in their relationships, and also influence the strategies they engage to stop the violence (Conyers Jr.; 2007; Raj & Silverman, 2002). There is widespread agreement that culturally responsive intervention refers to the provision of culturally and linguistically relevant services. Such services are manifested in two ways: 1) in an organizations capacity to employ professionals whose race and ethnicity mirror the identified population of need and 2) in an organizations capacity to employ people who can also speak languages salient within the identified ethnocultural communities (Sue, 1998). There has been much research that suggests that race and/or ethnic matching along with linguistic capacity contributes to positive case outcomes such as lower rates of premature attrition in treatment, higher rates of goal attainment, and longer periods of intervention (Erdur et.al., 2000; Fujino et.al., 1994; Yeh et.al., 1994; Zane et.al., 2005). Much of the research regarding race, ethnicity, and language matching examines client outcomes, engagement, and satisfaction, while very little research to date considers the effects of race, ethnicity, and language matching on the practitioners involved. Studies that have examined questions relevant to the professionals involved are primarily focused on transference and countertransference issues which can be argued, is a different pathway to the same end client outcomes via analysis of the process of treatment or psychotherapy (Dadlani, 2010; Foster, 1998; Gowrisunkur; 2006; Nagai, 2009). Manoleas and his colleagues (2000) examined contributions associated with race, ethnicity and language among Latino/a clinicians with Latino/a clients by looking at how certain worker characteristics could inform our understanding of culturally competent practice. They surveyed 65 Latino and Latina clinicians to examine and isolate practitioner skills, values, and orientations that could potentially shed light on what Latino and Latina clinicians do and dont do in service of the Latino/a community. No studies to date have looked at the impact of race, ethnicity, and language matching on practitioner well-being. Studies that have examined practitioner well-being in the context of mental health and community based work fall primarily under the domain of research associated with compassion fatigue, secondary trauma, and burnout (Collins and Long, 2003; Hesse, 2002; Robinson-Keilig, 2010). Within this growing body of work variables such as gender, race, ethnicity, and age have not been found to be significant risk factors for secondary trauma, compassion fatigue or burnout. However, within these studies race and ethnicity have been considered as single demographic or control variables, and not as mediating variables (Pearlman & MacIan, 1995; Rudolph et.al. 1997; Schauben & Frazier, 1998; Stamm, 1998). Variables that have been found to heighten practitioner vulnerability for compassion fatigue, secondary trauma, and burnout are fewer years of experience, large caseloads, increased contact with clients, long working hours, and previous history of trauma (Collins & Long, 2003). It is not uncommon to find all of these variables fewer years of experience, large caseloads, increased contact with clients, long working hours, and previous history of trauma among Asian community based workers and practitioners working in settings where IPV is a primary reason for referral, especially if the Asian professionals working with survivors of violence originate from countries that have experienced war and devastation, like Vietnam, Laos, and Cambodia. Yet research into ethnic, race, and linguistic case matching primarily focuses only on client and case outcomes. This study aims to examine the effects of ethnic and race and linguistic case matching on practitioner well-being and explore implications such effects may

Authored by Tien Ung, PhD, LICSW

Parallel Proccesses 3 IRB

have on the work. Findings from this study will have significant implications for and help to inform best practices relative to organizational cultural responsiveness, cross cultural intervention, and workplace safety. Subject Population and Recruitment The sampling frame for this study are Asian or Asian-American professional helpers working in the context of family violence. The rationale for this is three fold. Firstly, the focus on family violence work in immigrant communities reflects an identified area of need relative to the discovery of best practices (personal communication, Wendy Yallowitz, December 8, 2009). Secondly, according to the US Census Bureau (2008), the Asian American population is projected to increase from 16 million to 41 million by 2050. Moreover, in a study conducted by the National Association of Social Workers (NASW, 2005) about workforce trends, social workers reported that 49% of their caseloads consisted of Asian or Pacific Islander clients while only 1% of the workforce is Asian. Based on these demographics the NASW concluded that the social work workforce is not keeping pace with population trends. Thirdly, the choice of Asian and Asian American communities in Massachusetts is also associated directly with this researchers area of practice and community engagement, and was identified by key community stakeholders (refer back to General Description). Subsequently this study will draw on stratified purposive and snowball sampling procedures in an attempt to generate a sample of 30 45, Asian or Asian-American men and women, who work as helping professionals in the field of family violence either part or full time, in the capacity of caseworker/case manager, advocate, or social worker. All of the eligible participants will also have some grasp of both written and verbal English given their capacity to work in social service agencies providing intervention in Massachusetts. This researcher does not anticipate any participants under 21 years of age or any participants over 65 years of age given the part and fulltime workforce that is being targeted. Stratified purposive sampling is a recommended practice when subjects are selected for inclusion in a study in order to learn about a specific phenomenon or achieve a certain goal (Patton, 2001). Snowball methods are appropriate in order to identify as many possible participants in hard to reach or specifically targeted populations. Recruitment of participants for this study will happen by public announcement in two ways. This researcher will post a public announcement for research in the local NASW newsletter that is broadly distributed on a monthly basis to its membership. This announcement will simply name the title of the study, its purpose, and eligibility criteria. In addition, three types of contact information will be listed in the call for this researcher: Simmons address, Simmons phone number, and Simmons email. In addition, this researcher will also explore with the local NASW chapter the possibility of a mass mailing of the information mentioned above about the study to include contact information for this researcher. The mass mailing would be sent to selfidentified Asian or Asian-American social workers in their membership. Similarly, this researcher will reach out to the two agencies in the Massachusetts community where there has already been an ongoing and established relationship relative to consultation and training to confirm their continued interest in the study and possible mechanisms of their eligible staff. As previously mentioned, since the research question and focus for this study came from community based and driven work with local agencies (see General Description), it is appropriate that the workers from those same agencies are also given an opportunity to participate in the study. Finally, in line with community based participatory research, this researcher will work with the agencies identified to determine the strategies for recruitment. Amendments to this IRB application will be filed once the details of those strategies are outlined. The process of informed consent will begin when potential subjects initially reach out to this researcher to inquire about the study. In these correspondences, once participants have had a chance to ask and have their questions answered and it is clear that they want to volunteer to

Authored by Tien Ung, PhD, LICSW

Parallel Proccesses 4 IRB

participate (e.g., they say something such as, OK, I want to do this), this researcher will begin to share with them more information about the design, methods, and expectations of their roles, and rights in the study by summarizing all of the information in the informed consent. I will end the screening call with a request to send materials that summarize our discussions about the study to them. With their consent and the provision of a mailing address, this researcher will mail them the informed consent with a self-addressed envelope to be signed and mailed back to me. The interviews will be set up once this researcher has received a signed consent from the interested participant. This researcher will make follow up phone calls to inquire about continued interest if returned consents are not received within 2 weeks time. No more than 3 phone calls will be made to each applicant. The researcher will continue to receive informed consents and include interested participants in the study until 3 months following the last interview and focus group. Sources of Research Material This researcher will obtain data in the form of verbal narratives from the participants in this study through the use of individual interviewing and focus groups. The data will be captured, with the participants permission via digital audio recording. (Please refer to the informed consent and interview guide for specific details). There will be no other sources of data used in this study. Risks & Protection Against Risks There are minimal risks associated with this study for participants. Recalling, and retelling their immigrant and acculturation experience may be something that is upsetting for participants, especially if those experiences were positive for trauma or distressing in other ways. This researcher will debrief the participants experience in the interview and the focus groups and offer resources to the participant in the event that their distress could benefit from some form of intervention (Please refer to informed consent). Relative to participant anxiety about their identity in the study, it should be noted that participant identifying information will be known only by this researcher and protected in locked and password protected environments. Analysis of the data that yields dissemination of any kind in either written or verbal format will never reveal individual identifying information; findings will be aggregated into themes, and any individual references to participants data will be nonidentifying (e.g., One participant said...). Stored data will be destroyed three years from the completion of the study in accordance with data storage protocols. Benefits Possible benefits to participants would fall under the scope of well-being, emotional safety, and emotional validation. It is not uncommon for professionals of color to be more burdened in organizations with the charge of carrying the capacity for cultural competence (Susan Donner, personal communication September 13, 2010). In this way, professionals of color in social service organizations are often expected to do the cultural competency work, though are not often treated or regarded as experts. Participating in this study could empower and validate workers expertise, and possibly impact their sense of morale, esteem, and experience of being understood in the work place. Benefits for organizations from this research entail deeper understanding about the needs of their workforce. This understanding will enable organizations to develop practices and create systems that support Asian workers, and encourage their innovation and professional growth. As a possible consequence, organizations may understand better how to recruit Asian workers into their organizations, and also how to sustain and retain them. In addition, organizations involved in this study will begin to identify parameters that define their particular model of culturally competent practice which was an original vision and motivation for the study. Drawing on these new insights, programs can build in further evaluation as a means to more clearly flush out those principles with the goals of identifying and replicating best practice models in the field of family violence relative to the Asian community.

Authored by Tien Ung, PhD, LICSW

Parallel Proccesses 5 IRB

Lastly, findings from this study could have significant implications on how we educate, train, and develop sound culturally competent professionals working in the area of family violence who are not of the same race and ethnic heritage as their clients. Specifically, the lessons learned span across four main domains that can be integrated into training curriculum both in the classroom and in field related work: 1. What constitutes best cultural responsive practice in the context of family violence work in Asian communities? 2. How is it learned and how can it be sustained? 3. What are the dilemmas and burdens of cross cultural practice in the context of family violence from the worker's experience? 4. How do we ensure staff well-being in the context of the burdens and dilemmas of cross cultural practice in family violence work?

Authored by Tien Ung, PhD, LICSW