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Sticks and stones: training protocol strategy to reduce violence in relationships
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Sticks and stones: training protocol strategy to reduce violence in relationships
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Content
Sticks and Stones: Training Protocol Strategy to Reduce Violence in Relationships
by
Lori Elizabeth Feather, LCSW-C
A Capstone Project Presented to the
FACULTY OF THE USC SUZANNE DWORAK-PECK SCHOOL OF SOCIAL WORK
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
Doctor of Social Work
August 2024
2
TABLE OF CONTENTS
I. Abstract……………………………………………………………………...3
II. Acknowledgements……………………………………………………….....4
III. Positionality Statement………………………………………………………5
IV. Problem of Practice and Literature Review………………………………….6
V. Theoretical and/or Conceptual Framework…………………………………..10
VI. Methodology………………………………………………………………….12
VII. Project Description……………………………………………………………15
VIII. Implementation Plan………………………………………………………….20
IX. Evaluation Plan……………………………………………………………….21
X. Challenges/ Limitations………………………………………………………22
XI. Considerations and Implications……………………………………………...23
3
Abstract
The issue of intimate partner violence (IPV) is a social concern that affects people of all ages,
races, genders, abilities, and socioeconomic backgrounds. Psychological IPV is perhaps the most
widespread type of IPV, yet it is often not well represented in literature and interventions. It's
often referred to as the invisible type of IPV throughout research documents. Forty-eight percent
of men and women in the United States reported experiencing psychological violence in their
relationships, according to the National Coalition Against Domestic Violence (NCADV) (2015).
This paper explores psychological IPV under the Grand Challenge of Building Healthy
Relationships to End Violence as presented by the American Academy of Social Work and Social
Welfare (2020). It presents a proposed capstone project, Sticks and Stones, aimed at reducing the
prevalence of psychological IPV through the development and implementation of a training
protocol strategy to reduce unhealthy relationships through education, training, and peer
education and interventions for youth with mental health diagnoses. This paper explores the
issue addressed by the capstone proposal through the lens of Social Learning Theory, and
reviews Sticks and Stones through an Empowerment Theory lens, addressing the community
youths’ lack of knowledge and available resources to successfully reduce the prevalence of
psychological IPV by addressing the issue through awareness and education, providing training
to mental health staff to increase comfort and competence with the topic of psychological IPV.
By increasing the education and training offered on psychological IPV, an increase in staff
competency is the desired outcome, along with an increase in the rate of youth relationships free
from psychological and other forms of IPV. The project intends to build a capable workforce in
mental health workers in order to ultimately impact outcomes for youth by reducing the
prevalence of IPV in youth relationships. Keywords: Intimate Partner Violence, youth
relationships
4
Acknowledgments
I would like to express my deepest gratitude to my professor and chair of my committee for her
invaluable patience and feedback. I also could not have undertaken this journey without my
defense committee, who generously provided their knowledge, guidance, and expertise.
Additionally, this endeavor would not have been possible without the generous support of Arrow
Child and Family Ministries PRP program director and staff in Baltimore, Maryland, without
whom this project would not be what it has become.
I am also grateful to my classmates and cohort members, especially my learning pod ladies, for
their editing help, late-night feedback sessions, and moral support throughout this endeavor.
Thanks should also go to my design team and the countless individuals who influenced and
inspired me throughout my research and development of this project.
Lastly, I would be remiss in not mentioning my family, especially my husband, my children, my
parents, and my friends. Their belief in me and the support they have offered has kept my spirits
and motivation high during this process. Their emotional support through this endeavor has been
essential to my success. I would not be where I am without all of you.
5
Positionality Statement
As a woman living in a society where one in three women have experienced IPV, it is impossible
to separate myself from this epidemic. IPV is not something that can be escaped by any of us.
One in four men have experienced IPV as well. The impact that IPV has had on my life is the
result of a society in which IPV is not just a problem that can be swept under the rug; it is
systemic and in the air we breathe. It is a part of all of us. IPV became something I could no
longer ignore when I realized that this systemic, life-altering epidemic is the water, and we are
the fish. There is no escaping IPV. None of us are immune. If it has not knocked on your door, it
has shown up at the house of someone you love. This inescapable truth led me to the jumping-off
point. I could do nothing, or I could create change. As a mother to four amazing individuals, I
knew I had to act so that I could create something that would create a barrier or buffer between
my children and the very real possibility of being impacted by psychological intimate partner
violence in their future relationships.
6
Problem of Practice and Literature Review
Psychological violence within relationships (psychological intimate partner violence) is a
social problem that falls under the umbrella of the Grand Challenge of Building Healthy
Relationships to End Violence. The American Academy of Social Work and Social Welfare
developed this challenge to improve individual and family well-being by building healthy
relationships to end violence through interventions to strengthen the mental and physical health
of individuals, families, and communities at large (American Academy of Social Work & Social
Welfare, 2020). Psychological intimate partner violence is a pervasive, invisible type of intimate
partner violence, negatively impacting those exposed to it and leaving survivors with lasting
negative physical and mental sequelae, including an increased risk of developing a mental illness
as well as negative self-esteem (Taquette & Monteiro, 2019). It is a problem that spans
generations, cultures, and every socio-demographic group. According to the National Coalition
Against Domestic Violence (NCADV), forty-eight percent of men and women in the United
States reported experiencing psychological violence in their relationships. The NCADV defines
psychological violence as “verbal abuse, acts, threats of acts, and coercive tactics to control,
terrorize, and denigrate their victims” (2015). One major deficit in the fight against
Psychological IPV is that while psychological IPV is the most common type of IPV, it is the least
researched when compared to research examining sexual and physical violence (Alkan,
Sercemeli, & Ozmen, 2022). This scarcity in literature and research makes all populations more
susceptible to this type of violence and, therefore, more susceptible to the risks and possible
negative outcomes related to exposure to this violence. Karakurt and Silver (2013) posit that the
consequences of emotional abuse are just as damaging as the consequences of physical abuse as
7
it targets the emotional and psychological well-being of the victim and also often constitutes a
precursor to physical abuse.
In her TedTalk, Lizzie Glazer focused on the significance of society grasping that
psychological abuse is just as present and terrible as physical abuse and stresses the importance
of society expanding its view of domestic violence by acknowledging the damage found in
unseen or internal scars that psychological and verbal abuse leave (Glazer L. , 2018).
Psychological violence often leads to other mental health and physical health conditions for the
victims. It increases the likelihood of the perpetuation of violence in children who witness
intimate partner violence, as this issue is not confined to the adult population. Exposure to
violence during childhood or adolescence can lead to an increase in mental health issues and can
perpetuate ongoing intimate partner violence. Children who witness violence are more likely to
either become perpetrators of violence in their future relationships or become victims of similar
types of abuse. Intimate partner violence in youth and adolescent relationships is recognized as
teen dating violence. According to the Centers for Disease Control (CDC), violence in an
adolescent relationship creates the precedent for future relationship problems, including intimate
partner violence and sexual violence perpetration and/or victimization throughout life (National
Center for Injury Prevention and Control, Division of Violence Prevention, 2023).
People with chronic mental illness (CMI) have been found to be at higher risk for all
forms of IPV and are more likely to suffer subsequent ill health. They are less likely to disclose
the occurrence of IPV and seek help from medical/health professionals (Khalifeh, Oram,
Trevillion, Johnson, & Howard, 2015). It is in these circumstances that is imperative that
clinicians and other professionals are adequately trained and are comfortable in utilizing this
training in order to provide intervention for these individuals. Adolescents with mental illness
8
are at a higher risk of teen dating violence than adolescents without mental illness (Traugh,
2018). The effects of their mental illness, including poor judgment, depression, bouts of mania,
etc., can make teens with mental illness more susceptible to dating violence (Traugh, 2018). This
problem space is imperative to address, as children and adolescents, especially those with mental
health concerns, in general, are a vulnerable population that is overlooked and underserved in
research and intervention.
There is a widespread agreement that prevention efforts should aim to reduce Intimate
Partner Violence (IPV) by promoting healthy, respectful, nonviolent relationships at various
levels, including individual, relationship, community, and societal levels (Centers for Disease
Control and Prevention, 2022).
Solution Landscape
While there have been numerous developments in intervention strategies to provide
solutions and services for those who have experienced IPV, there is less coverage on
psychological IPV in literature and other sources. This is arguably because psychological IPV is
not always recognized as its own form of intimate partner violence, which has led to a smaller
number of solutions targeting psychological IPV than those for IPV in general.
Macro- Level Solutions
Social media campaigns and informational campaigns have become popular sources of
distributing knowledge and awareness for the topics included in IPV found in relationships.
Campaigns like those included in the No More Initiative and the ‘Love is Respect’ campaign
have gotten traction in raising awareness by providing education, fundraising opportunities,
volunteer opportunities, and information on where and how to get help in order to escape an
9
abusive relationship. Social media campaigns across various platforms have made progress in
disseminating information about warning signs of abuse to younger populations (Feather, 2023).
Hotlines and public service announcements have been established and shared on platforms such
as YouTube to reach individuals using various technologies. For instance, if one were to google
‘existing solutions for psychological intimate partner violence, the first search result is the
National Domestic Violence Hotline number for domestic violence support. These public
awareness campaigns utilize their platforms to disseminate information to the public, hoping to
increase awareness of the issue of unhealthy relationships and intimate partner violence, as well
as spread awareness of resources available (Feather, 2023).
Mezzo- Level Solutions
Collaborative efforts have been made, such as that of Children’s Hospital of Philadelphia
(CHOP) and Lutheran Settlement House’s STOP IPV program, which aims to address intimate
partner violence and teen dating violence. They also consider the impact of child abuse and
community violence on individuals and families through a collaborative, multi-component
approach (Children's Hospital of Philadelphia Center for Violence Prevention, 2023). The goal of
STOP IPV is to support screening by pediatric healthcare providers to identify families
experiencing intimate partner violence and minimize the adverse effects of childhood intimate
partner violence exposure. They accomplish this through training, education, and awarenessraising to enhance CHOP’s trauma-informed response to this social problem (Children's Hospital
of Philadelphia Center for Violence Prevention, 2023).
School-based prevention programs have been established in some communities to assist
in preventing intimate partner violence beginning with teen dating violence. Such programs offer
education and skill-building activities that increase awareness at earlier ages and stages of
10
relationships. HAVEN is a non-profit organization located in Oakland County, MI, that provides
a wide range of prevention and intervention services, including shelter, counseling, advocacy,
and educational programming. HAVEN partners with their local area schools to provide
educational opportunities for nominal fees in levels from pre-kindergarten through high schools,
presenting age-appropriate materials (HAVEN, 2023)This intervention impacts people on an
individual level, schools at the mezzo level, and the community at the macro level, spanning
micro, mezzo, and macro levels. School-based prevention strategies can be immensely
successful, as teachers often have the opportunity to play a pivotal role in helping families access
help and services (Lloyd, 2018). While HAVEN’s innovative approach provides numerous
programming opportunities, the programming is limited to the area schools, has not expanded
outside of the area, and is not a free educational program for the participating schools,
potentially limiting participation.
Micro-Level Solutions
There are numerous treatment options for treating individuals who are suffering from
experiencing psychological abuse in relationships. Most of these treatments consist of
psychotherapy with interventions aimed at treating mental health disorders such as anxiety,
depression, and post-traumatic stress disorder, as well as other disorders that are common in
people who have suffered from IPV. These treatments come into practice as intervention
strategies after the abuse has already occurred, as there is a lack of strategies to prevent
psychological IPV from initially occurring.
Conceptual/ Theoretical Framework
11
The issue that Sticks and Stones was developed to address can be explained using two
theoretical frameworks. The first one is the Intergenerational Transmission of Violence Theory
(IGT), which suggests that experiencing household violence (direct victimization) or witnessing
it (indirect/vicarious victimization), particularly during childhood, leads to subsequent IPV
(Intimate Partner Violence), either perpetration or victimization (Powers, Cochran, Maskaly, &
Sellers, 2020). The second framework used is the Social Learning Theory (SLT), which states
that learning occurs through observation, imitation, and modeling. It also suggests that learning
can occur merely by observing the behaviors of others. Both frameworks focus on the exposure
to influential role models (parents) who perpetrate or experience interpersonal violence within
the household that children witness and later imitate. These frameworks also stress the
importance of passing on beliefs, values, and norms conducive to IPV (Powers, Cochran,
Maskaly, & Sellers, 2020).
SLT supports other explanations for IPV, including extrafamilial socialization, gender
roles, violent masculinity, and the role of differential reinforcement. This proposed capstone
project aims to induce change by providing education and training to mental health staff. Those
trained staff will subsequently employ the curriculum to educate youth in groups of their peers in
an agency setting. The curriculum will include topics that enhance and support the development
of healthy interpersonal relationships. By providing this education and specialized training to
mental health staff, the anticipation is that the staff will have increased knowledge and skills to
implement the IPV-specific curriculum with their clients who have mental health diagnoses. This
will enable youth to establish heathier relationships, leaving them less susceptible to
experiencing or perpetrating relationship violence.
12
Social Learning Theory is one of the most used theories to explain relationship violence,
positing that people exhibit the behaviors they were exposed to as children and adapt those
learned behaviors into adulthood to continue the cycle of behavior. To address the issue from a
solution standpoint, the Empowerment Process Model can be applied, as Sticks and Stones aims
to reduce the prevalence of psychological intimate partner violence by educating and training
mental health professionals on characteristics and warning signs of psychological IPV (Albanesi,
Tomasetto, & Guardabassi, 2021). They can then teach youth with mental health diagnoses
healthy relationship characteristics, empowering them to guide themselves to healthy
relationships and away from harm.
This solution ultimately aims to enable mental health professionals to pass knowledge
and skills to youth to teach them to advocate for themselves and others against the threat of
psychological intimate partner violence and avoid psychologically abusive relationships.
Utilizing Social Learning Theory, along with Intergenerational Transmission of Violence Theory
in explaining the issue of psychological IPV, Sticks and Stones would follow the same premise
of teaching and modeling to individuals to allow them to learn and adapt positive relationship
skills (Powers, Cochran, Maskaly, & Sellers, 2020). They will also learn to identify harmful or
negative relationship characteristics in relation to psychological IPV, as well as other types of
abuse identified under IPV.
To accomplish this, the Sticks and Stones initiative would train clinicians and mental
health staff to teach a curriculum to be used with teens to develop a peer intervention strategy in
a community program setting. These staff members would learn a curriculum (Peace Over
Violence: In Touch With Teens) that addresses relationship violence from a prevention
perspective (Peace Over Violence, 2024). The intent is to train the clinicians and mental health
13
staff in this curriculum, who will implement the curriculum with teens and adolescents to be peer
advocates and support to their peers, as well as absorb and utilize the information learned to
prevent violence in their own lives (Feather, 2023). The In Touch With Teens (ITWT) curriculum
is comprised of eleven units designed to help young people develop healthy relationships. It
provides information about power and control, elements of healthy relationships and healthy
sexuality, and media literacy. Additionally, it includes education on sexual harassment, sexual
assault, and dating violence. The curriculum also focuses on developing pro-social skills such as
empathy, impulse control, effective communication, problem-solving, and bystander
accountability (Peace Over Violence, 2024). For the purposes of Sticks and Stones, this
curriculum has been adapted into four training sessions for mental health staff and clinicians to
be given in four 8- hour training sessions across the span of four months.
Methodology
A wide range of design tools and design thinking principles were employed in the
development of this Capstone Project. This necessitated extensive data collection to investigate
the problem and extent of psychological violence in intimate partner relationships, the causes of
this issue, and the impact it has on individuals, families, and communities.
To start, extensive literature reviews were initiated by conducting thorough searches
across various platforms and databases, using general and specific search terms in academic and
research-oriented databases. Peer-reviewed journal articles, books, and other publications were
reviewed in this process. Databases such as Google Scholar, Gale, ProQuest, PsycInfo, Sage,
Oxford Clinical Psychology, among others, were used to conduct an in-depth review of
psychological intimate partner violence. Relevant search terms such as psychological violence in
intimate partner relationships, psychological aggression in intimate partner relationships, non-
14
physical forms of domestic violence/intimate partner violence, causes of psychological intimate
partner violence, psychological IPV and children, men as victims of domestic violence, gaps in
research with children and IPV, etc., were used to locate relevant works and articles.
Further, broad-scope internet searches were conducted to find sources of grey resources
to provide additional information regarding current coverage of psychological IPV in
mainstream media and social media platforms. These searches resulted in information gathering
from news reports, individual experiences from survivors of psychological IPV through
interviews, TedTalks, short videos on YouTube, blogs, journal entries, and other sources of grey
publications. These searches also resulted in reviewing campaigns created to combat the issue of
IPV, some specifically addressing psychological violence, as well as organizations and coalitions
providing statistical evidence on the prevalence of psychological intimate partner violence and
its lasting consequences for survivors.
Besides the literature review, other methods of information gathering were implemented
to further analyze the scope of the issue. On a more narrow scale, information was gathered on
how psychological intimate partner violence affects local communities on the Eastern Shore of
Maryland, as well as how individuals are impacted by this issue across the United States.
Information was gathered through observation, disseminating surveys, conducting interviews,
and continued literature review to gather voices pertinent to develop a fuller understanding of the
wicked problem.
Surveys were disseminated to clinical mental health professionals with distinctions made
for the population worked with. Clinical mental health professionals received surveys for the age
of the population worked with, so those who work with adolescents were differentiated from
15
those who work with the adult population (18 years and older). In total, 20 surveys were
disseminated to clinical mental health professionals, with seven completed surveys returned.
Interviews were conducted with an advocate for domestic violence survivors and a
teacher in Wicomico County public schools, with two others contacted and awaiting interviews.
An interview with a male victim of intimate partner violence, both physical and psychological,
was also conducted during the information-gathering phase. The team also gathered stakeholder
input through interviews and ongoing staff meetings with the implementation agency, utilizing
design criteria to develop an implementation plan and designate a plan of action for a learning
launch.
The development of a design team was initiated, and the team was utilized in the initial
planning and development of the Capstone project throughout it’s inception. This team included
advocates, survivors of IPV, social workers, mental health professionals, and staff members of
the implementation agency, Arrow Child and Family Ministries. Their opinions and perspectives
provided essential and invaluable information, guiding the development and design process
throughout the project's progression. Reviewing key assumptions of the issue and applying realworld experiences from my team led to the development of a napkin pitch used in the
presentation of the iterations that have occurred throughout the development process. These
efforts culminated through a learning launch, where the high-fidelity prototype was implemented
in the agency setting of the Psychiatric Rehabilitation Program at Arrow Child and Family
Ministries.
Design Justice
16
Sticks and Stones embodies several design justice principles, which can be recognized
throughout different aspects of the work presented in the project. Some of those design
principles include sharing design knowledge and tools with communities through educating
mental health providers to enrich and better the lives of our children, especially those with
mental health diagnoses (Design Justice Network, 2024).
Sticks and Stones also utilized design justice principles to sustain, heal, and empower
communities and center the voices of those who are directly impacted by the outcome of the
design process (Design Justice Network, 2024). There is evidence to support the notion that this
project is both wanted and necessary to advance the solution of this societal issue. Staff have
implemented the first three units from the ITWT curriculum, received through Sticks and Stones
training with their monthly groups involving their program youth, and feedback has been
positive in nature. Staff who participated in this project through the learning launch of Sticks and
Stones report that their population (the ultimate beneficiaries of this project) has found it useful
and beneficial, relatable, and knowledge-boosting. In addition, staff reports that their population
engages and requests further involvement through activities taught to the staff.
Project Description
Sticks and Stones aims to provide additional knowledge and training to mental health
clinicians and staff of mental health programs to increase competency and comfort when
addressing concerns relating to intimate partner violence. The project intends to support
clinicians and staff in developing the capacity to work with youth for the ultimate prevention of
IPV. Improving the self-efficacy of clinicians improves self-confidence in their ability to bring
IPV into conversation and treatment with the youth in their programs, thus improving their
ability to initiate change with youth, specifically with those who have mental illness. Higher
17
self-efficacy increases comfort in specific domains (Maddux & Kleiman, 2024). Using this
information, increasing self-efficacy will increase provider comfort in broaching subjects related
to IPV with youth, changing the trajectory for youth and improving outcomes. Sticks and Stones
was created to increase the knowledge of mental health staff and clinicians by increasing the
training they receive that specifically addresses IPV in adolescent and teen relationships. It is
intended to be delivered specifically for clinical staff working with youth in the area of intimate
partner violence to allow for healthy relationship development for youth, specifically those who
suffer from mental health conditions, as this population is often overlooked when considering
issues of IPV.
Sticks and Stones aims to contribute to the Grand Challenge of Building Healthy
Relationships to End Violence as it is detailed in the Grand Challenges of Social Work (The
Grand Challenges of Social Work, 2021). This challenge aims to “reduce interpersonal violence
by 10% within the decade by strengthening healthy relationships” (American Academy of Social
Work & Social Welfare, 2020). To accomplish this goal, social workers from across the
profession collaborated to bring awareness to the issue of interpersonal violence and the lasting
negative impact it has on individuals, family relations, and communities while providing an
integrated platform to address a multifaceted social problem that spans generations, ages, races,
genders, abilities, and socioeconomic status. By strengthening relationships across sectors, social
workers seek to implement a framework representing the broad scope of violence and supporting
resilience and healing for those affected by violence. This Grand Challenge aims to reduce
interpersonal violence, encompassing the issue of intimate partner violence (The Grand
Challenges of Social Work, 2021). The issue of intimate partner violence (IPV) is a complex
one, much like that of interpersonal violence, as it is also not contained within one group or
18
population and can be found in all societies throughout the globe. This project will contribute to
this GCSW by increasing the skill and competency of social workers, counselors, and mental
health staff, potentially having a lasting positive impact on individuals and families, promoting
healthy relationships, and ending relationship violence for our youth and teens with mental
health concerns.
The attributes of this project are broken down into design criteria of what it must include,
could include, should include, and won’t include. This capstone project must be accessible to
mental health program staff and clinicians to utilize with the youth population and it must
increase awareness of healthy relationships and provide education on psychological violence as a
type of IPV. The project could include partnerships within the community and mental health
agencies that serve youth populations and utilize existing resources, staff, and systems/agencies.
It should address gender bias in IPV, as well as biases in relationship violence. It should also be
implemented in programs and mental health agencies with a primary population of youth, with a
significant focus on youth with mental health diagnoses. This project should also be easily
translated from training the staff to implementation in practice by those staff. This project will
not exclude youth based on mental health diagnoses.
The high-fidelity prototype is comprised of a training manual. The high-fidelity training
manual outlines the process strategy of training mental health professionals to utilize the In
Touch With Teens (ITWT) curriculum from Peace Over Violence through a series of 4 training
modules, complete with developed PowerPoint presentations, agendas for training, and outlines
to follow. These PowerPoint presentations also have embedded activities that are pulled from the
ITWT curriculum to lead staff in completing activities that they will use with their clients in
group sessions after the completion of their trainings. Objectives of the high-fidelity prototype
19
include assessing current working knowledge of topics being covered by the curriculum and
prototype and measuring the increase in the level of self-reported comfort and sense of
competency of staff when teaching clients about the subjects of intimate partner violence (IPV)
and topics covered in the curriculum. The high-fidelity prototype is intended to be utilized as a
series of training modules to provide further education to the staff of mental health programs to
then educate youth with mental health diagnoses about healthy relationships and the dangers of
IPV and related topics.
The intended implementation agency staff has currently tested the high-fidelity prototype
through regular meetings intended with the developer in which potential modifications
recommended for implementation success are discussed. Portions of the prototype were shown
to the implementation staff to gather critical feedback on final implementation strategies.
Insights were incorporated into the design and development of the prototype through the
modification of the outline of ITWT, and activities were included for review. Other insights
include the inclusion of mental health-specific statistics to connect the importance of
implementing this program with youth who have been diagnosed with mental health concerns.
Because the high-fidelity prototype was tested with staff members, no ethical issues arose during
testing. Plans to continue staff meetings regularly have been established, and a meeting schedule
has been developed.
Sticks and Stones aims to provide training to mental health staff and clinicians in the
areas of intimate partner violence, possible causes of IPV, warning signs, how to identify IPV,
and aspects of developing healthy relationships, as well as how to relate these topics to youth in
a clinical setting. The project aims to enhance knowledge, capability, and comfort in teaching
youth with mental health diagnoses not only about IPV but also how to have safe, healthy
20
relationships when they could be more vulnerable due to their mental health symptomology. The
goals set forth have been proven realistic thus far, having provided training to a group of mental
health staff, who have gone forward to introduce the curriculum to their youth population in a
monthly group setting. Sticks and Stones follows a path starting with the training and curriculum
being introduced to mental health program staff in a training forum at their agency of practice.
After completing the training modules, the staff will apply what they have learned to their
practice, introducing topics covered to their youth populations at an age-appropriate level. This
solution aims to level the playing field for these youth, who are more vulnerable and susceptible
to IPV in their relationships.
Sticks and Stones directly aligns with the logic model presented in Appendix 2 and the
theory of change presented. Utilizing funding resources, agency collaborations, curriculum and
partnerships, the activities include conducting training for mental health agency staff, adapting
educational curriculum and training for youth, and establishing partnerships to expand Sticks and
Stones as the projected outcomes include scaling and expansion. Sticks and Stones is intended to
have specific outcomes that include the developed training curriculum that can be utilized in the
training of mental health staff, continuing to engage with mental health programs and agencies to
support the training effort of mental health staff in the proposed curriculum, and finally to have
youth educated by the staff using the provided curriculum.
There are numerous outcomes expected from the implementation of Sticks and Stones.
The outcomes are grouped into short-term, mid-term, and long-term categories. Short-term
outcomes include providing education for mental health providers, increasing knowledge, ability,
and self-agency, and raising awareness of psychological intimate partner violence (IPV). Midterm outcomes consist of reducing the number of young people in unhealthy relationships,
21
increasing reporting of psychological IPV, building the capacity to work with youth for IPV
prevention, and enhancing clinicians' competence in addressing IPV-related issues. Mid-term
outcomes would be reflected in a change of behavior by increasing the number of groups on this
issue available to youth in the implementation agency programming. Long-term outcomes
involve improving the ability of young people with mental health diagnoses to form relationships
without psychological IPV and ultimately increasing awareness of psychological IPV to
empower individuals and reducing the incidence of IPV among youth particularly those with
mental illness.
Through the development of Sticks and Stones, numerous ethical considerations have
been carefully considered to negate possible negative outcomes. Because the ultimate
beneficiaries are youth who have been diagnosed with mental illnesses, careful consideration of
the curriculum utilized in the training to be implemented by staff occurred to analyze both
chronological and developmental age to ensure appropriateness for use with a broad range of
youth. As the identified direct users of Sticks and Stones are mental health staff, some ethical
concerns have been mitigated, as the training will be given to the staff who will then implement
it with their specific populations. This is critical as the staff is knowledgeable about their clients
and the appropriateness of the curriculums; they can adapt the content as necessary to meet the
needs of the population. Working directly with staff members means that ethical considerations
related to the confidentiality and consent of the end beneficiaries for Sticks and Stones will not
be a factor in this phase of the project. Clinicians will introduce the information in a setting in
which they are sensitive to the impact on the youth, can modulate the information should it be
necessary to do so and have the ability to follow up with the youth who may struggle with the
information and in the establishment of real-life relationships. Because Sticks and Stones is
22
intended to promote social change on a broad scale by training clinicians in mental health care
settings, the project hopes to reach a broad array of children and young people on an ongoing
and expanding basis.
Sticks and Stones aims to expand the current education initiatives and raise awareness
about psychological intimate partner violence. By educating mental health providers and
empowering youth to recognize and avoid violence in relationships, as well as providing
assistance to their peers when needed, we can reduce relationship violence in future generations.
This solution is realistic, achievable, and represents a significant step forward in the effort to
reduce psychological intimate partner violence. Through the specific development of this
program, Sticks and Stones intends to reach a vast group of youth through group settings in
mental health programs, expanding the reach of the program through the adoption of the training
throughout mental health programs moving forward.
Implementation Plan
A learning launch of Sticks and Stones took place on May 23, 2024 with the staff of the
psychiatric rehabilitation program at Arrow Child and Family Ministries at their Baltimore, MD,
location. Four direct staff members, as well as the program director, were in attendance for the
first module of training of Sticks and Stones. The first module of training begins by reviewing
the purpose and goals of the training and curriculum, followed by units covering Roots of
Violence, Power and Control, and Recognizing Unhealthy Relationships from the In Touch With
Teens curriculum. The first training module was facilitated by the developer of Sticks and Stones
and followed the agenda presented in the first training session, located in Appendix 6 - High
Fidelity Prototype. The plan moving forward is to continue the training modules monthly for a
total of 4 monthly trainings. Staff feedback of the learning launch included a desire to implement
23
the first 3 units of the curriculum with their youth population to gain insight and practice learned
techniques and activities.
A line-item budget can be found in Appendix 3, detailing start-up costs along with a
projected one-, two- and three-year budget for Sticks and Stones. The expenses detailed in the
budget are estimates and are subject to change due to economic factors and one-time expenses.
Expenses incurred to date have been covered by in-kind donations received by anonymous
donors. Additional funding opportunities continue to be developed at this time to ensure
sustainability as Sticks and Stones anticipates scaling opportunities to other programs and
additional agencies, with anticipated funding becoming available through grant programs
identified within the Community Foundation of the Eastern Shore. These funds would be utilized
in the expansion of Sticks and Stones into agencies located on the Eastern Shore within
Maryland, Delaware, and Virginia, as this foundation disperses funds to local agencies and
programs within a specified geographic area. Scaling opportunities have presented themselves
through word of mouth from staff who have begun to receive the training offered, branching off
into separate agencies connected to staff and expressing interest in taking the Sticks and Stones
program to their separate agencies.
Evaluation Plan
Sticks and Stones will be implemented with mental health workers and clinicians who are
expected to utilize it to utilize with their youth populations. As such, the number of staff
members trained utilizing the developed training modules will be one of the main measures of
success. Along with the tracking of staff training, data will be collected regarding staff
perceptions of training and relevance to ultimate beneficiaries utilizing the curriculum
evaluations included in the modules. Along these lines, a pre-test and post-test of their
24
knowledge base has been requested by the staff at the target agency to utilize for themselves at
the start and end of each training module.
Continued monitoring and evaluation are anticipated through ongoing communication
with Arrow Child and Family Ministries to optimize the training delivery and continue to make
improvements to ensure that Sticks and Stones remains effective as the project evolves.
Evaluation tools include pre and post-tests, along with qualitative first-hand feedback from the
staff trained regarding both the training they receive, and feedback from the ultimate
beneficiaries through staff reports. Communication with staff is expected on at least a monthly
basis throughout the duration of training and will continue while the staff implements with their
populations. Communication through email and phone calls has occurred with the staff director
as well as staff of the PRP program beginning in January of 2024 to continue the adaptation and
development of Sticks and Stones on a bi-weekly basis. Staff meetings were attended on at least
a monthly basis to continue ongoing communication efforts and ensure understanding of the
implementation plan and schedule of planned implementation strategies. As Sticks and Stones
continues to be implemented, communication with staff will continue in the form of staff
meetings to record feedback and outcome measures. Staff will be recording feedback through
evaluation forms provided through the developed curriculum that will be returned to the creator
of Sticks and Stones through email. Further feedback and continued development will continue
through the implementation process and after to record continued outcome data.
Challenges/ Limitations
Obstacles during the implementation phase of Sticks and Stones primarily have related to
timetables and scheduling for the training. These obstacles, which mostly relate to scheduling
training when all 5 members are available, were initially a challenge; however, they have been
25
overcome by scheduling in advance to allow time to synchronize staff calendars. To mitigate this
issue further, training was scheduled to capitalize on existing staff meetings and a lighter
schedule. At this time, no other challenges have been identified. However, funding for future
scaling opportunities could become an obstacle, although it can be overcome with funding
endeavors through the identified community foundation.
Conclusion and Implications
Sticks and Stones aims to empower mental health clinicians and staff to change the
trajectory of IPV in relationships involving youth with mental health diagnoses. It is an effort to
address the disparity in society for youth with mental health diagnoses who are more susceptible
to IPV in their relationships. Elevating the ability, capability, and knowledge of mental health
staff who work directly with youth who have mental health concerns will allow those staff
members to level the playing field for their population to empower youth to build relationships
free from IPV.
Intimate partner violence is a societal issue that spans all socio-demographic categories,
including the youth in our communities and specifically those with mental illnesses. Combined
with youthful naivety and chronic mental health concerns, this population is vulnerable to the
dangers of IPV in their relationships. Sticks and Stones aims to close the gap of vulnerability
with this population by addressing those in helping positions so that the issues associated with
IPV do not go unnoticed in these youths’ lives. Ultimately, the goal of Sticks and Stones is to
empower youth with mental illness to take charge of their intimate relationships and build
healthy relationships free from violence. Sticks and Stones has set up roots in Maryland with the
intent to expand geographically in order to reach mental health clinicians and staff around the
country.
26
Throughout this collaborative design process, this project was continually developed with
the input of a design team consisting of stakeholders, end-users, and professionals in the field of
mental health. Through this process, the project was developed and adapted into a training
program for mental health staff from an original project who will work with youth. Through this
iteration process Sticks and Stones was created, striving to make an impact for our youth and our
future. By giving additional training to mental health professionals, specifically addressing the
issue of intimate partner violence in its multiple forms, Sticks and Stones hopes to create change
in the profession in order to benefit vulnerable youth.
Sticks and Stones has conducted a learning launch with Arrow Child and Family
Ministries PRP program staff. The implementation plan will proceed with the continuation of
training implementation with Arrow Staff until all four training units have been conducted.
Further plans include the staff taking the knowledge and skills learned through Sticks and Stones
and applying it to practice with their youth populations through monthly groups held in the PRP
program. Full implementation is expected to be completed with this agency by August 2024,
with staff utilizing the training in practice in groups following each training unit (training
received in May 2024 will be applied to PRP groups with youth in June 2024). The process of
creating Sticks and Stones was a complex and rewarding iterative process that will have a great
impact on the youth in communities and foster a brighter, safer future free from intimate partner
violence.
27
References
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Albanesi, C., Tomasetto, C., & Guardabassi, V. (2021). Evaluating interventions with victims of
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Karakurt, G., & Silver, K. E. (2013). Emotional Abuse in Intimate Relationships: The Role of
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6708.VV-D-12-00041
Khalifeh, H., Oram, S., Trevillion, K., Johnson, S., & Howard, L. M. (2015). Recent intimate
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Appendix 1: Design Criteria
CRITERIA WIDER OPPORTUNITY SPACE
MUST • Be accessible to children from
elementary school age to
young adult populations.
• Increase awareness of healthy
relationships and provide
education on psychological
violence as a type of IPV
• Be applicable to multiple
roles of mental health
clinicians
• Implement an inclusive curriculum
for youth with mental health
concerns/diagnoses
• Develop a curriculum that
addresses healthy relationship
development, including warning
signs of unhealthy relationships,
IPV with specific attention to
psychological IPV
COULD • Include partnerships within
the community and mental
health agencies that serve
youth populations
• Utilize existing resources,
staff, and systems
• Explore partnership opportunities
with existing community resources
• Maximize available staff and look
for development opportunities
SHOULD • Address gender bias in IPV
• Be implemented in programs
and mental health agencies
with a primary population of
youth with mental health
diagnoses
• Include education to all students,
regardless of gender, covering the
disparities of information from
missing voices
WON’T • Exclude individuals based on
social determinants
• Provide opportunity to all
32
Appendix 2: Logic Model
33
Appendix 3: Line Item Budge
34
Appendix 4: Implementation Time-Line
35
Appendix 5: Curriculum Evaluation
Appendix 6: High Fidelity Prototype
36
Appendix 6: High Fidelity Prototype
Appendix 6: Curriculum Evaluation
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Abstract (if available)
Abstract
The issue of intimate partner violence (IPV) is a social concern that affects people of all ages, races, genders, abilities, and socioeconomic backgrounds. Psychological IPV is perhaps the most widespread type of IPV, yet it is often not well represented in literature and interventions. It's often referred to as the invisible type of IPV throughout research documents. Forty-eight percent of men and women in the United States reported experiencing psychological violence in their relationships, according to the National Coalition Against Domestic Violence (NCADV) (2015). This paper explores psychological IPV under the Grand Challenge of Building Healthy Relationships to End Violence as presented by the American Academy of Social Work and Social Welfare (2020). It presents a proposed capstone project, Sticks and Stones, aimed at reducing the prevalence of psychological IPV through the development and implementation of a training protocol strategy to reduce unhealthy relationships through education, training, and peer education and interventions for youth with mental health diagnoses. This paper explores the issue addressed by the capstone proposal through the lens of Social Learning Theory, and reviews Sticks and Stones through an Empowerment Theory lens, addressing the community youths’ lack of knowledge and available resources to successfully reduce the prevalence of psychological IPV by addressing the issue through awareness and education, providing training to mental health staff to increase comfort and competence with the topic of psychological IPV. By increasing the education and training offered on psychological IPV, an increase in staff competency is the desired outcome, along with an increase in the rate of youth relationships free from psychological and other forms of IPV. The project intends to build a capable workforce in mental health workers in order to ultimately impact outcomes for youth by reducing the prevalence of IPV in youth relationships.
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Behavioral Health for All Kids
Asset Metadata
Creator
Feather, Lori Elizabeth
(author)
Core Title
Sticks and stones: training protocol strategy to reduce violence in relationships
School
Suzanne Dworak-Peck School of Social Work
Degree
Doctor of Social Work
Degree Program
Social Work
Degree Conferral Date
2024-08
Publication Date
08/07/2024
Defense Date
07/22/2024
Publisher
Los Angeles, California
(original),
University of Southern California
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Tag
intimate partner violence,mental health,psychological violence,youth relationships
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Tags
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