Summary Report: Preventing revictimization* and use of Aggression following girls’ maltreatment

A Life Course Approach

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*This report uses the term ”revictimization”, which is commonly used to refer to the link between early and later experiences of victimization. However, we recognize that not all women and girls who have experienced violence identify with or use the term “victim.”

Women and girls who experience childhood maltreatment are more likely to be victimized again or to use relational aggression later in childhood, adolescence, and/or adulthood.

One in three Canadian women will experience violence or abuse at least once in their lifetime, often first during childhood, placing them at greater risk for later revictimization and/or use of relational aggression. This lifetime exposure to violence has significant physical, psychological/emotional, behavioural, and interpersonal health consequences. Preventing violence and its health impacts requires attention to the systemic, social, and individual factors that affect the vulnerability, resources, resilience, and wellbeing of women and girls from childhood to adulthood. At the same time, it is important to remember that women and girls are 0diverse, and pathways to revictimization or use of relational aggression may be different for different individuals. This report provides an overview of research-based and promising programs to prevent and reduce revictimization and use of relational aggression among women and girls who have experienced childhood maltreatment.

Focusing on women and girls does not mean that they are responsible for the occurrence or prevention of the violence they have experienced.

Fundamentals to Remember:

  1. Identity is complex: Women and girls affected by violence may identify anywhere along the spectrum of gender identity (e.g. trans*, cisgender, genderqueer). Women and girls are diverse and may simultaneously identify with multiple groups (e.g. Indigenous, older, disabled).
  2. Violence is a continuum: Violence occurs in many forms. This includes but is not limited to physical violence, sexual violence (e.g. assault, harassment), psychological violence, harmful sociocultural practices (e.g. female genital mutilation), and structural violence (e.g. sexism, ageism, racism).
  3. Context is key: Violence, especially when it causes serious injury or death, is disproportionately perpetrated against women by men. Women who use violence often do so in the context of their own victimization. The broader social context (e.g. historical and current oppressions) impacts these lived experiences.

Understanding the Connections between Maltreatment as a Girl and Later Revictimization/Use of Relational Aggression*

*For a detailed review of these connections, please see our previous report and newsletter:

Report: Links between the Maltreatment of Girls and Later Victimization or Use of Violence Report
Newsletter: Issue 20: Links between the maltreatment of girls & later victimization or use of violence

Both cross-sectional and longitudinal research finds links between childhood maltreatment and:

  • maltreatment later in childhood
  • bullying in childhood and adolescence
  • sibling abuse or aggression in childhood and adolescence
  • sexual assault and harassment in adolescence/adulthood
  • physical assault in adolescence/adulthood
  • dating or intimate partner violence in adolescence/adulthood

The multi-level factors that increase vulnerability to revictimization can generally be grouped as: (1) those that increase the risk of both the initial and subsequent victimization (e.g. poverty, gender inequality, parental substance use issues); and (2) those that are set in motion by the initial experience of abuse (e.g. affect dysregulation, low self-esteem, post-traumatic stress disorder). Most hypotheses on revictimization focus on the second group of factors, suggesting that alterations in psychological and psychosocial adjustment, abilities to recognize risk, and expectations of adult relationships increase vulnerability to later victimization. The first group of factors, however, are equally if not more important to address in preventing revictimization. Factors from each group can also interact with each other in complex ways across the life course.

Most theories linking early victimization to later use of relational aggression are not gender-specific, and like revictimization models, focus primarily on individual factors. More work is needed in this area, but one promising approach is the feminist ecological model, which accounts for multiple complex interactions between individual (e.g. childhood maltreatment, psychological difficulties), interpersonal (e.g., parent criminality, peer pressure), community (e.g. neighbourhood violence), and societal (e.g. gender inequality, structural violence) risk factors.

  • While any experience of violence can impact the health and well-being of survivors, revictimization typically involves unique pathways, sequelae, and implications for prevention.
  • The use of relational aggression by women and girls is intricately linked to their early experiences of victimization, but more work is needed to further examine this relationship and understand gender-specific pathways.
  • Lifetime exposure to violence, through both victimization and use, has significant short- and long-term consequences for health. Prevention efforts must consider women’s and girl’s histories of violence.

Revictimization across the Life Course

  • Childhood Sexual Abuse (age 4 by uncle)
  • Domestic Violence (age 21 by boyfriend)
  • Sexual Violence (age 73 by caretaker)

Prevention across the Life Course

Contextualizing Prevention

Before reviewing existing prevention programs, it is important to remember the following:

  1. Not all studies of prevention programs are based on only samples of women/girls and not all test for gender differences in effectiveness. It is possible a program may only work or work better for boys/men, especially with regard to use of relational aggression.
  2. Women and girls with histories of victimization may have unique needs relative to those who have never experienced victimization. This might impact the effectiveness of prevention programs that do not consider past victimization.
  3. Due to the limited number of programs for reducing revictimization specifically, we also include programs for survivors of violence that reduce the consequences of victimization, which may in turn reduce vulnerabilities linked to revictimization.
  4. Preventing violence from being disproportionately perpetrated by men and boys against women and girls in the first place is ideal. There is a need for community and societal-level interventions to address the root causes of gender-based violence (e.g. gender inequality, unhealthy masculinities, intersecting systems of oppression).

Levels of Prevention

Primary prevention: aims to intervene before the occurrence of victimization or use of aggression by preventing the development of associated risk factors (e.g. limited educational opportunities, parental substance use).

Secondary prevention: targets girls or women at high risk of experiencing victimization or using aggression, such as those who live in low-income neighborhoods.

Tertiary prevention: takes place after victimization or use of aggression has been identified, with interventions intended to minimize the impact of victimization for survivors and decrease the risk of recurring use of aggression.

Research-Based Victimization Prevention Programs*t

*For more information on each program, please see our full report
tPrograms included if they reduced relevant risk factors or increased protective factors.

 

Infancy/

pre-school

School age

Adolescence/

young adulthood

Adulthood

Primary

prevention

 

Walk Away, Ignore, Talk, Seek Help (WITS)

Enhanced Assess, Acknowledge, Act

Sexual Assault

Resistance Program

 

Secondary

prevention

Nurse-Family Partnership

Healthy Start Program

Psychoeducational parenting intervention

 

Web-based Combined Sexual Assault Risk and Alcohol Use Reduction Program

 

Tertiary

prevention

Child-Parent Psychotherapy

Community-provided Trauma-focused Cognitive Behaviour Therapy

Community-Based Intervention Program Project Support I & II

Strengths- and Community-Based Support and Advocacy

Multisystemic Therapy

DePrince Group Interventions

Revictimization Prevention Program

Sexual Assault Risk Reduction Program

Healing Our Women Project

Bolded programs are specific to girls/women and/or revictimization.
Programs included if they reduced relevant risk factors or increased protective factors.

Research-Based Relational Aggression Prevention Programs*t

*For more information on each program, please see our full report
tPrograms included if they reduced relevant risk factors or increased protective factors.

 

School age

Adolescence/young adulthood

Primary prevention

I Can Problem Solve (ICPS)

Life Skills Training

Promoting Alternative Thinking Strategies (PATHS)

Sisters of Nia

Safe Dates Program

Families for Safe Dates Program Moms and Teens for Safe Dates

Secondary prevention

Second Step

Linking the Interests of Families and Teachers (LIFT)

Seattle Social Development Project

Safe Dates Program

Tertiary prevention

Making Choices: Social Problem Skills for Children

Friend to Friend (F2F)

Multi-dimensional Treatment Foster Care

Functional Family Therapy

Multisystemic Therapy

Youth Relationships Project

The Fourth R

Bolded programs are specific to girls/women and/or revictimization.
Programs included if they reduced relevant risk factors or increased protective factors.

Program In-Focus: The Enhanced Assess, Acknowledge, Act Sexual Assault Resistance Program

  • Developed, pilot-tested, and implemented in Canada by Dr. Charlene Senn (University of Windsor).
  • Consists of four 3-hour units which aim to teach young women how to assess risk, acknowledge danger, and engage in verbal or physical self-defence.
  • Evidence from a randomized controlled trial involving three Canadian universities indicates that women who participated in the program had a significantly lower risk of both reported attempted sexual assault and reported completed sexual assault one year later.
  •  The program was found to be effective for both women who had experienced prior victimization and women who had not.
  • After two years, the program was still found to significantly reduce the risk of attempted and completed sexual assault, as well as attempted coercion and non-consensual contact by 30-64%.
  • Significant increases were also found in perceptions of personal risk, risk detection, self-defence, self-efficacy, and knowledge of effective verbal and physical resistance strategies.

Program In-Focus: Friend To Friend (F2F)

  • School-based program designed for urban, mostly African American fifth-grade girls.
  •  Goals: reduce physical and relational aggression, improve problem-solving skills, increase prosocial behaviours.
  • Developed in collaboration with parents, teachers, community members, and girls themselves using a participatory action framework.
  •  Highly accepted by participants and their teachers and is considered culturally sensitive.
  • Relationally aggressive girls are grouped with prosocial role models.
  • Found to significantly decrease relational and physical aggression, loneliness, and hostile attributions.
  • Found to significantly increase prosocial behaviour, problem-solving abilities, and peer likability (as reported by teachers).

Promising Victimization/Aggression Prevention Programs*

*For more information on each program, please see our full report
tPrograms included if they reduced relevant risk factors or increased protective factors.

 

School age

Adolescence/young

adulthood

Adulthood

Primary prevention

Early Childhood

Sexual Assault Education and Prevention Program (V)

The Fourth R: Uniting Our Nations

 

Secondary prevention

MAC-UK (RA)

 

 

Tertiary prevention

 

Trauma Systems Therapy (RA)

Brief Acceptance and Mindfulness-Based Program (V)

Intensive Treatment Program for Female Offenders (RA)

Spirit of a Warrior Program (V/RA)

Sexual Assault Education/ Prevention Program for Female US Navy Personnel (V)

Bolded programs are specific to girls/women and/or revictimization.
V=Victimization prevention; RA=Relational aggression prevention

Prevention Programs with Applications Across Life Stages*

*For more information on each program, please see our full report

Program

Level of Prevention

Prevention of Victimization or Relational Aggression

Incredible Years Program

Primary

Victimization

Raising Healthy Children

Primary

Relational Aggression

Triple P Parenting Program

Primary/secondary

Victimization

Strengthening Families Program

Primary/secondary

Victimization

Olweus Bullying Prevention Program

Primary/secondary

Relational Aggression

Brief Strategic Family Therapy

Secondary

Relational Aggression

Parent-Child Interaction Therapy

Secondary

Victimization

Trauma-focused Cognitive Behavioural Therapy

Tertiary

Victimization

Game-based Cognitive Behavioural Therapy

Tertiary

Victimization

Dialectical Behaviour Therapy

Tertiary

Victimization

Multisystemic Therapy

Tertiary

Victimization

Developing Protective Resources and Resilience

Beyond focusing on reducing risk factors, building strengths and promoting resilience may be especially important to preventing revictimization and future use of aggression by girls/women who have experienced childhood maltreatment.

Although many of the prevention programs listed in this report include components to develop protective resources, little research has actually examined what factors may have been involved to prevent revictimization among survivors of early abuse or violence who never experienced subsequent victimization or use of aggression.

Higher levels of protective factors in adolescence among youth with high levels of cumulative risk exposure may be particularly important for reducing later odds of violence.

Breaking the Link between Early Victimization and Later Revictimization or Use of Aggression

Key Protective Factors:

  • Self-efficacy
  • Sense of mastery
  • Proactive coping
  • Situational assertiveness
  • Empowerment strategies
  • Self-esteem
  • Emotional regulation strategies

Prevention Approaches:

Societal-Level

Violence against women and girls is ultimately a systemic issue, rooted in gender inequality.

Achieving gender equality involves removing all legal, social, and economic barriers to women’s and girls’ empowerment.

This requires policy changes and programs to:

  • Eliminate childhood poverty
  • Increase access to educational and economic opportunities
  • Recognize and reduce unpaid work
  • Achieve food security
  • Increase access to clean water and sanitation
  • Make all urban and rural areas safe, inclusive, and sustainable
  • Challenge gender norms and attitudes
  • Raise awareness of gender-based violence

Community-Level

Neighbourhood risk factors are among the most salient and consistent predictors of violence.

Community interventions must focus on:

  • Reducing poverty
  • Increasing safety and neighbourhood cohesion
  • Economically empowering women
  • Addressing gender norms and attitudes
  • Engaging men and boys as partners in ending violence against women and girls

Considerations and Future Directions

Key Messages

  • Childhood maltreatment and later revictimization or use of relational aggression are strongly associated. This link is not inevitable and has important implications for prevention.
  • Prevention involves addressing complex, multi-level factors and requires coordination between all stakeholders and sectors who directly or indirectly provide services to women/girls who have experienced victimization/use aggression.
  • Women and girls are not responsible for the violence they have experienced, but work can be done to reduce vulnerabilities and promote resilience while simultaneously working to end gender-based violence in society overall.

Unanswered Questions

  • Can programs intended to prevent initial victimization or reduce its consequences effectively disrupt the pathway toward additional victimization?
  • What are the gender-specific pathways and risk factors from childhood maltreatment to later use of relational aggression by women and girls?
  • Do existing programs work for diverse groups of women/girls or are more culturally sensitive programs needed?

Next Steps

  • Develop a girl/woman-centered approach to victimization and use of aggression prevention.
  • Include revictimization and use of aggression as possible outcomes of child maltreatment and work to reduce this risk within existing programs.
  • Focus on diversity: women’s and girls’ experiences of victimization and use of aggression are directly related to their status within a gendered society AND are simultaneously shaped by additional social locations and systems of oppression (e.g. racism, homophobia, transphobia, poverty, ableism, ageism, place of residence, colonization).
  • Conduct longitudinal, intersectionality-informed, mixed-methods research to identify the salient signposts at different stages of development for different groups of girls/women along pathways of safety and nonviolence to better inform prevention programs.

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Authors

Linda Baker, Ph.D., C.Psych., Learning Director, Centre for Research & Education on Violence Against Women & Children, Western University

Nicole Etherington, Ph.D., Research Consultant, Centre for Research & Education on Violence Against Women & Children, Western University

Graphic Design

Elsa Barreto, Digital Media Specialist, Centre for Research & Education on Violence Against Women & Children, Western University

Suggested Citation:

Etherington, Nicole A. & Baker, Linda L. (2018). Preventing Revictimization and Use of Aggression Following Girls’ Maltreatment: A life course approach. Summary Report. London, Ontario: Centre for Research & Education on Violence Against Women & Children. ISBN 978-1-988412-22-1.

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