Expect Respect Support Groups:
A trauma-informed approach to
preventing dating abuse among
vulnerable youtht Respect
NCVC
NATIONAL CONFERENCE
SEPTEMBER 10, 2013
BARBARA BALL, PHD
Mission:
SafePlace exists to end sexual and domestic violence
through safety, healing, prevention and social change.
Vision:
A community free of rape, sexual abuse and domestic
violence.
24-hour Hotline 267-SAFE (7233) or
927-9616 for the Deaf community
The Expect Respect Program
 Goal: To promote healthy relationships and
prevent dating and sexual violence among teens
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Began in 1989
Responsive to schools’ needs
Staff of 15
Private and govt. funding
A Comprehensive Approach
SUPPORT GROUPS
(24 weekly sessions)
Support Vulnerable Youth –
Build Skills for Healthy
Relationships
YOUTH
LEADERSHIP
Training and youth-led
campaigns (8 sessions)
Youth Theatre Ensemble
(year-round)
Schools, Parents &
Community Partners
School policy
Training
Parent engagement
Community partnerships
Mobilize Teen Leaders –
Change Social Norms in the
Peer Group
Decreased
Victimization and
Perpetration
Increased Healthy
Teen Relationships
Increased
community health
and safety
Engage Teachers, Parents &
Community Organizations –
Build Safe Schools and
Communities
When you were in 8th grade …
What were you watching on TV?
What music were you listening to?
What did “dating” mean?
What were the big issues/concerns in your life?
Developmental Perspective on
Teen Relationships
WHAT DOES DATING LOOK LIKE IN MIDDLE
AND HIGH SCHOOL?
Teen Relationships
Teens are:
 Inexperienced with romantic relationships
 Want independence from parents
 Have romanticized views of love, often informed by
media images
 May experience pressure by peers to have dating
relationships
 Are more likely to turn to a friend than a parent or
other adult when they experience dating violence
Teen Dating Abuse
Dating abuse involves
emotional, digital,
physical and sexual abuse
of a dating partner
Estimated 10-30% of
adolescents report
victimization
Teen Dating Abuse Looks Like
 Insults, name-calling, put
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downs
Use of technology to harass or
intimidate
Jealous and controlling
behavior
Isolation of partner from
friends/family
Threats to hurt self or others
Hitting, choking, kicking,
restraining
Forced or coerced sexual
activity
Birth control sabotage
Physical Dating Violence
Percentage of High School Students Who
Experienced Dating Violence 1999-2011
(YRBS)
10
9
8
7
6
5
Percentage
4
3
2
1
0
1999
2001
2003
2005
2007
2009
2011
The percentage of high school students who experienced physical dating violence
defined as “hit, slapped, or physically hurt on purpose by their boyfriend or
girlfriend during 12 months before the survey.” National Youth Risk Behavior
Survey, CDC, 1999-2011
Health and Mental Health
Victimization associated with
 Injury
 Substance abuse
 Unhealthy weight control
behaviors
 Depression & suicide
 Anxiety
 Trauma
 Self-harm
 Substance abuse
(Jouriles et al., 2006; Roberts
et al., 2003; Silverman et al.,
2001; Wolfe et al., 2003)
Sexual and Reproductive Health
 17.8% of high school girls
were forced to engage in
sexual activity by a dating
partner. (US DOJ, 1997)
 Teen girls in physically
abusive relationships were
3-6 times more likely to
become pregnant. (Roberts et
al, 2005)
 Teen girls abused by male
partners were 3 times more
likely to become infected
with an STI/HIV. (Decker et
al, 2005)
Academic Performance
% of Dating Violence Victims
Association of Dating Violence Victimization with
Academic Performance (YRBS 2009)
25
20
15
10
5
0
Mostly A's
Mostly B's
Mostly C's
Academic Performance
Mostly D's/F's
mental health
teen pregnancy/
sexual coercion
hate crimes
youth
violence
bullying
digital
abuse
gang violence
teen dating
abuse
drop out
alcohol/tobacco/drugs
Supporting Youth Exposed to
Violence
Exposure to Violence
 National Survey on Children’s Exposure to Violence
(Finkelhor et al., 2013)
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41% of children were physically assaulted in the last year
13% of children were harmed by a parent or caregiver
22% witnessed family and community violence
10% of girls ages 14-17 experienced sexual assault or abuse
More than 13% of children report being physically bullied, 30%
reported being emotionally bullied
15% had been exposed to violence six or more times in the past year
5 % had been exposed to 10 or more violent acts in the past year
Poly-victimization and Trauma
Children exposed to one form of violence are at far
greater risk to experience another form of violence
(Finkelhor et al., 2009)
Current trauma symptoms are more tied to variety
and number of exposures than to specific
victimization types
(Hamby, 2011)
Capacity for Healthy Relationships
 Self-regulating emotions &
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behaviors
Constructive and non-violent
conflict resolution
Understanding of the
consequences of one’s
behavior on others
Empathy
Sensitivity to the point at
which “playful” aggression is
harmful
Understanding “consent”
An understanding of what
constitutes a healthy
relationship
Emergence of Violence in Peer and Dating
Relationships
 Aggression as an effective
strategy for problem
solving, gaining control,
attention and status
 Aggression as a mean of
increasing engagement
with partners
 Models of relationships as
distrustful and hostile
 Norms that are accepting of
violence and its
consequences
(Pepler, 2012)
Understanding Vulnerable Youth
 Insecure in relationships
 Afraid of rejection
 Sensitive to disrespect
 Need for closeness
 High drama in relationships
 Unrealistic expectations
 Deficit in social skills
 Normalize violence
 Deal with depression,
substance abuse
 Grow up in a difficult
environment with multiple
challenges to safety & well
being
(Wekerle & Wolfe, 1998; Bartholomew, 2001; Downey, 2000)
Traumatic Stress and Healing
 Ingredients for healing
 Safety
 Supportive environment
 Sense of bel0nging
 Self-regulation (feelings and behaviors) enhanced through
exploring multiple channels of communication and expression
(movement, role play, art, music, poetry)
 Skills
 Empowerment
Expect Respect Support Groups
 Expect Respect
Support Groups for
Youth exposed to
violence
 Middle and high
schools
 Separate-gender
groups
 24 sessions
Groups Provide
 Trauma-informed
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approach
Relationship with caring
adult
Supportive peer group
A place to practice
relationship skills
Norms that support
giving and getting
respect
Easy access to services
Getting Started
CONFIDENTIAL SUPPORT GROUPS
24 SESSION CURRICULUM
AT SCHOOL, DURING THE SCHOOL DAY
5 – 10 MEMBERS
SEPARATE GROUPS FOR BOYS AND GIRLS
Developing Support for the Program at School
 Establish school agreement
 Identify partners and referral system (counselor,
nurse, outside agency personnel)
 Find a private place to meet with students
individually and in groups
 Schedule support groups so students can be pulled
out of class
Referrals
 Educate the entire staff on
who/how to refer
 Provide “one-pager” with
referral info
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Problems with peers
(bullying, harassment,
fighting)
Violence in the home
Dating abuse (victim or
abuser)
Pregnant or parenting
 Have pocket cards available
with information and
resources
Recruiting Group Members
Would you have been
interested in a group
like this when you
were in school?
What can you do to
make the program
attractive to teens?
Working with the Expect
Respect Curriculum
CURRICULUM OVERVIEW
COUNSELOR’S ROLE
GROUP FORMAT
SELECTED CURRICULUM SESSIONS
Curriculum Overview 24 sessions
 Developing group skills
 Choosing equality and respect
 Recognizing abusive relationships
 Learning skills for healthy relationships
 Getting the message out
The Counselor’s Role
 Listen
 Model openness and trust
 Share power
 Prevent rudeness, judging, disrespect
 Weave connections among group members
 Use curriculum to start dialogue, teach skills
 Support members in asking for and giving support
 Make the group “safe”
 Explain confidentiality agreement
Group Format
 Check-In
 Introduction
 Activities and
discussion
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Art
Poetry
Role play
Videos
Group games
Work sheets/ handouts
 Wrap-Up
Developing Group Skills
Sessions 1 - 5
 Creating Group Guidelines
 Weaving Connections
 Listening and Supporting Each Other
 Expressing Feelings
 Communicating Assertively
Supportive Ways of Treating Each Other
More…
Less…
To show respect for each
other, we must be
To cooperate, we must
be
To listen more
effectively, we must be
To make our needs
known, we must be
Invite group to develop group guidelines.
The Puppeteer
Session 4. Feeling Cards pg. 86
Session 5. Communicating Assertively pg. 91
 Role play Assertive
Communication
Role Play Assertive Communication
 Break into groups of 3 (2 actors and one observer), choose a
scenario and role play aggressive, passive and assertive
responses
1.
2.
3.
4.
Your partner is 40 minutes late to pick you up for school in
the morning.
You are out with a group of friends when your partner makes
an insulting remark about you.
You bought movie tickets, but your partner tells you he/she
has made other plans.
You decide the relationship is not working out and you want
to break up.
 Which response is most effective?
Choosing Equality and Respect
Sessions 6 – 10
 Exploring Dating Expectations, Rights and
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Responsibilities
Questioning Gender Stereotypes
Defining Abuse and Respect
Recognizing Use and Abuse of Power
Identifying Warning Signs of Dating Violence
Session 7. Questioning Gender Stereotypes pg. 112
 Gender stereotypes in
the media
 Voices in your head
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My mom always says …
My dad always says …
My friends always say …
My boyfriend/girlfriend/
partner always says …
Session 9. Recognizing the Use & Abuse of
Power pg. 130
 Power Poem
 Power looks like…
 Power sounds like…
 Power smells like…
 Power tastes like…
 Power feels like…
Recognizing Abusive Relationships
Sessions 11 – 15
 Dealing With Stress
 Naming the Violence in Our Lives
 Breaking the Cycle of Violence
 Handling Anger
 Identifying Jealousy and Control
Session 14. Handling Anger pg. 172
o Anger assessment
o Anatomy of anger – what does your
anger tell you?
o My anger is like a …
Learning Skills for Healthy Relationships
Session 16 – 20
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Moving from Abusive to Healthy Relationships
Resolving Conflicts
Setting Boundaries (Sexual Limits)
Asking for Consent
Ending a Relationship
Getting the Message Out
Session 22. Mixed Gender Discussion
 What have you always
wanted to know about
girls or boys but were
afraid to ask?
 What information do you
need from girls or boys to
understand them better?
 How are boys and girls
similar? Different?
 What makes it difficult to
ask questions like these
to a dating partner?
Creating Safe Schools
SCHOOL POLICY
Address the Continuum of Abuse
Bullying
Dating Violence
Sexual Harassment
 Link TDV policy with efforts to respond to & prevent
bullying, cyber-bullying, sexual harassment, sexting
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Continuum of abuse in teens’ relationship and adolescent
development
Importance of the peer group in teen dating violence and teen
dating conflicts
 Avoid labeling students as perpetrators or victims,
instead think of target and alleged offender
Elements of An Effective School Response
o Victim Safety
o Parent notification
(victim)
o Investigation
o Reporting to
authorities
o Consequences for
alleged perpetrator
o Support Services
Austin ISD School Policy Components
Freedom from Discrimination, Harassment and
Retaliation
 Notice of student and parent rights
 Student complaint form
 Student-on-student altercation response chart
 School-based Stay Away Agreement
 Transfer
AISD Respect For All
www.austinisd.org/respectforall
Creating Safe Communities
ENGAGING INFLUENCERS
Engage Influencers
Influencers
•
Teachers
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Older Teens
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Parents
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Healthcare providers
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Coaches
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Faith leaders
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After school programs
School-Community
Partnerships
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Parents Matter!
www.startstrongparents.org
 The best time to prepare
teens to develop healthy
relationships is before
dating begins
 Parents
Talk to your teens about
their peer and dating
relationships.
 Create space for an honest
conversation. Listen.
 Stay involved in your teen’s
life.
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Start Strong Parent Concepts
You Speak Adult 1
Status Update
You Speak Adult 2
Talk To the Hand
Family Dinner (Spaghetti)
Family Dinner (Chicken)
Bull
This Is A Test
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Training for Parent Support Specialists
 Provide the link to the community
 Are sensitive to cultural values about dating
 Empower parents
 Create space for conversation
 Reduce parents’ anxiety
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Middle School Transition Workshops
http://theaustinproject.org/2011/01/spotlight-on-the-parent-transition-initiative
 Engage parents at a time
when they are involved with
the school
 Address adolescent
development, forecast social
emotional needs, and build
skills for parenting a teen
 Begin the conversation about
healthy teen relationships
 Inform about school policy
concerning bullying and
dating violence
 Facilitate parent-teen
dialogues
Healthy Relationships
 Train nurses for
screening, response and
prevention
 Collect local data-Substance Use and Safety
Survey
 Update health curriculum
 Engage the School Health
Advisory Council (SHAC)
 Healthy Relationship
Survey
Coordinated School Health Model, CDC
Screening & Response Protocol for School Nurses
 Introductory statement
 Confidentiality
 Screening questions
 If you are concerned…
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Assess risk
Document
Safety plan
Complaint, SRO
Link to support services
 Closing statement
A Role for Coaches
http://www.coachescorner.org/index.asp?page=22
 Inside Out Coaching
 Coaching Boys Into
Men
Law Enforcement
Travis County Sheriff’s
Office
 Town hall meetings
 Training for officers on
using Choose Respect in
the classroom
 Events
 Vehicle wrap
 Annual PSA and art
contest
Mobilize Youth Leaders
Youth Leadership Training
 8-lesson curriculum
 Recognize and confront bullying, sexual harassment,
sexual assault, and dating violence
 Learn skills for peer support, advocacy, and community
action
 Aligned with requirements for health classes in
Texas
 Training can be provided to existing youth groups
in schools or in the community
 Followed by a service learning project on campus
Youth Have Power
 To make healthy choices
 To act as role models and
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leaders
To educate others
To mobilize peers
To support friends
To contribute to
solutions
Evaluation of Expect Respect Support
Groups - Timeline
1988
First
Expect
Respect
groups
2003
2006-10
CDC
Development
Empowerment
of Tools for
2005
Evaluation
Qualitative Program
Evaluation Evaluation
2010-14
Controlled
Effectiveness
Trial
2009-10
Pilot Study
Pilot Study 2009-2010
Preliminary program evaluation
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No control group
Goals
1. Describe pre-to-post changes
a)
Do ERSG participants change significantly in relationship norms,
feelings of insecurity in relationships, and dating behaviors?
2. Test model of dating behavior change
a)
Do positive relationship norms and emotional/social support
(reduction in feeling insecure in relationships) predict a decrease in
controlling behaviors and a decrease in perpetration of emotional
abuse and physical violence/sexual coercion?
Measures
Norms
 Acceptance of physical dating violence perpetrated either by a boy or a
girl – 8 items
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Foshee, V., et al., (1998). An evaluation of SafeDates, an adolescent dating violence prevention program.
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It is OK for a boy to hit his girlfriend if she did something to make him mad.
Boys sometimes deserve to be hit by the girls they date.
It is OK for a boy to hit his girlfriend if she insulted him in front of friends.
 α = .88
Feelings
 Feelings of Insecurity in Relationships – 3 items
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Adapted from: Purdie, V. & Downey, G. (2001). Rejection sensitivity and adolescent girls' vulnerability to
relationship-centered difficulties.
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I worried they would cheat on me or betray me.
I felt upset when they did things that didn’t include me.
I worried that they really liked someone else better than me.
 α = .70
Measures continued
Behaviors
 Reported on behaviors in dating
relationships in 3 months prior
to the assessment
 Controlling behaviors (3)
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I tried to keep them from spending time
with other people.
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I made them describe what they were
doing and where they were.
α = .75
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 Emotional/verbal abuse (3)
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I made nasty comments about them to
others.
I made fun of them in front of others.
α = .62
Measures continued
 Physical violence (5 items) &
sexual violence (5 items)
perpetration were combined
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I hit them with a fist or a hard
object.
I scratched or slapped them.
I grabbed or touched their private
parts without their consent.
I forced them to kiss me.
α = .80
Adapted from: S.L. Martin (2007) Peer Sexual
Harassment
Wolfe, D. A., et al. (2001). Development and
validation of the Conflict in Adolescent Dating
Relationships Inventory. Psychological
Assessment, 13, 277-293.
Participants
Gender
Girls
N= 70 (36%)
Boys
N=127 (64%)
High School
N=93 (47%)
Middle School
N=104 (53%)
Hispanic
N=121 (61%)
African American
N=44 (22%)
White
N=18 (9%)
Other
N=14 (7%)
Grade Level
Race/ Ethnicity
Participants (cont).
 Attendance – range of 2-24 sessions, M = 12.32, SD =
6.25;
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53% low attenders (2-12 sessions, M = 7.09)
47% high attenders (13-24 sessions, M = 18.18)
 Prior dating violence victimization assessed at
baseline (life-time):
Physical dating
violence
victimization (only)
Emotional dating
violence
victimization (only)
Physical AND
Emotional
victimization
Boys N=16
13%
N=11
9%
N=6
5%
Girls N=5
6%
N=19
27%
N=9
13%
Results: Mean Change (Pre to Post)
Females
Males
Pre
Post
∆
Pre
Post
∆
.333
.300
-.033
.487
.449
.038
Relationship Insecurity
1.557
.901
-.656***
1.000
1.161
.161
Controlling Behavior
.681
.395
-.286
.735
.446
-.289*
.438
.241
-.197*
.310
.215
-.095
Acceptance of Dating
Abuse
Perpetration
Emotional Dating Abuse
Perpetration
Results: Percentage Change (Pre to Post) for
Physical Dating Abuse/ Sexual Coercion (Perpetration)
Females
Pre
Post
Physical Dating
34
6%
Abuse/Sexual Coercion
%
(Perpetration)
* Wald test significant at p < .05
Males
∆
Pre
Post
28%* 24% 24%
∆
0%
Results: Change Model for Girls
Results: Change Model for Boys
Discussion: Outcomes
 Evidence for positive changes associated with the
support groups from pre to post test
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Boys: decrease in controlling behaviors
Girls: decreases in insecurity in relationships, emotional abuse
and physical/sexual violence perpetration
 Need for a rigorous and controlled evaluation
Discussion: Strategies for Prevention
 Pre-to-post changes in norms were not observed
 No clear link between norm changes at the individual level and
behavioral changes
 Only for boys an association between decreased acceptance of
dating violence and decreased feelings of insecurity
 Norm changes may occur at the group level (group
norm)
 Norm changes may occur more slowly, or not be
captured in measures
Discussion: Strategies for Prevention with At-risk
Youth
 Changes in how participants feel about their
relationships (insecurity) are significantly related to
behavior changes
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Feeling insecure in relationships may be result of abusive current or
past relationships, insecure attachments, low self-esteem
 Need to address emotional needs of at-risk youth and to
provide opportunities for supportive relationships
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Supportive group environment
Caring adult
Positive role model
Intensive & ongoing programming
Resources
 www.loveisrespect.org, National Teen Dating Abuse Helpline, 1
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866-331-9474 TTY 1-866-331-8453
www.thatsnotcool.com, Family Violence Prevention Fund
www.athinline.org, MTV
www.breakthecycle.org, Break the Cycle
www.glsen.org, Gay, Lesbian and Straight Education Network
www.coaches-corner.org, Futures Without Violence
www.mencanstoprape.org, Men Can Stop Rape
www.EthicsEd.com, Preventing Sexual Misconduct and Abuse in
Schools
www.startstrongteens.org/resources/policy, Start Strong Model
School Policy
Resources Continued
 www.startstrongparents.org, Start Strong Parents
 www.startstrongaustin.org
 www.safeplace/expectrespect, Expect Respect Program
 www.aauw.org, Harassment-Free Hallways, American
Association of University Women
 www.wellesley.edu, Bullyproof: A Teacher’s Guide on Teasing
and Bullying for Use with Fourth and Fifth Grade Students
and Flirting or Hurting? Publications Office 781.283.2510
 www.stopbullying.gov, Resources for Schools, Parents and
Students
 http://lovewhatsreal.com/index.html, Center for Healthy
Teen Relationships, Idaho Coalition Against Sexual and
Domestic Violence