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https://doi.org/10.1177/15248380231168641
TRAUMA, VIOLENCE, & ABUSE
1 –18
© The Author(s) 2023
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DOI: 10.1177/15248380231168641
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Review Manuscript
Our enduring dependency on social and economic forms of
support for life itself is not something we grow out of—it is not
a dependency that converts to independence in time. When there
is nothing to depend upon, when social structures fail or are
withdrawn, then life itself falters or fails: life becomes
precarious. (Butler, 2020, p. 50)
The need for trust only arises in a risky situation. (Mayer et al.,
1995, p. 711)
I talk to no one, there’s no one I can trust, no one I can turn to,
and no where I can go. (IPV survivor, Lippy et al., 2020, p. 262)
Intimate partner violence (IPV) survivors face grave risks
to their physical and mental health, including traumatic
brain injury (Government Accounting Office, 2020;
Kwako et al., 2011), chronic pain, post-traumatic stress,
depression (Dutton et al., 2006), and even death (Velopulos
et al., 2019). They often have pressing legal and economic
needs as well, as they try to protect themselves from the
abuse, attain safety, and—if they have left or are planning
to leave their abusive partner—establish their own
1168641TVAXXX10.1177/15248380231168641TRAUMA, VIOLENCE, & ABUSEKennedy et al.
review-article2023
1Michigan State University, East Lansing, USA
2University of Wisconsin-Whitewater, WI, USA
3University of Texas at Austin, Austin, USA
4RTI International, Washington, DC, USA
*These authors are listed alphabetically.
Corresponding Author:
Angie C. Kennedy, School of Social Work, Michigan State University, 254
Baker Hall, East Lansing, MI 48824, USA.
Email: kenne258@msu.edu
Can This Provider Be Trusted? A Review
of the Role of Trustworthiness in the
Provision of Community-Based Services
for Intimate Partner Violence Survivors
Angie C. Kennedy1, Kristen A. Prock2, Adrienne E. Adams1*,
Angela Littwin3*, Elizabeth Meier1*, Jessica Saba1*,
and Lauren Vollinger4*
Abstract
While there is a growing literature on intimate partner violence (IPV) survivors and service providers, it is limited by
its largely atheoretical and descriptive nature, and its emphasis on individual-level survivors’ help-seeking. We seek to
broaden our understanding by shifting the focus onto organizations and service systems and introducing the concept of
these providers’ trustworthiness toward survivors. Provider trustworthiness in delivering services includes benevolence
(locally available and caring), fairness (accessible to all and non-discriminatory), and competence (acceptable and effective in
meeting survivors’ needs). Guided by this conceptualization, we conducted an integrative review drawing on four databases:
PsycINFO, PubMed, Web of Science, and Westlaw. We identified studies for inclusion that were published between January
2005 and March 2022, and we examined the trustworthiness of community-based providers serving adult IPV survivors in the
United States, including domestic violence services, health and mental health care, the legal system, and economic support
services (N = 114). Major findings include (1) many survivors live in communities with no shelter beds, mental health care, or
affordable housing; (2) many services are inaccessible because they lack, for example, bilingual staff, sliding fees, or telehealth
options; (3) too many providers are harmful or discriminatory toward survivors, especially those who are, for example,
sexual or gender minorities, immigrants or non-English-speaking, poor, or Native, Black, or Latinx; (4) many providers appear
to be incompetent, lack evidence-based training, and are ineffective in meeting survivors’ needs. We call on researchers,
advocates, and providers to examine provider trustworthiness, and we offer an introduction to measuring it.
Keywords
disclosure of domestic violence, domestic violence and cultural contexts, intervention/treatment, legal intervention, gay,
lesbian, bisexual, and transgender (GLBT)
2 TRAUMA, VIOLENCE, & ABUSE 00(0)
household (Chiaramonte et al., 2021). However, many
survivors do not access formal services. Drawing on the
United States (U.S.) National Intimate Partner and Sexual
Violence Survey, 85% of young women not attending col-
lege who reported IPV within the past year had not dis-
closed to a service provider (Addington, 2021), while
33% of all adult female survivors had never disclosed to a
provider over their lifetime (Cho et al., 2020). Survivors
who are recent immigrants, transgender, and/or living in
isolated rural areas are especially unlikely to obtain for-
mal help (Alvarez & Fedock, 2018; Dolan & Conroy,
2021; Peek-Asa et al., 2011).
For some survivors, service providers may simply be
unavailable in their community or impossible to access.
Those who do access services may not disclose their abuse.
For example, survivors receiving health care may hide the
reason for their bruises, even when asked directly by health
providers (Dichter et al., 2020; Liebschutz et al., 2008).
Others may opt to disclose and be met with uncaring, incom-
petent, or even harmful or discriminatory responses by pro-
viders, thus furthering the risks they face and the precarity of
their situation (An & Choi, 2019; Bell et al., 2011; Calton
et al., 2016; Monterrosa, 2021). Overall, despite growing
awareness of survivors’ needs, services specifically designed
to support them (hereafter, domestic violence [DV] services),
and millions of dollars in ongoing funding via the Violence
Against Women Act, our current patchwork of formalized
help, including DV services, health and mental health care,
the legal system, and economic support services, is failing to
reach or effectively serve many survivors (Jordan et al.,
2020; Koss et al., 2017; Kulkarni, 2019; Park, 2015).
There is a pressing need to understand the reasons why this
is so. Trust theory offers us novel insight into these complex
dynamics between providers and IPV survivors, and can guide
us in moving the field forward and deriving solutions. While
there has been a great deal of research conducted on survivors
in relation to formal services, this empirical work is limited by
both its largely atheoretical, descriptive nature, and its empha-
sis on individual survivors, rather than on formal providers.
By framing this research as survivors’ “help-seeking,” such as
their personal choices related to seeking services as well as the
barriers they report, we are reifying the idea that these are pri-
marily individual-level challenges, rather than issues largely
rooted in community-based organizations and service sys-
tems. Consider the example of an IPV survivor in the United
States who only speaks Spanish. She needs help, but does not
know where to go because she cannot find information she can
understand. Is this an issue primarily due to her lack of English
proficiency (her responsibility), a language barrier (indetermi-
nate responsibility), or the lack of bilingual providers and out-
reach to Spanish-speaking community members where she
resides (providers’ responsibility)? We submit that these sorts
of problems must be understood as based in organizations and
systems, rather than the responsibility of individual survivors,
or as barriers they must overcome. Trust theory, with its
emphasis on organizational trustworthiness as a critical aspect
of how systems operate and in turn foster trust among the peo-
ple they serve (Mayer et al., 1995; Schoorman et al., 2007),
can help us shift the spotlight onto service providers and illu-
minate why so many survivors’ needs are unmet. From this
vantage point, organizations that fail to offer bilingual staff
and outreach are low in trustworthiness. It follows that untrust-
worthy providers are unlikely to be trusted by survivors, with
grave implications for their willingness to disclose the abuse,
engage with services, and begin the process of healing
(Battaglia et al., 2003; Cook & Stepanikova, 2008; Jaiswal &
Halkitis, 2019; Rabelo et al., 2019).
For our conceptualization of provider trustworthiness and
integrative review of the literature, we draw on the theoreti-
cal foundation developed by Mayer et al. (1995), who define
trust as
the willingness of a party [the trustor, e.g., a survivor] to be
vulnerable to the actions of another party [the trustee, e.g., a
service provider] based on the expectation that the other will
perform a particular action important to the trustor. . .. (p. 712)
Their work emphasizes the risk involved in trusting, the
relational nature of trust, and the trustee’s trustworthiness—
without this, trust cannot develop. They home in on three
essential aspects of organizational trustworthiness: benevo-
lence (good will toward the trustor, their best interests in mind,
availability, positive orientation, care, and warmth), integrity
(fairness, justice, equity, consistency between words, and
actions), and ability (competence, skill, effectiveness, and
helpfulness; Mayer et al., 1995). We focus on benevolence,
fairness, and competence as the three core domains that define
service provider trustworthiness, for practicality and clarity:
All three terms are easily modified into adjectives (e.g., a fair
organization rather than the more cumbersome organization
with integrity), and all three are clear (e.g., a competent orga-
nization is clearer and more descriptive than an able one).
In keeping with a more recent article by Mayer and col-
leagues in which they revisited their model and stressed its
applicability across a range of organizational levels
(Schoorman et al., 2007), we apply the concept of organiza-
tional trustworthiness to a variety of community-based pro-
viders offering services to IPV survivors, including DV
services, health and mental health care, the legal system, and
economic support services. Each of these providers operates
at the meso or organizational level in society, representing a
bridge between individual survivors and the institutional
level (Ray, 2019). For example, a survivor’s neighborhood
police station can be understood as a local organization that
links them to the broader institution of state legal protection
and enforcement. While the importance of trustworthiness
among providers of DV services, health and mental health
care, and economic support services may be self-evident, we
argue that legal system providers such as law enforcement
are similarly duty-bound to engage with survivors in a
Kennedy et al. 3
trustworthy manner: The provision of safety and security by
law enforcement is a public good (Meares & Prowse, 2021)
that all survivors are entitled to, and the Law Enforcement
Code of Ethics emphasizes the duty to serve and protect all
members of the community, without prejudice (International
Association of Chiefs of Police, 1957).
Our work complements the burgeoning research on trust
across a range of systems: Scholars have explored citizens’ trust
in government institutions, which has precipitously declined in
the United States over the last 50 years (Citrin & Stoker, 2018);
patients’ mistrust of health providers, which is associated with
reduced care utilization and increased disparities (Benkert et al.,
2019; Jaiswal & Halkitis, 2019); and trust in law enforcement,
which is predicted by officers’ trustworthiness and associated
with citizens’ willingness to cooperate with law enforcement
(Hamm et al., 2017). Throughout this work, researchers have
shown the vital role that trust and trustworthiness play in influ-
encing people’s engagement with larger systems, and shaping
their positive outcomes. Despite this groundswell of interest in
trust, as well as the inclusion of trustworthiness and transpar-
ency as a key principle of trauma-informed care (SAMHSA,
2014), research on survivors and service providers has not uti-
lized trust-related theory, with few exceptions (see Battaglia
et al., 2003; Fedina et al., 2019). We seek to redress this with our
conceptual framework and integrative review, which build on
and synthesize a range of interconnected research while offering
novel insights into IPV survivors’ interface with service provid-
ers: As noted, we draw on Mayer et al. (1995) and Schoorman
et al. (2007) for our three trustworthiness domains of benevo-
lence, fairness, and competence, and in addition, we integrate
the related health access concepts of service availability, acces-
sibility, and acceptability (Andersen, 1995; Penchansky &
Thomas, 1981) into our framework.
The first domain of trustworthiness, provider benevo-
lence, includes good will toward survivors, prioritizing their
best interests and needs, and a positive orientation toward
them characterized by care, warmth, and kindness; in con-
trast, providers with a low level of benevolence are cold,
uncaring, revictimizing, and/or harmful toward survivors
(see Figure 1). The availability of services represents a mini-
mum threshold of benevolence: The lack of services in a sur-
vivor’s community communicates very clearly that they are
not valued and their interests and needs are not important,
and is a form of social exclusion (Hilbert & Krishnan, 2000).
The second domain of trustworthiness, provider fairness,
involves delivering services to survivors that are equitable,
just, have integrity, and demonstrate consistency between
stated policies and staff actions; providers with low fairness
are unjust, inequitable, inconsistent, and/or discriminatory
toward survivors. Whether or not a provider is accessible to
all survivors, regardless of cost, location, language, ability
status, gender identity, and so on, falls under the domain of
fairness. The third domain of trustworthiness, provider com-
petence, includes service delivery to survivors that is skillful,
effective, helpful, culturally congruent, evidence-based, and
able to meet survivors’ self-defined needs; providers who are
low in competence are ineffective, unskilled, culturally
incongruent, do not draw on relevant empirical evidence,
and/or are unable to meet survivors’ needs. The extent to
which a provider delivers services that are acceptable to sur-
vivors falls under the domain of competence.
Our trustworthiness framework can encompass related the-
oretical concepts that scholars have developed to capture how
service providers in organizations, institutions, and systems fail
to meet the needs of survivors, thus offering some welcome
integration to this field of study. For example, institutional
betrayal, conceptualized as the manner in which an institution
harms individuals who trust or depend on it via acts of commis-
sion (e.g., a culture that perpetuates violence against survivors)
and/or omission (e.g., a lack of available services for survivors;
Smith & Freyd, 2014), can be understood as an egregiously
low level of benevolence, and thus low institutional trustwor-
thiness. Additionally, procedural and distributive justice, which
have been examined in relation to IPV survivors’ interactions
with the criminal legal system, are defined as the fairness of
both the legal process and the legal outcome, respectively, from
a survivor’s point of view (Calton & Cattaneo, 2014). As such,
these forms of legal system-level fairness are fundamentally
about the system’s trustworthiness. Finally, as noted earlier, the
trauma-informed care principle of provider transparency is also
related to fairness toward survivors, and consequently a matter
of trustworthiness (SAMHSA, 2014).
Using the conceptual framework of provider trustworthi-
ness we have presented here as our guide, we conduct an inte-
grative review of recent empirical research on adult IPV
survivors and community-based formal service providers.
Integrative reviews are designed to capture and synthesize a
range of studies (e.g., qualitative and quantitative, as well as
theoretical) and make contributions to theory development,
with clear implications for practice and policy (Whittemore &
Knafl, 2005). Taking an intersectional feminist approach, we
conceptualize survivors’ social location within intersecting
systems of stratification (e.g., race/ethnicity, class, sexual and
gender identity, immigration status, ability status, and so on)
as differentially conferring power, status, risk, and access to
resources (Hancock, 2016; Sokoloff, 2005; see also Collins &
Bilge, 2016; Crenshaw, 1991; May, 2015). Guided by this
intersectional approach, we prioritize marginalized survivors
in our review. We examine qualitative, quantitative, and
mixed methods research, as well as review articles, on pro-
vider characteristics that fall under the trustworthiness
domains of benevolence, fairness, and competence. Within
each domain section, we review DV services, health and
mental health care, legal services, and economic supports. We
conclude with a summary of our key findings, gaps in the lit-
erature, preliminary thoughts on how the field can initiate the
measurement of provider trustworthiness, and implications.
Method
We systematically searched four databases: PsycINFO,
PubMed, Web of Science, and Westlaw. Articles were eligible
4 TRAUMA, VIOLENCE, & ABUSE 00(0)
for inclusion if they reported on or reviewed studies that sam-
pled formal providers who offered services to adult IPV survi-
vors, or adult IPV survivors themselves who were cisgender
women, transgender women or men, or nonbinary; were com-
munity-based (i.e., not in college or institutional settings like
jail or prison); included at least one aspect of provider trustwor-
thiness (i.e., benevolence, fairness, or competence, or a related
characteristic); focused on survivors’ or providers’ perspectives
on actual services provided or sought out/attained; were con-
ducted in the United States; and were published in a peer-
reviewed or law journal between January 2005 and March
2022. As many scholars have noted, systematic electronic
searches often need to be supplemented by other search
strategies, including ancestry searching, hand searching, and
communication with experts in a particular research area, in
order to optimize the inclusion of studies (Conn et al., 2003;
Whittemore & Knafl, 2005). In keeping with this recommenda-
tion, we searched reference lists of articles obtained via our
database searches and hand searched for potential articles in
relevant journals, and we included a book chapter and national
report that focused on LGBT survivors, given the paucity of
peer-reviewed studies and our goal of prioritizing marginalized
survivors. See Figure 2 for further details on our search, which
yielded a sample of 114 sources, including 53 qualitative, 21
quantitative, 16 mixed methods, and 24 review articles (14
from peer-reviewed journals, 10 from law journals).
Domains of Provider Trustworthiness: Benevolence, Fairness, and Competence
Provider Fairness
High Fairness:Provision of serviceisaccessible to allIPV survivors, regardless of cost,location, language,
abilitystatus, genderidentity, etc.;providerdeliversservicesthatare equitable, just,haveintegrity,and
demonstrateconsistency betweenwritten policiesand staffactions
LowFairness: Provisionofservice is inaccessibleto survivors; provider is unjust,inequitable,inconsistent,
and/or discriminatory toward survivors
•Proceduraland distributive justice, andtrauma-informed provider transparency,fallunder this domain
Provider Competence
High Competence:Provision of serviceisacceptable to allIPV survivors; provider delivers services in a
mannerthatisskillful,effective,helpful,culturally congruent, evidence-based,and able to meet survivors’
self-defined needs
LowCompetence: Provisionofservice is unacceptable to survivors; provider is ineffective, unskilled,
culturally incongruent, failstodrawonempirical evidence,and/orisunabletomeetsurvivors’needs
•Culturalcompetencefalls underthisdomain
Provider Benevolence
High Benevolence: Provision of service is available to all IPV survivors in their community; provider
demonstrates good will toward survivors, priorizes their best interests and needs, and exhibits a posive
orientaon toward them characterized by care, warmth, and kindness
Low Benevolence: Provision of service is unavailable to survivors in their community; provider is cold,
uncaring, revicmizing, and/or harmful toward survivors
• Ins�tu�onal betrayal falls under this domain
Figure 1. Provider trustworthiness domains and their defining characteristics.
Kennedy et al. 5
The First Domain of Provider
Trustworthiness: Benevolence
DV Service Providers
These providers include emergency shelter and transitional
housing programs, advocacy related to accessing other
Records idenfied
through PsycINFO
(n = 915)
Records idenfied
through PubMed
(n = 809)
Records idenfied
through Westlaw
(n = 1,424)
Records idenfied
through Web of Science
(n = 729)
Records idenfied
through other means
(n = 58)
Abstracts
screened in
(n = 54)
Abstracts
screened in
(n = 47)
Abstracts
screened in
(n = 20)
Abstracts
screened in
(n = 33)
Total abstracts reviewed
(n = 212)
Duplicates removed
(n = 55)
Abstracts screened in
(n = 157)
Full-text arcles assessed for eligibility
(n = 144)
Abstracts excluded (n = 13)
•Abstracts did not meet eligibility criteria aer
second review
Arcles excluded (n = 30)
•Results not specifically focused on provider
benevolence, fairness, or competence
•Results not separated by gender
•Examined hypothecal survivor situaons
•Conducted outside of the United States
Studies
included in
final synthesis
(N = 114)
Figure 2. Search strategy, reported based on the PRISMA model (Moher etal., 2009). Example search terms: (domestic violence
OR intimate partner violence OR IPV victims) AND (DV services OR emergency shelter OR health services OR primary care OR
mental health services OR therapy OR legal system OR law enforcement OR housing OR food assistance) AND (barriers OR trust*
OR benevolent OR availability OR gap OR unmet need OR caring OR fair OR access* OR aware* OR discriminat* OR utiliz* OR
competent OR accept* or effective OR satisfaction OR useful).
community-based services (e.g., legal advocacy), support
groups, individual counseling, and crisis lines. DV ser-
vices represent a critical source of support for tens of thou-
sands of survivors: During one 24-hr period in September,
2021, over 70,000 survivors and children were served
by these organizations; on the other hand, over 9,000
6 TRAUMA, VIOLENCE, & ABUSE 00(0)
survivors were denied help because the services they
sought were unavailable (National Network to End
Domestic Violence [NNEDV], 2021). Emergency and
transitional housing programs offered by DV providers are
especially unlikely to be available in rural areas or have
limited beds (Edwards, 2015; Kulkarni et al., 2010; Macy
et al., 2010; Peek-Asa et al., 2011; Pollack, et al., 2010;
Stone et al., 2021). Survivors of color in rural areas can
face added burdens locating emergency shelter due to
racial segregation, lack of provider outreach, and limited
services in their county (Donnelly et al., 2005), as well as
extreme geographic isolation: Roughly one-third of Native
Alaskan survivors live in remote communities without DV
services (Johnson, 2012).
Beyond basic housing needs, other critical DV services
may be unavailable as well, including integrated programs
for survivors with severe mental illness (Van Deinse et al.,
2018) and/or substance abuse issues (Stone et al., 2021),
services for survivors with pets (Krienert et al., 2021;
Kulkarni et al., 2010), survivor support groups (Aguillard
et al., 2021), individual counseling for survivors and/or chil-
dren (Fisher & Stylianou, 2019; Kulkarni et al., 2010; Macy
et al., 2010), employment-related services (Fisher &
Stylianou, 2019), and services for batterers (Kulwicki et al.,
2010). As we noted earlier, the availability of a particular
service in a given community represents the minimum
threshold of benevolence, and thus provider trustworthi-
ness—the lack of available emergency shelters in particular
means that many survivors are forced to stay with their abu-
sive partner or become homeless, because they have
nowhere else to go (Koss et al., 2017; Stone et al., 2021;
Wilson & Laughon, 2015).
If DV services are available, staff may be kind and caring,
or cold, dismissive, or even harmful or revictimizing toward
survivors. In general, DV providers are perceived as caring
by survivors (Bergstrom-Lynch, 2018; Fisher & Stylianou,
2019; Fox et al., 2018; Ingram et al., 2010; Nnawulezi &
Sullivan, 2014; Phillips et al., 2021). As a Mexican survivor
who had immigrated to the United States describes:
These people in helping agencies, they have a lot of experience.
They know how to treat people who have been abused. They
have the words to make you feel better, they are very good; they
are caring when they talk to you. (Ingram et al., 2010, p. 870)
This sense of being listened to and cared for can foster
a sense of safety and trust, as this White, low-income sur-
vivor with an opioid disorder states: “I was able to talk to
someone that I knew I could trust that wouldn’t let every-
body know, kept it confidential . . . It took a while, but it
eventually brought my self-esteem back up . . . I felt safe
. . .” (Phillips et al., 2021, p. 538). On the other hand, DV
service providers may be dismissive or uncaring toward
some survivors (Crowe & Murray, 2015; Guadalupe-Diaz
& Jasinski, 2017; Weisz, 2005), as this transgender survi-
vor describes:
Well [the DV shelter staff] wanted to help but they made a big
fuss about my trans status. I overheard the staff say “the other
residents are going to be scared and the children are going to be
scared and it’s not going to be the environment that we want
here” and then they told me they didn’t have a room for a single
person . . . I couldn’t wait to get out, I mean the [other residents]
were not violent to me but they were just not welcoming . . .
Even the staff was a little off because I knew from the start they
weren’t even on the same page about having me there.
(Guadalupe-Diaz & Jasinski, 2017, p. 787)
Furthermore, some survivors may experience direct harm
from DV services, including racial microaggressions
(Nnawulezi & Sullivan, 2014), triggering of post-traumatic
stress symptoms due to the lack of privacy afforded them by
shelter staff (Bergstrom-Lynch, 2018), and belittling surveil-
lance of their parenting (Fauci & Goodman, 2020). In addi-
tion, DV service providers may play a catalytic role in the
removal of survivors’ children, particularly in isolated areas
such as tribal communities where DV and child protective
services are co-located (Jock et al., 2022).
Health and Mental Health Providers
Health providers, especially hospital emergency staff, are
critical in identifying and treating survivors’ injuries and
other sequelae, as well as offering IPV information and
linking them to services (McKay et al., 2021; Phares et al.,
2019). However, many providers may be ill-equipped to
support survivors, due to their lack of resources and/or
uncaring approach; in other cases, they may cause direct
harm to survivors. For example, relevant staff (e.g., a des-
ignated social worker or IPV-trained nurse) or resources
may be unavailable in some health settings (Alvarez et al.,
2018; Dichter et al., 2015; Kirst et al., 2012); rural survi-
vors with disabilities may find that telehealth options are
nonexistent (Aguillard et al., 2021). If care is available,
providers who are supportive and warm can facilitate survi-
vor disclosure, services access, and trust, while providers
who are cold or dismissive can have the opposite effect
(Dichter et al., 2020; Kirst et al., 2012; Liebschutz et al.,
2008; Ravi et al., 2021; Reeves & Humphreys, 2018). This
survivor receiving care from a Veterans Affairs Medical
Center illustrates the latter:
[Medical providers] always ask “Do you feel like hurting
someone or do you feel like someone’s gonna hurt you” but they
don’t really go past that. And they tell you they ask you that
because they have to ask you that . . . The message I get is you
don’t give a damn . . . You only doing it because it’s a part of
your job description that you have to do it . . . So if something
was going on, I wouldn’t fucking tell you because you don’t
really care. (Dichter et al., 2020, p. 2658)
Additionally, survivors can be harmed or revictimized by
health providers due to their sexual and gender minority status
(Scheer et al., 2020), or via mandatory reporting laws
Kennedy et al. 7
requiring health providers to report suspected child abuse and
IPV-related injuries to child protection services or law enforce-
ment (Dichter et al., 2015; Lippy et al., 2020). For most survi-
vors, mandatory reporting goes against their wishes and causes
further harm; ultimately, it can lead to distrust of the health
care and legal systems and unwillingness to disclose in the
future (Lippy et al., 2020).
There is limited research on mental health services’
benevolence, but the available literature suggests that pro-
viders are unavailable in many survivors’ communities,
especially those in rural locales (Aguillard et al., 2021;
Brabeck & Guzmán, 2008; Simmons et al., 2015; Ting &
Panchanadeswaran, 2009; Valdovinos et al., 2021). As with
the health providers reviewed above, mental health profes-
sionals may revictimize or further harm survivors, as this
provider attests: “Victims are skeptical and lack trust in the
system, many have had negative experiences with mental
health providers in the past” (Simmons et al., 2015, p. 12). In
contrast, a caring therapist can have a profound effect, as
Santa, an immigrant from Mexico who endured IPV from
two partners and has been apart from her mother and daugh-
ter for 13 years, describes: “She listens. Sometimes I need
her to give me a big hug and I ask her for it. (Santa begins to
cry). Believe me, that when she hugs me I feel like it is my
mother’s hug” (Valdovinos et al., 2021, p. 9). Given the
daunting mental health issues facing many survivors (Dutton
et al., 2006), providers who are unavailable or harmful, and
thus untrustworthy, contribute to the high rate of unmet men-
tal health needs among survivors (Simmons et al., 2014; Van
Deinse et al., 2018).
Legal System Providers
In this section, we focus on the benevolence of law enforce-
ment (LE, including Border Patrol, Immigration and
Customs Enforcement, and tribal LE), attorneys, judges,
and other legal system-affiliated providers (e.g., court-
appointed mediators in custody cases). For some survivors,
LE is unavailable in their community due to systemic rac-
ism, sexism, and victim-blaming (Bhuyan & Velagapudi,
2013; Decker et al., 2019; Miller, 2008), poor resources and
understaffing, and a focus on non-IPV-related crimes such
as drug offenses (Jock et al., 2022), leaving them with little
recourse. For example, Black and Latina survivors may wait
in vain for the police to show up after an assault (Bhuyan &
Velagapudi, 2013; Deutsch et al., 2017; Mookerjee et al.,
2015). Many Native survivors, especially those in isolated
communities, face similar challenges, with both tribal and
non-tribal LE often unavailable and unresponsive (Jock
et al., 2022; Johnson, 2012). Some states’ restrictive eligi-
bility requirements mean that protection orders (POs) are
unavailable to survivors who are lesbian, bisexual, transgen-
der, or in a dating relationship (vs. married or cohabiting)
(Calton et al., 2016; Logan et al., 2005, 2006), while survi-
vors in rural communities may find that, even though they
meet eligibility requirements, local judges or LE will refuse
to issue or enforce a PO (Bhuyan & Velagapudi, 2013;
Phillips et al., 2021). Finally, the U Visa, created by Congress
in 2000 as a mechanism to help undocumented crime survi-
vors achieve permanent legal status in the United States as
long as they are deemed “helpful” to LE, is capped at 10,000
per year, rendering it unavailable to most eligible IPV survi-
vors (Alanko, 2019).
There are only a few instances in the empirical literature
of legal providers such as court personnel, legal advocates,
and mediators being caring, friendly, and warm toward sur-
vivors (Bell et al., 2011; Rivera et al., 2012; Weisz, 2005). In
contrast, for many survivors, LE is a source of great harm:
Lesbian, gay, and transgender survivors, especially those of
color, may find that LE ignores or minimizes their abuse, or
more egregiously, assaults, harasses, arrests, or otherwise
revictimizes them (Guadalupe-Diaz & Jasinski, 2017; Jordan
et al., 2020; National Coalition of Anti-Violence Programs
[NCAVP], 2018; Scheer et al., 2020; Walters, 2011; Wirtz
et al., 2020). Survivors who are undocumented immigrants
can face deportation if they seek out LE, a serious harm
many are not willing to risk (Bhuyan & Velagapudi, 2013;
Ingram et al., 2010; Lee & Hadeed, 2009; Mahapatra & Rai,
2019; Reina & Lohman, 2015; Robinson et al., 2021; Ting &
Panchanadeswaran, 2009; Vidales, 2010), as one Mexican
survivor makes clear:
Not being a legal resident was my biggest problem . . . I was
afraid of the police especially after I was deported back to
Mexico by the police before, I did not call the police when my
husband beat me because I thought that the police would deport
me back to Mexico again. (Vidales, 2010, p. 539)
Furthermore, survivors are harmed by LE’s involvement of
child protective services (Lippy et al., 2020; Mookerjee
et al., 2015; Phillips et al., 2021), nuisance laws that penal-
ize them for calling 911, resulting in eviction in some cases
(Arnold & Slusser, 2015; Park, 2015), revictimizing cus-
tody battles (Gutowski & Goodman, 2020), and litigation
abuse, in which abusive partners use the legal system to
torment survivors with no accountability (Ward, 2016;
Williams, 2012).
Economic Support Providers
In the United States, there is a systemic shortage of afford-
able housing (National Low-Income Housing Coalition,
2022) along with limited economic supports, especially
for families with children (National Academies of
Sciences, Engineering, and Medicine, 2019). Survivors—
in particular, those who are poor or more likely to face
housing discrimination such as Black (Arnold & Slusser,
2015) or transgender people (Wirtz et al., 2020)—bear the
effects of this inadequate safety net, with extensive stud-
ies demonstrating the lack of available housing as one of
8 TRAUMA, VIOLENCE, & ABUSE 00(0)
their most critical unmet needs (Ammar et al., 2014;
Chiaramonte et al., 2021; Clough et al., 2014; Eastman &
Bunch, 2007; Fisher & Stylianou, 2019; Fox et al., 2018;
Jayasundara et al., 2018; Kulkarni et al., 2010; Logan
et al., 2005; Macy et al., 2010; Mookerjee et al., 2015;
Park, 2015; Rizo et al., 2022; Robinson et al., 2021; Sabri
et al., 2015; Stone et al., 2021; Ting & Panchanadeswaran,
2009; Valdovinos et al., 2021; Wilson & Laughon, 2015).
Transportation and child care are other significant unmet
economic needs reported by survivors (Aguillard et al.,
2021; Alvarez & Fedock, 2018; Edwards, 2015; Kulwicki
et al., 2010; Ta & Hayes, 2010).
Temporary Assistance for Needy Families (TANF), a
public assistance program for families with children cre-
ated in 1996 to replace Aid to Families with Dependent
Children, is one potential path to receiving economic sup-
port for poor survivors with children. Indeed, TANF
included an amendment, the Family Violence Option
(FVO), designed to give states the option of waiving man-
datory requirements for survivors who disclose IPV
(Holcomb et al., 2017). Unfortunately, only one in four
women who are eligible for TANF receive it (Congressional
Research Service, 2021), and despite the evidence that a
majority of recipients have experienced IPV, less than 5%
obtain an FVO waiver (Hetling et al., 2006; Lindhorst et al.,
2008). Research indicates that the latter is due, in part, to
TANF workers’ cold and uncaring attitude toward survi-
vors: This lack of care, coupled with the great discretionary
power of the worker, results in few survivors being offered
and obtaining a FVO waiver (An & Choi, 2019; Hetling,
2011; Lindhorst et al., 2008, 2010; Nikolova et al., 2021).
The Second Domain of Provider
Trustworthiness: Fairness
DV Service Providers
When DV services are available in the community but sur-
vivors do not know about them, this is a provider-level out-
reach and education issue that renders services inaccessible
to survivors. As we have argued, accessibility is about fair-
ness, and thus provider trustworthiness. As Koss et al.
(2017) note: “Little is known about the services victims
might have used but could not find, what justice is desired
by victims, how services could have been made accessible,
and what community supports existed to help but were not
mobilized” (p. 1022). Many studies have documented this
DV services accessibility issue (Beaulaurier et al., 2008;
Ravi et al., 2021; Weisz, 2005; Wilson et al., 2007), espe-
cially for survivors who are immigrants (Akinsulure-Smith
et al., 2013; Ingram, 2007; Ingram et al., 2010; Kamimura
et al., 2015; Kulwicki et al., 2020; Postmus et al., 2014;
Latta & Goodman, 2005; Wachter et al., 2021), sexual or
gender minorities (Robinson et al., 2021), or have a crimi-
nal record (Dennis & Jordan, 2015).
DV services may also be inaccessible because they do not
have bilingual staff for non-English-speaking survivors
(Alvarez et al., 2018; Alvarez & Fedock, 2018; Bhuyan &
Velagapudi, 2013; Crandall et al., 2005; Macy et al., 2010;
Robinson et al., 2021; Vidales, 2010; Wachter et al., 2021),
accommodations for survivors with disabilities (Baker et al.,
2009; Robinson et al., 2021), or services for survivors from
outside their county or state (Kulkarni et al., 2010; Wilson
et al., 2007). More seriously, DV service providers such as
emergency shelters can be unfair and discriminatory toward
transgender and nonbinary survivors, refusing their access
(Guadalupe-Diaz & Jasinski, 2017; Jordan et al., 2020;
NCAVP, 2018; Scheer et al., 2020; Wirtz et al., 2020), as this
transgender female survivor attests:
The homeless shelters are mostly full of men and I learned it
wasn’t safe for me there . . . But I remember the woman’s shelter
didn’t want me either, they said they only allow women there and
they have children there and that I would cause like a scene or
something . . .. (Guadalupe-Diaz & Jasinski, 2017, p. 787)
Shelter staff may also act unfairly toward survivors by
being punitive, inconsistent, or opaque regarding rules (e.g.,
related to curfew or chores) or through their failure to stock
culturally specific food and hair products (Bergstrom-Lynch,
2018; Gregory et al., 2021; Nnawulezi & Sullivan, 2014).
Health and Mental Health Providers
Based on the limited research available, health and mental
health providers may be inaccessible to survivors because of
their lack of outreach (Brabeck & Guzmán, 2008; Rodríguez
et al., 2009), bilingual staff (Aguillard et al., 2022; Alvarez
et al., 2018; Brabeck & Guzmán, 2008; Lipsky et al., 2006;
Rodríguez et al., 2009), a sliding fee payment scale for those
without insurance (Cheng & Lo, 2015; Simmons et al., 2014;
Ta & Hayes, 2010), or a telehealth option (Aguillard et al.,
2022). Furthermore, evidence suggests that some health pro-
viders are discriminatory toward certain groups, such as sur-
vivors who are transgender (Scheer et al., 2020) and poor
Haitian immigrants (Latta & Goodman, 2005). This per-
ceived discrimination is patently unfair and thus illustrates
these providers’ lack of trustworthiness.
Legal System Providers
As with other services, many survivors’ access to the legal
system and their rights under the law are curtailed because
of limited outreach and education, especially among those
who have recently immigrated and/or do not speak
English. For example, survivors may not receive any
information on what their rights are under U.S. immigra-
tion laws (Akinsulure-Smith et al., 2013; Crandall et al.,
2005; Latta & Goodman, 2005; Lee & Hadeed, 2009;
Mahapatra & Rai, 2019; Mookerjee et al., 2015; Oyewuwo-
Gassikia, 2016; Ting & Panchanadeswaran, 2009), or how
Kennedy et al. 9
to obtain a PO to protect themselves from their abusive
partner (Alanko, 2019; Logan et al., 2005, 2006; Messing
et al., 2017). Although VAWA has a self-petition provision
designed to support undocumented immigrant survivors in
obtaining legal status who may not qualify for a U Visa,
many eligible survivors have not been made aware of it,
thus rendering it inaccessible (Ingram et al., 2010;
Kamimura et al., 2015; Lam, 2016). Furthermore, suc-
cessful self-petition requires that a survivor be married,
and able to prove that their marriage is “bona fide” to LE,
who have been granted broad discretion in how they
review and certify these cases; these challenges further
erode the accessibility of this legal option (Boltyanskiy,
2019; Grant, 2013).
Research on the perceived fairness of the legal process
and outcomes (i.e., procedural and distributive justice)
among survivors indicates that being treated fairly is more
highly valued than a specific legal outcome, with a fair pro-
cess associated with an intent to use the system again as well
as improved quality of life and reduced depression symp-
toms over time (Bell et al., 2011; Calton & Cattaneo, 2014;
Fleury-Steiner et al., 2006). However, some survivors strug-
gle to even access LE or the legal system, because of the lack
of bilingual providers in their community (Ammar et al.,
2014; Johnson, 2012; Lam, 2016; Vidales, 2010), while oth-
ers face racial or gender/sexual identity discrimination at the
hands of legal providers such as LE and judges (Bhuyan &
Velagapudi, 2013; Calton et al., 2016; Decker et al., 2019;
Deutsch et al., 2017; Grant, 2013; Guadalupe-Diaz &
Jasinski, 2017; Jock et al., 2022; Monterrosa, 2021), as this
Black survivor in Baltimore illustrates:
The first incident . . . I hated the police that day. The attitude
was just so disassociated, so disrespectful. I think it made it
worse for me because one of the officers was a woman. I’m
sitting there hysterical with cuts on my arm. To look up and see
her texting . . . it was real disheartening that when a situation
like that, you have some officers who don’t care. (Decker et al.,
2019, p. 776)
Economic Support Providers
Drawing on the limited work in this area, when housing sup-
ports are available in a given community, they may be inac-
cessible. For example, survivors with a history of eviction or
poor credit—oftentimes caused by their abusive partner—
can be unfairly disqualified from accessing means-tested
housing assistance, such as Section 8 (Clough et al., 2014;
Jayasundara et al., 2018). Similarly, when survivors do apply
for TANF and disclose IPV in hopes of receiving an FVO
waiver, they are frequently met with a lack of transparency
about the requirements, a very cumbersome process unlikely
to result in a waiver, and biased, inconsistent caseworkers
with great discretionary power (An & Choi, 2019; Hetling,
2011; Lindhorst et al., 2008; Nikolova et al., 2021). In toto,
these issues illustrate the lack of fairness, and thus trustwor-
thiness, of the meager economic supports for survivors in the
United States.
The Third Domain of Provider
Trustworthiness: Competence
DV Service Providers
There is limited research that seeks to measure providers’
competent, evidence-based, effective delivery of services
(Kennedy et al., 2012). Instead, we have primarily qualita-
tive work that describes survivors’ responses to services.
This research indicates that many survivors find DV ser-
vices such as emergency shelters to be helpful (Phillips
et al., 2021; Postmus et al., 2014; Ravi et al., 2021), espe-
cially in comparison to other formal providers (Brabeck &
Guzmán, 2008; Burgess-Proctor, 2012; Mahapatra &
DiNitto, 2013). DV services can help survivors gain safety,
confidence, and trust in formal providers, as well as attend
to basic material needs, as this Mexican-origin survivor
attests: “The shelter is very helpful because I can sleep at
night finally, and my son can sleep at night” (Brabeck &
Guzmán, 2008, p. 1281). On the other hand, some DV pro-
viders offer a “standard menu” of services (Koss et al., 2017,
p. 1023) that fails to effectively meet diverse survivors’
needs: Providers may be culturally incompetent (Donnelly
et al., 2005; Kulwicki et al., 2010; Oyewuwo-Gassikia,
2019; Shaw et al., 2022) or lack training and expertise in
working with survivors who are sexual and gender minori-
ties (Jordan et al., 2020; Scheer et al., 2020), have severe
mental health issues (Simmons et al., 2014; Van Deinse
et al., 2018), or require support and material aid in response
to reproductive coercion by their partner (McGirr et al.,
2020). Furthermore, research on shelters suggests that some
survivors find the strict rules, time limits, and lack of pri-
vacy unacceptable and ineffective in meeting their needs
(Bergstrom-Lynch, 2018; Fauci & Goodman, 2020; Fisher
& Stylianou, 2019; Gregory et al., 2021; Valdovinos et al.,
2021; Wilson et al., 2015; Wood et al., 2020), as this survi-
vor shares:
I just felt confined because of the curfew, I really couldn’t go
anywhere, without them knowing . . . and it’s like I had to put
part of my job on hold because some of the shifts I work would
be at night and I have a safety plan here that won’t allow me to
be out at nighttime. (Wood et al., 2020, p. 13)
Health and Mental Health Providers
Health providers may lack competence because they have not
received training in IPV and trauma-informed care (Alvarez
& Fedock, 2018; Crowe & Murray, 2015; Dichter et al., 2015;
Kirst et al., 2012), which in turn can lead to reduced screening
and willingness to talk about IPV (e.g., safety planning) with
10 TRAUMA, VIOLENCE, & ABUSE 00(0)
survivors (Alvarez et al., 2018; Colarossi et al., 2010; Phares
et al., 2019; Rodríguez et al., 2009). Providers may ignore
evidence of abuse, or be rigid and prescriptive when a survi-
vor does disclose (Liebschutz et al., 2008; Reeves &
Humphreys, 2018). These sorts of ineffective, incompetent
responses illustrate health providers’ lack of trustworthiness,
which then contributes to survivors’ mistrust of the healthcare
system (Reeves et al., 2018). In contrast, an evidence-based,
trauma-informed approach to health care is associated with
improved mental health outcomes for survivors (Scheer &
Poteat, 2021). In the realm of mental health care, working
with a competent, evidence-based therapist or participating in
a support group can be very helpful, even life-saving
(Aguillard et al., 2022), even though some survivors may
encounter providers who lack cultural competence (Latta &
Goodman, 2005; Li et al., 2022) or expertise in working with
survivors with disabilities (Aguillard et al., 2021).
Legal System Providers
While some providers, such as legal aid attorneys and the
occasional LE officer, are reported as being effective and
helpful to survivors (Ingram et al., 2010; Messing et al.,
2017; Phillips et al., 2021; Purvin, 2007; Ting &
Panchanadeswaran, 2009), most of the research in this area
indicates that survivors’ interface with the legal system is
characterized by its lack of competence and effectiveness in
meeting their needs (e.g., Addington, 2021; Decker et al.,
2019; Lippy et al., 2020). For example, even though some
survivors report feeling safer as a result of a PO (Logan et al.,
2006; Logan & Walker, 2009), many survivors describe POs
as ineffective, primarily because of incompetent enforce-
ment by the police (Beaulaurier et al., 2008; Bell et al., 2011;
Brabeck & Guzmán, 2008; Edwards, 2015; Jock et al., 2022;
Lippy et al., 2020; Logan et al., 2005, 2006; Williams, 2012).
Judges, attorneys, mediators, LE, and other legal personnel
may lack critical training in IPV (Burgess-Proctor, 2012;
Craig-Taylor, 2008; Deutsch et al., 2017; Rivera et al., 2012),
push survivors toward punishment of their partners against
their wishes (Lippy et al., 2020), or be indifferent to survi-
vors’ suffering (Arnold & Slusser, 2015; Mookerjee et al.,
2015; Postmus et al., 2014). This lack of competence and
effectiveness in meeting survivors’ needs contributes to mis-
trust of LE (Ammar et al., 2014) as this survivor makes clear:
The DA was going for a much more severe consequence when I
wanted a different type of help for my abuser, not a long-term
incarceration or more DV/anger management classes that he
could BS his way through . . . I didn’t trust anyone again in this
type of position. (Lippy et al., 2020, p. 263)
Economic Support Providers
Based on the limited literature, service providers may lack
training and expertise in what economic supports are avail-
able to survivors, for example, VAWA housing provisions
(Clough et al., 2014; Jayasundara et al., 2018), which clearly
reduces their ability to effectively meet survivors’ needs.
Although there are evidence-based best practices for TANF
case workers to effectively screen for IPV and facilitate dis-
closure, almost no workers follow these practices (Lindhorst
et al., 2008); in fact, research suggests that welfare workers
are incompetent and ineffective in screening, identifying, and
waiving requirements for the vast majority of survivors who
qualify (An & Choi, 2019; Hetling, 2011; Lindhorst et al.,
2010; Reina & Lohman, 2015). In contrast, a majority of sur-
vivors who accessed their Employee Assistance Program for
help related to IPV report being extremely or very satisfied
with the help they received (Pollack et al., 2010).
Key Findings, Gaps in the Literature,
Measuring Trustworthiness, and
Implications
In summary, survivors often require the assistance of com-
munity-based formal providers to help them address the IPV
they have experienced, their health and mental health, legal
issues they may be facing, and the need for economic sup-
port. We have argued that framing survivors as individual-
level help-seekers facing barriers to formal services misses
the mark; instead, we should widen our scope to focus on
service providers and their trustworthiness. That is, the onus
must be on formal providers to be benevolent, fair, and com-
petent toward survivors, with services that are locally avail-
able and caring, accessible and non-discriminatory, and
acceptable and effective in meeting survivors’ needs. Trust
research in related fields suggests that by demonstrating
trustworthiness, providers can earn survivors’ trust, which is
in turn linked to improved utilization of services and ongoing
engagement with providers (Cook & Stepanikova, 2008;
Hamm et al., 2017; Jaiswal & Halkitis, 2019), openness and
full disclosure of sensitive information (Battaglia et al.,
2003; Cook & Stepanikova, 2008), positive health and men-
tal health outcomes (Benkert et al., 2019; Rabelo et al.,
2019), and reduced health disparities (Jaiswal & Halkitis,
2019). In short, provider trustworthiness and survivor trust
appear to be integral in working with survivors to effectively
meet their needs. Unfortunately, as our review shows, many
providers fall far short of this ideal, instead demonstrating a
lack of benevolence, fairness, and competence toward survi-
vors (see Table 1 for a summary of key findings).
For our review, we have drawn on recent literature that
at least peripherally includes aspects of provider trustwor-
thiness or its core domains (i.e., benevolence, fairness, and
competence), but this work does not directly or compre-
hensively examine provider trustworthiness, nor the rela-
tionship between trustworthiness and survivor trust. Our
review is further limited by its minimal inclusion of the
gray literature and its narrow focus on adult survivors and
community-based providers in the United States; addition-
ally, we did not explore why providers might act in ways
Kennedy et al. 11
that demonstrate a lack of benevolence, fairness, and/or
competence toward survivors. Further research is needed
that assesses the availability of services across survivors’
communities, particularly among marginalized survivors;
this information could be obtained via a needs assessment
approach or through methods such as geographic informa-
tion system mapping. We know that many survivors find
formal services inaccessible for myriad reasons, but how
this lack of access shapes their trust in providers—and
related outcomes such as retention, health, and mental
health—is not known. It is also critical that we examine
both the ways that providers across different systems are
cold, uncaring, harmful, and discriminatory or otherwise
unfair toward survivors, and how these untrustworthy
behaviors influence survivor trust and related outcomes.
For example, we know very little about the benevolence
and fairness of health and mental health providers toward
diverse survivors. Perhaps the biggest gap is in our empiri-
cal understanding of provider competence: The extent to
which providers of DV services, health and mental health
care, legal services, and economic supports are competent,
evidence-based, culturally congruent, and effective in
meeting survivors’ needs is largely unknown, as is the rela-
tionship between provider competence and survivor trust
(see Table 2 for implications).
To address all of these gaps, researchers should begin by
assessing provider trustworthiness across the domains of
benevolence, fairness, and competence; trustworthiness can
be evaluated from both survivor and provider perspectives
(see Table 3 for measurement items). Survivor trust, and its
relationship to provider trustworthiness and its core domains,
should likewise be evaluated among diverse groups of survi-
vors, to address such key questions as: Is survivor trust posi-
tively related to provider trustworthiness? Are all three
trustworthiness domains equally important in facilitating trust
across different types of providers, or do they vary? Is survi-
vor trust linked to other critical variables of interest such as
retention in services, positive health and mental health out-
comes, and economic well-being? In terms of practice and
policy implications, it behooves providers themselves to shift
toward rigorously evaluating their trustworthiness and striv-
ing to increase it, in an effort to build positive relationships
Table 1. Key Findings Related to Provider Trustworthiness and Survivor Trust.
• Provider trustworthiness includes benevolence, fairness, and competence and is critical to building and maintaining trust among
survivors; trust is associated with willingness to disclose sensitive information like IPV, engagement with services, improved health
and mental health outcomes, and reduced disparities
• The availability of services represents a minimum threshold of benevolence: Many survivors live in communities with no DV shelter
beds, mental health care, available LE, or affordable housing
• Providers that are low in benevolence include cold, uncaring, harmful, and revictimizing DV services, health and mental health care,
LE and other legal providers, and economic support services, for example, TANF
• The accessibility of providers is about fairness: Many services are inaccessible to survivors because they lack, for example, bilingual
staff and outreach, a sliding fee scale, telehealth options, or transparent, fair rules
• Too many providers are unfair or discriminatory toward survivors who are, for example, sexual or gender minorities; immigrants or
non-English-speaking; Native, Black, or Latinx; or have a criminal record
• The acceptability of services falls under provider competence: While many survivors find DV services and Employee Assistance
Programs to be helpful, LE and the legal system are often viewed as unhelpful
• Many providers appear incompetent: They are ineffective, culturally incongruent, untrained in IPV or working with diverse survivors,
indifferent toward survivors, and unable to meet survivors’ needs
Table 2. Implications for Research, Practice, and Policy.
• Researchers should focus on provider trustworthiness and its relationship to survivor trust and other key outcomes; initiating the
measurement of the three core domains of trustworthiness is a critical first step
• Researchers should explore major gaps in our understanding, including the availability of services across diverse survivors’
communities; the ways that inaccessible or cold, harmful, and discriminatory providers shape survivor trust and related outcomes;
and the extent to which providers are competent, evidence-based, and effective in meeting diverse survivors’ needs, and how this
influences survivor trust
• Service providers and practitioners who work with survivors should undertake their own trustworthiness self-study, in the interest
of increasing their trustworthiness and building trust with survivors they serve
• Marginalized survivors, such as sexual or gender minorities; Native, Black, or Latinx; non-English speaking; poor or low income; and
those with disabilities or severe mental health issues, have typically had extensive experiences with untrustworthy, discriminatory,
harmful providers: New providers should acknowledge this and prioritize their own trustworthiness in order to rebuild these
survivors’ trust
• Advocates, policymakers, funders, and program evaluators should include providers’ trustworthiness (i.e., their benevolence, fairness,
and competence) as an essential characteristic in evaluating specific providers and their work with survivors, including survivor
outcomes
12 TRAUMA, VIOLENCE, & ABUSE 00(0)
with survivors and effectively meet their needs; advocates,
policymakers, and funders may wish to consider trustworthi-
ness as a key characteristic on which to evaluate providers
and their work.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, author-
ship, and/or publication of this article.
ORCID iD
Angie C Kennedy https://orcid.org/0000-0003-3642-9530
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Table 3. Provider Trustworthiness Indicators and Example Items (from Survivors’ Perspective).
Trustworthiness Domains Indicators
Example Items
Does [Name of Provider] offer services that are. . .
Benevolence Availability Located close to where you live?
Good will Welcoming to you, including making you feel comfortable and safe?
Interpersonal warmth Kind and caring?
Client-driven Attentive to your specific needs and goals, rather than what they think is best
for you?
Fairness Accessibility Accessible to you regardless of cost, service hours, lack of a car, language
spoken, ability status, and so on?
Integrity Honest and true to their word?
Consistency Fair in applying rules or policies so that all survivors are treated the same way?
Non-discriminatory Free from bias against your race/ethnicity, country of origin, sexual or gender
identity, ability to pay, and so on?
Competence Acceptability Acceptable to you, meaning that what they offer seems good enough for you
to use?
Evidence-based Based on information drawn from research on violence and working with
survivors, rather than just what they think will work?
Culturally congruent Knowledgeable about and respectful toward your values, beliefs, and customs?
Effectiveness Skillful and able to help you meet your needs and achieve your goals?
Kennedy et al. 13
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Author Biographies
Angie C. Kennedy is an Associate Professor in the School of Social
Work at Michigan State University. Her work focuses on cumulative
victimization and partner violence among adolescents and young
adults, particularly those who are poor or marginalized. Current
research projects use the life history calendar to capture change over
time: young women’s experiences with co-occurring IPV across
relationships, beginning with their first; cumulative victimization
and mental health among young transgender women; and coercive
control, economic abuse, and coerced debt among women who have
divorced abusive partners. Additional interests include IPV-related
stigma and stigmatization, service provider trustworthiness and
survivor trust, and survivors’ mental health, academic, and eco-
nomic outcomes.
Kristen Prock is an Assistant Professor of Social Work and affili-
ated faculty in Women’s and Gender Studies at the University of
Wisconsin-Whitewater, joining the faculty in 2019. Dr. Prock’s
research examines LGBTQ-related discrimination, policy, and
practice in higher education, exploring the lived experiences of
individuals facing multiple marginalization, and teaching evidence-
based practice in social work education. Dr. Prock is a licensed
clinical social worker with expertise in adolescent trauma and men-
tal health, youth homelessness, and program evaluation.
Adrienne E. Adams, PhD, is an Associate Professor in the
Department of Psychology at Michigan State University. Dr.
Adams’ research focuses on economic abuse in intimate relation-
ships and the economic effects of intimate partner abuse on survi-
vors’ lives. Dr. Adams also has expertise in developing and evaluat-
ing interventions to address intimate partner abuse.
Angela Littwin, University of Texas at Austin School of Law,
studies bankruptcy, consumer, and commercial law from an empiri-
cal perspective. Her current research includes studying the attitudes
toward bankruptcy among consumers being sued by debt collectors,
bankruptcy local legal culture, and the relationship between domes-
tic violence and survivors’ consumer credit and coerced debt. She
has published in journals such as the Texas Law Review, University
of Pennsylvania Law Review, California Law Review, and American
Bankruptcy Law Journal.
Elizabeth Meier is a PhD student in the School of Social Work at
Michigan State University. She has experience as an LMSW work-
ing with survivors and perpetrators of domestic violence, sexual
assault, and child sexual abuse, in both community settings and at
a maximum-security men’s prison. Her research interests include
institutional trust and betrayal, moral injury, and the deradicaliza-
tion of social movement organizations over time. Current projects
include studies into economic abuse among recently divorced
women with abusive ex-partners, perceived vulnerabilities of peo-
ple engaging in civil court services, and combat veterans’ experi-
ences of trust and betrayal across the deployment cycle.
Jessica Saba, LLMSW, is a doctoral student at Michigan State
University’s School of Social Work and a practicing therapist. Her
research interests include examining the intersections of settler
colonialism, resistance, and gender particularly within the
Palestinian context. Jessica currently supports a mixed methods
research project examining the experiences and effects of coerced
debt in abusive marriages.
Lauren Vollinger, PhD, is a community psychologist and research
analyst at RTI International in the Division of Applied Justice
Research. Her research focuses on using community-based partici-
patory methods to examine and strengthen system responses to
human trafficking and sexual violence to best support individuals
who have overcome those experiences.
