- Oct 23, 2005
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I need some help with a course assignment. I need to interview someone who has experienced domestic violence (or "intimate partner violence (IPV)")
The questions are below so that you can decide whether you want to participate, but do not respond here because your responses should be totally anonymous. If you are willing to help, you will find the anonymous survey form at IPV Survey
Please help if you can! Thank you!
Purpose:
This questionnaire is about domestic violence (also called intimate partner violence - IPV). It is for someone who is either experiencing IPV at present or has experienced it in the past.
Privacy:
You may remain totally anonymous - I only need a real person to be honest abut a real experience, but I have no need to know the identity of the person responding. I do need a little personal and family demographic info, but I have no interest in identifying who responded. I am posting this request in several places, so I will not even know where you saw it.
*
1. Demographics:
age at time of the experience
ethnicity
your religious/spiritual beliefs
marital status at time of experience and now
gender
occupation at time of experience
Example ... 41 yr old Latino Catholic heterosexual single mom working as a clerk in the government office.
*
2. Family demographics:
Describe your family - age, gender, and strength of relationship with spouse/significant other, children, parents, siblings, and other significant close relatives.
*
3. Describe the problem(s)
What happened?
How long ago did it start?
Has it ended?
*
4. What would you like to achieve if you were to seek counseling? or What would your goals have been if you had sought counseling at the time?
*
5. History of Problem(s)
Previous counseling?
Previous solutions attempted?
How well did those approaches work?
*
6. Describe the stress in your life at the time of the experience.
*
7. What resources (support people, personal strengths, agencies, etc) are or were available to you?
*
8. What worked, or what do you think would work, to resolve the problem.
*
9. What Ethical, Legal, or Cultural Issues would impact the solutions you would consider? (for instance, some people will not consider divorce an option based on their religious, ethical, or cultural values)
This is the last question, so you may also add any other thoughts or comments that you wish here.
The questions are below so that you can decide whether you want to participate, but do not respond here because your responses should be totally anonymous. If you are willing to help, you will find the anonymous survey form at IPV Survey
Please help if you can! Thank you!
Purpose:
This questionnaire is about domestic violence (also called intimate partner violence - IPV). It is for someone who is either experiencing IPV at present or has experienced it in the past.
Privacy:
You may remain totally anonymous - I only need a real person to be honest abut a real experience, but I have no need to know the identity of the person responding. I do need a little personal and family demographic info, but I have no interest in identifying who responded. I am posting this request in several places, so I will not even know where you saw it.
*
1. Demographics:
age at time of the experience
ethnicity
your religious/spiritual beliefs
marital status at time of experience and now
gender
occupation at time of experience
Example ... 41 yr old Latino Catholic heterosexual single mom working as a clerk in the government office.
*
2. Family demographics:
Describe your family - age, gender, and strength of relationship with spouse/significant other, children, parents, siblings, and other significant close relatives.
*
3. Describe the problem(s)
What happened?
How long ago did it start?
Has it ended?
*
4. What would you like to achieve if you were to seek counseling? or What would your goals have been if you had sought counseling at the time?
*
5. History of Problem(s)
Previous counseling?
Previous solutions attempted?
How well did those approaches work?
*
6. Describe the stress in your life at the time of the experience.
*
7. What resources (support people, personal strengths, agencies, etc) are or were available to you?
*
8. What worked, or what do you think would work, to resolve the problem.
*
9. What Ethical, Legal, or Cultural Issues would impact the solutions you would consider? (for instance, some people will not consider divorce an option based on their religious, ethical, or cultural values)
This is the last question, so you may also add any other thoughts or comments that you wish here.
