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Building Capacity to Address the Abuseof Persons with DisabilitiesElizabeth P. Cramer a , Shane R. Brady a & David A. McLeod ba School of Social Work, Virgina Commonwealth University ,Richmond , Virginiab Anne & Henry Zarrow School of Social Work , The University ofOklahoma , Norman , OklahomaPublished online: 30 May 2013.

To cite this article: Elizabeth P. Cramer , Shane R. Brady & David A. McLeod (2013) Building Capacityto Address the Abuse of Persons with Disabilities, Journal of Community Practice, 21:1-2, 124-144,DOI: 10.1080/10705422.2013.788371

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Journal of Community Practice, 21:124–144, 2013Copyright © Taylor & Francis Group, LLCISSN: 1070-5422 print/1543-3706 onlineDOI: 10.1080/10705422.2013.788371

NOTES FROM THE FIELD

Building Capacity to Address the Abuse ofPersons with Disabilities

ELIZABETH P. CRAMER and SHANE R. BRADYSchool of Social Work, Virgina Commonwealth University, Richmond, Virginia

DAVID A. McLEODAnne & Henry Zarrow School of Social Work, The University of Oklahoma,

Norman, Oklahoma

In this Notes from the Field article, we discuss how community-levelinterventions based on empowerment and capacity building arenecessary to fully address the problem of abuse of persons withdisabilities. Through an innovative community–university partner-ship, an empowerment approach was used to build the capacity ofstakeholders, concerned about abuse of persons with disabilities, toestablish better programs, policies, and practices to serve this pop-ulation. Stakeholders from various disciplines and consumers withdisabilities partnered to implement training for disability serviceproviders and modify policy and practice within criminal justiceagencies. Lessons learned and recommendations for others whowant to build capacity in this area are provided.

KEYWORDS Empowerment, capacity building, collective ability,accessibility

Women and men with disabilities are at risk of experiencing abuse atthe hands of family and household members and from service providersand other individuals whom they know (Brownridge, 2006; Cohen, Forte,Du Mont, Hyman, & Romans 2006; Oktay & Tompkins 2004; Smith, 2008;Young, Nosek, Howland, Chanpong, & Rintala, 1997). Abuse of individualswith disabilities may include physical and sexual assault (Brownridge, 2006;

Address correspondence to Elizabeth P. Cramer, Professor in the School of Social Work,Virginia Commonwealth University, 1001 W. Franklin Street; PO Box 842027, Richmond, VA23284. E-mail: ecramer@vcu.edu

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Martin et al., 2006; Young et al., 1997); controlling behaviors targeting one’sdisability, such as refusing to transfer a person from a bed to a wheelchairor disabling one’s adaptive equipment (Gilson, Cramer, & DePoy, 2001); andeconomic control and exploitation, such as forcing a person to turn over hisor her Supplemental Security Income payment (Martin et al., 2006).

The issue of abuse of persons with disabilities is not new to commu-nities or social work practitioners working in community settings; however,how best to address the issue of abuse among persons with disabilities hasbeen an ongoing challenge to community practitioners (Cramer & Plummer,2010; Powers et al., 2002). Until recently, domestic violence programs tendedto leave the issue of abuse among disabled persons up to Adult ProtectiveServices, independent living centers, and other disability service providers.Chang and colleagues (2003) also noted that many providers of disabilityservices are not equipped with the necessary training and awareness to iden-tify all patterns of abuse, especially intimate partner violence, among theirconsumers. Recent best practice literature in the area of abuse preventionand intervention suggests that multiple sectors of the community need tobe engaged to address abuse among persons with disabilities (Chang et al.,2003; Cramer & Plummer, 2010). Stakeholders to engage in this effort includestaff members from disability services and advocacy organizations, AdultProtective Services, law enforcement, courts, legal services, domestic andsexual assault programs, hospitals and rehabilitation centers, and consumerswith disabilities. It is through involving multiple sectors of the community,especially survivors of abuse and persons with disabilities, that commu-nities can develop the greatest capacity to address abuse of marginalizedpopulations (Vinton, 2003).

The Interactive Community Assistance Network (I-CAN!) AccessibilityProject, in which the authors have been involved, is an example of auniversity–community collaboration in Virginia between disability servicesand advocacy organizations, domestic and sexual violence programs, con-sumers with disabilities, professionals from the criminal justice and socialservices sectors, and hospital personnel. Although there have been many dif-ferent goals that evolved throughout the course of the project, an overarchinggoal has been capacity building for the purpose of increasing the collectiveability of the community across sectors to address abuse among personswith disabilities. Using an empowerment approach, this project has servedas a catalyst for stakeholders to improve programs, policies, and practicesfor abused persons with disabilities (Fawcett et al., 1995).

EMPOWERMENT AND CAPACITY BUILDING

From the Community Psychology literature, empowerment of people withina community “refers to the efforts of individuals with common concernsand characteristics to increase the degree of control over their own destiny

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and their capacity to influence bodies that make decisions that affect theircommunity and its members” (Balcazar, Keys, & Suarez-Balcazar, 2001,p. 54). Rappoport (1987) described empowerment as individuals gainingmastery over issues of concern to them, as well as effecting changes in theircommunity. In the social work literature, empowerment has been definedas transforming the individual and collective powerlessness experiencedby oppressed populations into personal and political power (Gutierrez,Parsons, & Cox, 2003).

Gutierrez and colleagues (2003) discussed empowerment of individ-uals, groups, or agencies on three levels: (intra)personal, interpersonal,and community/environmental. The first level focuses on power achievedthrough self-efficacy, self-esteem, competence, and perceived control overone’s life. An example would be an abused individual who chooses to leavean abuser and enters a domestic violence shelter. The second level, theinterpersonal or interactional level, is the relational aspect of power; in otherwords, it is power that is achieved by how much one has the ability toinfluence others, including assertiveness and knowledge and skills on howto obtain necessary resources. An example would be an abused individ-ual who is successful in obtaining a Preliminary Protective Order by goingto the courthouse, completing the required paperwork, and telling one’sstory in front of the judge. The final level—labeled environmental/politicalor behavioral in the literature—focuses on one’s influence on his or herenvironment and involvement in social change. For example, an abusedindividual may choose to participate in a public speak-out against domesticviolence. Through this collective social action, he or she would raise visibilityabout the problem of domestic violence in his or her community.

The terms community building, community empowerment, capacitybuilding, and locality development have often times been used interchange-ably in social work related literature (Checkoway, 1995; Gamble & Weil,2010; Weil, 1996). The authors of this article have chosen to use Balcazaret al.’s (2001) definition of community capacity building: “a process bywhich individuals who share a common predicament can help and supporteach other, both in their efforts to pursue individual needs and in their effortsto develop a local agenda to address commonly identified needs” (p. 57).In this process, participatory methods are used to identify the community’sneeds; this is then followed by the provision of knowledge and skills todevelop leaders and advocates who are prepared to take action regardingthose needs that had been previously identified. Social workers are par-ticularly interested in capacity building efforts with members of historicallymarginalized groups who are in positions of lower power (Lee, 2001; Netting,Kettner, & McMurtry, 2008; Reisch, 2005; Rothman, 2008; Solomon, 1976;Weil, 1996). Building community members’ capacity to engage in changeefforts can target all three levels of the empowerment approach. Personallevels of empowerment are increased when one’s self-efficacy is enhanced

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by gaining knowledge and skills for action. Interpersonally, members feelempowered because they are seeing that their efforts are influencing theactions or behaviors of other people. On the environmental level, memberscan feel empowered when they witness changes to agency programs andpractices as well as laws that affect them (Gutierrez et al., 2003).

EMPOWERMENT AND CAPACITY BUILDING TO ADDRESSABUSE OF PERSONS WITH DISABILITIES

The empowerment approach is consistent with the philosophies of domes-tic and sexual violence programs (Busch & Valentine, 2000) and is a corevalue within disability service organizations and among disability activistsand consumers (Houston, 2004; Kietzman, Matthias, & Benjamin, 2004;Mackelprang & Salsgiver, 2009). The disease or medical model of dis-ability has been rejected in favor of a social model of disability, whichperceives disability as a social problem due to the lack of full integra-tion of persons with disabilities into society (Disabled World, 2010). Thesocial model acknowledges the strengths of persons with disabilities andthe ways in which the environment becomes disabling for this population(Mackelprang & Salsgiver, 2009).

Capacity building for addressing abuse of persons with disabilities isnecessary because abused persons with disabilities may seek assistance fromvarious agencies and informal providers. People with disabilities are morelikely to come into contact with nondomestic violence professionals thandomestic violence professionals (Swedlund & Nosek, 2000). People may feelmore comfortable discussing issues of abuse with professionals with whomthey already have established relationships, trust, and rapport, rather thanstrangers whom they have never met. Persons with disabilities are statisticallyless likely to disclose violence than the nondisabled population; therefore, toaddress violence against this population it is essential to engage in capacitybuilding through developing and strengthening bridges between agenciesand sectors of the community (Sabol, Coulton, & Korbin, 2004).

The I-CAN! Accessibility Project utilized an empowerment-based, capac-ity building approach that sought to improve the capacity of communitysectors and organizations to address abuse of persons with disabilities. Thestrategies used to build capacity in the stakeholders involved in this projectincluded: identification of needs and experiences of abused persons withdisabilities in the region served by the project; provision of knowledge toprofessionals and consumers to enhance their ability to serve as advocatesand leaders; inclusion and meaningful participation of members of vulnera-ble or marginalized groups on the project’s Advisory Board and in carryingout the project’s activities; and the development of empowerment, partic-ularly on the intrapersonal and interpersonal levels, in project participants

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through their participation on the project’s Advisory Board and their role inimplementing the project activities.

PROJECT IMPLEMENTATION AND CAPACITY BUILDING GAINS

Project Overview

The I-CAN! Accessibility Project is a collaboration between two univer-sity units—Social Work and the University’s Center for Excellence inDevelopmental Disabilities Education, Research, and Service (UCEDD)—andthe regional Independent Living Center (ILC; over time, the collaboratorsexpanded to the other 15 ILCs in the state). The funding comes from asexual and domestic violence victim services’ grant through the VirginiaDepartment of Criminal Justice Services. Funding began in 2007 and covereda 2-year period. The project subsequently received two funding renewals,each covering 2-year cycles.

The paid project team consists of a principal investigator/project codi-rector, who is a professor in social work, and whose effort is 8% on theproject; the other codirector, who is a part-time UCEDD employee whoseeffort is 5% on the project; and an hourly project coordinator, who works10–12 hr per week. The local ILC collaborator serves 13 localities (includingfour cities and eight counties). There are typically between 14 and 16 staffmembers, depending on their current projects and funding. They operatefrom the philosophy that “persons who are disabled can take charge of theirown lives and live independently” (Resources for Independent Living, 2012,home page). Consistent with the empowerment approach, this ILC providesservices to

strengthen the integration of persons who are disabled into communitylife . . . advocate for the personal and collective rights of persons whoare disabled . . . develop new resources in the community to supportthe independent lifestyle . . . bring together individuals and groups todevelop common goals and work toward achievement of those goals . . .

and act as a spokesperson for the disabled community in public andgovernmental relations. (Resources for Independent Living, 2012)

During the past 6 years of the project, the advisory board has consistedof anywhere from 22 to 28 persons. The advisory board includes repre-sentatives from domestic and sexual violence programs (one from a localagency and one from a statewide coalition); disability service and advocacyorganizations (three representatives from the local ILC, one from the stateDepartment of Deaf and Hard of Hearing, one from the state Department ofBlind and Visually Impaired, one from the state Department of RehabilitativeServices, one from the state’s developmental disabilities council, one from a

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university deaf–blind project, and one from a university’s disability supportcenter); criminal justice and law enforcement (one from local law enforce-ment, one from victim witness, one from the state’s Office of the AttorneyGeneral, one from the Poverty Law Center); aging services (one from AdultProtective Services, one consultant on elder abuse, one from a project onabuse in later life); and five individuals with disabilities. Currently on theboard, two persons self-identify as survivors of brain injury, one identifies asdeaf, one person is blind, and the fifth person identifies as deaf-blind. In thepast, persons with disabilities on the board have included those who identifyas having physical or mobility disabilities.

The initial primary purpose of the I-CAN! Accessibility Project focusedon making family abuse protective orders more accessible for persons withdisabilities, specifically by evaluating the accessibility of the I-CAN! onlineFamily Abuse Protective Order module, and by training disability serviceproviders at a local ILC to better assist abused consumers. Project goalshave evolved over time as the project gathered more information about theexperiences of abused persons with disabilities when they tried to accessservices.

Virginia’s I-CAN! program is an online initiative housed within theCommonwealth’s Supreme Court, Office of the Executive Secretary (OES),designed to allow users to get information about protective orders and tocomplete the paperwork necessary for a Preliminary Protective Order. Theuser still must take the paperwork to the local courthouse for filing and toappear in front of the Judge.

In the first year of the project, a pilot committee was formed, whichconsisted of six people with different types of disabilities. The pilot commit-tee completed two separate evaluations: an evaluation of the I-CAN! On-lineProgram and an evaluation of the process for filing a Family Abuse ProtectiveOrder at a local courthouse. The purpose of the I-CAN! On-Line Programevaluation was to identify the obstacles faced by people with disabilities inaccessing and working through the I-CAN! Program. Additionally, an infor-mation technology consultant specializing in accessible Web sites conductedan evaluation of the I-CAN! Program. Evaluation results from the pilot com-mittee and the information technology consultant’s evaluation, along withrecommendations for making the I-CAN! Program more accessible, weregiven to OES. The purpose for the evaluation of the process for filing aFamily Abuse Protective Order was to identify obstacles people with disabil-ities face when filing for Family Abuse Protective Orders within the localcourthouse. The evaluation results, along with recommendations for makingthe court process and the court house more accessible, were given to thecourthouse’s clerk.

In 2008, the project team, staff members from the local domestic andsexual violence program, and OES staff members collaboratively developed acurriculum for training the ILC agency workers. The training session focused

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on the dynamics of domestic abuse, how to use the I-CAN! On-Line Program,how to assist someone in completing the I-CAN! On-Line Program, andmandated reporting and Adult Protective Services. The training session wasevaluated and the results are provided in the next section of the article.Additionally, the project team and the ILC worked together to create agencyforms to capture services that staff provided to consumers around issues ofabuse and/or assistance provided to consumers to use I-CAN! The projectcoordinator assembled a case review team, which included representativesfrom Social Services and domestic/sexual violence programs. This team metas needed to assist in identifying and addressing any needs that the ILC ortheir consumers may have faced as they sought assistance for abuse-relatedproblems as well as potential service gaps in the community to addressconsumers’ needs.

The project team, with assistance from an advisory board member, pro-duced a booklet entitled, “Understanding Family Abuse Protective Orders inRichmond, Virginia.” This booklet, available in English, Spanish, and Braille,explains the process of obtaining a Family Abuse Protective Order throughthe local court. Following the training session, the ILC advertised the avail-ability of staff members to assist consumers with protective orders and theI-CAN! Program by dissemination of flyers to over 600 consumers and ser-vice providers in its database; flyers were modified for persons who aredeaf and hard of hearing and were also produced in Braille. The agencyalso put an announcement and a link to I-CAN! on the home page ofthe agency’s Web site. An empowerment-based evaluation was also con-ducted of advisory board members and the results are reported later in thearticle.

In 2009, the project team, in collaboration with the local domestic andsexual violence program, developed two curricula and provided additionaltraining to RIL staff. The first training focused on sexual violence intervention.A second training focused on risk assessment and safety planning related topeople with disabilities experiencing abuse. These training sessions werealso evaluated. The ILC continued to collect monthly service statistics ofcases involving abuse and the case review team meetings continued to beoffered on an as-needed basis.

In 2010, the project team and a working committee of advisory boardmembers, ILC staff, and domestic/sexual violence advocates, developed aguide to assist other Virginia ILCs to replicate the community coordinatedapproach to assisting abused persons with disabilities that had been devel-oped in the initial project locale. Each guide was tailored to the individualILC by including resources specific to the geographic region covered bythat ILC. The project coordinator and an advisory board member met withthe directors of all the ILCs in Virginia to distribute the guides and to dis-cuss steps in building the capacity of the ILCs to identify and address abuseconcerns of their consumers.

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In 2011, the goals of the project were to conduct an accessibility eval-uation of the revised I-CAN! Family Abuse Protective Order module and anew Non-Family Abuse Protective Order module, as well as to survey allILC directors about the usefulness of the guide that the project developedfor ILCs to replicate the support and service model that had been developedwith the local ILC. The project is in the midst of completing its 2012 activities,which include an update to the protective orders’ booklet and the develop-ment and implementation of a statewide training session for Virginia’s courtclerks. The learning goal of the clerk training is to provide information ofhow best to assist people with disabilities in court participation in com-pliance with Americans with Disabilities Act regulations by identifying andaddressing both physical and attitudinal aspects of accessibility. The trainingmodule was co-developed with OES and the state’s Office of Protection andAdvocacy.

Capacity Building Gains of I-CAN!

The authors describe the process, products, and evaluation of the projectwithin an empowerment-based capacity building framework. The mostnotable project successes are demonstrated by gains or improved capac-ity on four levels: the collaborating agency, advisory board members directlyinvolved in the project, the larger community of stakeholders impacted bythe issue of abuse of persons with disabilities, and the systems of policiesand procedures that have been put in place to respond to this problem.

Agency Gains

The agency gains relate to the change in organizational culture of the col-laborating ILC in addressing issues around abuse of persons with disabilities.Concrete indicators of this change in culture include a notification in theagency brochure and via the agency’s Web site that assistance is availablefrom agency staff related to I-CAN!, referrals for abuse-related concerns, alink to the I-CAN! program from the agency’s home page, and institutionaliz-ing the collection of monthly statistics on consumers served who indicated anabuse-related concern. The concrete changes in agency policy and practicewere indicative of capacity building in the area of improving an organiza-tion’s service delivery to consumers (Netting et al., 2008; Urban Institute,2001).

The ILC agency workers also were able to demonstrate increasedcomfort and confidence in addressing abuse-related concerns among theirconsumers as evidenced by the results of the evaluations of the two train-ing sessions described earlier. For the first training session, a pre-/posttest,online survey was designed to determine changes in agency workers’ knowl-edge and behaviors related to domestic violence, the I-CAN! online program,and Adult Protective Services. Fourteen workers attended the training; nine

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completed the pretest and six completed the posttest. There were only fivematched pairs, however. Because of the small sample size of this pre- andposttest, the authors offer results from an evaluation form given to partici-pants at the end of the training session. In response to the question, “Whatwas the most valuable part of this training?” one person wrote, “I was verypleased with the in-depth information about domestic violence. I haven’tdone a seminar in DV in quite some time. I felt that the information wasup-to-date and very useful.” Several participants in the training indicated thatlearning about the I-CAN! Program was the most valuable part of the ses-sion. Additionally, a question that asked the workers how they thought theywould use the information provided in the training session yielded importantfindings. Responses to this question included: “This information will be veryuseful with my clients everyday;” “Working with families, I will be able tooffer them valuable information as part of resource information sharing;” “Bemore observant;” “As a person doing assessments in persons homes to be onguard for cues of violence and abuse in home. To revisit the UAI’s used in VAto see if a safety/personal safety question can be added to psycho/social evalas another trigger to gain insight.”

The second set of training sessions provided to the ILC staff membersfocused on risk assessment and safety planning. The trainings were identi-fied as needed by I-CAN! staff members from antidotal data received fromILC staff members during previous years as a result of dialogue between ILCand I-CAN! staff members. Nine ILC staff members participated in the riskassessment and safety training, which was facilitated by advocates from alocal domestic violence program. The curriculum for the training was devel-oped in two different resource books; a risk assessment and safety guideresource and workbook, and a facilitator’s guide for implementing the cur-riculum. These materials were developed by I-CAN! staff members in consultwith staff members from the local domestic violence program, ILC adminis-tration, and literature on best practices for building capacity in nondomesticviolence programs about how to address domestic violence. The collabora-tion between I-CAN!, ILC, and the domestic violence program was done toensure that the knowledge and skills being taught were needed by ILC staffmembers, as well as being taught at an appropriate level and in a culturallysensitive way.

The training evaluation, given to participants at the conclusion of thetraining session, used a combination of open- and closed-ended questions.The closed-ended questions were developed to test participants’ level ofknowledge acquired through the training; whereas the open-ended questionssought to test participants’ ability to apply newly acquired knowledge toproposed practice scenarios. Eleven ILC staff members attended the training,nine of which completed the evaluation.

It is important to note that although participants were given oppor-tunities to test out acquired knowledge with practice scenarios, analysiswas conducted at a descriptive level with no right or wrong assessment

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of responses conducted. The decision to assess responses at a more descrip-tive level was made by program staff members to reduce anxiety amongparticipants in the training, so that they were more likely to engage and tryout new skills.

The closed-ended questions were designed to measure participants’comfort level with performing various tasks related to risk assessment andsafety planning (knowledge outcomes), and open-ended questions askedparticipants to actively apply the skills learned in the training to specificquestions related to risk assessment and safety planning scenarios (practiceoutcomes). The final analysis of data collected from participants followed aposttest-only design, and analyzed participant data using descriptive statisticsand thematic analysis. The thematic analysis techniques utilized for this studywere guided loosely by Creswell (1998), and assessed participant responsesfor each question by separating out similar responses, and counting numberof occurrences for each response. The final themes labeled for each ques-tion represent the I-CAN’s staff logic, grounded in both literature and practiceexperience, for making sense of participant responses to each question.

The comfort scale questions used a 6-point-Likert-type response scaleranging from 1 (no comfort) to 6 (a high degree of comfort). Staff members’mean comfort scores with conducting various risk assessment and safetyplanning activities were generally high, with the highest mean score asso-ciated with defining risk assessment, 5.00, which corresponds with mostlycomfortable. This item had the lowest standard deviation of any item, .866.The lowest mean score for comfort scale questions was 4.44 with a standarddeviation of 1.24; this question was associated with assessing danger levelsin consumer relationships. The mean score of 4.44 falls between the cate-gories of fairly comfortable and mostly comfortable, indicating that even thelowest mean score for staff comfort with risk assessment and safety planningwas still quite high.

Open-ended questions provided additional supporting data verifyingthe success of the risk assessment and safety planning training in meet-ing the goals outlined above. Staff members were able to identify barriersto consumer disclosure of domestic violence, positive ways to respondto consumer disclosure of domestic violence, and considerations of safetyplans. For example, one question asked ILC staff members to identifyproper responses to consumer disclosure of domestic violence. Staff mem-bers reported, from highest to lowest occurrence, the following acceptableresponses to consumer disclosure of domestic violence: provide support (6),listen to consumer (4), solicit information (4), develop safety plan with con-sumer (4), offer resources (4), remain calm (3), ask consumer what theywant (3), remain non-judgmental (2), validate consumer experience (2), berespectful (1), and document disclosure (1). All of the responses provided byparticipants to this question indicate at least some level of mastery for howto handle consumer disclosure of domestic violence. All of the responses

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provided by participants were deemed correct reactions to consumer disclo-sure of domestic violence by both I-CAN! and domestic violence programstaff members. Staff members were also able to think critically about assess-ing the level of danger in various scenarios; however, some participants didnot fully understand the purpose of danger assessment.

The training sessions offered the opportunity for ILC agency workersto enhance their knowledge about abused persons with disabilities and togain skills in assisting consumers who are experiencing abuse. This trainingeffort was intended to not only build the capacity of individual workersbut also to impact the overall agency’s capacity to address the abuse ofpersons with disabilities as a critical social issue affecting the communitythat it serves. The original goals of the training, as previously outlined, wereassessed by I-CAN! and ILC staff as being successfully met. ILC staff memberswere provided with information about risk assessment and safety planning,taught how to assess for risk as well as how to safety plan with consumers,and increased the overall capacity of ILC staff to properly assess consumers’level of risk in abuse situations as well as how to develop safety planswith consumers. The success of this training was evidenced in the highmean scores across the evaluation, as well as in the ability of participants toanswer direct questions related to risk assessment and safety planning thatdemonstrated their ability to utilize newly learned skills. Overall, the capacityof ILC staff to appropriately identify, assess, and intervene with consumersexperiencing abuse was increased as a result of this training.

Inclusion of Community Stakeholders

The goals of this project, although invaluable, may only be as relevant asthose who provide input in their construction. This is why project partnerscreated an advisory board to help provide specific guidance. Due to thediverse representation of the board, a training component is included dur-ing each quarterly advisory board meeting. Previous trainings have includedAdult Protective Services policy updates, disability awareness, brain injuryand domestic violence, Americans with Disabilities Act, and sexual anddomestic violence awareness sessions. These trainings are intended to helpboard members process the issues about which we are seeking their inputwith nuanced complexity. This complexity of thought is vital when address-ing issues regarding the intersection of violence, disability, and protectivesystems.

Advisory board members were socialized into how to work in meetingswhere there are several accommodations occurring simultaneously becausemany outside of the disability community had not been exposed to this.For example, members were asked to say their names before they spoke.The reason is because the members with visual disabilities could not see themembers’ name tags. This was also a helpful strategy for the members with

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brain injuries who sometimes were challenged by remembering people’snames and their affiliations. The project staff members and disability ser-vice providers and advocates modeled how to communicate with personswho are deaf by looking at the deaf person when he/she is communicatingrather than looking at the sign language interpreter, who is simply verbaliz-ing the communication of the deaf member. The project staff members tookan active role in bridging and interpreting differing philosophies among col-laborators and attempted to create opportunities for dialogue and resolutionwhen controversial issues arose. The bridging of differing philosophies andfacilitation of conflict and/or difference is an important task in consensusbased community organizing and a necessary skill set for effective capacitybuilding efforts (Gutierrez et al., 2003; Weil, 1996).

The project team was interested in the impact of participation in theproject’s advisory board on its members, particularly because of the mixof professionals from different sectors and consumers on the board. At theend of the second year of the project, a mixed-methods, online survey wasdistributed to advisory board members to assess whether participation onthe advisory board produced empowerment related gains among members.It is important to note that the questionnaire developed for this study was notadministered at the beginning of the advisory board process; therefore, base-line data about previous levels of empowerment are not available. Thus, thefindings related to the analysis of advisory board questionnaires are limitedto descriptive usefulness as opposed to predictive or explanatory usefulness.

Empowerment as a construct was chosen as a means for guiding thedevelopment of the advisory board questionniare due to underlying valuesand outcomes related to the capacity building goals of the I-CAN! program.The I-CAN! program staff utilized the working definition for empowermentdeemed most applicable to social work community practice provided byGutierrez et al. (2003), who indicate that empowerment is a multidimensionalconstruct that occurs across three distinct, but interrelated dimensions ofpower; personal, interpersonal, and political. Simply put, the project teamwanted to understand if advisory board members felt self-confident, capableof participating, and more aware of disability issues and domestic violence(personal); benefited from the group process, believed that the advisoryboard group was an effective means for creating change (interpersonal), andif advisory board members perceived that they had created systemic levelchanges as a result of participating on the board (political).

Thirteen advisory board members completed the advisory board ques-tionnaire. The questionnaire included four demographic questions, 13 Likert-type scale questions (5-point scale ranging from 1 [strongly agree], 5 [stronglydisagree], 3 [neutral]), and 6 open-ended questions that asked advisory boardmembers to describe how they were changed as a result of their participationin the board, what changes the group made to the current system to improvepolicies and practices related to abused persons with disabilities, and their

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perceptions of their personal contributions to the advisory board, as well asthe overall group dynamics. The breakdown of the sample by gender was78.6% women and 21.4% men, which is fairly representative of social workand many other sectors participating on the advisory board. The breakdownin membership by professional sector or role is as follows: Five advisoryboard members came from the criminal justice sector, four members fromsocial service agencies, three members from disability specific agencies orsector, one member from higher education sector, and one consumer withdisabilities. Two members indicated other for this question, and one memberindicated identity in more than one sector.

Although the questions developed were not taken from a validatedempowerment scale, I-CAN! staff identified questions for each dimension ofempowerment (personal, interpersonal, and political) that were guided bythe empowerment framework previously discussed. Responses to scale itemquestions were analyzed utilizing descriptive statistics that identified mediansand ranges for responses due to the ordinal level of data that was collected.The Cronbach’s alpha for the scale questions was .773. The questions thatresulted in the highest median scores with lowest ranges of variation were:Other Advisory Board members seemed interested in my views (median =2; range = 1), I thought a lot about Advisory Board issues outside of meet-ings (median = 2; range = 2), and whenever I spoke at Advisory Boardmeetings, others listened (median = 2; range = 2). The question related tothinking about advisory board issues outside of meetings directly relates toraised awareness or consciousness, which is often discussed as an aspect ofpersonal empowerment (Gutierrez et al., 2003). The two questions relatedto the sample’s perception of the advisory board process relates best tothe interpersonal dimension of empowerment, specifically successful groupprocesses and positive dynamics (Rappaport, 1987).

Qualitative data were analyzed utilizing basic thematic analysis withinan empowerment framework. Data relating to individual gains were coded aspersonal power, data about group process gains or dynamics were coded asinterpersonal power gains, and data on systemic level changes or individualactions resulting from participation were coded as political power.

For example, one question asked advisory board members, “How doyou think your participation with the I-CAN Advisory Board will effect youin the future?” One participant stated, “Keeps accessibility in the forefront ofmy thoughts when addressing issues.” This response was coded as personalpower as it relates the most to individual consciousness and awareness.Another participant responded to this question by stating, “Having the inputfrom individuals from various backgrounds and agencies is always helpfulto the decision making process.” This response was coded as interpersonalpower as it relates best to positive gains resulting from participating in thegroup process. Finally, another participant responded, “Share informationwith Texas Brain Injury Board.” This response indicates an action that may

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be political in nature and is grounded in concrete action that this participantis stating she/he will do as a result of his/her participation with the advisoryboard. Overall, most of the sample (over 86%) reported positive gains acrossthe questions developed to assess empowerment. It is important to note thatmany of the reported positive gains relate to the personal and interpersonaldimensions of empowerment; however, the sample reported fewer gains inquestions targeting the political dimension of empowerment.

The empowerment gains of advisory board members are important toconsider in a project that aims to build community investment in a socialissue. Advisory board members’ willingness to participate in future effortsdesigned to create social change and build capacity will likely be pos-itively influenced by their experience with the project’s advisory board.Additionally, positive group experiences that were evident in the analysis ofthis questionnaire indicate that many members will likely participate in futurecollaborations, which is an essential outcome of both group empowermentand successful capacity building (Rothman, Erlich, & Tropman, 2001). It isespecially notable that the advisory board members who may be perceivedto be in the lowest power positions (consumers with disabilities) perceivedtheir experience on the board and in the project’s activities as more positiveand participatory than their professional counterparts.

Community- and System-Level Gains

This project has generated numerous products focused not only on improve-ment of service delivery systems, but also on community engagement andempowerment. Among these have been three different training manuals,as well as a facilitators’ guide, all designed as reference tools for ILC staff.Informational wallet cards, developed for people with disabilities, and thebooklet “Understanding Family Abuse Protective Orders in Richmond, VA”were developed and made available to consumers in English, Spanish, andBraille throughout the region that was the focus for this project. Theseproducts were developed in cooperation with people with disabilities anddistributed through numerous agencies in the area.

Another important facet of the project has been to provide accessibil-ity evaluations of the systems in the community that are designed to assistconsumers to obtain protective orders. Persons with disabilities have beeninvolved in the evaluation of the I-CAN! online program as well as physicalon-site evaluations of the local Juvenile and Domestic Relations court facil-ities and their policies and procedures associated with the application forprotective orders. These evaluations have uncovered the accessibility barri-ers in the process of acquiring protective orders. The Office of the ExecutiveSecretary has utilized the accessibility evaluation reports to make modifica-tions to the I-CAN! Program. As OES has expanded the I-CAN! program byadding a new module, the project has continued to organize accessibilityevaluations, which are conducted by persons with disabilities.

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Assessing the effectiveness of the project programming and productsis imperative; however, the core of this project is a focus on advocacy.This advocacy may be centered on improving domestic and sexual violenceprotective resources for persons with disabilities, but latently it also servesseveral additional functions, including capacity building and empowermentamong I-CAN! Accessibility Project advisory board members as well asacross the community; creation of linkages and partnerships between sectors,agencies, and people; and coordination among community based agencies.Other beneficiaries include government agencies, which can benefit fromthe project’s outcomes, assessment, and lessons learned in future policyand program planning. Further, it is an intended aim that community basedcapacity building will not only create enhanced access to services for peoplewith disabilities, but could also empower community based response agen-cies to take leadership roles for assisting these populations while providinginformed practice and services.

The advisory board composition and meeting structure facilitated com-munity and systems gains. Interactions among advisory board membersallowed for building new and stronger agency partnerships, as well asby providing opportunities to learn about the service philosophies andapproaches of agencies that historically had little to no contact with eachother. Through bringing together diverse groups and members of the com-munity for the collective goal of addressing abuse of persons with disabilities,the community as a whole was better able to address the problem. By invit-ing representatives from many sectors of the community, which normallyhave only limited or conflict oriented contact with one another, positiverelationships were established that have been maintained over time. Theadvisory board training sessions not only served to educate members abouttopics related to abuse of persons with disabilities, but they also facilitatednetworking and trust among advisory board members. Numerous agencycollaborations developed as a result of advisory board meetings, includingcross-referrals, staff in-services, and jointly sponsored programs. Collectiveefficacy was promoted through group members having an equal voiceand opportunity to contribute expertise to the group process, which alsocontributed to positive group outcomes (Gutierrez et al., 2003).

Structural gains have been evidenced by positive changes in policiesand practices to address violence against persons with disabilities; this per-haps has been the area of change that has taken the longest and been themost frustrating goal to attain. Yet, there have been documented and visiblestructural changes that have occurred as a result of the work of the I-CAN!Accessibility Project. The findings of the accessibility evaluation reports ofthe I-CAN! Program were used to improve the accessibility of the protectiveorder modules. Additionally, modifications were made to another documenton the I-CAN! site relevant to local courthouses to include more specific infor-mation related to accommodations for persons with disabilities. Our FamilyAbuse Protective Order booklet, described earlier, was distributed at the local

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courthouse, the domestic and sexual violence program in the area, and thecollaborating ILC. It was so popular that it was updated after its initial print-ing and a project goal for 2012 is to revise it once again based on sweepingchanges in protective order laws in the Commonwealth. Project staff andadvisory board members were involved in advocating for these changes inthe protective order laws in Virginia, which included treating cases wherethe abuser is not considered a family or household member (such as a non-cohabitating boyfriend or girlfriend who doesn’t have a child in common ora personal care attendant who is not an intimate partner or relative of thevictim) similarly to cases where the abuser is a family or household member.

Another way that structural change was achieved in the I-CAN! Projectis through project staff members (the codirectors and project coordinator)serving on regional domestic and sexual violence task forces and state advi-sory boards. At these task force and advisory board meetings, they were ableto raise issues concerning persons with disabilities.

As in any bureaucracy, there are often compromises and what onewould like to see changed is not necessarily what ultimately happens. Thisreality, however, does not diminish the fact that the online program to assistpersons in filing for protective orders is now in a more accessible formatfor persons with disabilities and the Commonwealth’s protective orders thatcover nonfamily abuse are now similar to the ones that cover family abuse.Furthermore, central agencies in the community that provide services to per-sons with disabilities are now better equipped to identify and intervene inabuse cases and they are more aware of the resources in their communityto which they can refer their consumers. The project has met its originalgoals of making protective orders more accessible for persons with disabil-ities and training disability service providers to assist consumers who arebeing abused.

PROJECT CHALLENGES

Although there were many important project accomplishments, there havebeen several critical challenges over the course of the project. One signifi-cant on-going challenge is the lack of resources in the area for persons withdisabilities with severe medical conditions who need emergency housing.Another significant barrier to the work of the project has been accom-modations for persons with disabilities who go to court for protectiveorders.

The different organizations’ ideologies and approaches to their workwith persons affected by abuse sometimes created misunderstandings andconflict between persons involved in the project. This was especially thecase around the issue of mandated reporting to Adult Protective Services ofsuspected abuse of persons 60 and older and incapacitated persons. The

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domestic violence programs believed that they were exempt from the statestatute on mandated reporting and argued for their service recipients’ self-determination, while Adult Protective Services viewed these programs asmandated reporters. As a result of the issue first being raised within the workof the I-CAN! Accessibility Project, the state family violence program throughthe Department of Social Services held statewide meetings of Adult ProtectiveServices and domestic/sexual violence direct service workers and adminis-trators and other interested parties to discuss differing perceptions about thisissue. Ultimately, a working group was created to develop a cross-trainingcurriculum for Adult Protective Services personnel and domestic/sexual vio-lence advocates similar to the national Greenbook Initiative (Child ProtectiveServices and domestic/sexual violence cross-training). (For a more detaileddiscussion of this controversial issue and how it impacted this project, pleasesee Cramer & Brady, in press.)

An additional challenge has been the low service numbers of consumerswho have been assisted by the collaborating ILC who have abuse-relatedconcerns. The project goals and objectives required data collection of peopleserved with abuse-related concerns for the first two years of the project; afterthe project moved in other directions, and the data collection was no longerrequired, the agency ceased to keep these records. The agency averagedabout 2–3 abuse-related cases a quarter. In the training on risk assessmentand safety planning, it became clear that staff members were reluctant todirectly question consumers about abuse, in part because of the agency’sconsumer-driven orientation for services and partly due to their own per-sonal discomfort. The training facilitators could have spent more time duringthe training on how to ask the appropriate questions that would allow fordisclosure of abuse and they also could have addressed the staff members’concerns about asking these direct questions. The agency’s workers tendedto wait for consumers to disclose abuse and this led to relatively low numbersof cases.

FUTURE DIRECTIONS AND RECOMMENDATIONSFOR OTHER COMMUNITIES

During 2012, the advisory board has been engaged in a strategic planningprocess. As part of this process, the board has determined that the projectshould focus its work on subpopulations of persons with disabilities whohave unique needs related to abuse, specifically persons who are deaf andhard of hearing and survivors of brain injury. The project will continue towork with OES to incorporate the suggested modifications to the online,protective order modules to make them more accessible for persons withvarious disabilities. An updated booklet on protective orders, geared towardpersons with low literacy and cognitive disabilities, will be produced for

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community distribution, based on recent changes in state law concerningprotective orders. The project is also in the final stages of creating a cur-riculum focused on educating/training court clerks on the issues faced bypeople with disabilities when they go to court for abuse-related concerns.

Although the results of the I-CAN! Accessibility Project may not begeneralizable to other communities, the lessons learned from utilizing aempowerment-based, capacity building approach offer potential benefits toother communities seeking to bring sectors, agencies, and persons togetherfor a shared interest.

Working “With” and not “For” the Community

Through the utilization of a capacity building approach, it was possible tobring together multiple sectors of the community, along with consumers toaddress issues of mutual concern. Through involving multiple sectors, agen-cies, and populations in addressing abuse of persons with disabilities, it waspossible to solicit more perspectives on the issue than would be possible intraditional top down approaches to community organizing. Although it wasoften challenging to facilitate and manage differening personal and orga-nizational philosophies that were present at the table, this process helpedto ensure more buy-in at a community level through cultivating collectiveownership over the issue of abuse of persons with disabilities.

Addressing Difference in Community Organizing

Another important aspect that can be taken from the I-CAN! AccessibilityProject is the importance of openly identifying and addressing difference asit arises between people, organizations, and sectors. Difference can comein a variety of forms, including differences in philosophy between organiza-tions, differences of opinion between advisory board members, differencesamong the characteristics of members, and historical barriers between var-ious community sectors. These various forms of difference each have thepotential to disrupt or stop capacity building from taking place.

Identifying and addressing difference occurred on many different lev-els with the I-CAN! Accessibility Project. One of the most important aspectsof difference that required attention during the project related to ensuringthat all advisory board members were able to participate in advisory boardmeetings. To ensure full participation, I-CAN! project team staff membersprovided accommodations for a variety of disabilities, including larger sizeprint, sign language interpreters and CART (Communication Access RealtimeTranslation), travel (taxis and accessible van transportation), and reiterat-ing ground rules for communication at the onset of every advisory boardmeeting. Through the use of accommodations, every board member wasable to participate in meetings, and provide essential perspectives needed

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to guide the project. Differences in philosophy of participating organizationsand sectors were also regularly addressed openly and honestly by projectstaff members.

The Relationship Between Empowerment and Capacity Building

One of the implicit goals of the I-CAN! Accessibility Project was to promotethe empowerment of advisory board members, many of whom also identifiedas consumers with disabilities. As noted earlier, an evaluation was developedby project staff members to assess advisory board members’ empowermentgains. It was discovered that advisory board members felt as though they hadcontributed to the group process, learned from working with others, and feltinvested in working towards larger changes. Although these findings werepromising, as it seemed to point to a connection between empowerment andcapacity building, it is also important to know that advisory board members,on average, indicated that they did not feel as though they had created larger-level systemic change at the time of the questionnaire. The authors suggestthat advisory board members’ political empowerment, which involves abelief among participants that larger systemic change can be achieved, prob-ably takes longer to accomplish because this type of systemic change can bequite slow.

University–community collaborations can be effective in building capac-ity to address pressing social issues. Attention to process, as much as toproduct, is vital to create empowering experiences for participants. Largerstructural gains can be achieved, albeit very slowly, when stakeholders areprovided with education and the resources to effect change.

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