Teen dating violence (TDV) is a public health concern for youth in the United States, with TDV associated with both short- and long-term negative health outcomes. According to the 2021 Youth Risk Behavior Survey (YRBS), 13.9% of surveyed high school students had experienced physical, sexual, or both types of TDV in the preceding year (Clayton et al., 2023). Other studies suggest that the YRBS may be a conservative estimate of prevalence, especially after accounting for psychological and verbal violence (Brar et al., 2023). Exposure to TDV as a teen is associated with outcomes that last well beyond childhood, related to mental health, physical health, educational attainment, and substance use (Reidy et al., 2017; Taquette & Monteiro, 2019).
Early intervention can be beneficial, with TDV prevention programs shown to improve knowledge and attitudes and reduce violence in adolescents (Lee & Wong, 2022). Prevention strategies aimed at youth arguably should begin before the onset of romantic relationships (Capaldi & Langhinrichsen-Rohling, 2012). Structural barriers (e.g., time, travel, attendance) often impede implementing programs with fidelity in many settings; thus, a majority of TDV interventions take place in school settings (Piolanti & Foran, 2022). The age range in which relationships begin, which is often as early as elementary and middle school, also makes the school environment ideal for TDV prevention efforts, due to the significant amount of time youth spend in these settings during the day (Edwards et al., 2023). Expect Respect, a comprehensive prevention initiative developed by SafePlace, a founding partner of the SAFE Alliance based in Austin, Texas, is one of the few school-based violence prevention programs with evidence of success in reducing TDV behaviors (Ball et al., 2012, 2015; Reidy et al., 2017) yet it has not been implemented on a broad scale. Recent Expect Respect implementation has been focused on multisystem approaches to disseminating the evidence-based intervention, some using social work practicum placements.
The Expect Respect program incorporates structured school-based support groups that focus on at-risk youth who have encountered violence in their home environments or in peer and dating relationships (Ball et al., 2015). These support groups, traditionally organized separately by gender, follow a 24-session curriculum, and provide a safe space for preteens and teens to share their experiences, offer and receive emotional support, and acquire skills for fostering healthy relationships. The curriculum is divided into five units:
- Developing group skills
- Choosing equality and respect
- Recognizing and healing from abusive relationships
- Learning skills for healthy relationships including empathy, communication, boundaries, consent, and handling rejection, and
- Promoting nonviolent relationships in the community (Ball et al., 2015, p. S41).
Given the prevalence and long-term impact of teen dating violence (TDV) on youth, implementation of effective prevention programs, such as Expect Respect, is urgently needed. Many states require interpersonal violence training as part of school health education programming. Dissemination (i.e., scaling the program to reach more schools and youth) and implementation (i.e., ensuring high-quality facilitation of the program) remains challenging (De La Rue et al., 2017; Edwards et al., 2023). Previously identified challenges include collaboration with schools, funding, community involvement, and the commitment of group leaders (Edwards et al., 2023). A qualitative study of facilitators from a school that implemented Expect Respect highlighted several barriers to implementation, including insufficient referrals, inconsistent attendance, and low levels of school support (Ball et al., 2015). School pressure, specifically regarding student classroom performance, was noted as a contributor to poor group attendance, due to teachers not wanting to release students and having them miss academic content (Ball et al., 2015). Poor attendance limits group engagement. If there is a rotating group of students who do not know each other well, the curriculum can feel more like a class rather than structured peer support and educational activity (Ball et al., 2015). Although time and staffing challenges within the school setting are not new barriers to prevention program implementation, the COVID-19 pandemic exacerbated a national teacher shortage that increased the workload for teachers (Schmitt & deCourcy, 2022).
Development of Collaborations for School of Social Work Practicum Placement
The current program took a novel approach to the implementation of Expect Respect in schools to address limitations of staffing, which is one well-recognized pitfall to effective and sustainable implementation of prevention interventions. To increase feasibility, acceptability, integration, and expansion, a team collaborated to address program implementation challenges, staffing needs, and funding constraints. This initiative required collaboration between the University of Pittsburgh School of Social Work, SAFE (the developers of Expect Respect), the University of Pittsburgh Medical Center (UPMC) Adolescent Medicine department, and several area public school districts, which included 40 middle schools across one county, reaching over 700 students.
The team approach began with a relationship between the School of Social Work and Adolescent Medicine, with the desire to implement a unique program in local schools. The programs were currently working together in a collective impact initiative focused on child thriving and racial equity called The Pittsburgh Study (thepittsburghstudy.org), which led to a foundation of collaboration and relationship. Each member of the collaborative team played an important role that was defined at the start of the relationship. The School of Social Work identified social work students with an interest in learning school-based interventions, provided practicum placement oversight, and funded the student’s stipend; SAFE provided the Expect Respect curriculum and technical assistance throughout the years of implementation; and UPMC Adolescent Medicine oversaw program implementation, hired and coordinated community partners, provided supervision for social work students by a licensed clinical social work practicum instructor, and worked directly with the schools. The collaboration created an infrastructure with each member contributing areas of expertise, funding, and workforce.
UPMC Adolescent Medicine had established relationships with schools and local victim service advocates, including prevention specialists, and facilitated the partnership between the School of Social Work, SAFE, and the public schools. Extensive school partnerships were already in place with UPMC Adolescent Medicine through The Pittsburgh Study. The steady stream of MSW students placed with the Expect Respect program for practicum experience ensured adequate coverage to begin implementing in-school groups throughout the region. UPMC Adolescent Medicine facilitated training with SAFE to prepare students in the Expect Respect curriculum, and oversaw the supervision of social work students in their practicum training.
Process of Onboarding and Training Social Work Students
The Expect Respect practicum placement is a rigorous placement that can be tailored for a first-year generalist or a second-year clinical placement. The placement requires thoughtful consideration of student–placement fit due to the high level of independence needed and the nature of the work, which involves middle school youth with histories of exposure to violence, including cases of significant acuity.
The onboarding process for the paid practicum placement, which has undergone multiple funding iterations, begins with MSW students applying for the position of Expect Respect social work student, with advertising facilitated through the practicum placement office in the School of Social Work. Funding for this initiative emerged from both federal-level grant mechanisms and in-kind support from both the School of Social Work and Adolescent Medicine. Following receipt of applications, thorough reviews are conducted by both the practicum liaison in the School of Social Work and the Adolescent Medicine community facilitator (who serves as the primary field instructor). Subsequently, the community facilitator conducts individual interviews with promising applicants that explore student motivation and enthusiasm for the unique demands of this placement. This meticulous approach helps ensure that selected candidates are well-suited for the responsibilities inherent in the placement. There are between five and 10 MSW students each year in these placements, depending on the number of participating middle schools.
Developing successful cofacilitation requires substantial guidance from the practicum instructors. All students participate in this practicum for eight months, and the first two months primarily focus on didactic training and practice-group facilitation before working within the middle schools. The training structure has been structured and improved to gradually and purposely increase student confidence and ability to independently engage with middle school students, providing psychoeducation on violence prevention topics while successfully cofacilitating groups with experienced community partners.
Expect Respect is a unique practicum placement strengthened by the cohort model and the support of community facilitators. Student training meets the needs of the CSWE Competencies (Council on Social Work Education, 2022) and provides students with tangible skills for future employment. Students gain skills in interacting with key personnel in school settings, facilitating groups, navigating difficult conversations, learning healing-centered approaches for supporting youth with exposure to trauma, and working with cofacilitators to implement established group curricula. Most other practicum placements at our school of social work do not provide this level of robust opportunity to learn across all these dimensions simultaneously.
Students spend the first six weeks learning about the Expect Respect curriculum and multiple modalities, and receive training on group facilitation and trauma-informed care. A benefit of the Expect Respect training is its exposure to multiple skill sets and its clinical approach to implementing this evidence-based intervention. During this time students meet regularly, both virtually and in person, to train on the program. They also are provided extensive self-paced training online that is then discussed in the group meetings. They are not working directly with students during this time, but are preparing their group facilitation skills and understanding of the population they will be working with. They continue to receive weekly clinical supervision to talk through issues that may arise during the intensive training sessions. This comprehensive preparation period encompasses becoming familiar with the Expect Respect curriculum, getting acquainted with their community cofacilitators, and gaining insights into the unique dynamics of their respective communities. The Expect Respect curriculum is imparted through interactive mock sessions, where students are challenged to exhibit flexibility and adaptability to cater to the evolving needs of youth participants. These sessions are enriched with real-life scenarios, incorporating discussions on prevalent community issues such as school conflicts, shootings, and other forms of violence. A comprehensive list of trainings relevant to each CSWE competency appears in Table 1.
Table 1
Sample of Training Related to CSWE Competencies EPAS 2022 Completed by MSW Students
| CSWE Competency (EPAS 2022) | Training Session |
| Demonstrate ethical and professional behavior |
|
| Advance human rights and social, racial, economic, and environmental justice |
|
| Engage antiracism, diversity, equity, and inclusion in practice |
|
| Engage in practice-informed research and research-informed practice |
|
| Engage in policy practice |
|
| Engage with individuals, families, groups, organizations, and communities |
|
| Assess individuals, families, groups, organizations, and communities |
|
| Intervene with individuals, families, groups, organizations, and communities |
|
| Evaluate Practice with individuals, families, groups, organizations, and communities |
|
Additionally, to foster a deeper understanding of community diversity, each student creates a community asset map of the school neighborhood they are assigned (Briggs & Huang, 2017). By focusing on the strengths and abilities of the communities they serve, this community asset map serves as a foundational step towards enhancing students’ awareness and appreciation of the multifaceted environments in which they will operate (Briggs & Huang, 2017). The map is fundamental for social work students to examine systemic factors in communities that can lead to violence in the youths’ lives. The assessments also provide students with an understanding of the lived experiences of students, staff, and community facilitators.
Collaborative Practicum Training
Expect Respect social work students cofacilitate groups with community members. These are advanced skills, and the students are trained prior to the first group. Students are encouraged to view the neighborhoods holistically from a strengths-based perspective. Community facilitators are sometimes connected to a school (such as an athletic coach), while others are working with youth in various settings and interested in being trained to implement prevention. Community members participate in training individually to prepare them for the specifics of the Expect Respect program and of the school they will be working in, and for collaborating with social work students. There are also opportunities for all community members to participate in training with all social work students. Social work students and the cofacilitators also participate in preparation and debrief meetings weekly to ensure impactful facilitation of the groups.
The collaboration between Expect Respect and the School of Social Work offers students invaluable real-world experience in the field of TDV prevention. Expect Respect as a practicum placement is unique in its balance of community work, group facilitation, administration of a program, and engagement with youth. Social work students require a high level of independence to effectively cofacilitate Expect Respect with a community partner and cultivate a safe and empathic space for students to discuss sensitive topics. The Expect Respect curriculum is designed to be flexible enough for facilitators to use their discretion to shift session sequences and allow space to acknowledge current events occurring in the community, while maintaining fidelity to the curriculum. This flexibility is necessary since the nature of school and community violence varies in each school, and social work students need to be able to shift to address topics relevant to the middle school students. This level of work requires training social work students at the micro level for TDV doing group work, but also at the mezzo level through community collaboration and work at the school level. In this placement, social work students become experienced not only in trauma-focused intervention and prevention with youth, but also in navigating a school system bureaucracy while being aware of and addressing community-level events. This is a skill that may not be in standard practicum instruction and is pivotal to successful TDV prevention work in schools (Finnie et al., 2022).
Social work students also benefit from the mentorship and guidance of seasoned professionals within Expect Respect. This exposure to experts in the field of TDV allows social work students to expand their knowledge base and gain insights into best practices for TDV prevention. The training also included 20-plus hours of self-guided modules on trauma and violence from the Pennsylvania Coalition Against Domestic Violence (PCADV) and the Pennsylvania Coalition to Advance Respect (PCAR). As a result, they graduate with a deeper understanding of the complexities of TDV and the skills necessary to address this issue effectively.
School and Community Experience
The collaboration of Expect Respect and social work students is a reciprocal relationship between middle schools and the communities in which the schools are located. Schools gain access to a dedicated and knowledgeable pool of social work students who are passionate about promoting healthy relationships among young individuals. For long-term sustainability, the integration of students from the School of Social Work has enabled more middle schools to engage in Expect Respect. These students contribute fresh perspectives and innovative ideas, enriching the TDV prevention programs within educational settings. The combination of the social work students, who typically leave after their eight-month practicum, and the community facilitator, who stays in the same school and often has long-term relationships with the youth, provides a balance that has been successful in the school system.
Furthermore, the presence of social work students within schools provides additional support for middle schoolers who may be experiencing TDV or other related challenges. Social work students may serve as trusted advocates and resources for these students, offering guidance and assistance when needed. The use of social work students also allows for scaling up evidence-based programs that are CDC recommended, such as Expect Respect, without extensive financial overhaul or staffing from the school or community organizations (Ball et al., 2015).
Challenges and Limitations
This type of collaboration, involving multiple players and goals, requires a large time commitment and navigation of individual pressures and procedural considerations within each institution. Notably, the SAFE program in Austin, which has been implementing Expect Respect for many years, has employed only behavioral health professionals as facilitators, rather than using the social work practicum placement model. The program at the University of Pittsburgh has developed with adjustment and growth each year, with the goal to infuse the field of behavioral health social workers with expertise in interpersonal violence. Some of the major hurdles include funding, coordination of and identification of MSW students, and communication across many different collaborators. It also requires extensive trauma-sensitive training. Due to the need for ongoing training and supervision for the MSW students, this was a resource-intensive operation. A key to success was identifying one faculty person in the practicum office, along with a primary field liaison, for providing supervision.
Broader Impact and Implications
Sustained collaboration among the TDV prevention program Expect Respect, UPMC Adolescent Medicine, and the University of Pittsburgh School of Social Work, has been implemented successfully. The accomplishments of the collaboration provide a model that can be replicated by other communities using a similar approach, ensuring the sustainability and growth of these programs. Additionally, this model can be replicated and adapted in different regions, expanding the workforce of TDV prevention professionals and providing valuable experiential learning opportunities for social work students.
One of the most promising aspects of the collaboration is its emphasis on sustainability and scalability. By using a community-engaged approach to adapting the Expect Respect program, integrating social work students, and having the oversight of two established professional programs, Expect Respect has seen seven years of growth and modification, with local middle schools asking to join or expand annually. Collaboration between the University of Pittsburgh School of Social Work, SAFE, UPMC Adolescent Medicine, and the local public school system has demonstrated the feasibility of enhancing TDV prevention efforts. This collaboration benefits schools by enriching prevention programs, providing social work students with essential practical experience, and ultimately contributing to the broader workforce of professionals dedicated to promoting healthy relationships among children and youth. This collaborative model holds great promise for the future of TDV prevention initiatives, both locally and nationally.
References
Ball, B., Holland, K. M., Marshall, K. J., Lippy, C., Jain, S., Souders, K., & Westby, R. P. (2015). Implementing a targeted teen dating abuse prevention program: Challenges and successes experienced by Expect Respect facilitators. Journal of Adolescent Health, 56(2), S40–S46.
https://doi.org/10.1016/j.jadohealth.2014.06.021
Ball, B., Tharp, A. T., Noonan, R. K., Valle, L. A., Hamburger, M. E., & Rosenbluth, B. (2012). Expect Respect support groups: Preliminary evaluation of a dating violence prevention program for at-risk youth. Violence Against Women, 18(7), 746–762.
https://doi.org/10.1177/1077801212455188
Brar, P., Shramko, M., Taylor, S., & Eisenberg, M. (2023). The moderating influence of school adult connectedness on adolescent dating violence and mental health. Journal of School Health, 93(4), 297–304.
https://doi.org/10.1111/josh.13268
Briggs, L., & Huang, Y. (2017). Asset-based community maps: A tool for expanding resources in community health programs. Pedagogy in Health Promotion, 3(3), 195–201.
https://doi.org/10.1177/2373379916664736
Capaldi, D. M., & Langhinrichsen-Rohling, J. (2012). Informing intimate partner violence prevention efforts: Dyadic, developmental, and contextual considerations. Prevention Science, 13(4), 323–328.
https://doi.org/10.1007/s11121-012-0309-y
Clayton, H. B., Kilmer, G., DeGue, S., Estefan, L. F., Le, V. D., Suarez, N. A., Lyons, B. H., & Thornton, J. E. (2023). Dating violence, sexual violence, and bullying victimization among high school students—Youth Risk Behavior Survey, United States, 2021. Morbidity and Mortality Weekly Report Supplements, 72(1), 66–74.
https://doi.org/10.15585/mmwr.su7201a8
Council on Social Work Education. (2022). 2022 educational policy and accreditation standards for baccalaureate and master’s social work programs.
https://tinyurl.com/5y9ue5r3
De La Rue, L., Polanin, J. R., Espelage, D. L., & Pigott, T. D. (2017). A meta-analysis of school-based interventions aimed to prevent or reduce violence in teen dating relationships. Review of Educational Research, 87(1), 7–34.
https://doi.org/10.3102/0034654316632061
Edwards, K. M., Orchowski, L. M., Espelage, D. L., & Temple, J. R. (2023). What is not in the methods section: Challenges, successes, and lessons learned from conducting school-based interpersonal violence prevention research. Journal of Interpersonal Violence, 38(3–4), 4507–4532.
https://doi.org/10.1177/08862605221109881
Finnie, R. K. C., Okasako-Schmucker, D. L., Buchanan, L., Carty, D., Wethington, H., Mercer, S. L., Basile, K. C., DeGue, S., Niolon, P. H., Bishop, J., Titus, T., Noursi, S., Dickerson, S. A., Whitaker, D., Swider, S., & Remington, P. (2022). Intimate partner and sexual violence prevention among youth: A community guide systematic review. American Journal of Preventive Medicine, 62(1), e45–e55.
https://doi.org/10.1016/j.amepre.2021.06.021
Lee, C., & Wong, J. S. (2022). Examining the effects of teen dating violence prevention programs: A systematic review and meta-analysis. Journal of Experimental Criminology, 18(1), 1–40.
https://doi.org/10.1007/s11292-020-09442-x
Piolanti, A., & Foran, H. M. (2022). Efficacy of interventions to prevent physical and sexual dating violence among adolescents: A systematic review and meta-analysis. JAMA Pediatrics, 176(2), 142–149.
https://doi.org/10.1001/jamapediatrics.2021.4829
Reidy, D. E., Holland, K. M., Cortina, K., Ball, B., & Rosenbluth, B. (2017). Evaluation of the Expect Respect support group program: A violence prevention strategy for youth exposed to violence. Preventive Medicine, 100, 235–242.
https://doi.org/10.1016/j.ypmed.2017.05.003
Schmitt, J., & deCourcy, K. (2022). The pandemic has exacerbated a long-standing national shortage of teachers. Economic Policy Institute.
https://eric.ed.gov/?id=ED626637
Taquette, S. R., & Monteiro, D. L. M. (2019). Causes and consequences of adolescent dating violence: A systematic review. Journal of Injury and Violence Research, 11(2), 137–147.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6646825/