Exploring Professional Agency in Domestic Violence Interventions Within Social and Health Care

This is a self-archived version of an original article. This version may differ from the original in pagination and typographic details. Author(s): Title: Year: Version: Copyright: Rights: Rights url: Please cite the original version: CC BY-NC-ND 4.0 https://creativecommons.org/licenses/by-nc-nd/4.0/ Exploring Professional Agency in Domestic Violence Interventions Within Social and Health Care © 2024 Author and Journal Published version Piippo, Sisko Piippo, S. (2024). Exploring Professional Agency in Domestic Violence Interventions Within Social and Health Care. Nordic Journal of Working Life Studies, Early online. https://doi.org/10.18291/njwls.151240 2024 1 Nordic journal of working life studies Exploring Professional Agency in Domestic Violence Interventions Within Social and Health Care1 ❚ Sisko Piippo2 Postdoctoral Researcher, University of Jyväskylä, Finland ABSTRACT While the existing research on domestic violence (DV) interventions has provided substantial insights into the challenges associated with addressing DV, the factors that facilitate its intervention in social and health care remain under-researched. This study focuses on DV intervention practices that professionals have deemed successful and employs subject-centered sociocultural theories of professional agency to analyze how professional agency is manifested in these situations. To this end, 10 focus group interviews were conducted with 45 experienced social and health care professionals. The collected data were subjected to thematic content analysis. The findings illustrate how professional agency is manifested in various contexts: through understanding DV as a phenomenon and its contextual factors (epistemic agency), launching a process (processual agency), collaborating with other professionals (relational agency), and reflecting on one’s own actions and emotions (reflective agency). KEYWORDS Agency / domestic violence / domestic violence interventions / professional agency / professional practices / social and health care Introduction Domestic violence (DV) is a global gendered problem that significantly undermines the well-being and equality of its victim-survivors (VS), causing considerable economic and public health costs (Bellis et al. 2019; Siltala et al. 2023). DV is most commonly manifested as violence against women (e.g., FRA 2014). The Council of Europe Convention on Preventing and Combating Violence Against Women and Domestic Violence (Istanbul Convention) obligates the ratifying states to enact comprehensive measures to address and prevent DV. The professionals in public social and health care are in a key position to address DV and support its VS. The challenges that involve tackling DV in the social and health care services— already widely reported by several studies (e.g., Allen-Leap et al. 2023; Heron & Eisma 2021; Husso et al. 2021; Keeling & Fischer 2015; Niklander et al. 2019; Wild 2023)— highlight not only the individual but also the institutional and organizational constraints posed by the precarious working conditions of social and health care. Finland’s Ministry of Social Affairs and Health aims to prevent DV and develop DV interventions in the nationwide public service system (Ministry of Social Affairs and Health 2019). However, at the practical level, the efforts taken by welfare organizations 1 You can find this text and its DOI at https://tidsskrift.dk/njwls/index. 2 Corresponding author: Sisko Piippo, Department of Social Sciences and Philosophy, University of Jyväskylä, Finland. E-mail: [email protected]. 2 Exploring Professional Agency in Domestic Violence Interventions Sisko Piippo to achieve this aim have been lacking, relying mainly on short-term projects (Nipuli 2019). Nurturing the outcomes of the various development projects has posed a challenge for social and welfare organizations (e.g., Husso et al. 2021). Furthermore, the theme of violence has not become a visible part of the curricula of social and health care education programs, thus failing to equip, for example, graduate professionals from Finnish universities to address DV, even though they may regularly work with violencerelated problems in their practice. According to a Finnish study (Niklander et al. 2019), more than 80% (N = 1642) of the personnel in social and health services reported that they require DV-related additional training, and this issue has been highlighted in the rest of the world as well (e.g., Cleak et al. 2021; Lundberg & Bergmark 2021). Although many professionals effectively intervene daily, their perspectives on successful practices remain under-researched. This study thus investigated the practices of social and health care professionals in successful DV interventions, which refer to the situations in which the professionals helped in ending violence in a VS’s life or otherwise improve their safety (Jarnkvist & Brännström 2019; Kennedy et al. 2024). In these situations, professionals make active use of their professional spaces; they make choices, possess the ability to act accordingly, and uphold professional ethics, ultimately achieving specific outcomes. In other words, they exercise agency (e.g., Eteläpelto etal. 2013; Priestley et al. 2013). A professional’s action that has achieved its intended purpose or produced positive outcomes for VSs can offer insightful perspectives for developing social and health care professional practices and can thus reveal the areas for improvement and the elements necessary for fostering a supportive and conducive environment for those affected by violence. Exercising agency involves both agentic capacity and contextual conditions (Emirbayer & Mische 1998; Eteläpelto et al. 2013), which fit well with addressing DV in social and health care, where professionals’ actions are highly contextualized by the institutionally, culturally, and socially shaped conditions and structures of statutory settings. Recent working-life studies have regarded professional agency as an essential factor in fostering the development of work communities and organizations. Teachers’ agency in educational settings has been widely explored in this manner (e.g., Priestley et al. 2013; Vähäsantanen 2015), and the same goes for professional agency in information technology work (Collin et al. 2017), in elderly care (Carstensen et al. 2022), in hospital organization (Collin et al. 2015), and in decision-making in child protection (Parada etal. 2007). To the author’s knowledge, however, no study has similarly explored the role of professional agency in social and health care for addressing DV. This study examines DV intervention practices considered successful by professionals, with the aim of identifying (1) the areas in which professional agency is manifested and (2) how this agency is exercised. The research widens the conceptual discourse on professional agency to DV interventions in the social and health care context. Its analysis also extends the existing literature by detailing critical factors that could be addressed through DV education, training, and practice development in working life. DV services in Finnish social and health care Finland, despite being considered a welfare state and a model of equality, has a disproportionately high level of violence against women compared to Europeancountries. Nordic journal of working life studies 3 According to an EU-wide study conducted by the European Union Agency for Fundamental Rights (FRA 2014), Denmark, Latvia, Finland, and Sweden have the highest rates of violence against women from their current or previous partners. In Denmark and Latvia, 32% of women reported experiencing physical and/or sexual violence from their partners; similarly, 30% of women in Finland and 28% in Sweden indicated the same. For comparison, the EU average rate of intimate partner violence reported by women was approximately 22%. These figures are significant, as they challenge the assumption that greater gender equality in public and professional life automatically translates to lower rates of gender-based violence. Moreover, notably, in Finland and Denmark, only about 10% of women reported partner violence to the police, compared to the EU average of 20% (FRA 2014). Compared to other Nordic states, the development of DV services in Finland began relatively late in the 1990s and was driven more by feminist groups and international obligations than by a strong national political will. However, significant development efforts have been made in the twenty-first century, particularly in conjunction with the ratification of the Istanbul Convention. The Finnish Social Welfare Act (1301/2014) now mandates that public social services address the support needs of DV victims, although the third sector has also played an active role in providing such services. However, the challenge of identifying violence as a part of basic-level public services persists, with case referrals remaining few and specialist services being underutilized (e.g., Notko et al. 2021; Virkki et al. 2015). In health care, for example, less than 1% of violence survivors are recognized, although the VSs of DV avail health care services 80% more than the rest of the population. Moreover, the cost incurred by physical violence against women in close relationships is EUR 150 million per year (Siltala et al. 2023). The Ministry of Social Affairs and Health (2019) plays a central role in planning and steering the execution of the obligations outlined in the Istanbul Convention to prevent and combat DV. Although these guidelines have been issued in collaboration with the Finnish Institute for Health and Welfare, they have been practically implemented through mainly short-term and disparate development projects. Examining the implementation of a Finnish DV service model, Husso and colleagues (2021) reported serious challenges and uncertainties in fostering and sustaining the implemented practices in the specialized health care, partly due to the low commitment of managerial levels, which may convey to the staff that DV interventions are not considered important or integral to their work. Instead of comprehensively reviewing and reorganizing basic tasks, the tendency in the implementation of national guidelines seems to be to reinvent the wheel by initiating new development projects. Besides the significant wastage of economic and human resources in the long run, researchers have highlighted that the ongoing development efforts and continuous changes may cause ‘development fatigue’ (Husso et al. 2021), a scenario Priestley and colleagues (2015) referred to as the paradox of innovation without change. In summary, DV services in welfare organizations have not been uniform, producing variations in service provision and access to assistance across different areas within the public service system (e.g., Husso et al. 2021; Siltala et al. 2023). In 2023, Finland underwent one of its most significant social and health care system reforms in history (see Kangas & Kalliomaa-Puha 2022 for more details). Presently, well-being service counties, serving as regional entities, are responsible for organizing and delivering social and health care services in their designated areas. According to the report of the FinnishInstitute for Health and Welfare (Krogell & Niklander 2023), the situation 4 Exploring Professional Agency in Domestic Violence Interventions Sisko Piippo regarding DV service provision and coordination still varies significantly in these service counties. Professional agency Professional agency was conceptualized as the actions and enactments professionals undertake in the context of their working life (Vähäsantanen et al. 2022). A subjectcentered, sociocultural perspective on agency was adopted, drawing upon the theoretical frameworks from social science, post-structural research traditions, as well as sociocultural, life course, and identity theories (Eteläpelto et al. 2013). Professionals’ resources, activities, and choices for DV interventions are interconnected with the sociocultural, institutional, and organizational elements and structures of social interaction in their work communities (Collin et al. 2015; Emirbayer & Mische 1998; Eteläpelto et al. 2013). As Eteläpelto et al. (2013, p. 62) stated, ‘Professional agency is always exercised for certain purpose’. Agency’s intentional nature is affirmed when an individual has several options to choose from, and the chosen action leads to specific outcomes based on the individual’s choice (Priestley et al. 2015). Conscious, goal-oriented action involves the power to choose between possibilities and the ability to act accordingly (Eteläpelto et al. 2013). Moreover, agency is driven by motivation, as it is associated with the intention to create a future that diverges from one’s current and past circumstances (Priestley etal. 2015). Professionals’ actions are thus influenced by temporal factors, which encompass the interactions between their past experiences, present actions, and future goals (e.g., Emirbayer & Mische 1998; Hitlin & Elder 2007; Priestley et al. 2015). Although agency is exercised in the present, such as when encountering VSs, it is informed by both personal and professional past experiences, and any professional action is shaped by the future, with a structured and proactive orientation toward setting aims for work and while planning actions. Agency is also linked to efforts aimed at change, involving active and purposeful actions to improve one’s working conditions (Collin et al. 2015; Priestley et al. 2015; Vähäsantanen et al. 2022). However, agency can serve different purposes, including resisting changes and striving to maintain the existing conditions (e.g., Eteläpelto et al. 2013, p. 61; Vähäsantanen 2015). Regarding the intentional and purpose-driven actions and decision-making processes of educated professionals, it is essential to consider the knowledge necessary for them to perform competently in their professional roles. Agency’s epistemic dimension refers to knowledge and knowing, and as an epistemic agent, a professional is responsible for both what they know and what they do not know (Damsa et al. 2010; Reed 2001, p. 18). Exercising epistemic agency involves taking knowledge-related actions, such as gathering and using information. Professionals draw upon diverse forms of knowledge to assess VSs’ life situations and identify their service needs, including those related to DV exposure. Complex phenomena, such as DV, do not have an inherent way of manifesting themselves; instead, they are constructed from explicit and implicit information provided by clients (Virkki et al. 2015). To transform the sometimes unclear Nordic journal of working life studies 5 signs and hints into a problem that can be addressed, professionals must formalize them, and the organizational context influences whether a phenomenon is interpreted as a professionally relevant target problem (Kadzin 2011). Epistemic agency also sees people as ‘productive participants in these knowledge-laden, object-driven activities’ (Damsa etal. 2010, pp. 459–469), highlighting knowledge sharing and collective learning (Damsa etal. 2010). Furthermore, relational agency (Collin et al. 2015) is necessary for cooperation among stakeholders in multi-professional work that addresses DV. Professionals assess and define VSs’ situations from their own perspectives, build a shared understanding, and share responsibilities and roles for interventions. Agency is thus exercised when professionals, both as individuals and groups, use and construct knowledge, make choices, and take stances in their work (Eteläpelto et al. 2013). Alongside subject-centered sociocultural theory, professional agency has also been approached from the perspectives of emotions. The emotional dimension associated with exercising agency highlights the significance and influence of emotions on professionals’ actions and decisions (e.g., Hökkä et al. 2019, 2022). In ethically and morally demanding DV intervention practices, emotional dimension underscores the role of emotions in shaping professionals’ perceptions, motivations, and responses (e.g., Piippo et al. 2021). In summary, agency is not a singular trait—instead, it is an individual’s autonomous capacity to do, implement, or achieve something within specific institutional and sociocultural conditions. These conditions can both facilitate and constrain a professional’s actions. For instance, teachers’ autonomy and agentic actions may be limited by top-down administrative directives, rigid curriculum frameworks, or standardized testing requirements (e.g., Priestley et al. 2015; Vähäsantanen 2015). In welfare service practices, proceduralization and standardization per se have been perceived negatively (e.g., Parada et al. 2007). Conversely, social and health care professionals have identified the lack of guidelines and instructions within and between organizations as significant obstacles to addressing DV (e.g., Coicolea et al. 2023; Notko et al. 2021; Virkki et al. 2015). As Priestley (2015) stated, the lack of regulations does not necessarily equate to agency, and agency may be enhanced by policies that specify goals and processes. In addition, it is crucial to acknowledge that social and health care institutions differ significantly from school institutions, as teachers’ work is inherently subject to more national-level regulation, including adherence to curriculum standards. Methods Ten focus group interviews were conducted with 45 professionals working in social and health care (Table 1). The interviews were conducted as part of the EU-funded development and research project named Enhancing Professional Skills and Raising Awareness on Domestic Violence, Violence against Women and Shelter Services (EPRAS) (Niklander et al. 2019). The study was approved by the ethics committee of the University of Jyväskylä. The COREQ reporting guidelines for qualitative studies were followed (Tong et al. 2007). 6 Exploring Professional Agency in Domestic Violence Interventions Sisko Piippo Table 1 Focus group participants (n = 45). Group type Interviewees Total 1. Shelter A social worker and three counselors 4 2. MARAC1 group A health care social worker, a deacon, a police officer, a psychologist, and an adult social worker 5 3. Family counseling unit A social worker and three psychologists 4 4. Multi-professional group Two social workers (child protection and family counseling unit), a nurse, and a counselor 4 5. Elderly care Two adult social workers, two nurses, and a counselor 5 6. Shelter Two social workers and two counselors 4 7. Shelter Four counselors 4 8. Multi-professional group Three social workers (child protection and family counseling unit), two nurses, and a deacon 6 9. Child protection Two social workers 2 10. Child protection Six social workers and a counselor 7 Data collection This study aimed to interview experienced professionals working in different fields, but at the same operational level in addressing violence (Brinkmann & Kvale 2018; Farnsworth & Boon 2010). The professionals were recruited from six locations, including both larger cities and rural municipalities. It would have benefited this study to include professionals from disability services and addiction services, as their client groups are highly vulnerable to violence, but participation was voluntary. Additionally, the interviewees were recruited in collaboration with the contact persons from the organizations and municipalities that were cooperative partners in the EPRAS project. These contacts played an active role in assembling the focus groups. The final interviewee selection, especially in smaller locations, was also influenced by the professionals’ workload and their availability for interviews, which took place in 2017. The selected interviewees were women with a Finnish ethnic background, and their average work experience was approximately 10 years, ranging from 2 to 38 years. The researchers and interviewees were not acquainted with each other. Regarding the objectives and implementation of the study and their rights, the interviewees were informed in advance. Written consent was provided before the interviews, which were conducted at the interviewees’ workplaces by one to three female researchers, including two with Ph.D. qualifications and one Ph.D. scholar. The researchers had experiences in interviewing professionals, using the focus group interview method, and researching DV-related topics. The following themes were discussed: • Encountering DV in one’s occupation • DV-related education in basic education and during one’s career • DV-related training needs • DV and multi-professional cooperation • Prerequisites and possibilities for tackling DV in one’s work Nordic journal of working life studies 7 Although the researchers posed questions based on each theme, they gave the interviewees sufficient space to present their views without overly strict guidance. The focus group method was chosen for data collection, as it enables researchers to identify and map a theme’s different aspects and monitor the development of discussions in which the interviewees justify their views (Farnsworth & Boon 2010; Fern 2001). When necessary, the researchers took on the role of moderators to ensure that everyone received equal opportunities to participate inthe discussions and to support the interactions between participants (Brinkmann & Kvale 2018). The researchers recorded the interviews, which had an average duration of 1.5 hours, in both audio and video formats and transcribed them verbatim. To ensure anonymity, any identifiable references to the focus groups or interviewees were replaced with numbers: in the extracts, “G” denotes the focus group number, and “P” the participant number. Limitations For a sole-authored article with data analyzed by a single author, relying on the analyst’s perspective may limit the breadth of interpretations and the depth of insights gained from the data. However, to maintain reflexivity and ensure rigor in the analysis process, the author enhanced the analysis by consulting with scholars from diverse social science disciplines. Concurrently, during the analytical phase, the author disseminated preliminary findings at multiple seminars and conferences, thereby leveraging the received feedback to augment the research. The relatively small sample size might limit the results’ broad generalization. However, as per the analysis, the interviewees’ experiences with DV interventions yielded rich data, and the sample size proved adequate for achieving thematic saturation in the data (Farnsworth & Boon 2010; Liamputtong 2020). The interviewees, it must be noted, were recruited from organizations involved in the EPRAS project, which means that they could be more aware of DV compared to the general social and health care population. It should be emphasized, however, that the EPRAS project had not organized any DV-related training or other activities for the organizations before the interviews. The purposive sample, while a limitation, offers valuable insights. Given this study’s focus on successful DV intervention practices, the experienced participants who had already engaged with the topic provided relevant insights applicable to various service system contexts. A careful step-by-step analysis of the rich data was conducted and reported. The study faced homogeneity in gender and ethnic background among its participants, which may limit the results’ generalizability to more multicultural social and health care contexts. Even if this homogeneity aptly reflects both the ethnically homogeneous nature of Finnish society and female dominance in social and health care, considering social and health care in different contexts, more research is needed on diversity and intersectionality for developing DV interventions (e.g., Allen-Leap et al. 2023; Etherington & Baker 2018). Commitment at the organizational level may have influenced employee participation, potentially creating a sense of duty rather than a genuine interest in cooperation (Liamputtong 2020). The participants were thus clearly informed of their voluntary participation, and their right to withdraw their consent without consequences at the beginning of the interviews was emphasized. No participant, it is worth noting, declined to participate in the interviews, and no one withdrew their consent afterward. 8 Exploring Professional Agency in Domestic Violence Interventions Sisko Piippo Data analysis Using thematic content analysis (Braun & Clarke 2006), the data was coded into firstorder concepts, second-order themes, and aggregate theoretical dimensions (Gioia et al. 2012 pp. 20–22). The data structure is summarized in Figure 1. Figure 1 Data structure. To identify professional agency, the transcripts were first read and re-read, focusing on how the professionals described their practices in DV interventions, how they helped remove violence from a VS’s life or helped strengthen a VS’s safety in other ways. The practitioners’ experiences, insights, and views of the prerequisites for addressing DV successfully were identified, and their discussions about decision-making, how choices between options were made, how those choices were reasoned and justified, and how acting according to a chosen option was enabled or restricted were all noted (Parada etal. 2007; Priestley et al. 2013). The interviewees’ statements were inductively coded, and the similarities and differences between them were checked to combine them into descriptive, first-order concepts. The second-order themes illustrate different ways of exercising agency. They were formed using a subject-centered sociocultural theory of agency to identify the factors at the micro, meso, and macro levels that affect the exercise of agency in DV interventions. Four levels were identified: individual, relational, organizational, and societal. Exercising agency at each level was examined more closely, and the nuances were analyzed more thoroughly (Table 2). Finally, the aggregate theoretical dimensions grouping the manifestations of professional agency were constructed (Gioia et al. 2012): epistemic, processual, relational, and reflective. Nordic journal of working life studies 15 holding regular meetings with clear agendas, transparent information-sharing practices between professional groups, collaborative decision-making regarding the division of labor, and a clear understanding of the individual responsibilities for the necessary actions and follow-ups after meetings. Reflective agency Reflective agency demonstrates the temporal nature of agency (e.g., Emirbayer & Mische 1998; Hitlin & Elder 2007), as it is exercised in relation to both past and future, involving reflections on the possible consequences of one’s own action and inaction and the emotions evoked by DV. As the extracts below clarify, by reflecting on challenging cases, professionals may develop insights into alternative approaches they might adopt in similar future situations. G10P6 (a social worker): If you ask about [DV], what are the consequences? At that moment, what state of mind are those parents in? On the other hand, it need to be addressed; you always have to protect the child. G5P5 (a nurse): Yes, I think I made a mistake. So, I didn’t think about the consequences. It was a good idea, but things didn’t go like in Strömsö.2 Reflective agency manifests as the meticulous consideration of the potential consequences and future implications of a professional’s decisions, including the possible ramifications of inaction (Hökkä et al. 2019; Parada et al. 2007). The interviewees acknowledged that violence typically does not cease without external intervention (Jarnkvist & Brännström 2019). Inaction on the part of professionals may leave a VS susceptible to further abuse and harm, exacerbating the situation; moreover, a professional, as an authority, might be held responsible for a VS’s potentially severe, even lethal, injuries. At the individual level, exercising reflective agency included recognizing the emotional burden triggered by violence and identifying the factors contributing to it. G5P3 (a nurse): Everything, from irritation to disgust to anger. All possible emotional scales, yet you have to serve the client’s needs, help them progress. Sometimes, you have to acknowledge that there’s nothing you can do about it. After all, we are all masters of our own lives. As a professional, you can’t burn yourself out and try to live the lives of others. G3P1 (a psychologist): How do you keep enough distance? I have learned that, too; earlier, I didn’t know how. It was the worst violence case I’d had in my career; there were so many forms [of violence], and there were injuries, permanent damage in her limbs. Still, they stayed together, even though we tried to help, but they stayed together. I was afraid that she would die. So, I felt I lost to that man. I had a dream where I lost a power struggle to that man over that woman. Now, I understand 16 Exploring Professional Agency in Domestic Violence Interventions Sisko Piippo that I went along with it in some way, that I should be a part of that struggle for power. I couldn’t keep enough distance. After all, it is a person’s own choice. If a professional has taken all the actions within their authority, but the VS, for example, refuses to leave a violent partner, respecting that VS’s autonomy may oblige the professional to step aside. This, in turn, may cause moral distress and require the professional to distance themselves from the situation. Besides, encountering DV can prompt professionals to reflect on their own personal experiences, values, and principles, bringing them face-to-face with their own vulnerability as humans. As a social worker from the shelter noted, ‘In general, the essential thing is that one has somehow dealt with one’s own attitudes and history of violence’ (G6P2). However, intense emotions, including negative ones, are considered a natural aspect of the work, and the ability to manage them is acquired through work experience. In addition, a supportive work community is highly valued. G1O2 (a shelter counselor): And that kind of frustration might be so momentary for a certain thing. And then, in a way, when you say it out and ventilate your own thoughts, then it’s already gone through and forgotten. Reflection extends to the collective level when challenging cases, and ethically demanding decisions are discussed with colleagues. In addition to managing distressing and painful emotions, exercising reflective agency also involves identifying the positive emotions professionals experience when applying their expertise. G2P3 (a psychologist): But if I succeed in getting [a client] to work with it then, frankly, I’m excited because I know I have something to give, that I’m able to do it. G9P1 (a social worker): I don’t know the right word; such a positive feeling when you kind of make that breakthrough. Somehow, [DV] comes up, someone dares to say it. It’s like it brings a different kind of drive to the job when you can talk openly and directly about that thing. Positive emotions stem from professionals feeling that their work is meaningful and from their own capacity to act (Hökkä et al. 2019). They also feel success and joy when a VS recognizes violence and seeks help; for professionals, this creates the possibility of improving the VS’s difficult life situation. Disclosing DV can also help professionals understand the VS’ vulnerable living conditions and facilitate open communication about the issue. Furthermore, as a counselor admitted, ‘I have to say that I also admire a person who has survived such brutal situations’ (G4P1), and such admiration can foster empathy. Conclusion This study examines DV intervention practices considered successful by social and health care professionals, with the aim of identifying (1) the areas in which professional Nordic journal of working life studies 17 agency is manifested and (2) how this agency is exercised. The findings of this study illustrate that professional agency is manifested in various contexts: through understanding DV as a phenomenon and its contextual factors (epistemic agency), launching a process (processual agency), collaborating with other professionals (relational agency), and reflecting on one’s own actions and emotions (reflective agency). Exercising agency in DV interventions underscores the significance of possessing comprehensive knowledge regarding DV as a phenomenon (e.g., Cleak et al. 2021; Jarnkvist & Brännström 2019; Wild 2023). By recognizing the broader societal factors and systemic inequalities that contribute to violence, professionals can help shift the focus away from victim blaming, which, in turn, can contribute to changing the attitudes and beliefs surrounding victimization (Wild 2023). By thoroughly understanding the complexities of a VS’s situation, professionals can offer more empathetic and supportive responses, which can ultimately alleviate the VS’s feelings of shame or self-blame (e.g., Heron & Eisma 2021). A contextual understanding of DV is deemed crucial within public services, where professionals interact with VSs from diverse backgrounds (e.g., Allen-Leap 2023). However, the interviewees of this study left unmentioned relevant social categories such as housing, sexuality, and religion, all of which can influence VSs’ perspectives, experiences of DV, and disclosure options. Similarly, technology-facilitated violence was seldom brought up in the focus group discussions. Continuing education related to DV should be systematically provided to staff within social and health care services. Such training should include a comprehensive overview of DV as a gendered phenomenon, the diversity of its forms, and its consequences. Additionally, educational programs in the social and health care sectors should incorporate DV-related topics into their degree requirements. For example, Swedish legislation mandates the inclusion of DV-related themes in the education of various professional groups within these sectors (Carlsson, 2020). Knowledge about DV is essential for identifying it and is therefore at the core of successful intervention practices. However, as Reed (2001) noted, possessing knowledge does not necessarily translate into appropriate actions. Examining the processual, relational, and reflective forms of agency thus yields vital insights into the factors that contribute to successful DV interventions. Findings of the study emphasize the importance of organizational protocols in facilitating the application of knowledge in practice (see also Lundberg & Bergmark 2018). While prior research on professional agency often perceived established protocols negatively, particularly as constraints on individual autonomy (e.g., Priestley etal. 2015), this study found that, for instance, guidelines and instructions were mostly viewed positively and considered supportive in addressing DV. Several focus group participants highlighted the use of structured working models, such as routinized DV screening, as practices that facilitated their actions, particularly in identifying DV and initiating intervention processes. Nonetheless, some critical perspectives emerged, with interviewees questioning the overall usefulness of existing protocols (e.g., Nordesjö etal. 2022). The scope of this study did not allow for a more detailed analysis of the professionals’ reluctance to implement guidelines and instructions related to asking about DV or the subsequent processes following disclosure. While the findings can illustrate the elements of maintenance in exercising agency (Vähäsantanen 2015), without transformative attempts or even direct and active actions—a concept also referred to as resistant agency (Collin et al. 2015)— an important research topic would have been to investigate 18 Exploring Professional Agency in Domestic Violence Interventions Sisko Piippo how the implementation of new procedures, for instance, has unfolded and to ascertain whether staff members have undergone training and familiarization with these procedures (for a discussion of organizational challenges in implementation, see Husso etal., 2021). According to some interviewees, new methods and tools may currently ‘just appear’ on internal platforms without formal and proper introduction or communication. The interplay between formal and informal practices, as discussed by Carstensen and colleagues (2022), should be considered an important topic in the development and implementation of DV intervention programs. In the data, there are also indications of transformative agency (e.g., Vähäsantanen 2015). Within the work units, there are change-oriented individuals actively focused on DV, whose agency manifests as autonomous and simultaneously as the behavior of a ‘lone wolf’. These professionals independently expand their knowledge and skills regarding DV outside their office hours, actively engage in and interacted with multiprofessional networks as both experts in their own field and learners from other professions, and even unconventionally experiment with new ways of working to achieve the best interests of VSs. Such autonomous employees can undoubtedly act as catalysts for promoting transformative practices at the organizational level, but without collective agency (e.g., Collin et al. 2015) and a drive to develop work as a shared endeavor (Damsa et al. 2010), striving for change remains a personal effort of individual employees. Considering the high turnover of personnel, the possibility of change remains uncertain and vulnerable. In emotionally and ethically demanding work, this becomes a critical aspect of occupational well-being as well. Previous research indicates that the emotional burden triggered by violence, coupled with negative attitudes and prejudices related to violence, constitutes significant barriers to addressing DV (e.g., Keeling & Fisher 2015; Piippo et al. 2021; Wild 2023). The analysis of reflective agency further revealed the profound emotional impact that violence has on professionals. However, beyond the emotional stress and burden, the findings of this study highlight that positive emotions stemming from successful DV interventions can significantly enhance individuals’ perceptions of the importance of their work and their capacity to take action (Hökkä et al. 2019, 2022). It is vital to acknowledge the importance of reflection and to integrate the emotional aspects of addressing DV into broader discussions within social and health care organizations. The significance of positive emotions at work, particularly in relation to work commitment and well-being, should receive more attention in research on DV interventions. References Allen-Leap, M., Hooker, L., Wild, K., Wilson, I. M., Pokharel, B., & Taft, A. (2023). Seeking help from primary health-care providers in high-income countries: A scoping review of the experiences of migrant and refugee survivors of domestic violence, Trauma, Violence & Abuse 24(5): 3715–3731. https://doi.org/10.1177/15248380221137664 Ambrose-Miller, W., & Ashcroft, R. (2016). Challenges faced by social workers as members of interprofessional collaborative health care teams, Health & Social Work 41(2): 101–109. https://doi.org/10.1093/hsw/hlw006 Bellis, M. A., Hughes, K., Ford, K., Ramos Rodriguez, G., Sethi, D., & Passmore, J. (2019). Life course health consequences and associated annual costs of adverse childhood Nordic journal of working life studies 19 experiences across Europe and North America: A systematic review and meta-analysis, Lancet Public Health 4(10): 517–528. https://doi.org/10.1016/S2468-2667(19)30145-8 Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology, Qualitative Research in Psychology 3(2): 77–101. https://doi.org/10.1191/1478088706qp063oa Brinkmann, S., & Kvale, S. (2018). Doing interviews, SAGE Publications Ltd. Carlsson, N. (2020). Lärosätenas utbildningsbehov i frågor om mäns våld mot kvinnor och våld i nära relationer. Göteborg’s Universitet. Institutionen för socialt arbete. Slutrapport. https://www.gu.se/sites/default/files/2021-06/La%CC%88rosa%CC%88tenas%20 utbildningsbehov%20i%20fra%CC%8Agor%20om%20ma%CC%88ns%20va%CC%8Ald_Slutrapport_200712sista.pdf Carstensen, K., Burau, V., Dahl, H. M., & Nielsen Hald, A. (2022). How welfare professions contribute to the making of welfare governance: Professional agency and institutional work in elder care,Journal of Social Policy 51(4): 900–919. https://doi.org/10.1017/ S0047279421000271 Cleak, H., Hunt, G., Hardy, F., Davies, B., & Bell, J. (2021). Health staff responses to domestic and family violence: The case for training to build confidence and skills, Australian Social Work 74(1): 42–54. https://doi.org/10.1080/0312407X.2020.1808029 Goicolea, I., Bäckström, H., Lauri, M., Carbin, M., & Linander, I. (2023). Daring to ask about violence? A critical examination of social services’ policies on asking about gender-based violence, Journal of Gender-Based Violence7(3): 467–482. https://doi.org/10. 1332/239868021X16914328798715 Collin, K., Paloniemi, S., & Vähäsantanen, K. (2015). Multiple forms of professional agency for (non)-crafting work practices in a hospital organization, Nordic Journal of Working Life Studies 5(3a): 63–83. https://doi.org/10.1080/0312407X.2020.1808029 Collin, K., Lemmetty, S., Herranen, S., Paloniemi, S., Auvinen, T., & Riivari, E. (2017). Professional agency and creativity in information technology work. In M. Goller & S. Paloniemi (Eds.),Agency at work: An agentic perspective on professional learning and development (pp. 249–270). Cham: Springer. https://doi.org/10.1007/978-3-31960943-0_13 Crenshaw, K. (1991). Mapping the margins: Intersectionality, identity politics, and violence against women of color, Stanford Law Review 43(6): 1241–1299. https://www.jstor.org/ stable/1229039 Damşa, C. I., Kirschner, P. A., Andriessen, J. E. B., Erkens, G., & Sins, P. H. M. (2010). Shared epistemic agency: An empirical study of an emergent construct,Journal of the Learning Sciences 19(2): 143–186. https://doi.org/10.1080/10508401003708381 Emirbayer, M., & Mische, A. (1998). What is agency? The American Journal of Sociology 103(4): 962–1023. https://doi.org/10.1086/231294 Eteläpelto, A., Vähäsantanen, K. Hökkä, P. K., & Paloniemi, S. (2013). What is agency? Conceptualizing professional agency at work, Educational Research Review 10: 45–65. https://doi.org/10.1016/j.edurev.2013.05.001 Etherington, N., & Baker, L. (2018). From “buzzword” to best practice: Applying intersectionality to children exposed to intimate partner violence, Trauma, Violence, & Abuse 19(1): 58–75. https://doi.org/10.1177/1524838016631128 Farnsworth, J., & Boon, B. (2010). Analysing group dynamics within the focus group, Qualitative Research 10(5): 605–624. https://doi.org/10.1177/1468794110375223 Ferguson, H. (2018). How social workers reflect in action and when and why they don’t: The possibilities and limits to reflective practice in social work, Social Work Education, 27(4): 415–427. https://doi.org/10.1080/02615479.2017.1413083 FRA (2014). European Union Agency for Fundamental Rights. EU-wide survey: Violence against women. Main results report. https://fra.europa.eu/en/publication/2014/violenceagainst-women-eu-wide-survey-main-results-report. 20 Exploring Professional Agency in Domestic Violence Interventions Sisko Piippo Gioia, D., Corley, K., & Hamilton, A. (2012). Seeking qualitative rigor in inductive research: Notes on the Gioia methodology, Organizational Research Methods 16(1): 15–31. https://doi.org/10.1177/1094428112452151 GREVIO. (2019). Istanbul convention: Baseline evaluation report Finland. Council of Europe. https://rm.coe.int/grevio-report-on-finland/168097129d Heron, R. L., & Eisma, M. C. (2021). Barriers and facilitators of disclosing domestic violence to the healthcare service: A systematic review of qualitative research, Health & Social Care in the Community 29(3): 612–630. https://doi.org/10.1111/hsc.13282 Hitlin, S., & Elder, G. H. (2007). Time, self, and the curiously abstract concept of agency, Sociological Theory 25(2): 170–191. https://doi.org/10.1111/j.1467-9558.2007.00303.x Husso, M., Notko, M., Virkki, T., Holma, J., Laitila, A., & Siltala, H. (2021). Domestic violence interventions in social and health care settings: Challenges of temporary projects and short-term solutions, Journal of Interpersonal Violence 36(23–24): 11461–11482. https://doi.org/10.1177/08862605198984 Hökkä, P., Vähäsantanen, K., Paloniemi, S., Herranen, S., & Eteläpelto, A. (2019). Emotions in leaders’ enactment of professional agency, Journal of Workplace Learning 31(2): 143–165. https://doi.org/10.1108/JWL-07-2018-0086 Hökkä, P., Vähäsantanen, K. & Ikävalko, H. (2022). An integrative approach to emotional agency at work, Vocations and Learning 16: 23–46. https://doi.org/10.1007/s12186-022-09299-3 Jarnkvist, K., & Brännström, L. (2019). Stories of victimization: Self-positioning and construction of gender in narratives of abused women, Journal of Interpersonal Violence 34(21–22): 4687–4712. https://doi.org/10.1177/0886260516676 Kadzin, A. E. (2011). Conceptualizing the challenge of reducing interpersonal violence, Psychology of Violence 1(3): 166–187. https://doi.org/10.1037/a0022990 Kangas, O. & Kalliomaa-Puha, L. (2022). Finland finalises its largest-ever social and healthcare reform. European Comission. European Social Policy Network. ESPN Flash Report 2022/39. https://ec.europa.eu/social/main.jsp?pager.offset=20&advSearchKey=ESPNFlash&mode=advancedSubmit&catId=22&doc_submit=&policyArea=0&policyAreaSub=0&country=0&year=0 Keeling, J., & Fisher, C. (2015). Health professionals’ responses to women’s disclosure of domestic violence, Journal of Interpersonal Violence 30(13): 2363–2378. https://doi. org/10.1177/0886260514552449 Kennedy, A. C, Prock, K. A, Adams, A. E, Littwin, A., Meier, E., Saba, J., & Vollinger, L. (2024). Can this provider be trusted? A review of the role of trustworthiness in the provision of community-based services for intimate partner violence survivors, Trauma, Violence, & Abuse 25(2): 982–999. https://doi.org/10.1177/15248380231168641 Krogell, J. & Niklander, E. (2023) Lähisuhdeväkivallan ehkäisyn rakenteet vaihtelevat eri puolilla maata – koordinaattoriverkostosta tukea ohjeiden toimeenpanoon. Tutkimuksesta tiiviisti 64/2023. Terveyden ja hyvinvoinnin laitos, Helsinki. [The structures for the prevention of intimate partner violence vary across the country – A coordinator network to support the implementation of guidelines. Results in brief 64/2023. Finnish Institute for Health and Welfare] https://urn.fi/URN:ISBN:978-952-408-238-9 Liamputtong, P. (2020). Qualitative research methods. 5th ed. Oxford University Press. Lundberg, L., & Bergmark, Å. (2021). Self-perceived competence and willingness to ask about intimate partner violence among Swedish social workers, European Journal of Social Work 24(2): 189–200. https://doi.org/10.1080/13691457.2018.1540970 Ministry of Social Affairs and Health. (2019). Combatting domestic and intimate partner violence. https://stm.fi/en/combating-domestic-violence Niklander, E., Notko, M., & Husso, M. (eds.) (2019). Intervening in domestic violence and training of professionals in social services and health care and the police: Evaluation of the EPRAS project. Report 15/2019, Helsinki: National Institute for Health and Welfare, Finland. http://urn.fi/URN:ISBN:978-952-343-413-4 Nordic journal of working life studies 21 Nordesjö, K., Ulmestig, R. and Denvall, V. (2022). Coping with tensions between standardization and individualization in social assistance, Nordic Social Work Research 12: 435–49. https://doi.org/10.1080/2156857X.2020.1835696 Notko, M., Husso, M., Piippo, S., Fagerlund M. & Houtsonen, J. (2021). Intervening in domestic violence: Interprofessional collaboration among social and health care professionals and the police, Journal of Interprofessional Care 36(1): 15–23. https://doi.org/10. 1080/13561820.2021.1876645 Parada, H., Barnoff, L., & Coleman, B. (2007). Negotiating ‘professional agency’: Social work and decision-making within the Ontario child welfare system, Journal of Sociology and Social Welfare 34(4): 35–56. DOI: 10.15453/0191-5096.3293 Piippo, S., Husso, M., Hirvonen, P., Notko, M., & Glumbíková, K. (2021). Institutional and affective practices of domestic violence interventions in social work: Malignant positioning of victims. In: Husso M., Karkulehto S., Saresma T., Laitila A., Eilola J., & Siltala H. (eds) Violence, gender and affect. Palgrave studies in victims and victimology, Cham: Palgrave Macmillan. https://doi.org/10.1007/9783-030-56930-3_6 Priestley, M., Biesta, G. J. J., Philippou, S., & Robinson, S. (2015). The teacher and the curriculum: exploring teacher agency. In: D. Wyse, L. Hayward & J. Pandya (eds.), The SAGE Handbook of Curriculum, Pedagogy and Assessment. Sage. http://hdl.handle. net/1893/21687 Reed, B. (2001). Epistemic agency and the intellectual virtues, The Southern Journal of Philosophy 39: 507–26. https://doi.org/10.1111/j.2041-6962.2001.tb01831.x Siltala, H., Hisasue, T., Hietamäki, J., Saari., J. Laajasalo, T., October, M., Laitinen, H.L., & Raitanen, J. (2023). Domestic violence–related use of services and the resulting costs in health, social and legal services. Prime Minister’s Office Helsinki. https://julkaisut.valtioneuvosto. fi/bitstream/handle/10024/164566/VNTEAS_2023_4.pdf?sequence=1&isAllowed=y Statistics Finland. (2023). Rikosja pakkokeinotilasto [Statistics on offences and coercive measures]. Cases of domestic violence committed by a cohabiting partner reported to the authorities increased by 21.2 per cent in 2022 – Statistics Finland Tong, A., Sainsbury, P. & Graig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups, International Journal for Quality in Health Care 19(6): 349–357. https://doi.org/10.1093/intqhc/mzm042 Virkki, T., Husso, M., Notko, M., Holma, J., Laitila, A. & Mäntysaari, M. (2015). Possibilities for intervention in domestic violence: Frame analysis of health care professionals’ attitudes, Journal of Social Service Research 41(1): 6–24. https://doi.org/10.1080/01488376. 2014.917449 Vähäsantanen, K. (2015). Professional agency in the stream of change: Understanding educational change and teachers’ professional identities, Teaching and Teacher Education 47: 1–12. https://doi.org/10.1016/j.tate.2014.11.006 Vähäsantanen, K., Räikkönen, E., Paloniemi, S., & Hökkä, P. (2022). Acting agentically at work: Developing a short measure of professional agency, Nordic Journal of Working Life Studies 12(1): 49–69. https://doi.org/10.18291/njwls.127869 Wild, J. (2023). Gendered discourses of responsibility and domestic abuse victim-blame in the English children’s social care system, Journal of Family Violence 38: 1391–1403. https:// doi.org/10.1007/s10896-022-00431-4 Notes 1 A Multi-Agency Risk Assessment Conference (MARAC) is a coordinated meeting where multiple agencies collaborate to assess and manage the risks faced by high-risk DV victims. 2A Finnish saying that means that things did not go smoothly despite having a good plan.