Skip to main content

Violence and Abuse in Rural America – Models and Innovations

These stories feature model programs and successful rural projects that can serve as a source of ideas and provide lessons others have learned. Some of the projects or programs may no longer be active. Read about the criteria and evidence-base for programs included.

Effective Examples

Wyoming Trauma Telehealth Treatment Clinic
Updated/reviewed February 2019
  • Need: To provide psychotherapy to survivors of domestic violence and sexual assault.
  • Intervention: University of Wyoming psychology doctoral students provide psychotherapy via videoconferencing to crisis center clients in two rural locations.
  • Results: Clients, student therapists, and crisis center staff were satisfied with the quality of services, and clients reported reduced symptoms of depression and PTSD.
Domestic Violence Enhanced Home Visitation Program (DOVE)
Added December 2018
  • Need: To reduce violence against pregnant women and women with infants in rural Missouri.
  • Intervention: A tool for existing home visiting programs, DOVE is a brochure-based and safety planning intervention for women experiencing interpersonal violence.
  • Results: Women receiving the DOVE intervention saw a larger average decrease in number of violent incidents than women in the control group.

Promising Examples

STAIR (Skills Training in Affective and Interpersonal Regulation)
Updated/reviewed January 2019
  • Need: To increase access to telemental health services for rural veterans, especially women, with a history of trauma.
  • Intervention: STAIR (Skills Training in Affective and Interpersonal Regulation) is a 10-week program designed to reduce PTSD and depression symptoms and increase emotional regulation and social functioning in clients.
  • Results: Therapists reported that clients attended more sessions when offered via teleconferencing, and clients reported satisfaction with the program.

Other Project Examples

Mitchell Area Safehouse and Family Visitation Center
Updated/reviewed November 2019
  • Need: To provide victims of domestic violence a safe space, advocacy, education, and family support services.
  • Intervention: The Mitchell Area Safehouse and Family Visitation Center in rural South Dakota provides emergency/transitional housing, support groups, and community education.
  • Results: In 2018, Mitchell Area Safehouse answered 1,061 crisis calls, provided shelter for 206 survivors, and advocated for 847 survivors.
Together We Can Be Bully Free
Updated/reviewed November 2019
  • Need: Union Parish, a rural county in Louisiana, was experiencing higher than average suicide rates among youth.
  • Intervention: Union General Hospital, a Critical Access Hospital, started a program to educate students grade 4 through 12 on the negative effects of bullying and how to model positive social behavior.
  • Results: The 3,000+ students trained have learned how to recognize, report, and react to bullying.
funded by the Federal Office of Rural Health Policy Butte Child Evaluation Center
Updated/reviewed September 2019
  • Need: Before 2000, Butte and southwest Montana had around 1,300 cases of child abuse a year, with only a 20% conviction rate for perpetrators of sexual abuse.
  • Intervention: Multiple agencies in the community came together to address the issue of child abuse by forming the Butte Child Evaluation Center (CEC), a Children's Advocacy Center.
  • Results: During a 3-year grant cycle, over 200 interviews and exams were performed on victims of sexual abuse and the Butte CEC became the first program in Montana to be accredited by the National Children's Alliance.
funded by the Federal Office of Rural Health Policy Family Advocacy Network
Updated/reviewed September 2019
  • Need: A service to address the high number of child abuse cases reported in Nebraska in the late 1990s.
  • Intervention: The Family Advocacy Network (FAN) was developed to assist in the investigations of child abuse cases. FAN provides forensic interviews, forensic medical examinations, hair follicle testing, case coordination, advocacy, and education to help prevent revictimization.
  • Results: FAN helped over 600 children and 23 adults in 2016, as well as educated hundreds of healthcare and community professionals.
Schoharie County ACEs Team
Updated/reviewed July 2019
  • Need: Agencies in Schoharie County, New York were seeing a widespread trend of Adverse Childhood Experiences (ACEs) in children and families they served.
  • Intervention: The Schoharie ACEs Team was formed as a way to educate rural communities about ACEs, the brain science behind it, and ways to build resiliency.
  • Results: The ACEs Team has put on 4 half-day educational conferences and 10 trainings for various groups across the region, trained 3 school districts on trauma-informed care, and provided resources for families exposed to trauma.
Hands of Hope In-School Prevention Program
Updated/reviewed May 2019
  • Need: To reduce and prevent abuse and violence in rural Grant County, Indiana.
  • Intervention: A prevention program uses age-appropriate materials to teach children from Head Start through high school about topics like healthy relationships and nonviolent ways to deal with anger.
  • Results: Surveys show that teachers appreciate the presentations and that students learn more about these topics, strategies they can use in violent situations, and available resources.
funded by the Health Resources Services Administration Futures Without Violence in Tillamook County
Updated/reviewed April 2019
  • Need: To address intimate partner violence (IPV) in primary care settings as a health concern. To increase healthcare providers' professional understanding about its prevalence and adverse impacts on patient health.
  • Intervention: In partnership with Safer Futures, Tides of Change provides an advocate at a local health clinic to give confidential services to IPV survivors and training to medical staff. The advocate uses curriculum and other materials designed by Futures Without Violence.
  • Results: Healthcare providers at the clinic reported increased understanding of IPV and its impact on health. As a result, IPV advocates received an increase in referrals from healthcare providers. Patients experiencing IPV reported a reduction in chronic, toxic stress and improved overall health after receiving advocacy services.
Sexual Assault Nurse Exams through the National TeleNursing Center
Updated/reviewed April 2019
  • Need: Clinicians in rural areas are often unprepared to treat sexual assault victims after an assault.
  • Intervention: The National TeleNursing Center (NTC) in Massachusetts uses telemedicine to connect Sexual Assault Nurse Examiners to clinicians in remote areas, offering them guidance through examinations.
  • Results: Clinicians report that the help gives them confidence through the examination process and NTC has assisted in the care of over 300 patients.
Canyon Creek Services
Updated/reviewed January 2019
  • Need: To reduce and prevent domestic violence and sexual assault in Utah's rural Beaver, Garfield, and Iron counties.
  • Intervention: Canyon Creek Services provides a 24/7 emergency hotline, emergency shelter, hospital response, and community education.
  • Results: From July 2017 to June 2018, CCS served over 720 survivors, 202 of them seeking emergency shelter. CCS presented within the community 56 different times with 1,443 participants.
Eastern Plains Sexual Assault Response Team (EPSART)
Updated/reviewed December 2018
  • Need: To support victims after sexual assault and to collaborate and streamline processes for victim-centered care.
  • Intervention: The EPSART holds monthly team meetings, case review, and opportunities for team training.
  • Results: Enhanced victim and public safety by facilitating investigations and successful prosecutions.
Fostering Futures in Menominee Nation
Updated/reviewed September 2018
  • Need: Since the late 1800's, trauma caused by historic events have greatly affected the way of life for Menominee Indians living on the Menominee Reservation. Economic, socioeconomic, behavioral health, and physical health issues have risen and are causing direct implications for Menominee youth.
  • Intervention: Through Fostering Futures, clinic, school, and Head Start/Early Head Start staff are trained in administering trauma-informed care and building resilience among children.
  • Results: Behavioral health visits at the Menominee Tribal Clinic have increased, school suspension rates have decreased, and graduation rates have improved from 60% to 85% since 2008.
Jana's Campaign: Love Doesn't Hurt
Added June 2018
  • Need: Prevention and education programs for schools to reduce gender and relationship violence among teenagers.
  • Intervention: Jana's Campaign offers school-based trainings, presentations, projects, and consultations through Love Doesn't Hurt: Teen Gender Violence and Prevention Program.
  • Results: So far, 490 middle and high schools and more than 53,000 students in Kansas, Nebraska, and Colorado have benefited from the program.

Last Updated: 11/7/2019