Understanding help-seeking barriers after Gender-Based Violence: Validation of the Barriers to Help Seeking-Trauma version (BHS-TR).

It is a devastating and tragic estimate that 35% of women worldwide have experienced either physical or sexual violence at some point in their lives (United Nations, 2015) (referred to hereafter as Gender-Based Violence, or GBV). While most research focuses on reducing violence, understanding power and control in families, and evaluating services, this study focuses on overcoming trauma recovery barriers. We document the development and psychometric properties of the development of the Barriers to Help Seeking for Trauma Scale (BHS-TR) scale conducted with 309 GBV survivors. EFA and CFA confirmed a 7-factor solution that explained 68.4% of the variance, with an alpha reliability of 0.87. Factors were Shame, Frozen/Confused, Problem Management beliefs, Unavailable, Financial Concerns, Discrimination, and Constraints. Convergent validity was found with Sense of Coherence (SOC) and Beliefs about Mental Illness (BMI), and external validity was found with all the subscales and depression/PTSD except Problem Management beliefs. Cluster analysis was used to confirm that the barriers factors grouped into Internal and External Barrier dimensions. Regression showed that BMI predicted 24% of External Barriers variance, and SOC predicted 20% of the variance of the Internal barriers. Implications include the need to understand the breadth of help-seeking survivors engage in, differentiate the varieties of barriers from shame and stigma, and work with survivors "where they are" to address perceived barriers.