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Children Exposed to Domestic Violence

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Mary To

on 18 April 2013

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Transcript of Children Exposed to Domestic Violence


group breaks the isolation felt, allowing them to tell their stories in the presence of others (Peled & Davis, 1995)
Retelling/reenacting a traumatic event in the safety of a therapeutic environment can be healing in of itself (Pynos & Eth, 1986)
Children see that they are not alone in their struggles, this helps them reach/connect out to others (Nisivoccia & Lynn, 1999) Children Exposed to Domestic Violence Introduction Effects Treatment Considerations Includes: physical, sexual, psychological assaults, and attacks against property or pets. Exposure to domestic violence can have a huge impact on the psychological, behavioral, cognitive, physical, and social aspects of a person's life. Approaches: Challenges Goals: Efficacy: Psychological Behavioral Cognitive Short term outcomes:

Long term outcomes: References: Anda, R. F., Brown, D. W., Felitti, V. J., Bremner, J., Dube, S. R., & Giles, W. H. (2007). Adverse childhood experiences and prescribed psychotropic medications in adults. American Journal Of Preventive Medicine, 32(5), 389-394. doi:10.1016/j.amepre.2007.01.005

Anda, R. F., Felitti, V. J., Bremner, J., Walker, J. D., Whitfield, C., Perry, B. D., Dube, S. R., & Giles, W. H. (2006). The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archives Of Psychiatry And Clinical Neuroscience, 256(3), 174-186. doi:10.1007/s00406-005-0624-4

Bureau of Justice Statistics (2000). Intimate partner violence statistics, available online at http://www.ojp.usdoj. gov/bjs/

Corey, M., Corey, G., & Corey, C. (2010). Groups: Process and practice (8th ed.). Belmont,CA: Brooks=Cole.

Dube, S. R., Anda, R. F., Felitti, V. J., Edwards, V. J., & Williamson, D. F. (2002). Exposure to abuse, neglect and household dysfunction among adults who witnessed intimate partner violence as children: Implications for health and social services. Violence And Victims, 17(1), 3-18. doi:10.1891/vivi.17.1.3.33635

Futa, K. T., Nash, C. L., Hansen, D. J., & Garbin, C. P. (2003). Adult Survivors of Childhood Abuse: An Analysis of Coping Mechanisms Used for Stressful Childhood Memories and Current Stressors. Journal Of Family Violence, 18(4), 227-239.

Griffing, S., Lewis, C. S., Chu, M., Sage, R., Jospitre, T., Madry, L., & Primm, B. J. (2006). The Process of Coping with Domestic Violence in Adult Survivors of Childhood Sexual Abuse. Journal Of Child Sexual Abuse, 15(2), 23-41.

Groves, B. M. (1999). Mental health services for children who witness domestic violence. The Future of Children: Domestic Violence and Children, 9(3).

Hurley, D.J., and Jaffe, P.G. Children’s observations of violence: II. Clinical implications for children’s mental health professionals. Canadian Journal of Psychiatry (1990) 35:471–

Ingoldsby, E.M., Shaw, D.S., Owens, E.B., & Winslow, E.B. (1999). A longitudinal study of interpersonal conflict, emotional and behavioral reactivity, and preschoolers’ adjustment problems among low-income families. Journal of Abnormal Child Psychology, 27(5), 343-356.

Landreth, G. L., & Sweeney, D. S. (1999). The freedom to be: Child-centered group playtherapy. In D. S. Sweeney & L. E. Homeyer (Eds.), Group play therapy (pp. 39–64). San Francisco, CA: Jossey-Bass.

Landreth, G. L. (2002). Play therapy: The art of the relationship. Hove, UK: Brunner-Routledge.

Nisivoccia, D., & Lynn, M. (1999). Helping forgotten victims: Using activity groups with children who witness violence. In N. B. Webb (Ed.), Play therapy with children in crisis (pp. 74–101). New York, NY: Guilford.

Mills, E., & Kellington, S. (2012). Using group art therapy to address the shame and silencing surrounding children's experiences of witnessing domestic violence. International Journal Of Art Therapy: Inscape, 17(1), 3-12. doi:http://dx.doi.org.ezproxy.net.ucf.edu/10.1080/17454832.2011.639788

Peled, E., and Edleson, J. Process and outcome in small groups for children of battered women. In Ending the cycle of violence: Community responses to children of battered women. E. Peled, P.G. Jaffe, and J.L. Edleson, eds. Thousand Oaks, CA: Sage Publications, 1995

Pynoos, R., and Eth, S. Witness to violence: The child interview. Journal of the American Academy of Child Psychiatry (1986) 25:306–19. Peled, E., and Davis, D. Groupwork with children of battered women: A practitioner’s manual. Thousand Oaks, CA: Sage Publications, 1995

Shechtman, Z. & Gluk, O. (2005). An investigation of therapeutic factors in children’s groups. Group Dynamics: Theory, Research, and Practice, 9, 127–134.

Sternberg, K.J., Lamb, M.E., Greenbaum, C., Cicchetti, D., Dawud, S., Cortes, R.M., Krispin, O., & Lorey, F. (1993). Effects of domestic violence on children’s behavior problems and depression. (Behavior Problems and Adjustment) Developmental Psychology, 29(1), 44-53.

Summers, A. (2006). Children's exposure to domestic violence: A guide to research and resources. National Council of Juvenile and Family Court Judges.

Thompson, E. (2011). The Evolution of a Children's Domestic Violence Counseling Group: Stages and Processes. Journal For Specialists In Group Work, 36(3), 178-201

Yalom, I. D. (2005). The theory and practice of group psychotherapy. New York, NY:Basic Books.
Trust issues
Varied definitions of domestic violence, assessment is difficult
Severity of distress: Feelings of shame, depression, anxiety
Status of current relationships
Working with the other family membersAddressing suspicions and evidence of other abuse
Minimizing the event and trauma
Cultural and generational processes
Re-victimization
Legal processes
Addressing enduring maladaptive patterns of behavior Prevalence:
Bureau of Justice Statistics
(2000)
Approximately 28% of marriages
Nearly 1.3 million women and 840,000 men
More than 3 million children witness domestic violence a year
Native Americans,African Americans->Hispanics->Asian Americans
SES, Cultural beliefs Protective Factors:(Summers, 2006)

Problem solving skills, autonomy, social competence, sense of purpose and future
Intellectual functioning
Strong relationships with other adults
Self-efficacy, initiative, optimistic thinking, internal motivation
Academic and extracurricular involvement
Access to healthcare, social services, and recreational facilities Risk Factors

Women ages 20-24 are at the greatest risk
Prior exposure to domestic violence
Lower SES, unemployment
Physical/mental disability
Substance use
Interpersonal difficulties
Education level
Lack of support and resources Co-occurring with neglect and maltreatment (30-60%), Separation from family, Emotional distress Physical Social Stomach/digestive issues
Headaches
Disturbances in sleeping and eating patterns
Obesity
Perceived high levels of stress
Psychotropic medications (Anda et al., 2007) Social isolation
Poor social skills
Tendency to withdrawal
Suspicious, fearful, and avoidant tendencies (Futa, Nash, Hansen, & Garbin, 2003)
Negative interpersonal relations
Legal issues Deficits in school performance
Attention difficulties
Confusion
Beliefs about aggression and violence
Defensiveness
Problems with memory and attention (Anda et al., 2006) Depression and anxiety
Feelings of guilt, fear, shame, insecurity, self-blame, and low self-esteem
Posttraumatic Stress Disorder
Suicidal thoughts
Lower psychological functioning
Emotional lability
Unresponsiveness, or minimal range of responsiveness Aggressive tendencies
Early sexual activity
Delinquency
Truancy
Increased probability of teen pregnancy
Influences parenting styles
Conduct problems
Regressive behavior
Substance Use Increased risk of intimate partner violence in adolescence and adulthood, Maladaptive interpersonal patterns, Parenting styles
Teaching coping skills
Addressing self-blame
Conflict-resolution skills
Anger Management
Example: Child may feel angry and wish to hit the therapist, therapist communicates acceptance of the angry feeling and encourages the child to ‘‘choose’’ a more appropriate expression of her or his anger.
Help Parent & Child link exposure to violence to symptoms
Teach strategies to manage and decrease
Example: child suffers from insomnia, therapist would work with parent to create soothing bedtime routines Work with families to create safe, stable, and nurturing environment for the child Individual Group recommended for younger children with strong parent component
Children who are severely traumatized (witnessed fatal violence-bereavement)
(6-10 weeks)
Settings: schools, battered women's shelters, mental health clinics and social agencies
Psychoeducational components
Target age between 6 and 15 with age span of 2-3 years
Less likely to be helpful to preschoolers Reflection-identify and express
Self-control: limit setting
Socially appropriate expression
Permissiveness of a play
Self awareness Addressing shame
Outlet for Silence
Object Relations Theory
Accessing procedural memory Structured Time-Limited Psychodynamic Art Therapy Non-Structured Child-Centered Play Therapy Psychodynamic CBT Models Adapted for PTSD Children cannot not recover from effects of DV if exposure continues
Strengthening relationships with non-abusive caregivers
Safety planning skills
encourage non-violent living situations Reducing problematic symptoms Help children deal with the emotions and consequences that follow exposure to DV Promote open discussion about their experiences Empirical studies investigating the outcomes of these interventions are extremely limited; no controlled studies have been published Follow-up interviews with participants, how- ever, suggest that the therapeutic interventions have positive effects.

Fundamentally qualitative due to retrospective nature Since research is limited to adult therapy groups, theories of adult groups are used to understand children’s therapeutic groups (Thompson, 2011)

Assumption that Children’s groups, like adult counseling groups, progress through a series of stages that are facilitated by the processes that occur between and among group members (Nisivoccia & Lynn, 1999)

Developmental differences in children may affect the process and evolution of their groups

Adjustment concerns of CEDV may further influence process and stage development of their groups (Thompson, 2011) stop flooding of negative affect
address recurrent intrusive thoughts of event
correcting distortions
not all children meet criteria
works well for adolescents The Process Mary To & Melissa Fernandez Child-centered Play Therapy Refers to the development of dynamic interpersonal relationships that form between and among group members and the facilitator in the context of a safe and nurturing setting that facilitates child-directed exploration and expression through play which represents children’s natural mode of expression (Landreth, 2002). Aim is to enhance the emerging self-concepts of children through: unconditional acceptance
empathic understanding
positive regard
respect for the child’s ability for self-directed problem-solving and self-control
appreciation for the child’s ability to direct the process of counseling Members experience: •being valued, prized, and respected.
Themselves in a new way
interactions that develop new beliefs about their personal power and ability to be successful in life
A sense of self-worth
Increase in resiliency that protects from stressors present in their home environment ‘I don’t have a dad anymore. He just be’s mean to my mom. My mom doesn’t have any money and she tells him to send some and he doesn’t.’’

In response to her disclosure, Jess stated: ‘‘One day my mom and dad were fighting and they was yelling so loud that I couldn’t hear nothin’.’’ Stage 2: Brief Self-Disclosure The Thompson (2011) case study reveals that the group of child members progressed through a series of stages similar to those typically seen in adult groups and the processes that facilitated the evolution of those stages were also similar to those in adult groups (Corey et al., 2010; Gladding, 2003; Yalom, 2005).

Developmental differences, however, made these processes manifest in different ways from processes that occur in adult groups (Shechtman & Gluk, 2005). Stages (Thompson, 2011) Thompson (2011) asks... Were there stages of group development that occurred in the counseling group for four young children exposed to domestic violence? (Groves, 1999) (Sternberg et al., 1993) (Summers, 2006)
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