Post on 14-Dec-2015
HOW TO BU I LD R ESI L I EN CY I N CHI LDR EN WHO SU FFER ADVER SE CHI LDHOOD EXP ER I EN CES AN D TOXI C STR ESS.
LU K E WA L D O
Child Witness to Domestic Violence
Our Objectives
Provide information about domestic violence, its impacts on parents and children, and how to safely identify and understand it.
Provide information about toxic stress and childhood trauma and how it impacts childhood development and future social and health outcomes.
Provide practices that may mitigate the impacts of toxic stress and childhood trauma and that may build resiliency in the impacted child and adult.
What is Domestic Violence?
Domestic violence is a pattern of assaultive and coercive behaviors – including physical, sexual, and psychological attacks as well as economic coercion – that adults or adolescents use to exert power and control over their intimate partners.
The Power and Control Wheel
Cycle of Violence
TENSION BUILDING
HONEYMOONABUSE CRISIS
Characteristics of an Abusive Personality
Controlling and Entitled: Rights without responsibilities.
Selfish, Superior and Possessive: His needs are to be met by others without reciprocity.
Coercive and Manipulative: Confuses love with abuse. Portrays himself in positive light while demeaning and
damning partner.
Contradictory: Behaves differently from how he sees and speaks of self.
Unaccountable, Denial and Minimization: Refuses to take responsibility for abuse, its seriousness and shifts blame to victim.
Serial Abuse: Abuse is part of personality, not reaction to partner.
Traumatized: Most likely the victim of childhood trauma.
Why Victims Stay
Safety Fear of physical harm to selves and
children if they attempt to leave
Fear of retaliation/stalking
Children Fear of emotional damage to children
Fear of involving the courts
Fear of losing custody and placement of children
Financial Economic dependence
Lack of alternative housing
Lack of job skills
Social Lack of support from family/friends
Lack of information regarding alternatives
Cultural and religious constraints
Why Victims Stay
Emotional Factors
Fear of lonelinessInsecurity over independence
and lack of emotional supportGuilt over failure of marriageBelief that partner needs them
and cannot survive aloneBelief that partner will changeFear/ambivalence over making
life changes All factors focus on ensuring their survival
Why Victims May Not Seek Help
Fear of retribution
Fear of losing children
Fear of employers reaction
Protecting relationship(s)
Severe isolation
Shame and humiliation
How Do Children Witness Domestic Violence?
Witnessing the abuse
Intervening in the abuse
Hearing the abuse
Witnessing the aftermath
Hearsay
Separate victims
Pawns
How Are Children Used in DV Situations?
Scapegoats Justifying abuse through child’s bad
behavior
Intimidation Threatening violence against the children
and/or pets
Legal Pawns Prolonged court proceedings about
custody/placement, especially when the abuser has previously shown little interest in the children
Withheld Taking children hostage, abducting them or
not returning them to other parent
Allies Talking to children about the abused parent’s
behavior. Encouraging the children to abuse the other parent
The Effects of Domestic Violence on Children
Behavioral EffectsAct out or withdrawAggressive
(“bullying”) or passive (“doormats”)
Attention-seekingCare-taking, filling
adult rolesOverachiever or
underachieverNightmares and/or
bedwetting
Physical EffectsAnxious/NervousRegression in
developmental tasksSomatic complaints
(e.g., headache, stomach aches, difficulty breathing, etc.)
Tired/Lethargic
The Effects of Domestic Violence on Children
Social Effects Bully/Victim of
bullying Difficulty making
friends Difficulty trusting
others Difficulty with clear
boundaries Isolated Poor conflict resolution
Emotional Effects Anger Burdened,
inappropriate roles Confusion, conflicted
loyalties Depression Fear Grief/Sense of loss Guilt (e.g., feels
responsible for the violence)
The Effects of Domestic Violence on Children
Cognitive/Attitudinal Effects Belief that abuse and
violence are acceptable in relationships
Belief that aggressive behavior enhances self-image
Exposure to violence associated with lower cognitive functioning
Long-term Effects Correlation with
adverse health outcomes in adulthood
Correlation with increased rates of depression, anxiety
Correlation with increased risks for juvenile delinquency/anti-social and high-risk behaviors
The Impacts of Childhood Trauma
The Adverse Childhood Experiences (ACE) study
Collaboration between the CDC and Kaiser Permanente.
Provided a physical examination to 17,000 patients, then surveyed them regarding their personal adverse childhood experiences such as abuse and neglect.
The ACE Study: Major Findings
Almost two-thirds of study participants reported at least one ACE, and more than one in five reported three or more ACEs.
The short- and long-term outcomes of these childhood exposures include a multitude of health and social problems.
The ACE Score is used to assess the total amount of stress during childhood and has demonstrated that as the number of ACE increase, the risk for serious health problems increases in a strong and graded fashion.
(Center for Disease Control and Prevention)
The ACE Study: Impacts on
Health
Physical and Behavioral Impacts
Alcoholism Chronic
Obstructive Pulmonary Disease
Depression Fetal death Health-related
quality of life Illicit drug use Ischemic heart
disease Liver disease Risk for IPV
Multiple sexual partners
STIs Smoking Suicide attempts Unintended
pregnancies Early initiation of
smoking Early initiation of
sexual activity Adolescent
pregnancy
The Impacts of Toxic Stress and Childhood Trauma
Social and Emotional Impacts
Attachment disorder/ Difficulty forming relationships
Difficulty identifying, expressing and managing emotions
Dissociation
Hypersensitivity to triggers
Aggressive, angry, and/or profoundly sad responses
Struggles with self-regulation Hypervigilance/guarded
Withdrawn and isolated
Persistent fear responses High risk behaviors
Self-harm
Unsafe sexual activity
Excessive risk taking
Substance use/abuse
Violence
Running away from home
The Impacts of Toxic Stress and Childhood Trauma
Impacts on Learning
Deficits in abstract reasoning skills Deficits in language development Difficulty understanding and responding
to rules, boundaries and laws Difficulty planning and anticipating the
future Difficulty problem-solving Reduced size of parts of the brain
responsible for: Attention Consciousness Language Memory Perceptual awareness Thinking
Survival mode Impulsive
As professionals in this field, it is our goal to help
foster resiliency in the children with whom we
work.
How to Foster Resiliency and Healing in Children
Safe environment Strong and caring relationships
with safe adults, especially mom Strong relationships within the
family and community Support child’s strengths and
interests Participation in positive
activities Permission to be angry, hurt,
confused, etc. Opportunities to talk about
events and express feelings
How to Foster Resiliency and Healing in Children
Early Intervention:
“Early intervention with children, by ameliorating the intensity and severity of the child’s response to trauma, can ‘decrease the probability of developing…sensitized neural systems’ that lead to persistence of trauma symptoms and defenses.” (Perry et al, 1995)
Safe Environment: Adult remains calm, ensures
child’s safety and provides “appropriate structure, limits, routines, and nurturance.” (Hodas, 2006)
Safety and Assessment
Dangerousness Assessment
Indicators Provided By Partners, Children or Other Family Members The history of violence in the relationship and
her fear of further violence and escalation; Abuse during pregnancies
Gun ownership or easy access to gun
Threats to kill her, the children or himself if she leaves
Strangulation
Forced sex
Severe and persistent monitoring and stalking; Severe and irrational jealousy
Severe isolation
Recent instability – unemployment, evictions, etc.
Substance abuse – alcoholism and/or use of “uppers”
Safety and Assessment
Safety Precautions
Workers must ensure that their involvement does not compromise their own safety or the safety of anyone in the family.
Promoting safety for all parties is the primary goal.
Inquiry into private family matters often is viewed by the abuser as a threat to his or her control over the family.
Separate interviews should be conducted with the children, alleged victim, and alleged perpetrator.
Safety and Assessment
Safety Precautions
Do not leave voicemail messages asking to speak with the alleged victim about the abuse.
Find creative means of contact (e.g., at the alleged victim's place of work or through the children's school).
Safeguard domestic violence information from the alleged abuser. Do not leave domestic violence resource information in plain sight.
Reflect thoroughly on potential consequences if suggesting to alleged victim that she leave the home or pursue other actions such as restraining orders.
Initial Contact
Observations
Visible injuries or injuries that are hidden or attempted to be hidden
Flinching or signs of anxiety Use of dominating or intimidating body
language Weapons Holes in walls, broken furniture, broken
doors and windows Locks on the outsides of doors Telephone is broken, disconnected, or
missing Home is not adequately accessible for
family member’s disabilities Guard animals, especially if family
members exhibit fear of the animals Home is in an isolated location
Interviews
Process
Interview the alleged adult victim first without the alleged batterer present and without the alleged batterer’s knowledge whenever possible.
If the alleged batterer is present, do separate interviews out of earshot of the alleged batterer.
If you cannot separate the partners, focus on issues other than the domestic violence. Resistance to separate interviews with adults may be an indication of domestic violence and a batterer’s control.
Interviews
Interviewing the Alleged Adult Victim
Immediately ask the alleged adult victim if it is safe to conduct an interview and what might be a safe manner to do so.
Never ask the alleged adult victim about domestic violence in front of the alleged abuser. Disclosures may make it unsafe if the alleged abuser is in the vicinity.
Use strategies to build rapport, encourage conversation and support the alleged adult victim.
Interviews
Interviewing the Alleged Adult Victim
Ask about other issues first before asking about domestic violence. Ask about relationship issues, including positive aspects. Begin with more general questions and follow with more specific and detailed questions.
Ask open-ended questions about well-being to start the conversation. However, express concerns and ask questions about bruises or other injuries.
Interviews
Interviewing the Alleged Adult Victim
Ask questions on the coercive tactics the alleged abuser may use.
The alleged adult (and children) may express positive feelings toward the alleged abuser. When asking questions about the abuse, focus on the alleged abuser’s violence and controlling behaviors, not personality.
Interviews
Interviewing the Alleged Adult Victim
Affirm to the alleged adult victim that the abuse is not deserved and not the fault of the alleged adult victim. The adult victim may not talk with
us from fear of removal of children and/or fear of abuser. This affirmation stresses our concern that both she and the children are in danger.
Stress that our priority is to work with the non-offending parent in planning to protect the children and parent together, whenever safe and possible.
Interviews
Interviewing the Alleged Adult Victim
Express concerns for the safety of the alleged adult victim and the safety of the children.
Identify what the alleged adult victim has done to stay safe and keep the children safe.
Consider that the adult victim’s actions have been survival strategies.
Recognize that because many adult victims lack access to financial resources or other housing options they may believe that it is better to stay with the alleged abuser.
Efficient, Effective Safety Planning
Requires knowledge about the abuser’s pattern of coercive control.
Builds on victim’s efforts to promote the safety and well-being of the children.
Is developed in collaboration with the victim.May include a domestic violence shelter, police or protective
order, but does not mandate or rely on these interventions.Includes informal resources (friends, family, employer).Attempts to account for the other critical needs of the
children, like stability.Is well documented.
Visitation
The abuser’s relationship as a parent presents complex issues. Tactics of manipulation and control may be present in the abuser’s relationship with the children: Start with the assumption that visits between the abuser and
children, if they occur, should be supervised. Check on possible restraining orders, no-contact orders or
conditions of probation and parole that would affect visitation.
Arrange visits carefully to ensure the safety of the children and the adult victim. Schedule separate visits when possible to increase safety and to allow the non-offending parent uninterrupted parenting time with the children.
Visitation
Give the visit supervisor adequate information on domestic violence and tactics of the specific abuser.
Talk to the child and non-offending parent to identify any of the abuser’s behaviors that cause discomfort or fear.
Ask the non-offending parent and the child to identify subtle tactics the abuser uses to manipulate or threaten the child and watch for those in visitation.
Have a child use a code word if feeling unsafe.
Visitation
Reassure the child that it is the responsibility of the visit supervisor to intervene in the visit.
Set limits on behaviors and conversation allowed in the visits.
Do not allow the child to be used to exchange information, gifts, or other property or tell the abuser about the non-offending parent.
How to Foster Resiliency and Healing in Children
Social Support: Give children the opportunity
to develop a personal narrative. With early intervention and
appropriate social support, “most children and adolescents…will recover almost completely from the fear and anxiety within a few weeks.” (NIMH, 2001)
Mental Health Treatment: Mental health treatment may
be necessary if recovery is delayed or there are coexisting issues such as depression and avoidance.
Community Resources: Milwaukee
ALMA Center (414) 265-0100 Asha Family Services (414) 875-1511 Hmong American Friendship Association (414) 344-6581 Milwaukee Women’s Center (414) 671-6140 Sojourner Family Peace Center (414) 276-1911
Belle Resource Center (414) 344-4466 Beyond Abuse (414) 276-1911 Sojourner Truth House (shelter) (414) 933-2722
The Healing Center (Sexual Abuse) (414) 671-4325 UMOS Latina Resource Center (414) 389-6500
Community Resources: Southeastern Wisconsin
Advocates of Ozaukee: (877) 375-4034Friends of Abused Families: (262) 673-7298Safe Harbor: (920) 452-8611Sister House: (262) 542-3828Waukesha Women’s Center: (262) 547-4600Women’s Horizons: (262) 652-9900
References
American Psychological Association: http://www.apa.org/monitor/2011/09/tools.aspx http://www.apa.org/pi/families/resources/children-trauma.pdf
American Psychiatric Association. 2000. Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision).
Center for Disease Control and Prevention: http://www.cdc.gov/ace/about.htm Center on the Developing Child at Harvard www.developingchild.harvard.edu Futures Without Violence:
http://www.futureswithoutviolence.org/content/features/detail/803 Ganley, A and Hobart, M. (2010). Social Worker’s Practice Guide to Domestic
Violence (DSHS Publication No. 22-1314). Washington State Department of Social and Health Services’ Children’s Administration.
Hodas, Dr. Gordon R. 2006. “Responding to Childhood Trauma: The Promise and Practice of Trauma Informed Care” http://www.dpw.state.pa.us/ucmprd/groups/public/documents/manual/s_001585.pd
f
National Child Traumatic Stress Network: http://www.nctsnet.org/ The National Center for Trauma-Informed Care:
http://www.samhsa.gov/nctic/healing.asp#risking