Childhood Exposure to Domestic Violence and Health
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Transcript of Childhood Exposure to Domestic Violence and Health
Children and youth Children and youth exposed to domestic violence exposed to domestic violence
A responsive system A responsive system grounded in resiliencegrounded in resilience
Linda ChamberlainJordan SizeloveDevorah LevineKristin Bodiford
IntroductionsIntroductions
Please share one word
that describes resilience to you
PurposePurpose
Impact of exposure to domestic violenceIntroduction to resilience Research on neuroplasticity and resilienceBuilding a responsive system with the lens
of resilience
Children’s ExposureChildren’s Exposure
Visual - as “eyewitness”
Audio - hearing the violence
Tool of Perpetrator - used in event
Aftermath - the impact of violence
“Seeing my mom get beat is worse than being beat myself.” (Teen)
ImpactImpact
Adverse health outcomes
School health and performance
Greater rates of antisocial behavior, substance abuse, suicide attempt, mental illness
Linked to other forms of community violence
Voices of YouthVoices of Youth
“Violence effects kids’ behavior because they think it’s ok to pick on women and those smaller than them.” (Teen)
“Most of the times kids know domestic violence is wrong, but they are traumatized by seeing their mom get beat up. I hit my younger bothers and stole cars because I was so angry.” (Teen)
Shifting Our View Shifting Our View
Increase capacity
Build partnerships
Small tests for change
Strengths based framework
No problem can be solved from the same level of consciousness that created it. We must learn to see the world anew.” Einstein
We get to chooseWe get to choose
Strengths-based view…. Strengths-based view…. Does not ignore problems/difficulties or the critical
need to ameliorate/prevent the harm caused. Key assumptions are:
◦individuals, families, and communities are defined not by their difficulty, but rather by their multiple strengths,
◦the amelioration of current difficulties or the prevention of future difficulties begins with the identification and marshaling of these strengths.
Kenneth Maton
Resilience … positive adaptation in the context of significant adversity
EnvironmentalInputsDEVELOPMENTALSUPPORTS & OPPORTUNITIES(Protective Factors)
In
FamiliesSchoolsOrganizationsCommunitiesPeers
Societal Impacts
THUSPRODUCING
POSITIVE PREVENTION&SUCCESSFULLIFE OUTCOMES
Individual Outputs
PROMOTINGPOSITIVEDEVELOPMENTALOUTCOMES
Social
Emotional
Cognitive
Moral-Spiritual
Individual Inputs
THAT MEETDEVELOPMENTALNEEDS
Love
Belonging
Respect
Power
Challenge
Mastery
Meaning
Safety
Caring Relationships
Positive Expectations
Meaningful Participation
Benard, 1991
VoiceVoice
BELIEFin
Resilience
Human Development Process >>Human Development Process >>Resilience in Action Resilience in Action
VoiceVoice
Who gets to decide? Who has a say?Whose voice is included?Whose voice is left out?
Choppin’ it Up Choppin’ it Up – Talking about – Talking about relationships and resiliencerelationships and resilience
www.choppinitup.org
Choppin’ it Up
Emerging Leaders
This is a story of one community’s commitment to create change.
Engaging the strengths of their youth.
DPC
Key questions from a Key questions from a resilience perspectiveresilience perspective
What impact does abuse in relationships have on you?
What does healthy mean to you? What does a healthy relationship look like?
How do you navigate to health?What do you need to support you?
Youth and Community Dialogue
Listening to stories of resilienceListening to stories of resilience
Multiplicity of identities, voices and stories
Creative resources and strengths
Sometimes powerful hidden resilience
Com
plex
ity
(www.choppinitup.org to hear stories of strength and resilience.)
Our own experiences with resilience
Beliefs >>Beliefs >>Influence LanguageInfluence Language
The beliefs we hold influence language
Language we use
Stories we tell
How often we tell them
Voices that are included
Voices that are left out
Language and Images Language and Images Generate ActionGenerate Action
Language and images lead to action
Positive images of our self and othersImages of the future from action and strengths in the presentWe get to choose which images propel us to resilience and thriving.
Cooperrider, D., Sorensen, P., Whitney, D., & Yaeger, T. (2001).
StatisticsStatisticsLet’s talk about statistics. Apparently I’m supposed to be pregnant, a drop out, disrespectful and have no morals.
I’m actually in school. I have a 3.5 grade point average. I have goals and morals.
I plan on going to school and majoring in pre law and criminal justice.
The Amazing Brain:The Amazing Brain:Risk Risk andand Resiliency Resiliency
Neuroplasticity=the ability of the human brain to adapt and change in response to experience and environment.
What is Trauma?What is Trauma?
“Overwhelming demands placed on the physiological system that result in a profound felt sense of vulnerability and/or loss of control.” (Robert Macy)
Bassuk, Konnath & Volk, 2006
TRAUMA
BRAIN
HPA Axis
Stress hormones
Brain always prioritizes survival
Cascade of physical, mental,cognitive and behavioral effects
Sequential Development of a ChildSequential Development of a Child’’s Brains Brain
Abstract Thought Problem solvingAffiliationAttachmentEmotional ReactivityMotor RegulationSleepDigestionBlood PressureHeart RateRespirationBody Temperature
Peter Camburn
NE
UR
OP
LA
ST
ICIT
Y
Sequential VulnerabilitySequential Vulnerability
Poor social skillsReading decrementSpeech problemsAttention problemsSeparation anxietyAggressive behaviorsHypervigilanceFailure to thriveStomach problemsSleep problemsLow stress tolerance
Peter Camburn
What other effects does violence have on children?
Understanding Experiences
Developmental
Tasks
Coping Strategies
EnvironmentalBuffers
Healing And
Recovery
Adapted from diagram on promoting social & emotional well-beingTo facilitate healing/recovery by Commissioner Bryan Samuels, ACYF
What Children Exposed to DV Need What Children Exposed to DV Need
Bancroft, 2004
Survival first!
Social connections build brain connections
Skill-building for impulse control & self-soothing
Feel physically and emotionally safe
Strong bond to non-battering parent
Express feelings & frustrations in non-destructive ways
Have their strengths praised and called upon
Promote self-esteem and competency to explore & experience the world
RESILIENCY NEUROPLASTICITY
What We Can DoWhat We Can Do
Magic Trees of the Mind” by Dr. Marian Diamond
•Developmentally appropriate Developmentally appropriate experiences to heal the brainexperiences to heal the brain
•Babies learn best through social Babies learn best through social interactionsinteractions
•Increase child-adult timeIncrease child-adult time
•Reduce exposure to media Reduce exposure to media violence and violence and ““media parentingmedia parenting””
•Active, experiential learning, Active, experiential learning, enrichment programsenrichment programs
•Head StartHead Start
•Home visitationHome visitation
WIC
Nurtured Heart Approach
SEL in Schools
Shelter, INC Parent Support
Foster Youth Health Collaborative
Choppin’ it Up
Teen Dating Abuse
Head Start
DiscussionDiscussion
www.familiesthrive.orgwww.familiesthrive.orginfo@[email protected]
NEUROPLASTICITY AND THENEUROPLASTICITY AND THE IMPACT OF VIOLENCE ON CHILDREN: IMPACT OF VIOLENCE ON CHILDREN:
RISK AND RESILIENCYRISK AND RESILIENCY
Linda Chamberlain PhD MPHAlaska Family Violence Prevention Project
Best Practices to PromoteBest Practices to Promote Resiliency and Neuroplasticity Resiliency and Neuroplasticity
Healing relationships◦Work with nonbattering parent & children
Social emotional learning & skills ◦Empathy
Social supportTrauma-informed parenting skills
ResourceResource www.instituteforsafefamilies.org
Resource: Strategies to Resource: Strategies to Strengthen Strengthen Non-battering Parent-Child BondNon-battering Parent-Child Bond
ReassuranceBe willing to talk about the violenceAsk how the violence made them
feelEncourage healthy coping strategies
Baker L, Cunningham A. Helping Children Thrive: Supporting Women Abuse Survivors as Mothers. 2004. www.lfac.on.ca
Resource: A Kid is So Special (KISS)Resource: A Kid is So Special (KISS)
Series of booklets developed by the Pennsylvania Coalition Against Domestic ViolenceThese interactive booklets are designed to strengthen mother-child bonds
◦“Growing Together” discusses child development
◦ “Playing Together” includes information on what a parent can do when there is hurting at home
Pennsylvania Coalition Against Domestic Violence (PCADV) at 800-537-2238
Best Practices: Child-Parent Psychotherapy Best Practices: Child-Parent Psychotherapy (CPP)(CPP)
Tailored to age & development stage of childConsiders child in context of parental relationship
- supporting mother as primary intervention Flexible intervention model includes:Crisis stabilization and advocacyFacilitate child’s expression through play, verbalization,
acting out fears, and angerHelp mother to understand child’s behaviors and find
protective ways to respondModeling appropriate protective behaviors
www.ncts.org; Lieberman et al, 1997; 2006
Child Parent PsychotherapyChild Parent Psychotherapy
At end of one-year treatment period (RCT Lieberman et al,2005):
◦Children had fewer behavioral problems, decreased trauma symptoms, and less likely to be diagnosed with PTSD
◦Mothers have fewer postttraumatic stress avoidance symptoms
◦Six months after intervention ended, children had fewer behavior problems and mothers had fewer psychiatric symptoms (RCT, Lieberman et al, 2006)
IQ and Exposure to DVIQ and Exposure to DV
Dose response relationship between level of severity of children’s cumulative exposure to DV and IQ scores (Koenen et al, 2003)
Trauma-specific treatment (CPP) improves IQ {performance, verbal, and full scale} scores (Lieberman et al, 2005)
This is not about changing youth. It is about unearthing what already exists, transforming narratives about youth to highlight their strengths, their hopes, and their dreams.
(Whitney & Trosten-Bloom, 2010)
TransformationTransformation
Beliefs >> Beliefs >> Support Resilience Support Resilience
Resilience begins with beliefs
Resilience begins with a change in consciousness, beginning with an act of belief, often in the face of accumulated evidence to the contrary.
Gervase Bushe 2002 (Adapted)
We coordinate with the resources and people
around us, •generating alternative ways,•for “going on together” or living our lives, •to survive and thrive in the face of challenge.
Resilience >> RelationalResilience >> Relational
Resilience is our ability to ‘go on together’.
We develop capacity to support each other
through building relationships of: • trust, • reciprocity, and • caring.
Resilience >> CommunityResilience >> Community
Resilience grows from our ability to support each other in community.
Negotiations between individuals and their environments:for the resources to define themselves as healthy amidst conditions collectively viewed as adverse.
Systems that are responsive, build resilience.
Resilience is contextual, supported by responsive systems.
Resilience >> SystemsResilience >> Systems
Michael Ungar
Resilience>>Resilience>>Responsive SystemsResponsive Systems
Community and Systems Community and Systems DisintegrationDisintegration
Breakdown of community lifeLoss of social capital Loss of linkages that
create sense of identity and belonging
Increased disconnection
The forces of community disintegration have gained steadily and will prevail unless we nurture community and reweave the social fabric. John Gardner
Threat to those most vulnerable: •children •youth•young families •elders
Resilience >> Resilience >> Building CommunityBuilding Community
Quality of caring for each otherQuality of caring for each otherStrong neighborhood, organizational Strong neighborhood, organizational
and community networksand community networksPositive social dynamics in communityPositive social dynamics in communityHigh collective efficacyHigh collective efficacyHigh levels of trust and reciprocityHigh levels of trust and reciprocity
While research shows us the absence of strong positive community contexts can be devastating, the presence of strong positive community contexts can be transformational.
The social fabric is at the core for resilience along the lifespan.
Resilience>>Resilience>>CollaborationCollaborationEffective community and multisystem collaboration depends on:
Responsive Systems>>Responsive Systems>>PrototypingPrototyping
Caring – Reflexive and responsive to individuals, families and communities
Capacity & Competency – Increasing our knowledge and skills. Changing policies and practices.
Communication & Connection – Regular and ongoing communication. Creating shared language. Developing relationships.
Coordination & Collaboration – Developing partnerships.
Environmental FactorsEnvironmental Factors
Change environmental policies and practices
Address issues of social injusticeReflect on beliefs, voice and language we
use, stories we tell in systems.Shift relational norms