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

QUESTIONS?

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

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National Child Traumatic Stress Network: http://www.nctsnet.org/ The National Center for Trauma-Informed Care:

http://www.samhsa.gov/nctic/healing.asp#risking