Transcript Domestic Violence and How it Affects Children

Child Witness to Domestic Violence
HOW TO BUILD RESILIENCY IN CHILDREN
WHO SUFFER ADVERSE CHILDHOOD
EXPERIENCES AND TOXIC STRESS.
LUKE WALDO
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
HONEYMOON
ABUSE 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 loneliness
Insecurity over independence and
lack of emotional support
Guilt over failure of marriage
Belief that partner needs them and
cannot survive alone
Belief that partner will change
Fear/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 Effects
Physical Effects
 Act out or withdraw
 Anxious/Nervous
 Aggressive (“bullying”)
 Regression in
or passive (“doormats”)
 Attention-seeking
 Care-taking, filling adult
roles
 Overachiever or
underachiever
 Nightmares and/or
bedwetting
developmental tasks
 Somatic complaints
(e.g., headache, stomach
aches, difficulty
breathing, etc.)
 Tired/Lethargic
The Effects of Domestic Violence on Children
Social Effects
Emotional Effects
 Bully/Victim of bullying
 Anger
 Difficulty making friends
 Burdened, inappropriate
 Difficulty trusting others
roles
 Confusion, conflicted
loyalties
 Depression
 Fear
 Grief/Sense of loss
 Guilt (e.g., feels
responsible for the
violence)
 Difficulty with clear
boundaries
 Isolated
 Poor conflict resolution
The Effects of Domestic Violence on Children
Cognitive/Attitudinal
Effects
 Belief that abuse and
violence are acceptable in
relationships
 Belief that aggressive
behavior enhances selfimage
 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
 Multiple sexual
 Chronic Obstructive
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Pulmonary Disease
Depression
Fetal death
Health-related
quality of life
Illicit drug use
Ischemic heart
disease
Liver disease
Risk for IPV
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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
 Deficits in abstract reasoning skills
The Impacts of
Toxic Stress and
Childhood
Trauma
 Deficits in language development
Impacts on
Learning
 Difficulty problem-solving
 Difficulty understanding and responding to
rules, boundaries and laws
 Difficulty planning and anticipating the future
 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
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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)
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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.
 Visible injuries or injuries that are
Initial
Contact
Observations
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
 Interview the alleged adult victim first
Interviews
Process
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.
 Immediately ask the alleged adult
Interviews
Interviewing
the Alleged
Adult Victim
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.
 Ask about other issues first before
Interviews
Interviewing
the Alleged
Adult Victim
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.
 Ask questions on the coercive
Interviews
Interviewing
the Alleged
Adult Victim
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.
 Affirm to the alleged adult victim
Interviews
Interviewing
the Alleged
Adult Victim
that the abuse is not deserved and
not the fault of the alleged adult
victim.
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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.
 Express concerns for the safety of
Interviews
Interviewing
the Alleged
Adult Victim
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
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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:
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Give children the opportunity to
develop a personal narrative.
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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:
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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
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Community Resources: Southeastern Wisconsin
 Advocates of Ozaukee: (877) 375-4034
 Friends of Abused Families: (262) 673-7298
 Safe Harbor: (920) 452-8611
 Sister House: (262) 542-3828
 Waukesha Women’s Center: (262) 547-4600
 Women’s Horizons: (262) 652-9900
QUESTIONS?
References
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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.pdf
National Child Traumatic Stress Network: http://www.nctsnet.org/
The National Center for Trauma-Informed Care:
 http://www.samhsa.gov/nctic/healing.asp#risking