Transcript Developmental effects of Violence on Young Children

Shelter from the Storm:
Supporting and Intervening with
Children Affected by Domestic
Violence
Betsy McAlister Groves, LICSW
Child Witness to Violence Project
Boston Medical Center
Take home messages for supporting
children affected by domestic violence
• Relationships matter!
– The parent child relationship
– Your relationship with the mother and child
• Children react to and cope with domestic violence
in different ways. Their capacities for coping vary
by age, temperament, and environmental support
• Know thyself! We as caregivers bring our own
strengths, vulnerabilities and histories to this work
Child Witness to Violence Project
• Provides counseling services to children age 8 &
younger (and their families) who have witnessed
significant violence
• Provides training/consultation to providers who work
with children affected by violence.
• Member of the National Child Traumatic Stress
Network/Early Trauma Treatment Network
Child Witness to Violence Project
childwitnesstoviolence.org
Special Projects
• Pediatric Resources
– Training videos for physicians
– Pediatric ER Screening
Project
• Strengthening Military Family Connections
• Training Initiative with DCF
• Training in Ecuador & Colombia
• Bi-annual training institute
Profile of children in CWVP
• Gender:
– Boys-65%
– Girls-35%
• Race/ethnicity
– Latino-57%
– African American-26%
– Caucasian-10%
– Other-7%
Components of Clinical Intervention
• Safety and stability
• Reduction of symptoms
• The opportunity to talk about the
traumatic experience in the safety of a
therapeutic relationship
• Strengthening of the child-parent
relationship
CWVP: Lessons Learned
• Domestic violence is the most toxic form of
exposure to violence for young children
• There is no age at which a child is immune
to the effects of exposure to violence
• A child’s reaction to the trauma is closely
related to the parent’s ability to cope with
the trauma
• Children create their own unique meaning
of domestic violence experiences
Domestic violence is a
particularly toxic form of trauma
for children.
The Continuum
of Exposure
to Domestic
Violence
Serious
injuries
Fatal
assaults
Physical assaults
Threats of
homicide
or suicide
Weapons threats
Severity
of violence
Highly controlling
behavior
Threats, intimidation
Destruction of property
Marital conflict, arguing, yelling
Number of
children
2.3
Trauma and Young Children
• Scheerenga & Zeanah (1995): Proposed
classification of PTSD symptoms in children age
48 months and younger
• Unanticipated finding: most potent trauma
variable predicting PTSD symptoms was
witnessing a threat to the caregiver.
Not all children are equally affected by
exposure to violence: Influences on a child’s
response
• Characteristics of the child
• Age
• Gender
• Temperament/personality
• Characteristics of the Family & Community
• Parenting
• Access to outside supports
• Characteristics of the Violence
• Frequency
• Severity
• Proximity
2.15
There is no age at which a child is
immune to the effects of domestic
violence.
Complex Trauma Survey
• Data on 100,000+ children across 54 sites of
the NCTSN
• Findings:
– Most frequently mentioned trauma was exposure
to domestic violence
– Average age of onset: 5 years old
Sample Characteristics
N=149 (29 shelter)
Boys=109
Girls=40
Age Range: 6 months – 6.9 years
0-2.9= 28 (22 boys)
3.0-6.9=121 (87 boys)
Age at First Exposure
0 - 2.9 years
3.0 - 6.9 years
N=149
61%
39%
Most frequently reported symptoms
found in CWVP referrals:
Temper Tantrums/Angry Outbursts
Aggressive with Peers
Aggressive with Adults
Demanding/Controlling
Play re-enactment
Nightmares
60%
60%
56%
50%
41%
40%
Supporting or repairing the parentchild relationship is an essential
ingredient to helping children.
Impact of Trauma on CaregiverChild Relationship
• Loss of sense of caregiver as reliable
protector
• Disturbed mental representations of who is
safe and who is dangerous
(Lieberman & Van Horn, 1998)
Impact of Trauma on CaregiverChild Relationship
• When the caregiver has also
experienced interpersonal trauma:
– The caregiver’s ability to establish and
maintain an empathic relationship with the
child may be impaired
– The caregiver may have a decreased
capacity to recognize danger or stress
– The child may take the role of caregiver
Tips for Parent Guidance
• Helping the mother with safety is often the first
and best way to help the child.
• Give parents information about child symptoms.
Remind parents that their child’s reactions are
normal reactions to an abnormal event.
• Assist parents in talking with child about the
traumatic event.
• Encourage parents to listen carefully to the child’s
fears and to develop a plan to help the child feel
more safe.
• Encourage parents to provide a predictable and
secure routine for the child.
Children create their own unique meaning
of domestic violence experiences
Principles of Intervention
• Healing begins with relationships
• Children must know what to expect in their
everyday surroundings
• Provide activities that promote a child’s
competence and self esteem.
• Don’t try to do it all alone
• Model nurturing behavior & teach alternatives
to violence.
• Pay attention to your feelings of helplessness
or hopelessness
Healing begins with
relationships
Children need predictability and
stability in their everyday
environments
Provide activities that
promote a child’s competence
and self esteem.
Model nurturing behavior &
teach alternatives to violence
We can’t do this alone!
Collaborations matter.
Pay attention to your feelings,
especially anger, helplessness,
hopelessness
(Working with families affected by domestic
violence changes our view of the world)
Trauma and the Caregiver
Exposure to children’s tragic stories can:
• Affect one’s view of the world
• Lead to feelings of hopelessness, helplessness and
inadequacy
• Trigger memories of personal experiences with
trauma
• Evoke feelings of anger at parents, at the system
• Lead to compromised job performance and burnout
Self audit: Where are my triggers?
• What about working with families affected
by domestic violence is most difficult for
me? Why?
• Which parents are hardest for me to work
with?
• What are my triggers in doing this work?
• Where do I get support?
More Information
• NCTSN.org
• http://www.developingchild.net
• Childwitnesstoviolence.org
Contact Information:
Betsy McAlister Groves, LICSW
Child Witness to Violence Project
Boston Medical Center
Boston, MA
617-414-4244
[email protected]
Website:
www.childwitnesstoviolence.org