The Effects of Domestic Violence on Children and Adolescents

1. The Effects of Domestic Violence on Children and Adolescents Nicole Trabold, CSW Doctoral Student School of Social Work University at Buffalo 2003 CDHS, College Relations Group, BSC Research Foundation

2. What is Domestic Violence • Frequently referred to as: • “Battering” • “Spouse Abuse” 2003 CDHS, College Relations Group, BSC Research Foundation

3. Commonly referred to today as Intimate Partner Violence (IPV) 2003 CDHS, College Relations Group, BSC Research Foundation

4. Definition • Is the violence committed by a spouse, ex-spouse, or current or former partner (heterosexual and homosexual relationships) • All definitions per the Center for Disease Control and Prevention (CDC), 2003 2003 CDHS, College Relations Group, BSC Research Foundation

5. Motivation = Domination and Control • Strategy = Purposeful Coercion • Tactics = Selectively Chosen • Pattern = Episodic, Recurrent, Chronic • Impact = Injury, Fear, Pain, Isolation • American College of Obstetrics and Gynecology 2003 CDHS, College Relations Group, BSC Research Foundation

6. Four Categories of Violence • Physical • Sexual • Threats of Physical or Sexual Harm • Psychological/Emotional 2003 CDHS, College Relations Group, BSC Research Foundation

7. Physical Violence • The intentional use of physical force with the potential to cause death, disability, injury, or harm • Pushing • Punching • Biting • Slapping • Kicking • Choking • Use of a Weapon 2003 CDHS, College Relations Group, BSC Research Foundation

8. Sexual Violence • The use of physical force to compel a person to engage in a sexual act against their will • Attempted or completed sex act involving a person that is unable to consent • Abusive sexual contact 2003 CDHS, College Relations Group, BSC Research Foundation

9. Threat of Physical or Sexual Violence • Use of words, gestures or weapons to communicate the intent to cause: • Death • Disability • Injury • Physical Harm 2003 CDHS, College Relations Group, BSC Research Foundation

10. Psychological/Emotional Abuse • Trauma to a victim caused by acts or threats of acts, or coercive tactics such as: • Humiliating the victim • Controlling the victim • Destroying property • Using the children to control the victims behavior • Withholding money and/or transportation • Isolation from friends and family 2003 CDHS, College Relations Group, BSC Research Foundation

11. Fighting vs. Abuse • Arguments, disagreements, and differences of opinion are part of a ‘normal’ relationship. • What distinguishes an abusive relationship is the ongoing pattern of disproportionate control and coercion • Abuse is not a ‘fight’ between people of equal power, but occurs where there is an imbalance of power and control tactics are used 2003 CDHS, College Relations Group, BSC Research Foundation

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14. Theoretical Frameworks • Social Cognitive Theory (Bandura) • Emphasis on observational learning • Violence was modeled and emphasized • Those that love you hit you • Those you love are people who can hit you • Feminist Theory • Violence is the result of a patriarchal social system that gives men responsibility for control over their female partners 2003 CDHS, College Relations Group, BSC Research Foundation

15. Social Exchange Theory • Interaction is guided by a cost – reward analysis • Ecological Theory • This recognizes that no one theory can predict IPV 2003 CDHS, College Relations Group, BSC Research Foundation

16. Intimate Partner Violence and Child Abuse/Maltreatment • A study conducted in a Massachusetts D.S.S found after a record review of suspected or confirmed child maltreatment cases that 32% also documented IPV - Hagen, 1994 • A study by Stark and Flitcraft, 1998 found after reviewing the medical records of mothers whose children were seen in a hospital setting and were referred for child maltreatment that 45% had a documented history of IPV 2003 CDHS, College Relations Group, BSC Research Foundation

17. 40% of women who were seeking services at a battered women’s shelter reported that their spouse physically abused their children- Suh & Abel, 1990 • According to Two National Surveys 50-70% of families with IPV also reported physical abuse toward the child – Bowker et al., 1988; Stauss & Gillis, 1990 2003 CDHS, College Relations Group, BSC Research Foundation

18. In Summary… • Studies show that in approximately 50% of cases where women are victims of violence, children are victims of physical violence • Or… in 50% of cases of child physical abuse, women are also victims of physical violence 2003 CDHS, College Relations Group, BSC Research Foundation

19. Intimate Partner Violence Harms Children In Various Ways • Perpetrators of violence may physically harm their intimate partner and their children • They may sexually abuse their children or the children of their intimate partner • The physical abuse prevents the victim of violence from caring for the children 2003 CDHS, College Relations Group, BSC Research Foundation

20. Harms Continued… • Children may be coerced by the perpetrator to assist in the violence against the victim • Children witness violence • Perpetrators of violence may undermine interventions to protect children 2003 CDHS, College Relations Group, BSC Research Foundation

21. So how do you ask about IPV? • First and foremost – INTERVIEW THE WOMAN ALONE • Create a private space to conduct an interview • Conduct the interview in the primary language 2003 CDHS, College Relations Group, BSC Research Foundation

22. How to ask… • Be direct and nonjudgmental • Have good eye contact • Stay calm • Do not exhibit emotionally charged reactions • Do not dismiss what is being told to you 2003 CDHS, College Relations Group, BSC Research Foundation

23. How do you start? • You may want to start in a general manner… • “Because violence is so common in many people’s lives, I’ve begun to ask all my clients about it.” • “Many women I see are dealing will violence in their relationships. Some are too afraid to bring it up themselves, so I have begun to ask about it routinely.” 2003 CDHS, College Relations Group, BSC Research Foundation

24. Specific Screening Questions • Are you in a relationship in which you have been physically hurt or threatened by your partner? • Has your partner ever destroyed things you cared about? • Has your partner ever forced you to have sex, or engage in sex that makes you feel uncomfortable? • Do you feel afraid of your partner? 2003 CDHS, College Relations Group, BSC Research Foundation

25. More Screening Questions… • Has your partner ever prevented you from leaving the house, visiting family, seeking friends, getting a job, or going to school? • Has your partner threatened or harmed your children in any way? • Do you have guns in your home? Has your partner threatened to use them? • Questions from the American Medical Association Practice Guidelines for Screening for IPV 2003 CDHS, College Relations Group, BSC Research Foundation

26. Or Sometimes You Need To Ask… • Did someone cause this injury? (or insert black eye, broken wrist etc.) 2003 CDHS, College Relations Group, BSC Research Foundation

27. Do You Screen in Front of Children? • If the child is 3 or younger it may be fine • However it is best to take the lead from the mother… so ask • Some factors to consider why not to have children present: • Women fear the children will accidentally disclose • Fear of traumatizing the child by listening • Need to protect the abuser • Concern that the child would worry and want to protect • Zink and Jacobson 2003 2003 CDHS, College Relations Group, BSC Research Foundation

28. What Next When The IPV Screen is Positive? • Safety Plan, Safety Plan, Safety Plan 2003 CDHS, College Relations Group, BSC Research Foundation

29. What is a Safety Plan? • A tool to assist in identifying options, evaluating those options and committing a plan to reduce the risk when confronted with threat of harm or with actual harm 2003 CDHS, College Relations Group, BSC Research Foundation

30. Developing a Safety Plan • When your partner escalates where can you move that is low risk • **avoid the kitchen, garage, or rooms where there are weapons ** • Use your judgment or intuition – if the situation is very serious what can be done to calm your partner 2003 CDHS, College Relations Group, BSC Research Foundation

31. Safety Planning Continued… • Where can you leave money, important documents and cloths (i.e. with someone or have a bag packed and hidden) • Can you create a code word or signal with a friend or neighbor that indicates the need for help • Is there a safe place to go - Is it appropriate to have a plan of escape 2003 CDHS, College Relations Group, BSC Research Foundation

32. Safety Planning… • Do they have an Order of Protection • Is it with them at all times • Are copies provided to those who need it (hospital, local police departments, friends or family, employer, children’s day care) • What will you do if your partner violates the order 2003 CDHS, College Relations Group, BSC Research Foundation

33. Safety Planning… • Provide community resources in a manner that is safe from the partner 2003 CDHS, College Relations Group, BSC Research Foundation

34. How Does Witnessing IPV Affect Children? • Children’s Problems Associated with Witnessing Violence have been categorized as: • Behavioral and Emotional • Cognitive Functioning and Attitude • Longer Term 2003 CDHS, College Relations Group, BSC Research Foundation

35. Children who witness parental IPV may exhibit • aggression • hostility • anxiety • social withdrawal • cognitive-functioning problems • depression • lower-verbal and quantitative skills • attitudes supporting violence • (Edleson 1999) 2003 CDHS, College Relations Group, BSC Research Foundation

36. Impact of Exposure to Domestic Violence • Increase in Externalizing Behaviors • Aggressiveness • Behavior problems in school • Temper Tantrums • Fights 2003 CDHS, College Relations Group, BSC Research Foundation

37. Increase in Internalizing Behaviors • Depression • Suicidal Behavior • Anxiety • Fear • Phobias • Insomnia • Bed-wetting • Low Self-Esteem 2003 CDHS, College Relations Group, BSC Research Foundation

38. Cognitive and Academic Functioning Problems • Impaired ability to concentrate • Difficulty with school work • Lower scores in verbal, motor and cognitive measures 2003 CDHS, College Relations Group, BSC Research Foundation

39. Witnessing IPV and Post Traumatic Stress Disorder (PTSD) • Study by Kilpatrick, Litt and Williams (1997) showed that 85% of children ages 6-12 who witnessed IPV had moderate to severe PTSD symptoms • Compared to 0% of the control group who had witnessed no violence 2003 CDHS, College Relations Group, BSC Research Foundation

40. PTSD Symptoms May Be • Emotional Numbing • Increased Arousal • Avoidance of Reminders of the Violent Event • Obsessive or Repeated Focus on the Event 2003 CDHS, College Relations Group, BSC Research Foundation

41. Long Term Implications • Retrospective studies have shown that negative effects of IPV persist into adulthood with increased rates of • Depression • Poor Self-Esteem • Violent Practices in the Home • Criminal Behavior • Fantuzzo and Mohr 1999 2003 CDHS, College Relations Group, BSC Research Foundation

42. Impacts of Violence on Child Development • Infancy • Insecure attachment 2003 CDHS, College Relations Group, BSC Research Foundation

43. Toddlers • Hesitancy to explore • Separation Anxiety • Aggression • Withdrawal • Reduced ability to cope with frustrations • Communication problems 2003 CDHS, College Relations Group, BSC Research Foundation

44. Preschoolers • Disrupted Interpersonal Relationships • Cognitive Difficulties • Lack in peer support • Caretaking by child 2003 CDHS, College Relations Group, BSC Research Foundation

45. School-age and Adolescents • Aggression, Delinquency • Self-Destructive Behaviors • Bias for interpreting hostile intent • Limited competent social responses • Depression, Anxiety, Fear • Post-Traumatic Stress Symptoms • Hypervigilance, Hyperarousal 2003 CDHS, College Relations Group, BSC Research Foundation

46. Disruptions at one stage my contribute to the next stage further disrupting the mastery of the following developmental stages 2003 CDHS, College Relations Group, BSC Research Foundation

47. How do you Respond to Children? • Believe Them 2003 CDHS, College Relations Group, BSC Research Foundation

48. Allow children the opportunity to tell their story • Start with what they know and think • You can ask neutral questions to facilitate the process for them only if you see they are willing to share • Do NOT ask further questions if the child appears uncomfortable or unwilling to continue the discussion 2003 CDHS, College Relations Group, BSC Research Foundation

49. Reflect Back on and Validate Their Feelings • That must have been scary for you 2003 CDHS, College Relations Group, BSC Research Foundation

50. Provide Reassurance - Children Need to Know That Adults are Available to Help • You may respond by saying: • It is not their fault • Violence is NOT ok • You do not deserve to have violence in your family 2003 CDHS, College Relations Group, BSC Research Foundation