Integrating Responses to Children Living with Domestic Violence

1. Integrating Responses to Children Living with Domestic Violence Nicky Stanley Professor of Social Work University of Central Lancashire

2. Domestic Violence in Finland • 30% of women have experienced physical and/or sexual violence by a current or previous partner since age of 15 • Second highest rate in EU survey after Denmark and Latvia. (European Union Agency for Fundamental Rights 2014)

3. Prevalence of Children’s Exposure to Domestic Violence Systematic review of Nordic studies(Kloppen et al 2015): 7%- 12.5% children across 9 Nordic studies had seen, heard or knew about domestic violence in their family UK prevalence study (Radford et al 2011) Under 11 11-17 18-24 At least one 12% 18.4% 24.8% type in childhood Severe violence 3.5% 4.1% 6% (kicking, choking, beating up)

4. Harm inflicted by domestic violence varies by developmental stage: • Infants and pre-school: delayed development, sleep disturbance, temper tantrums and distress • Schoolchildren: conduct disorders, problems in concentration and in peer relationships • Adolescents: depression, delinquency, aggression to peers, abuse in their own intimate relationships

5. Arguments for Interagency Approaches • Domestic violence widespread - children intimately involved - but for some professionals, children drop off the radar • DV has more than one victim – different agencies focus on different family members • Children’s needs can be hidden – harm arising from DV mainly emotional/psychological - agencies rely on other professionals to provide information • Children and families do not experience DV as an isolated issue, overlaps with child abuse, crime, poor housing, mental health needs, immigration issues.

6. Collaboration & Integration at 3 Levels: • Identification and Front Line Response • Screening and Assessment • Interventions offering support and assisting recovery

7. Identification and Front Line Responses

8. What do Children and Young People Want at the Front Line? • Children & young people want professionals to talk to them about domestic abuse, keep them informed & take them seriously: ‘They listen to the adults more … they don’t want to talk to you.’ (Nicola, Stanley et al 2010) ‘When my dad came round and he started kicking off, the police come round and they arrested him, they took a statement of my mum and that's it…they didn't say to us what happened if he was going to be released the next day or - we didn't find out anything.’(Dawn, Stanley et al 2010)

9. Police Practice with Children at DVA Incidents • Little evidence of police engaging with children • Half officers interviewed expressed some reluctance about talking directly to children • No information provided for children ‘… it's not something that's done as often as you would probably think’ (Frontline Officer 8) ‘I would probably have to say that they don’t [talk to children], probably because they wouldn’t know how to ….‘ (Supervising Officer 2)

10. Consequences for Communication with Children’s Social Services (Stanley et al 2012) • Quality and accuracy of information re names, addresses, children’s ages etc varied • Incidents where children were injured all reported to children’s social services • Extent of children’s involvement in incidents not always communicated • Information sometimes incomplete • Social workers interviewed described a lack of detail concerning children’s involvement in incidents in notifications received

11. Icelandic Pilot Project 2011-13 • Specialist children’s worker accompanied police to DV incident where children known to be in house • Children assessed for traumatic effects • Follow-up visit next day to complete assessment, further intervention available • Initial service - focuses on ‘hearing their voice’, creating sense of safety, relieving child of blame • Service now delivered by child protection services

12. Family Doctors’ Practice with Children Experiencing DV (RESPONDS study, Szilassy et al 2015) ‘It would be a very good thing to speak to the children about it…I'm not sure I would do that actually.’ GP18 ‘I must admit, if they're at school or a teenager or something like that, no, I don't. I've never, never made arrangements to do that, you mean to talk to them or examine them or what? ‘ GP25 Only 5 of 54 practitioners had done so/would do so: ‘…sometimes you have to because they've already decided they don't trust those grown-ups, then you have to be the one who tells them stuff.’GP30

13. Doctors’ collaboration with children’s social services • Majority described relationship as non-existent or problematic Lack of face-to-face contact: ‘I think what we miss out on is, is knowing …who the Social Workers are and what makes them tick, what sort of work they can be doing with these families’ PN08 Lack of feedback: ‘I haven't had any feedback from the Social Worker …it would be nice to know what's happening… ‘PN11

14. Doctors’ Collaboration with DV services • Two-thirds of those interviewed had no knowledge of local DV services or described the relationship as ‘distant’ ‘I don't know what services are available to be honest in this area …I'd have to go and find out.’GP13

15. Can of worms • ‘…if you don't know what you're going to do about something if you find out about it, then you don't make any effort to find out about it, the last thing you want to do is get someone to disclose domestic violence and then have no idea what you're going to do about it.’ GP22

16. Multi-Agency Screening and Assessment

17. Screening and targeted enquiry • Systematic review (Feder et al 2009) - lack of evidence for effectiveness & acceptability of screening women in health settings • NICE guidance (2014):‘Ensure frontline staff in all services are trained to recognise indicators of DVA and can ask relevant questions to help people disclose. The enquiry should be made in private on a one-to-one basis in an environment where the person feels safe, and in a kind, sensitive manner.’

18. High volume of referrals a differential response • Distinguishes levels of risk • Matches different service levels to levels of risk • Co-ordinates contributions of different professionals and organisations • N America & UK – differential response models widely used & underpinned by standardised risk assessment tools • Inherent risk of approach – families identified as ‘low risk’ domestic violence receive little support • Increasing arguments for early intervention services for low risk families

19. UK multi-agency structures Aim to promote information sharing and overcome differences in risk assessment: • MARACs (Multi-Agency Risk Assessment Conferences) – led by police, high-risk DV cases only, focus on adult victim but benefits for work with children • MASH (Multi-Agency Safeguarding Hubs) – police & social services pool data in ‘sealed intelligence hub’ – no robust evidence for effectiveness as yet • Interagency risk assessment panels or triage

20. Social work often fails to engage father/perpetrator in assessment ‘I personally don’t ever get involved with the perpetrator. Not at the time that the domestic violence has gone on.’ (Initial assessment SW, Stanley et al 2011) See also Alaggia et al’s (2015) Canadian study • Inaccessibility of fathers to social workers • Fathers’ limited involvement with children • Lack of relevant services for DV perpetrators • Concerns about staff safety • Social work traditionally focuses on mothers

21. Instead, focus on blaming mothers: ‘the woman I had written to was quite . . . frustrated... Because clearly she . . . had tried very hard to keep her child safe and felt that it was the husband or the ex-partner’s behaviour, that he should be the one that we should be addressing.’ (Initial Assessment Worker 3, Stanley et al 2011).

22. And sets up separation as a goal • Separation treated as goal of social work intervention • Services withdrawn when couple separated • However, separation itself is inherently risky and ‘is not a vaccination against violence’ (Jaffe): over half couples in Stanley et al’s (2011) sample were already separated.

23. Protecting Children from Domestic Violence beyond Separation • Likelihood and severity of domestic violence increases around point of separation • Family courts may have presumption of contact with father • Contact used to extend and maintain coercion (Radford and Hester 2016)

24. Listening to children’s views re contact with fathers Eriksson’s (2009) Swedish study found: • Children varied in whether they continued to see their fathers and whether they wanted to. • Few felt that social workers allowed them to participate in decisions made about future contact. • Morrison’s (2015) Scottish study found: court officers started from assumption that contact was always beneficial for children and failed to listen to children’s views.

25. Interventions Offering Support and Assisting Recovery

26. Interventions for Mothers and Children (Haworth et al 2016) • Psychoeducational group interventions for children only most effective if measuring mh symptoms • Interventions delivered to mothers & children in parallel most effective if measuring behaviour • Readiness for intervention was key • Children learn to: place responsibility for DV outside themselves, discover they are not alone, build self-esteem, have fun with others • Mothers learn to: engage with child’s perspective on DV, build parenting skills, communication with child improved.

27. Work with DV perpetrators reconceptualised as child protection • Kelly & Westmarland (2015) - over 2/3 of referrals to UK perpetrator programmes from children’s social workers • DVIP, London – locating specialist staff with skills and experience in working with DV perpetrators in child protection teams • Aims to build confidence and skills of child protection social workers in work with abusive fathers • Caring Dads – aims to integrate DV prevention and parenting skill training for fathers

28. Whole System Approaches

29. Whole Family Approaches to Domestic Violence • Increasing recognition that failing to work with perpetrators places responsibility on women for men’s violence and results in ‘mother blaming’. • Recognition that some families do not want to separate and DV continues beyond separation. • Need for interventions for children to be reinforced in family setting. • Growth in perpetrator services in UK is building confidence & skills in working with abusive men.

30. Many Forms of Whole Family Approaches: 1.One agency works with all family members who agree to be seen. They are usually seen separately and individually, perhaps with different workers for victim, perpetrator and children, sometimes together. 2. Different agencies work with different members of the same family, but co-ordinate their work. 3. Interventions are delivered to the family as a group - family are always seen together – draws on systems approaches.

31. Criticisms of ‘whole family’ approaches • Fails to recognise gendered power dynamics that inform DV – DV affects different family members differently. • Safety of women and children may be compromised. • Men resist family interventions and women & children become focus of services’ scrutiny. • Adolescents often want support in their own right, not as part of a family. • Organisations aiming to deliver whole family service struggle to maintain focus on all family members. • Evidence base currently weak

32. The Green Book – a model for interagency training and collaboration? Initiative over 5 years in 5 US states to ensure coordination of work of agencies involved in DV and child protection • Training to develop ‘Institutional empathy’ • Effective and neutral leaders • Specialist/co-located posts shifted agency practice • Multiagency teams/meetings reduced mother blaming, provided support &advocacy for all family members and co-ordinatedinterventions. (Banks et al 2008)

33. Institutional Empathy: understanding of the context shaping how another agency works “. . . we need to be having joint training and things like that …to know each other’s parts, what we do, because I still don’t know what other agencies do properly, I know they do something but I don’t know what.” (DV Specialist Police Officer, Stanley et al 2010) ‘I think I'd…like some more clarity on, you know, what, what the Police response would be [...] maybe even talk to people like solicitors and people involved further along the chain, to say well what actually happens to these women, what are the outcomes? …I'd like to know what happens rather than just my end of it.’ (GP1, Szilassy et al 2015)

34. Key Messages • All professionals need to listen to children and acknowledge their involvement in DV • Conceptualising DV as problem for all family members promotes integrated services • Risks and benefits characterise ‘whole family’ interventions • Anxiety about opening a ‘can of worms’ reduced when professionals have something to offer children • Recognise differences in professional priorities, practice and goals • Interagency training aimed at developing institutional empathy

35. References Banks D, et al (2008) Collaborative Efforts to Improve System Response to Families who are Experiencing Child Maltreatment and Domestic Violence. Journal of Interpersonal Violence, 23, (7) 876-902. Eriksson M (2009) ‘Girls and Boys as Victims: Social workers’ approaches to children exposed to violence’ Child Abuse Review 18 (6) 428-445. Howarth, E. et al. (2016) IMPRoving Outcomes for children exposed to domestic ViolencE (IMPROVE): an evidence synthesis. Public Health Research, 4.10 https://www.ncbi.nlm.nih.gov/books/NBK401353/ Kloppen, K. et al (2015) Prevalence of Intrafamilial Child Maltreatment in the Nordic countries: A Review. Child Abuse Review, 24, 51-66. Stanley, N. et al (2010) Children and Families Experiencing Domestic Violence: Police and Children’s Services’ Responses http://www.nspcc.org.uk/Inform/research/Findings/children_experiencing_domestic_violence_wda68549.html Stanley, N. et al (2012) ‘Engaging with Children’s and Parents’ Perspectives on Domestic Violence’. Child and Family Social Work, 17, 2, 192–201. Szilassy, E. et al (2015) Working Together, Working Apart: General Practice Professionals’ Perspectives on Interagency Collaboration in Relation to Children Experiencing Domestic Violence. In Stanley,N. &Humphreys, C. Domestic Violence and Protecting Children: New Thinking & Approaches.  London: JKP.