Title: Literature Review: Better Outcomes for Children and Young People Experiencing Domestic Abuse – Directions for Good Practice
Authors: Professor Cathy Humphreys, Dr Jane Ellis, Claire Houghton
Affiliations: University of Melbourne, NSPCC
The National Strategy to Address Domestic Abuse in Scotland acknowledges the correlation between domestic abuse and the mental, physical and sexual abuse of children. The reform of children’s services in Scotland includes developing a delivery plan focused on better outcomes for children and young people affected by domestic abuse. This international review aims to provide an evidence base to support directions for good practice, and includes a chapter on qualitative evidence from Scottish children’s own perspectives on domestic abuse.
There is a “widespread, chronic and serious social problem” of children living with domestic abuse – the Department of Health estimated 750,000 children in England and Wales were affected in 2002, and that about half the incidents of reported domestic abuse in Scotland involved children. Some 87% of recorded incidents in Scotland involve a female victim and a male perpetrator. To be alert to the safeguarding of all children it is important to acknowledge minority patterns of abuse.
Numerous studies report that domestic abuse and direct physical or sexual abuse of children often occur together. Analysis of 31 high-quality research studies showed that between 30% and 66% of children who suffer physical abuse are also living with domestic abuse, and a US study found an almost 100% correlation between the most severe abuse of women and physical abuse of children by men. The research also suggests there may be no clear distinction between witnessing domestic abuse and experiencing direct abuse the issue of domestic violence towards pregnant women marks how inadequate this distinction can be, with studies showing that pregnancy is a time of increased risk. The notion of “witnessing” fails to capture the extent to which children may be involved in domestic abuse – for instance in defending their mother or being in her arms when an assault happens.
Research on the impact on children living with domestic abuse indicates much higher rates of depression and anxiety, trauma symptoms and behavioural and cognitive problems than those who do not encounter these issues. Impacts on developmental and behavioural outcomes are similar for children witnessing domestic abuse and those experiencing direct physical abuse. Indeed, for children under eight years old witnessing abuse towards their primary care giver may be more psychologically disturbing than direct physical maltreatment.
Emerging evidence on the interaction between environment and babies’ neurological development draws attention to their vulnerability to the effects of trauma these studies also suggest that development is recoverable with early intervention and removal from the stressful environment.
Research looking at the impact of domestic abuse shows that in many groups there is a substantial sub-group whose well-being is comparable to that of other children. This raises questions as to whether a child protection referral is always best. Many factors may moderate the risks to and experiences of children including: the severity of the violence, the extent to which their needs are neglected, family and community support, and the mother’s mental health. Like their mothers, many children will recover behaviourally once they are in a safer environment.
There is an emerging conceptualisation of domestic abuse as an attack on the mother-child relationship. Anxiety and depression interfere with a mother’s parenting capacity, and an assault in front of her children undermines her self-respect and authority to parent confidently. Children often come to the notice of services when their mother’s health and well-being is undermined to the point where it affects her parenting. Unless this attack on their relationship is recognised, domestic abuse may not be recognised as a primary issue.
The literature shows that children see themselves as “integrally involved and as more than mere witnesses” and that their experience of domestic abuse influences interactions and relationships in all spheres of their lives. Children are often more aware of domestic abuse than their mother thinks, and their perception of its effect on themselves may differ. The meanings children attach to incidents, the actions they take to protect themselves or siblings and the direct abuse children may be suffering can all be unknown to the mother.
Children in these studies do not separate women’s and children’s abuse, but speak of the mental, physical and sexual abuse to which women and children are subjected. Their lives are commonly marked by fear, sadness and anger, and difficult, contradictory feelings towards the abusing father. The majority of children were clear that the violence was the father’s fault, though younger children may look for a reason or cause for the violence. The fear continues after separation from the father and discussions about contact are marked by anxiety.
Major issues that dominate children’s accounts are the effects of domestic violence on safety and the loss of the familiar. Losing a home, possessions and pets, and losing contact with siblings, grandparents and friends were sources of resentment.
The headline message is that children want to be safe and to be listened to. The most important people were mothers and siblings, and friends were a source of support. According to the research “Few children place their trust in professionals or feel they will or do respond appropriately with the exception of specialist domestic abuse children’s support workers in Women’s Aid.”
Key messages from children’s perspectives included:
● “Get the feelings out” by crying, by getting comfort (from toys, pets and mothers), getting anger out, writing or talking about feelings, or by doing other things as a way of escaping, such as being with friends or doing sport.
● The most common advice children give others is “don’t bottle it up”.
● Fear of being taken into care often prevents children telling anyone outside the family.
● Professionals should hold the perpetrator accountable as an abusive father.
● Many children can only begin to talk about and get over things once they are safe. Going into a refuge involves loss of friends and making new friends. Their experiences can provide an opportunity to talk and share with no stigma attached.
● Ways should be found to replace or bring or store children’s possessions and toys.
● Children need their own support worker whom they can trust. The same worker should be available early on and throughout the process of leaving the refuge.
● Confidentiality is vital in developing trust. This is about fear of the perpetrator and feelings of stigma. For children from ethnic minorities, these issues can be accentuated by having to leave their community, by cultural beliefs (such as bringing shame upon the family) and by fear of racism.
Key themes also emerge on the issue of protection. The authors suggest effective multi-agency collaboration should aim to provide a “powerful network of protection, one which rivals the power of the perpetrator to have his needs and demands prevail”. Protective intervention must focus on the perpetrator with the protection of children separate but linked to that of their mothers.
In many countries the automatic notification of the statutory child protection authority in domestic abuse cases has caused child protection systems to be overwhelmed. The authors suggest that many cases might be dealt with by earlier intervention. It is a complex issue differentiating those children at risk of significant harm and those who can be safely supported in the community.
In 1981, the Domestic Abuse Intervention Project in Duluth, Minnesota, USA, was the first multi-disciplinary programme to address domestic violence. This model is the one on which most UK and Australian programmes draw. Key points from the Duluth template for developing an integrated response are:
● A common language and philosophical framework.
● Consistent policies and procedures that co-ordinate practitioners’ interventions.
● Monitor cases from initial contact to case disposition to ensure practitioner and offender accountability.
● Co-ordinate inter-agency information exchange and inter-agency decisions on individual cases.
● Provide resources and services to victims and at-risk family members to protect them from further abuse.
● Use a combination of sanctions, restrictions and rehabilitation to hold offenders accountable and protect victims.
● Evaluate the co-ordinated response from the standpoint of victim safety and the goals of the intervening agencies (Pence and Shepard, 1999).
The authors of this review draw on the work of Burke (1999) to develop four principles for working with domestic abuse in families: safety and protection of children, empowerment and safety for women, responsibility and accountability of perpetrators, and attention to strengthening the mother-child relationship.
Other approaches discussed include exclusion orders, which allow women and children to remain in their own homes and are now the major front-line response to incidents of domestic abuse in Germanic countries. This requires significant support and monitoring to ensure compliance and will never be a safe option for some.
Men’s behaviour change programmes remain controversial. Research does suggest that attendance at the programmes is more effective than a simple arrest and probation response. Strengthening the response of the criminal justice system needs to be a priority to develop the programmes so that policing, prosecution, court, probation and the programmes are consistent in their approach.
The emphasis in this report on children’s perspectives, on international research data and on delivering directions for good practice make it a pertinent report that will be of interest to managers and practitioners involved in developing multi-agency approaches to domestic violence that keep children’s needs at the centre of the agenda.Importance of contact and consultation
● Children need to participate in decisions about contact, preferably with support from someone they trust and can confide in. If they do not want contact it should not be awarded. If it is awarded and children do not feel safe they should be allowed to opt out at any point.
● The professional support that children evaluate most highly is from specialist children’s support workers. Use regular evaluation to ensure children in refuges receive the range of support they recommend, especially one named worker throughout the time in refuge and resettling.
● Phase out the communal refuges that children hate.
● Make sure resettling housing options are child-friendly, and take steps to ensure women and children are safe their new home.
● Help children to stay in touch with friends.
● Offer structured group work for children.
● Schools must improve their support of children experiencing domestic abuse. Develop specialist support and ensure teachers have the skills to deal with the issues. Use children’s expertise about what can help.
● Participation of women and children in service development.
● A robust evaluation and monitoring system.
● The collection and sharing of co-ordinated domestic abuse data.
● Shared risk assessment, management and safety planning.
● Increased intervention with perpetrators from a range of agencies, specifically in relation to child protection.
● Accredited men’s behavioural change programmes as part of an integrated system with criminal and civil justice.
● Strong multi-agency interventions to enable more women and children to stay in their own homes safely: greater use of exclusion orders linked to house security measures, monitoring of perpetrators.
Dr Susannah Bowyer is research officer at Research in Practice
This article is published in the 18 September edition of Community Care magazine under the headline Better Outcomes in Domestic Abuse Cases