As family violence remains a pressing issue with more than 1 million Australian affected, the sector is constantly seeking more innovative, effective methods of addressing and intervening in instances of family violence involving children.
The complexity of the issue, due to differing policy responses of family law, child protection and family violence agencies, makes it difficult to evaluate intervention strategies with so many contributing factors. This article, however, defines effectiveness as proven to deliver better outcomes for the child in the context of family violence.
Intervention methods vary drastically in practice, method, settings and are often unique to the age group of the child. This article broadly examines five of the most recently successful intervention attempts across age groups based on industry research.
In their Comprehensive Review of Interventions for Children Exposed to Domestic Violence, Futures without Violence details several of the most effective intervention strategies for children experiencing or exposed to family violence.
- Child-Parent Psychotherapy
A therapeutic intervention, CPP works with the non-offending parent and children up to five years old. The therapy is delivered weekly in joint sessions with the parent and child and are designed to change the parent and child’s maladaptive behaviours while supporting appropriate interactions between them and working through the trauma they have experienced. The number of sessions range from 12 to 40 and the manual has been translated into Spanish, French and Italian.
In a randomized controlled trial with children exposed to domestic violence, 75 multiethnic preschool-age children and their mothers underwent CPP. At the end of the one-year treatment period, children who received CPP had:
- Fewer total behaviour problems
- Decreased traumatic stress symptoms
- Were less likely to be diagnosed with traumatic stress symptoms
The parent receiving CPP showed fewer posttraumatic stress avoidance symptoms compared to those in the control group. Six months after the intervention had ended, children who participated in CPP had significantly fewer behaviour problems and their mothers had less severe psychiatric symptoms compared to children and mothers who received only case management and community referrals.
- Trauma-Focused Cognitive Behavioral Therapy
A therapeutic intervention that focuses on the reduction of PTSD symptoms through individual therapy sessions with children, ages 3-18 years old, individual sessions with parents, and joint parent-child sessions. TFCBT can be delivered in the home, school or residential care and usually involves 12 to 16 sessions. There is also a shorter version available for mothers and children staying at domestic violence shelters.
An RCT was conducted in a domestic violence shelter for children with symptoms of PTSD related to domestic violence, children and parents were randomly assigned to receive 8 sessions of TFCBT of TFCBT or child-centered therapy (the usual care). TFCBT was shown to be more effective than child-centered therapy in improving the child’s PTSD and anxiety.
- Cognitive-Behavioral Intervention for Trauma in Schools
A classroom-based intervention delivered by school-based mental health clinicians, CBITS was developed for children who have witnessed violence. CBITS “helps children to process traumatic memories, express their grief, learn relaxation skills, challenge upsetting thoughts and improve social problem-solving.” Drawing is a tool to help children express themselves.
Originally designed for children in years 3 to 8, it has been adapted for high school age students, low literacy students, students in foster care and students in faith-based settings. The intervention is offered in 10 group sessions, at least one individual session for each student and up to four group meetings with parents.
In an RCT conducted with 6th grade students who were randomly assigned to an early intervention group or a delayed intervention comparison group. After three months, students in the early intervention group had significantly lower rates of PTSD symptoms compared to the control group. Sixty-seven per cent of the early intervention group reported less severe symptoms of depression than would be expected without the intervention.
“At six-month follow-up, there was no difference in PTSD symptoms, depression, or psychosocial dysfunction between the early intervention and the delayed intervention group (both groups had now received the intervention). This means that the positive effects were maintained in the early intervention group and that the delayed intervention group had achieved positive outcomes similar to the early intervention group.”
- Parent-Child Interaction Therapy
A behavioural family interaction designed for children up to 12 years old, PCIT uses step-by-step live coached sessions with the parent and child to address behavioural problems and reduce the risk of child maltreatment. The therapy emphasises changing negative parent-child interactions and improving the quality of relationships. Initially designed to be delivered by therapists, PCIT has also been adapted to be delivered by teachers and in domestic violence shelters.
In one RCT, parents were randomly assigned to one of three interventions:
- PCIT plus individualised services
- Standard community-based parenting group
Two years post-intervention, 19% of parents who received PCIT had re-reports of physical child abuse compared to 49% of parents who received standard community-based interventions. “Practitioners of PCIT have described how the intervention can be modified to address the effects of domestic violence on mothers and their children and the impact of victimization on mothers’ parenting skills.” It’s noted that PCIT should not be used for CEDV if the domestic violence is ongoing.
- Caring Dads: Helping Fathers Value Their Children
A parent intervention for men who have been identified as maltreating their children and/or exposing them to domestic violence (or are at high risk of)), Caring Dads aims to:
- Engage men in the process of examining their parenting style
- Increase their awareness of child-centered parenting
- eliminate abusive behaviours
- Promote respectful, non-abusive co-parenting with the child’s mother
- Recognise the impact of their abusive behaviour
- Connect them with other service providers to help their children be safe and recover from trauma
The intervention is offered in a variety of settings including batterer’s intervention programs, family service agencies, shelters, child protective service agencies and mental health service agencies for children and families. It involves systematic outreach to mothers and ongoing, collaborative case management with fathers combined with psycho-educational and cognitive-behavioural intervention methods to address core risk mechanisms for abusive behaviours.
Results from a preliminary evaluation of Caring Dads found decreased levels of hostility, denigration, rejection and anger towards their children compared to pre-intervention.
“There were statistically significant reductions in group mean scores for fathers’ laxness, over-reactivity, and hostility. At the individual level, 43% of men were classified as recovered or improved for reactivity, 25% had recovered or improved with regard to hostile behaviours, and 43.5% were recovered or improved relative to over-reactivity. More than one-third (36%) of the men showed improvement large enough to be clinically significant for co-parenting skills.”
Monique Yeoman, the Statewide Coordinator of Caring Dads at Kids First Australia, will be talking more about the initiative alongside sector leaders and practitioners at the Child-Centred Approaches to Ending Family Violence conference. Running from 18 – 20 September 2019 in Melbourne, the event will bring together senior leaders and practitioners from across Australia to discuss how the sector can be more child-centred in their responses to family violence in policy, service delivery and practice.
If you or someone you know is in immediate danger, please call 000 or visit your nearest hospital emergency.
Kids Helpline: 1800 55 1800
Men’s Referral Service: 1300 766 491
Lifeline: 13 11 14|
1800RESPECT: 1800 737 732