OVC Provider Forum Transcript

Helping Children Exposed to Domestic Violence
Miriam Berkman, Sherry Hamby  -  2009/10/26
are there particular lasting efects (sympptomology) for children who have used violence to protect one parent from another? PTSD being obvious, is there anything else that one should look out for?
1.  Sherry Hamby
 The latest research shows that children are often very involved in incidents of violence between parents. In one recent study by Jeff Edleson and his colleagues (2008), 43 of exposed children physically tried to stop a fight between their mom and their mothers partner. Unfortunately, we dont have good specific research on how different types of reactions are associated with outcome. Aside from PTSD, two things the existing literature does suggest you look for in the above scenario is the risk of child maltreatment and the risk of aggression problems on the part of the child. Children who witness violence between their parents are approximately 4 times more likely to be victims of maltreatment than other youth, according to the latest figures from NatSCEV, the National Survey of Childrens Exposure to Violence. Children who try to physically protect a parent may well put themselves at even greater risk.Also, problems with aggression and other externalizing behaviors are a well-documented outcome of exposure to DV, and so any indication of aggressive behavior on the part of the child would suggest a need to explore that further.
What does the latest research show about children who have a parent that is a victim of intimate partner sexual violence? Are there any promising practices in working with those children?
1.  Sherry Hamby
 Very little of the research specifically focuses on exposure to sexual violence between parents. In NatSCEV, we did ask one question on exposure to sexual violence for anyone close to the youth, and we did obtain a lifetime rate of 8%, so it is not a trivial problem, but that was for knowing about any victim (sister, friend, etc), not just parent victims. (Note this was for finding out about a sexual victimization, not being an eyewitness, which is presumably much rarer.) The rate for witnessing physical assault between parents was twice as high at 16% lifetime, so it is considerably more common. I am not aware of any programs that specifically address the effects of intimate partner sexual assault on children. Intimate partner sexual assault remains an under-studied area. Alicia Lieberman and Patricia Van Horn present a nice case study on this topic in their book, Psychotherapy with Infants and Young Children (2008).
What are effective strategies are used to talk with mothers about effects of violence on their children--without making them feel guilty or on the defensive?
1.  S
 What if this Mother is not responsive? What if she is the cause of this violence and/or what if she allows her older youth to perpetrate their violence? What are the next steps and/or would this be considered neglect and/or maltreatment if she does nothing? And if she is separated from the non custodial Father, what rightsrole can he play?
2.  Miriam Berkman
 Some helpful strategies include: (1) emphasizing how important mothers are in protecting their children from violence and that support from the nonviolent parent is one of the most important factors that protects children from negative psychological effects; (2) introducing the topic with an acknowledgement that most people are unaware of the effects of domestic violence on children, especially young children, because children often do not tell their parents of their distress; (3) emphasizing that there is help for children who do experience symptoms so that the mother does not need to feel the effects on her child will last forever.
Can you identify model programs that serve children, ages 12 and up, who are exposed to domestic violence?
1.  Miriam Berkman
 One excellent program for children is the Group Treatment for Children Affected by Domestic Violence developed by Childrens Institute, Inc. in Lost Angeles. This program includes parallel groups for children and non-offending parents that focus on safety, trauma-related symptom reduction, anger management and strengthening relationships between children and their non-offending parents. Joint parent-child sessions are included as well as opportunities for individual trauma-focused treatment for those children who have serious symptoms. More information can be obtained from Leslie Ross lross@childrensinstitute.org. Other trauma-focused treatment programs are described on the National Child Traumatic Stress Networks website www.nctsn.org.
Given the changes in children's neurobiology in response to violence and trauma (hyperarousal etc...), are there any evidence based treatments or approaches to helping these children with resulting behavioral or emotional consequences?
1.  Patricia Stern
 In speaking with the authors of TF-CBT, they have said that the intervention is not as effective for children exposed to domestic violence as for a acuteone-time traumatic incident
2.  Miriam Berkman
 There are several evidence-based treatments for children exposed to domestic violence and other potentially traumatic events described on the website of the National Child Traumatic Stress Network (www.nctsn.org) (see resources - topics - treatments that work). The treatment with the strongest evidence base is Trauma-focused Cognitive Behavioral Treatment (TF-CBT), a structured approach that includes psychoeducation, relaxation, techniques for emotional regulation, cognitive coping, enhancing safety and development and processing of a detailed narrative about the traumatic event(s). Web-based training is available through www.tfcbt.musc.edu. For young children (0-6), Child-Parent Psychotherapy (CPP), developed at UCSF by Lieberman and Van Horn, is a well supported treatment that works with the mother-child dyad to decrease trauma symptoms and enhance the childs relationship with the non-offending parent.
In view of the unfortunate fact that, in many communities, batterers treatment providers and victims support and advocacy are not communicating or cooperating well with each other, how would you suggest for each group to develop an independent program to 1. raise the awareness of DV impact on the children 2. Prioritize specific steps to elevate the childrens' needs (whether they have witnessed the abuse or not), in the interim period, whether either reconciliation or child custody agreements will eventually take place. 3. Outline steps to help the children recover from their tauma.
1.  Sherry Hamby
 Regarding both raising awareness and elevating children's needs, one of the most important steps that can be taken is making an assessment of children's exposure a standard part of screening in all types of programs. The Juvenile Victimization Questionnaire (http://www.unh.edu/ccrc) can be used for this. I also recommend Jeff Edleson's Children's Exposure to Domestic Violence scale (http://www.mincava.umn.edu/cedv/pubs.html). On the other side, I also recommend that in child protective agencies or similar child agencies, that an assessment be done of parent victimization--many steps mandated or suggested by CPS will be difficult or impossible to do if the parent is also a victim. Regarding recovery, several questions have more on this but the Safe Start initiative of the Dept of Justice has a lot of good information.
What are some good topics to start a children's group with, regarding this subject?
1.  melissa
 I totally agree. I have been leading children's support groups for three years now. I always start out having each child, my volunteer and myself offer their name and answer a favorite memory or something you are most proud of question. We also open up with a relaxation exercise. Most think it is silly and it gets them laughing and a little more comfortable before we head into the serious stuff. I also give each child materials to draw while I speak. If their hands are busy... they will talk more.
2.  Miriam Berkman
 Psychoeducation about domestic violence is important early in a group. It is also important to address issues regarding safety -- where kids feel safe and where they feel unsafe; how their bodies feel when they feel unsafe; what they can do to feel more safe. It is important to know if the group members are currently safe and whether they continue to witness violence. If there is ongoing violence, safety plannning with children and their parents is essential.
3.  cindiw
 I have been running childens groups for traumatized children and families impacted by violence for 20 years. I always start with child centered strength based tasks. Examples include, yourself in your favorite place, your role in the family, a memory etc. The child will most often lead you where to go from there
What counseling approaches are most effective with students 6 to 8 years old? What counseling approaches are most effective with students 9 to 11 years old? What are the most effective strategies for classroom teachers to use? What type(s) of on-going support are needed in the school environment? What type of training best prepares school staff for responding to elementary students' needs?
Is there some type of child therapy for that child that was a witness to all of the violence but was not physically injured themselves to keep the cycle from repeating itself?
1.  Miriam Berkman
 Treatment for children who are exposed to violence but not physically injured depends on what symptoms and reactions the child experiences. Many children who witness violence do develop trauma symptoms, and for these children there are evidence-based treatments, such as Trauma-focused CBT and Child-Parent Psychotherapy. (see treatments that work on website of National Child Traumatic Stress Network -- www.nctsn.org). One important reason to treat trauma symptoms is that untreated trauma may be reenacted in the child's own relationships. For children who do not display symptoms at the time of their exposure, safety planning, psychoeducation and support for healthy relationships are useful.
What strategies can you recommend for students who mimic violent/aggressive behaviors they have seen at home in the school setting?
Please discuss evidence-based group interventions for children exposed to domestic violence, aged 5-13, who may still be living in situations with on-going domestic violence. Please discuss psychological assessment tools to gauge the effectiveness of such intervention in assisting the children to develop bettter coping mechanisms, especially given the reality that the violence may be on-going.
In interviews with runaway and prostituted youth for a study of pathways to commercial sexual exploitation (CSE), many focused on dv in their families. Violence between parents figured prominently in teens’ narratives—they ran away, were pushed from their homes, or got lost in the shuffle of their mother’s escape to a shelter or transient housing with relatives. These locales did not focus on social needs of adolescent children of battered women. Separated from families they became vulnerable to CSE. Beyond treatment for PTSD these youth need significant social support. What can those who work with families exposed to dv do specifically to pay attention to these teens and help shift the trajectory of their lives away from further victimization?
1.  Sherry Hamby
 I am developing a new risk management and risk assessment approach called the VIGOR (Victim Inventory of Goals, Options, and Resources) that specifically is intended to help victims of DV include the needs of children in their assessment of safety planning is in part a response of this getting lost in the shuffle. Some info is on the FVPF conference website or you can contact me for more info.Additionally, although I appreciate the many significant and real challenges of having adolescent children, especially adolescent males, in shelter, some agencies are moving away from the more restrictive policies that kept many women from bringing older children to shelter.
What if an adult experienced domestic violence as a child and never received help. Is there any hope for treatment at that stage?
1.  Sherry Hamby
 Yes, there is still hope! Many, many victims of all forms of violence never seek help until adulthood. In some respects, treatment is easier with adults because they have a more complex understanding and are safe or have more control over their safety. Please don't hesitate to encourage adults to seek help.
When incorporating domestic violence into classroom curricula, what advice would you give to ensure children exposed to domestic violence in their homes do not feel "singled out" or feel additional trauma in the classroom (in terms of actual curriculum and/or lesson plan writing)?
1.  Sherry Hamby
 I present in front of groups of students often, and have 4 main suggestions: 1) Depathologize up front by giving data on how common this is--the lifetime NatSCEV rate is 1 in 4 youth, so you probably don't have just 1 or 2 exposed youth, there are probably many.2) Give some guidelines up front about group disclosures--it is not really a safe place to disclose, you cannot guarantee how others will react, so it is better to suggest alternatives. Depending on the age of the students, they may be comfortable talking about a friend.3)Make sure there are opportunities for private disclosure with facilitators later.4) Avoid media, case studies, role plays, or other stimuli that are especially intense--a somewhat sanitized version is less likely to trigger PTSD symptoms in distressed youth. I've even seen people break down in professional meetings when they weren't expecting intense depictions of violence.
What is some key information that teachers, school staff, and school counselors should know when dealing with children exposed to domestic violence?
1.  Sherry Hamby
 Hi Nancy (I thought that was you!--hello to all in Passamaquoddy land). You ask a great question, and one that is not given enough attention. Certainly treating depression or acting should help with peers too, but also many of these children need to be given explicit training on positive conflict resolution and how to have healthy, respectful relationships. They simply haven't had enough positive role models and so beyond don't hit they might not have a very clear idea about what to do instead (you've got to do something!). Alicia Lieberman's child-parent psychotherapy is one strong approach for working with individual families. The CDC has a good overview of prevention programs--the best teach these positive skills and not just how to avoid victimization. http://www.cdc.gov/violenceprevention/pub/YV_bestpractices.html
2.  Nancy Soctomah
 Woliwonthanks. So what specifically can we teach the nonoffending parent of these children and the child him/herself so as to put the child in a better position, i.e. bullyproof the child so that the child looks/behaves less like they've already been victimized? P.S. Greetings from sipayik, land of the dawn, and from us Passamaquoddies!
3.  jcj
 It is important to recognize and understand that children who have been exposed to domestic violence often have changes in their behavior. Not all children will act out but many will possibly withdraw from those around them. This may lead to depression within the child because they often feel that the abuse is their fault. Depending on the age of the child, the depression may lead to self-destructive behaviors or even to possible suicide.
4.  Sherry Hamby
 Re Nancy's question, we think it is likely that there are multiple pathways to re-victimization. Other children may recognize that these children are vulnerable, they may get victimized because besides being violent their parents are also not providing adequate supervision and protection, or these children may learn inappropriate social behaviors from their parents that increase their risks in other settings. Just to give a few possibilities.
5.  Nancy Soctomah
 Why are children exposed to domestic violence at increased risks for other victimizations, such as bullying at school, etc.?
6.  Sherry Hamby
 Teachers and other school professionals should know that exposure to DV greatly increases the risk of other forms of victimization that we may not normally associated with family violence. For example, in NatSCEV, exposure to DV was associated with a doubled risk of being bullied and a 75 increase in the chance of being emotionally bullied (aka indirect aggression). Many of the kids in the school environment who have one form of victimization will also be experiencing others. Exposure to DV is also associated with a nearly 4-fold increase in the risk of dating violence for adolescents. So once a child is identified as a victim of family violence, it would be ideal if school personnel also assessed for other victimizations.
Is there anyplace in the US where a coordinated effort is working well in balancing the needs of children to be safe and the needs of non-abusive mothers who are surviving DV to be safe and to parent their children?
I am a BSW intern at Prevent child Abuse Virginia. I was wondering what kind of policies are in place at a National Level that deal with children who are exposed to domestic violence. I also was wondering what some of the societal effects of children being exposed to domestic violence?
1.  Sherry Hamby
 There are a number of federal initiatives addressing children exposed to domestic violence. The Safe Start initiative is one of the largest (http://www.safestartcenter.org) and it funds and coordinates dissemination about a variety of interventions and epidemiological research. VAWA, the Violence Against Women Act, has enhanced the rights of minor immigrant children exposed to domestic violence. Children suffer a disproportionate burden of victimization in society and this creates a lot of health care and law enforcement costs, as well as costs in lost potential.
What are best practices in evidence based group treatment of children ages 5-13 exposed to domestic violence?
When working with children who have witnessed intimate partner violence in their homes, they will sometimes offer information about what they have witnessed, and then suddenly clam up, despite reassurances that they are safe. Any tips on helping them feel okay about talking about it when they seem to WANT to? (I usually engage them in play and/or art therapy or story-telling as a means of espressing their fears).
I have been the director of a creative arts therapy program for children and families for 13 years. I am always looking for feedback and ideas about retention for families affected by violence and transition. we see over 80 families each year but have about a 35% rate of completion, which is a minimum of six months of treatment. any suggestions?
1.  Miriam Berkman
 Continuity of treatment is a very complicated issue for families struggling with violence and other adverse circumstances. If you are working with an impoverished and transient group of families, it may not be realistic to expect many of them to commit and follow through with a 6 month program. You might consider whether there are shorter components of the program that can be offered separately and in a series that families can continue if they are able. It is also worth thinking about whether the nonoffending parents have sufficient support to enable them to continue bringing their children, with support including concrete things like transportation, child care for siblings, legal advocacy to keep safe, etc. and also emotional support for their own struggles.
I work for a domestic violence crisis center as the children's advocate. One of my main roles is to facilitate our children's support group for children who have been/are impacted by dv. We currently do not have an evaluation system in place as far as evaluating our program and the impact/effect it has on the children and families we service. I am having a difficult time finding an evaluation tool that would work for our agency because many of our families come and go....Any suggestions?
Could you identify some helpful assessment tools that could be readily used to evaluate change in children and their non-offending parent in group treatment for exposure to family violence? The group cycle is 12-wks; a primary goal for both children and adults is lessening shame and sense of isolation, increasing protective factors and social support.
1.  Sherry Hamby
 Achenbach's Child Behavior Checklist is one of the most commonly used in formal outcome studies. Grych & Fincham's Children's Perceptions of Interparental Conflict is also good and has a subscale on self-blame that could probably be used by itself. Parenting Styles and Dimensions Questionnaire has some good items on parental warmth. We also use the Trauma Symptom Checklist for Children and the Young Children version. For increases in protective factors, you might look at the Family Routines Inventory or the Family Involvement Questionnaire (Fantuzzo et al)
What is the best way to involve the non-offending parent in their child's therapy?
1.  12345
 Do you recommend meeting with the parent and child together or separately? Or both?
2.  Miriam Berkman
 In order to engage a nonoffending parent in therapy for their child, it is important to be clear that you do not judge the parent or hold them accountable for the violence the child has witnessed. It is helpful to let the parent know that their support for the child is an important factor in the child's recovery and that their involvement in the treatment will likely make the treatment more successful. Studies of TFCBT, one of the most widely used trauma treatments, have shown that children whose parents participated in treeatment had better outcomes than children who were treated alone.
How do you, as a children's group leader, balance working with children who present as aggressive as well as children who present as withdrawn?
1.  Miriam Berkman
 It is not clear what sort of group you are leading, how big it is or what the age range or criteria for membership. It is important for the membership to be similar enough developmentally and diagnostically that they can work together and participate in joint activities and discussion. It is essential that any group be safe for all participants, and particularly for children who have been exposed to violence, establishing ground rules for safety is extremely important. As a group leader, I would recommend reviewing the rules of the group and making sure the group isn't too big or too diverse for the leaders to manage. You might also review whether group activities are too stimulating or triggering for the aggressive children.
I work with a state chapter child advocacy center and we are working on a relationship with domestic violence programs. Has anyone done work with this or does anyone have any formalized relationships between child advocacy centers and domestic violence programs and would be willing to share?
1.  cindiw
 We have a very effective multi disciplinary team in our county that coordinates services between the CAC and the DV lead agency
When a young child has been injured by a parent and subsequent investigation/changes take place, what suggestions do you have to help the child with guilt and feeling responsibile?
What are the most efficient techniques we can use with children in order to stop the cycle of domestic violence? What if the children are going back to the same environment after we work with them--are there any techniques to help them become more resilient?
What is the best way to handle children who have been exposed to violoence in the home and now they think viloence is the answer? I have two kids who are very violent towards thier mother and others, how do i help stop this?
1.  Miriam Berkman
 It is important to establish a safe environment that includes clear and consistent limits against all use of violence for these children. It is also important to connect their behavior with their experiences of violence in the past. For some children, acting out aggressively is a response to experiences of trauma and these children can benefit from trauma-focused therapy. Family therapy may also be useful in reestablishing trusting relationships with parents.
What do you see as the future of working with children exposed to domestic violence?
1.  Sherry Hamby
 In the future, I hope there will be less adversarial relationships between providers who are focused on serving children and adults, and less coercive approaches used to working with families. Many of our institutions exist in their current forms more as historical accidents than because of any intentional creation of the best approach to addressing a particular problem, such as domestic violence. I'd personally, despite the difficulties of making institutional changes, like to see a large scale re-evaluation of how to best meet the needs of victimized families. I believe there are trends already to take more integrated approaches and to seeing how multiple family members and multiple generations are simultaneously victimized. Children's exposure to violence will be taken increasingly seriously.
What are your thoughts about working with fathers?
1.  Paul Clements
 Having a closely connected father is extremely important for children. Every effort should be made to keep fathers IN the family. Keep in mind that women abuse their spouses in equal numbers, that MOST accusations against the father are false, and most child abuse is perpetrated by the mother (including sexual assault). Most DV claims are made during the process of divorce and custody hearings, and are used to gain an advantage.
2.  Miriam Berkman
 It is important for clinicians to consider working with fathers in situations in which the violence is not overwhelming because fathers are often involved in the life of the child and family -- either present in the home or in contact through visitation. Many mothers also wish to keep their families together. Some fathers can be engaged in thinking about their role as fathers and the impact of their violence on their children even if they are not motivated to change for the good of their partner. It is essential to assess the level of violence and the father's motivation to change his behavior so as to avoid increasing danger for the child and family. Some recommended resources in this area will be posted.
In cases where the offender has been removed from the home, with a full no contact protective order,how do you think the best way to reintroduce the offender to the family after the order is lifted is?
1.  Miriam Berkman
 The best strategy will depend on what has happened between the removal of the offender and the lifting of the order. If there has been some batterer treatment or other intervention such that the nonoffending parent feels safe with the offender's return, the parents can explain to the child together that the offending parent was not at home because he had not behaved in a safe way, but now he has gotten some help and everyone will stay safe. It is ideal if the offender can acknowledge and take responsibility for his unsafe behavior and its negative effect on the family. If the order is lifted but there has been no real change or the nonoffending parent still doesn't feel safe, the nonoffending parent should develop a safety plan for herself and with the child.
What should the responsibilities and reporting requirements of teachers be who have studnets living in violent households?
How to assist clients that are involved in numerous concurrent DV cases, especially in their juvenile or dependency cases.
Are there materials to assist children in developing safety planning for themselves?
Greetings everyone. I am looking forward to hearing fresh ideas on how we can help children exposed to DV. Having witnessed DV myself as a child, I can say that it changes your perspective on relationships and your trust in people. You never forget what you have seen and heard. Within the military community that I serve there are so many additional stressors for families. Especially during this time of war. I am looking to expand my resource knowledge base and take back any suggestions.
What are some of the barriers associated with child disclosure of domestic violence, and in what ways as clinicians would you recommend getting around these barriers?
1.  Miriam Berkman
 Barriers to disclosure include: children's compliance with parents' direction not to tell about family secrets; fear of getting parents in trouble (with police, CPS or general authority); shame about bad things in their family. Clinicians can address these barriers by building relationships with the child and the non-offending parent, making sure the non-offenidng parent has access to advocacy and support to increase their safety and the safety of their children and letting the child know the clinician is concerned about them and their family. If a child seems worried about their parent, the clinician can explore the worry in a non-judgmental way. If the child begins to disclose violence, the clinician should be prepared to help with safety planning and referrals for advocacy.
What strategies do you recommend educators use when teaching about/formulating lesson plans for teen dating violence to lesson the trauma to child victims who may be in the classroom?
What are the effects (according to research) of the non-violent dynamics associated with power/control/DV on children (mother walking on egg shells, hostile enviornment, etc...)?
What are some of the barriers associated with child disclosure of domestic violence, and in what ways would you recommend getting around these barriers.
Please discuss best practices for speaking with the parents of children who have witnessed violence in the home whether due to parental/DV and/or sibling violence (beyond arguements)...For example, if the parent (victim) calls for assistance, how does one approach this conversation?
What do you suggest is a useful strategy for informing the courts of the effects of DV on children? It seems that the courts consistently push for the child to have an ongoing relationship and visitiation with the violent parent, despite the evidence that this is harmful to the child and the non-offending parent.
What advice could you give to a mother(non-offending parent) who is dealing with a child who seemingly sides with the batterer?
1.  Melissa
 I would suggest counseling for the both the child and the mother. Also,our dv agency offers education based support groups for children. Look to your local dv agencies for children's support groups. I believe education is key to breaking the cycle of violence and promoting healthy family relationships.
Some believe that having a universal definition for exposure is important in tackling the problem. How effective would universal terms be?
1.  Sherry Hamby
 Universal terms are extremely important and psychology lags far behind medicine and other sciences in this respect. Regarding exposure, we have focused on four levels that we think are important to distinguish in terms of degree of exposure and also in terms of how much danger the child is also in: 1) direct eyewitnessing 2) hearing but not seeing the violence (e.g., in another room) 3) finding out be seeing effects of violence after the incident (e.g., victims' injuries) 4) being told about it later (which could happen even years later and may not even directly involve victim or perpetrator)
Some states do not make domestic violence workers mandatory reporters, as in Vermont. How do the hosts feel about this?
Please coment on issues regarding intervention on domestic violence cases where children are also sexual violence victims
1.  Miriam Berkman
 Children who have experienced multiple forms of violence can be helped by trauma-focused therapy, such as TFCBT. It is important to conduct a thorough assessment of the child's trauma history, general developmental history and trauma symptoms. It is also essential that the child be in a safe setting where they are not conintiually being reexposed. Childen who have experienced many traumas are likely to benefit from interventions that help them relax,increase their ability to manage their emotions and use a wider range of coping skills. In discussing the narrative of the child's experience, treatment can be focused on the event that the child experiences as most distressing and can also address a series of events by constructing a life line and then focusing on the first, worst and other stand-out episodes.
What, currently, are the most effective workshops or counseling services provided by social service organizations/public entities?
1.  Sherry Hamby
 Safe Start has highlighted a number of organizations doing good work, many of which are public or have public connections. Some on their best practices list include St. Barnabas Hospital Family Safety Center in Bronx, NY, Southern Methodist Univ Dept of Psychology, and County of San Diego HHS. See http://www.safestartcenter.org
Children witnessing domestic violence is one of the most complex issues child protection workers deal with in making a decision about safety. Is there information about how other communities or states are assessing this?
How would I volunteer to do supervised visitation in NYS? Is there training that is offered prior to doing this for children when domestic violence is involved? thank you
What programs do you know of that target the family and parenting with child abuse 'prevention' objectives?
What recommendations do you have for preschool teachers who have young students who have been exposed to domestic violence? How can we support both very young children and their non-offending parent?
Are there suggestions about how to get family court on board with child victims and mother victims? The visitation that is legally mandated often increases the amount of trauma and distress for kids.
1.  Sherry Hamby
 This may be best viewed as a process over multiple cases. I know some judges are reluctant to terminate the rights of violent fathers. Documentation that focuses not just on the mother but also on the children. Showing how this has made the children more vulnerable in other settings.
What effect does it have on children when the victim makes excuses for the parent that abuses? What does it teach them?
Do you have advice for foster parents of children that have been abused by parents and/or other adults?
What are the less obvious signals and signs of a child that has been exposed to domestic violence? And what are some of the best practices for juvenile justice agencies and practitioners who are in the business of rehabilitating incarcerated juveniles?
1.  Sherry Hamby
 Safe Start (http://www.safestartcenter.org) has compiled some good information on this. The most difficult signs may be for the youngest children, but in general for very young children (0 to 6) you are at least as likely to see signs of increased irritability as more typical signs of anxiety or depression. Also more physiological signs such as sleep and eating disturbances. For school-aged children, feelings of guilt and feeling responsible--these may provide, in some measure, a sense of control for the child. Hyper or spacey behavior. Aggression is important to monitor in this age group.For adolescents, in addition to class signs of PTSD or depression, look for increases in risky behaviors, including using drugs, risky sexual behaviors, skipping school, and other forms of acting out.
is there any help out there for teens who are children resulting of sexual violence
Are you familar with Trauma Focused Cognitive Behavioral Therapy, and if so do you have knowledge of its success in helping children exposed to Domestic Violence?
1.  Miriam Berkman
 TFCBT is a good treatment for children exposed to dv who have trauma-related symptoms following their exposure. I have experienced and heard of many successful cases. Judy Cohen, one of the developers, recently completed a randomized controlled study specifically focused on kids who had witnessed dv, which has not yet been published.
Mirian Berkman and Sherry Hamby: As professionals in court and pyschological services for children, Could you please shed some light on how you would go about introducing a new concept; an intervention strategy that addresses not only children exposed to domestic violence but also children indulging in risky behaviors such as substance abuse, sex, school failures, violence, recidivism, etc.? I have a strategy that I would like to introduce to the juvenile court system and psychological services. I would like to have an assessment of the strategy conducted to determine its effectiveness in the prevention and treatment of risky behaviors. Thanks! Yvonne McGinnois http://www.rememberingmary.net
How effective would mentoring be in the life of a child experiencing trauma from crime?
1.  Miriam Berkman
 How effective mentoring would be for any specific child would depend on the child's strengths, challenges and the nature of their other relationships. Mentoring is an excellent support for a child who lacks consistent and supportive adults in his or her life. Some children exposed to violence would benefit greatly from a mentor, while others would benefit more from after school group activities, therapy or some combination of interventions.
What are some of the signs that children may display, if they are exposed to dv? If the signs are noticed, what should be done to help this child?
1.  Sherry Hamby
 Signs of stress, depression, and anxiety are most common. These can manifest differently at different ages--very young children may show irritability and interruptions with eating and sleeping habits. School-aged children may show classic PTSD or depressive symptoms, also guilt and increased aggressive behavior are common. Older youth may have any of these as well as increased acting out with drug use, risky sexual behavior, school problems, etc.It is important to note that there are many other causes of these symptoms, ranging from trauma related to bullying to grief reactions. So not every child with these signs is a victim of dv. But these are worrisome signs in every child, and a child that shows any lasting indication of these signs (beyond temporary bad moods) should be interviewed. Victimization is one very common cause of these symptoms and so questions about not just dv but a wide range of victimizations should be included.
What are some less obvious signs and signals that indicate that a child has been exposed to domestic violence? And what best practices do you suggest to juvenile justice agencies and practitioners that are in the business of rehabilitating juveniles?
1.  Sherry Hamby
 Hi Kim, see the earlier posting of this question for a reply.
What are the national best practices related to visitation in an attempt to maintain a parental relationship?
1.  Paul Clements
 National best practice agreement is that children should enjoy equally shared parenting time with each parent.
What are some key techniques that could be used to help a child with severe attachment disorder caused from dv related Incidence
1.  Miriam Berkman
 A good treatment approach for young children (up to about 7) who have experienced dv and who have disruptions in their attachment to their non-abusive parent is Child-Parent Psychotherapy. This is a dyadic treatment developed by Alicia Lieberman and Patricia Van Horn at the Child Trauma Research Project (CTRP)at UCSF. More information can be obtained from the developers or from the National Child Traumatic Stress Network www.nctsn.org.
How can health educators in high school settings and church youth leaders engage youth in homes where DV happens and the youth who may be the friend or classmate of this person?
1.  plcintx
 Have your local crime victim assistant center bring in their educator to educate not only the students but teachers also.
There are laws that are in place in many states that make it illegal for children to witness DV. Of course the laws vary. I was wondering if you agree with these and if you do what would be your response to an advocate that doesn't the biggest response is that it victimizes the mother twice and that the family doesn't have a source of income anymore. We are trying to pass a law in WA and have had a lot of resistance.
1.  Linda Arata
 I presume you are asking the presenters their opinion. Since I am here and have worked in the field for quite a number of years, I will share my opinion. I hope that is not intrusive. I would ask this: what is the proposed consequence if witnessing is illegal? In my opinion, upgrading the charges against the batterer would make sense. Blaming the victim would not. Read Jeff Edelson(sp?) on this topic.
2.  Sherry Hamby
 This is a complicated issue. I am not in favor of simply expanding mandatory reporting requirements. I would like to see exposure to dv handled in a fashion similar to serious suicidal threats--that some sort of intervention should be required, but that different options should be available. Much in the way that involuntary commitment is the best choice for some suicidal clients, child protective services involvement would be the best choice for some cases of exposure to dv. In other cases, however, other options might better meet the needs of everyone involved. Re-victimizing mothers, discouraging helpseeking, and the futility of imposing requirements such as new housing without supplying the resources to do so are legitimate concerns. On the other hand, NatSCEV also shows that the co-occurrence of exposure to dv and child maltreatment are extremely high, and more needs to be done to assess and ensure the safety of children in violent homes. The extent of the overlap was astounding to me--for example, 20 of children exposed to dv also had experienced custodial interference, versus only 1.5 of children not exposed to dv. These findings have impressed upon me the need to address all of the victims in a family together.
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