Journal Issue: Domestic Violence and Children Volume 9 Number 3 Winter 1999
Systems Responses to Children Exposed to Domestic Violence
Families affected by domestic violence utilize the services of health care, child welfare, mental health, and law enforcement agencies, as well as the courts and community-based domestic violence programs. Interventions for children in these families vary from system to system and from program to program within each system. Current services reach only a small percentage of the number of children exposed to domestic violence,25 and are typically not designed with the specific needs of these children in mind. Though specially designed services for children exposed to domestic violence are limited, innovative programs within each of these systems do exist. Currently, little is known about the effectiveness of these programs in improving outcomes for the children they serve.Community-Based Domestic Violence Services
Community-based domestic violence services emerged from the battered women's movement of the 1970s and 1980s. Early services focused primarily on providing shelter and advocacy to battered women. However, because most of the battered women utilizing these programs brought their children with them, many of these programs began providing services to the children as well. There are now more than 2,000 community-based domestic violence programs, and more than 1,300 provide shelter.26 Approximately half of all shelter residents are children.27 A 1997 survey shows that 72% of all shelters currently offer some type of children's services.28 These services range from child care to recreational activities to health care to mental health counseling, though the number of shelters offering each type of service is unknown.
Innovative shelter programs that specifically address childhood exposure to domestic violence include group counseling sessions for the children and special parenting classes for the battered mothers.29 Another promising approach is the use of child advocates who help child residents access the benefits and services they need, ensure that legal protections are in place for the children, and provide training to shelter staff on child development and the impact of domestic violence on children.30 Despite the array of services offered through shelters, most children affected by domestic violence do not have access to these services. Shelter programs are chronically underfunded and unable to meet the demand for services.31 Many battered women do not utilize shelters, either by choice or because these services are not available.32 Additionally, many shelters do not allow adolescent boys to enter as residents. Despite increases in recent years in the number of battered women accessing legal advocacy, counseling, and support groups through nonresidential programs, these services are less available to children.33 Identifying children through their contact with other public systems will increase their access to services only if a wide range of children's programs, in addition to those offered through shelters, is available. As Saathoff and Stoffel emphasize in their article in this journal issue, community-based domestic violence programs are beginning to work collaboratively with other agencies to develop more comprehensive responses to mothers and children affected by domestic violence.
- Stable public funding sources are needed to support comprehensive and coordinated community-based services for battered women and their children, as well as program evaluations and replication of effective interventions.
In her article, Culross states that between 4% and 30% of women entering emergency departments are suffering from a domestic violence injury.34 In the early 1990s, in recognition of the high health costs associated with domestic violence, key professional health care organizations developed guidelines for identifying and responding to domestic violence.35 As a result, many health care institutions have established domestic violence screening and assessment protocols, although it is unclear to what extent health care professionals use them. Studies indicate, for example, that only a little more than half of the women who enter emergency rooms for domestic violence related trauma either discuss their domestic violence experiences or are questioned about them by health care professionals,36 although many would disclose if asked.37 Because so many battered women have frequent contact with the health care system, it provides a critical venue within which to reach battered women and their children.38 In order for screening and assessment protocols to be used effectively, health care professionals need ongoing training about domestic violence and the use of the protocols.39
Once women and children affected by domestic violence are identified, health care professionals must be able to either provide them with or refer them to appropriate services. Some health care institutions have routine screening for domestic violence and offer specialized domestic violence services in-house, such as safety planning and support groups for battered women40 or therapeutic interventions for the children.41
- Because the majority of children exposed to domestic violence do not have access to services through traditional avenues such as battered women's shelters, new strategies for identifying and serving these children in other venues, such as health care institutions, must be developed.
Mental health system approaches to children exposed to domestic violence range from crisis interventions to individual, group, and family therapy programs.42 Crisis interventions can include mental health professionals providing on-site counseling in the home following a domestic violence incident, or immediate assistance to a child who is having trouble adjusting to shelter life. Group programs can offer children a safe venue in which to talk about the violence, improve self-esteem, and develop safety skills.43 Individual therapy is indicated for children who show extreme symptoms, though approaches vary.14 Some programs emphasize the development of social problem-solving skills that are often impaired by chronic exposure to domestic violence.42 Others employ therapy techniques used to treat posttraumatic stress disorder.44 Family therapy approaches may include counseling for mother and child, and referrals to other family support services. Because of the potential dangers, few family therapy programs include batterers. Those that do will only work with batterers who have done extensive work to change their violent behavior.45
It is not known how many mental health programs for children exposed to domestic violence have been established, or how many children participate in them. As Groves discusses in her article, children exposed to domestic violence may receive mental health services without being assessed and treated for exposure to domestic violence. Although the American Psychological Association has recently focused attention on childhood exposure to domestic violence, and some mental health professionals have, for years, provided special services to battered women and their children, most mental health professionals do not receive training in identifying, assessing, or treating children exposed to domestic violence. Funding for mental health interventions is limited, and often only supports short-term treatment that will not adequately address the long-term symptoms these children may exhibit, or the myriad of other stressors in these children's families. Crime-victim programs in several states provide funding so that children exposed to domestic violence, as well as adult victims, can receive long-term mental health treatment.46 Other innovative programs combine more traditional mental health services with housing and job assistance.47Child Protective Services
As mentioned above, research indicates that there is a high co-occurrence in families of child abuse and domestic violence. Yet, as Findlater and Kelly point out in their article, separate service systems with unique histories and treatment philosophies have developed to address each form of violence. Child welfare agencies are empowered by state and federal laws to investigate reports of child abuse and neglect, offer services to families, make case recommendations to the juvenile court, and place children in foster and adoptive homes. Services provided to families keep children at home whenever it is safe to do so, and return children who have been removed, once the harmful circumstances have been addressed. If efforts to return the child home fail and the juvenile court terminates parental rights, child protective services (CPS) will find a permanent placement, such as an adoptive home, for the child. Ensuring the safety of the child is the principal mandate of CPS. In contrast, though many community-based domestic violence programs offer services to children, they focus mainly on providing support to battered women. And, while most CPS services are court-ordered, participation in community-based domestic violence programs is voluntary.
Despite these differences, growing recognition of the co-occurrence in many families of child maltreatment and domestic violence has resulted in greater willingness on the part of CPS staff and domestic violence service providers to work together. Collaborative efforts to date have identified beliefs common to both systems: (1) the presence of domestic violence in families is harmful to children, (2) the safety of the mother affects the safety of the child, and (3) perpetrators must be held accountable. 48 Innovative pilot programs are successfully integrating child welfare and domestic violence services.49 Approaches include screening for domestic violence in all child maltreatment cases, having battered women's advocates on CPS staff to provide case consultation to workers and domestic violence services to families,50 and cross-field training for both CPS and domestic violence service providers.51 Though these pilot programs show promise as models for collaboration, recent research reveals that cross-agency training remains limited and many professionals in each system believe the intervention goals of the other system conflict with their own. In addition, agency policies in both fields are unclear about how to intervene when both forms of violence are present in a family.52 In 1999, the National Council of Juvenile and Family Court Judges (NCJFCJ) published a set of guidelines for effective intervention in cases involving both child maltreatment and domestic violence.53 These guidelines, developed by a committee of key experts in both fields, provide a framework through which local communities can design comprehensive, community-based responses that include protections for adult and child victims, support services for the families, and effective and enforceable legal interventions.
- CPS and domestic violence service organizations must develop clear protocols for intervening with families in which both domestic violence and child maltreatment are present, offering services that provide safety and stability to the child, support to the battered woman, and treatment and sanctions for the batterer.
Legal-system interventions include responses by law enforcement personnel to calls of domestic violence, probation services for batterers, prosecution of criminal cases, and court decision making. These systems have been slow to recognize and respond to the presence of domestic violence in their caseloads, but many states now have laws and protocols to improve responses. Several new law enforcement and court programs address the impact of domestic violence on children.
Between 1992 and 1996, only about half of female victims of domestic violence reported their victimization to law enforcement. 54 In 88% of these cases, there was either a police response or the victim went to the police station for help. This figure marks a considerable improvement in law enforcement responses compared to two decades ago when it was standard policy not to intervene in what were viewed as private disputes. Although police are typically the first professionals on the scene after a domestic violence incident has occurred, they have limited services to offer families. Law enforcement departments in several locales throughout the country have initiated specific programs to improve interventions, including cooperative arrangements with mental health professionals who, upon notification by police, appear at the scene of the domestic violence incident to assist child and adult victims.55 Other strategies include police report documentation of a child's presence in the home, which automatically qualifies the child for state victims of crime funding for support services,56 and specialized training in child development for law enforcement personnel.55
Domestic violence issues appear in all areas of the judicial system, including criminal court, juvenile court, family court, and other civil courts. Despite the recent use in several locales of innovative approaches to handle these cases, there is still widespread misunderstanding by judges and other court personnel about domestic violence and its potential impact on children. New programs (1) provide training on domestic violence issues to judges, child advocates, mental health professionals, and other court personnel; 57 (2) offer coordinated, cross-agency responses to cases involving both domestic violence and child maltreatment;58 (3) utilize specialized domestic violence courts; or (4) have a one-family, one-judge approach in which one judge hears all civil and criminal cases involving a particular family.59 To be effective, innovative court approaches should include comprehensive training for all court personnel, access to a wide range of family services, and supportive court administrative practices.60 Judges can play an important leadership role in encouraging coordinated responses for children affected by domestic violence.61
- Professionals who have regular contact with families and children, including teachers and child care workers, health and mental health care providers, law enforcement officers, child welfare workers, and court personnel, should receive ongoing training on domestic violence and its impact on children.