New Study: The Relationship between Protective Factors and Outcomes for Children Exposed to Violence

More and more research is revealing vital information about the issue of children’s exposure to violence (CEV). A new study from the Rand Corporation was released June 3 titled The Relationship between Protective Factors and Outcomes for Children Exposed to Violence.

The new study looks at protective factors that can help bolster children’s resilience and protect kids against the negative affects of exposure to violence. The authors’ goal is to better inform the creation and evidence-based intervention and prevention programs for children affected by violence.

Some of their findings showed:

• Children that had more experiences of violence re-exposure had more behavior problems than those children that had not been re-exposed.
• How protective factors and outcomes for these children are related.
• Intervention to enhance positive protective factors may be key to improving positive outcomes for children.

See the full abstract here.

To learn more please checkout the Safe Start Center’s publication page for a great selection of resources and links to more information about CEV.

Safe Start in the Community: Worchester, Mass.

Throughout the month we will feature the 10 Safe Start Promising Approaches grantees and the work they’re doing in their communities to help children exposed to violence and their families.

Marie is a 28-year-old mother of two sons: Jasper age 3 and Dion age 6. Six months ago, Marie broke up with her boyfriend, the father of her sons. Marie’s relationship with her boyfriend was volatile, with physical abuse as well as verbal threats and name calling. Jasper and Dion witnessed much of this violence. Recently, Marie and her sons moved into a shelter.

Marie’s sons exhibit increasingly concerning behaviors. Dion “acts out,” screaming at his mother, hitting her and pulling her hair when angry. He is aggressive toward children in the shelter and in school and calls his teacher names. Jasper has begun to mimic Dion’s behaviors. Both children frequently ask for their father and appear distressed and confused about their family’s changes. Marie is overwhelmed by her children’s behavior and does not know how to respond.

As part of the START with Kids program, Marie’s case manager meets with Marie and conducts a child assessment. On the basis of the assessment results, both children appear to have some delays and challenges in social and emotional development, behavior, and learning, and Marie appears very distressed when she is with her children. The shelter case manager discusses the results with the shelter team, including the clinical child specialist, to make recommendations about next steps.

Marie and her case manager work together to develop a child service plan for each son to address past and current family stressors. The case manager helps Marie enroll Jasper in an Early Head Start program and establish ongoing monitoring by a pediatrician. She refers Dion for play therapy and mobilizes school-based supports, including an Individualized Education Plan for Dion.

Safe Start in the Community: Spokane, Wash.

Throughout the month we will feature the 10 Safe Start Promising Approaches grantees and the work they’re doing in their communities to help children exposed to violence and their families.

Three-year-old Jack has already witnessed several domestic violence incidents between his parents at home and at his aunt’s house where he stays when his mom works. Lisa, Jack’s mom, has a history of experiencing and witnessing domestic abuse and does not want Jack to have the same experiences.

Since separating from Jack’s father, Lisa has been concerned that Jack’s previous exposure to domestic violence may have an effect on him. She notices that he is becoming more withdrawn and timid, so she enrolls him in Head Start. She meets with the Head Start family service worker and agrees to take the Adverse Childhood Experiences assessment. The results show both her and Jack’s level of traumatic stress.

Lisa learns that she and Jack are eligible for services from the Spokane Safe Start Initiative and begins the Attachment, Self-Regulation, and Competency (ARC) home visiting program. A Head Start staff facilitator meets 12 times with Lisa and helps her understand and identify the negative effects of trauma. Lisa learns ways to cope with the impact of her past experiences, as well as strategies to support Jack.

Jack benefits from the Spokane Safe Start Initiative at his Head Start program, where all staff members receive training in the Fostering Resiliency in Early Learning Environments (FREE) professional development program. By learning competencies to provide trauma-informed care to children and their families, the teachers and specialists can identify Jack’s needs and address them with appropriate skills, strategies, and services. For example, Jack’s teacher, Erin, recognizes that Jack experiences changes in routine as anxiety provoking and helps him practice self-soothing exercises. Erin’s practice of announcing changes in advance helps Jack and other children. Erin helps Jack improve social skills so that he can participate more successfully in group activities.

Safe Start in the Community: Queens, NY

Throughout the month we will feature the 10 Safe Start Promising Approaches grantees and the work they’re doing in their communities to help children exposed to violence and their families.

After a workshop on Positive Parenting Strategies at a local school, Monica asks to speak to Lorena, the Project CONNECT team member who gave the presentation. She relays her concerns about her son, Alex, whom she describes as defiant and angry. Monica recounts years of domestic violence she experienced with Alex’s father. Although her relationship with the father is over, she recognizes that the abuse that Alex witnessed was harmful to him. Lorena encourages Monica to enroll in CONNECT services at the Long Island City branch of the Queens Library.

At the library, Alex spends time in the children’s area, uses the library’s computers, or hangs out with the youth counselor while his mother works with the family therapist. The therapist tells Monica she can receive information from the library’s case manager on benefits, available services, job opportunities, and adult education classes.

In treatment, the therapist asks Monica and Alex to talk about what they want to happen at home, to clarify their goals, and to solve issues that might keep them from attending the sessions. The sessions provide a safe space for open discussions about stigma and fears regarding treatment and to speak about the violence that occurred in their lives and how to process the thoughts, feelings, and behaviors related to these traumatic events.

DOJ moving forward with CEV recommendations

In an April 12 meeting with the Coordinating Council on Juvenile Justice and Delinquency Prevention, Attorney General Eric Holder described work to move forward with plans to prevent and reduce instances of childhood exposure to violence.

The Defending Childhood Task Force released their report and 56 recommendations in December.

In December, Holder’s Defending Childhood Task Force issued a report and 56 recommendations to address this public health issue. Since then, Holder said he has enlisted officials from the Office of Juvenile Justice and Delinquency Prevention to get the ball rolling.

“Over the past several months, OJJDP’s leadership and staff members have begun to engage with a range of federal partners about how we might be responsive to the Task Force recommendations,” Holder said.

“At my request, Department leaders have developed near-and long-term strategies for how we can collaborate with our colleagues and counterparts in order to make a positive difference in four primary areas of activity:   raising public awareness, strengthening professional education and training, building knowledge through ongoing research, and increasing DOJ and federal coordination and capacity.

Over the next year, I am charging my DOJ colleagues to plan for the implementation of these recommendations.”

(Read Holder’s entire speech here.)

Currently, there are grantees working around the country on evidence-based programs and practices to address childhood exposure to violence under the Defending Childhood and Safe Start initiatives.

Last week, Holder also announced a new task force to address childhood exposure to violence in tribal communities, a response to the Defending Childhood Task Force recommendations.

The American Indian/Alaska Native Task Force on Children Exposed to Violence will be headed by Acting Associate Attorney General Tony West and will focus on:

• Improving the identification and treatment of American Indian and Alaska Native children exposed to violence;
• Supporting American Indian and Alaska Native communities and tribes as they define their own responses to this problem; and
• Involving American Indian and Alaska Native youth in developing solutions.

“This is nothing less than a national crisis – with serious ramifications for the future of our country, and for the young men and women who will soon be called upon to build that future,” Holder told the Council.

“The cost of failure and inaction – both human and moral – is simply too high to contemplate.  The responsibility for turning back the tide of violence rests with each of the leaders – in this room and far beyond it – who has made a commitment to fighting back.  And that’s why, as long as we work together, support one another, and remain steadfast in our determination to make the difference our children need – I believe there’s no limit to what we’ll be able to achieve.”

Click here to read the Defending Childhood Task Force’s full report.

Safe Start in the Community: Philadelphia, Penn.

Throughout the month we will feature the 10 Safe Start Promising Approaches grantees and the work they’re doing in their communities to help children exposed to violence and their families.

Carla is a 22-year-old African-American mother of Quinton age 2 and Sylvie age 1 month. Carla was sexually abused by her stepfather starting at age 8 and ending at age 15 when she ran away. She was placed in a foster home where her foster father sexually abused her from ages 15 to 17 when she again ran away. She lived with her boyfriend and was the victim of domestic partner violence. She has had several miscarriages as a result of the violence.

Carla is involved in the Health Federation of Philadelphia Early Head Start program, which referred her to the Enhanced Home Visitation Project (EHVP). She is exhibiting disturbing behaviors: cutting herself, physically attacking others in her home, having blackouts and seizures following flashbacks, non-nurturing with her children including withholding food, afraid to leave her house, and expressing feelings of hopelessness.

A family trauma specialist from EHVP visits Carla 24 times in her home to facilitate the Safety, Emotions, Loss and Future (S.E.L.F.) psycho-educational program. To work through the stages of trauma recovery, Carla learns how to create a safe environment. She uses candles, music, knitting, puzzles, and self-soothing techniques to ground herself.

Because Carla lives with relatives in an overcrowded household, it is difficult for the trauma specialist to create opportunities for Carla to engage with her children, but slowly Carla can hold her children, make eye contact, and share food with them. Gradually, Carla is becoming less angry and is able to maintain contact with two neighbors. For 6 weeks, Carla works on a transition project, develops a safety plan, and integrates self-soothing techniques into her daily activities. At one time, Carla did not believe she was a survivor, but now she writes in her journal: “Today I’m a survivor. I’m excited about a brighter future.”

Safe Start in the Community: Kalamazoo, Mich.

Throughout the month we will feature the 10 Safe Start Promising Approaches grantees and the work they’re doing in their communities to help children exposed to violence and their families.

Going into the Project PERK (Partnering to Effectively Reduce the Impact of Violence in Kalamazoo) parenting group, Kamilla feels uncertain. She knows her daughter was at the children’s group learning about the effects of experiencing violence. Both enjoyed their group experiences. Kamilla says, “I enjoy socializing with other parents. We help each other and learn that many of us have similar concerns. No matter how stressed I am when I come to group, I always leave feeling better.”

Kamilla says, “Not much has changed in my home or community but since I started Project PERK, I feel I’m handling it better. I can control my anger. By checking my stress level, I know when I need to take a time-out.” In groups, adults learn to identify their stress level by using a stress scale from 1 to 10. Parents learn how their brain responds to stress, how extreme stress affects their ability to think clearly, and how stress compromises their ability to make positive choices for their children. Their children obtain similar knowledge, which increases the family’s use of a common language for expressing feelings. Many parents in Project PERK feel connected and continue meeting on their own once sessions end.

Ursula, another member of the Project PERK group, reports that her grandson Enrique’s behavior improved once they began using the common language of stress levels to identify things that are challenging for Enrique. She notes, “Enrique’s behavior in school is improving.”

Sophie, also a member of the Project PERK parenting group, learned that children don’t always lash out just to be bad but can have something going on that causes this behavior. She says “By learning to cool down, I am not making situations worse. Now, I talk to my daughter, Mia, to see what’s really going on. Mia is also able to cool down instead of making the situation worse with anger.”

Mia says, “I’ve learned to calm my stress, ignore the bad stuff, or hold my breath and count to ten.”

Southwest Michigan Children’s Trauma Assessment Center (Project PERK)

Western Michigan University
1000 Oakland Drive
Kalamazoo, MI 49008

Focus:

Children and families exposed to violence living in Kalamazoo city or township

Age Range:

8–16

Interventions:

• Partnering to Effectively Reduce the Impact of Violence in Kalamazoo
• Psychological First Aid*
• Trauma Affect Regulation Guide for Education and Therapy*
• Trauma-Focused Cognitive Behavioral Therapy Referral*

*Evidence-based or promising practice

Women Making an Impact on CEV: Abigail Gewirtz

This month the Safe Start Center is honoring National Women’s History Month by profiling women who have made an impact on the issue of children’s exposure to violence.

Abigail Gewirtz, Ph.D., L.P. is an Associate Professor in the Department of Family Social Science at the Institute of Child Development at the University of Minnesota.  Her primary interests are in trauma, resilience, and promoting children’s healthy development with two distinct but interrelated research foci: the impact of exposure to traumatic stressors on parenting and child functioning, and the development, testing, and widespread implementation of family-based interventions.

She is Principal Investigator on a National Institute of Drug Abuse-funded randomized controlled trial to develop and test a web-enhanced parenting program for National Guard families with parents returning from deployment to Iraq and Afghanistan.  Dr. Gewirtz also directs Ambit Network, a SAMHSA/National Child Traumatic Stress Network Community Services and Treatment center focusing on the implementation of evidence-based interventions for traumatized school-aged children and their parents.

Why do you feel children’s exposure to violence and traumatic stress is an important issue and how did you get involved?

We now have a really good body of knowledge to show how damaging exposure to violence can be – to all aspects of children’s development, including emotional and behavioral adjustment, and relationships with others. But much less was known 20 years ago, when I was in graduate school. It’s thanks to not just burgeoning research, but also a spike in public awareness about children’s exposure to violence that we know and can do far more to prevent and ameliorate the impact of violence on kids, and their families.

What would you say are a few of the most valuable things you have learned through your work with ADAPT and the Ambit Network?

I keep being reminded how resilient kids are, and how much parents want to help their children through difficult transitions like the military deployment of a parent. I have learned how remarkably committed and hard-working military parents are, and how parents are so motivated to get parenting tools that can be used effectively to help promote kids’ healthy adjustment. Our early findings from our ADAPT military families study indicate that families benefit from simple parenting tools, and that these tools not only help parenting, but also improve parents’ own capacities to regulate emotions.

I also have learned that practitioners are thirsty to learn and implement empirically-supported therapy practices and tools for kids exposed to violence. It is amazing to hear testimonials from therapists, and from families, about how evidence-based trauma therapies have helped them – sometimes after several wrong turns in therapy. The work is pretty humbling, too. It takes a lot of time and resources to train people to deliver research-based practices with fidelity (i.e. to a quality standard). We were proud of our accomplishments in training over 200 Minnesota therapists to deliver evidence-based trauma treatment over the past few years. But, we realized that this number represents not even 2% of licensed mental health professionals in the state! We won’t be out of work any time soon!