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Pernebo, K., Fridell, M. & Almqvist, K. (2019). Reduced psychiatric symptoms at 6 and 12 months' follow-up of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence. Child Abuse & Neglect, 93, 228-238
Open this publication in new window or tab >>Reduced psychiatric symptoms at 6 and 12 months' follow-up of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence
2019 (English)In: Child Abuse & Neglect, ISSN 0145-2134, Vol. 93, p. 228-238Article in journal (Refereed) Published
Abstract [en]

Background: Long-term follow-up studies of interventions for children exposed to intimatepartner violence are few, and the sustainability of their outcomes often remains unexplored anduncertain. Current research including follow-up assessment suggests that treatment gains may bemaintained or continue post termination. In addition some children may show increased levels ofsymptoms.

Objective: The present effectiveness study investigated the long-term outcomes of two establishedgroup interventions for children exposed to intimate partner violence and their non-offendingparent.

Participants and Setting: The study included 50 children, 24 girls and 26 boys, aged 4 to 13 yearsattending a psychotherapeutic child and adolescent mental health service intervention and apsychoeducative community-based intervention.

Methods: Background information, child and parental mental health problems, trauma symptoms,and exposure to violence were assessed pre- and post treatment and at 6 and 12 months’follow-up.

Results: Sustained treatment gains and late improvements in children’s internalizing and externalizingsymptoms and in symptoms of traumatic stress were recorded from post treatment tothe follow-up assessments (p = .004– .044; d = 0.29–0.67). No significant increase in symptomswas reported. Additionally, very little continued or renewed child exposure to violence was reported.

Conclusions: The results of the study indicate that the children did benefit from the two interventionsstudied and that the outcomes of reduced child symptoms and protection from exposureto violence were sustainable. Children with severe trauma symptoms benefited the most, thoughmaternal psychological problems may for some have hindered recovery. Clinical implications arediscussed.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Children, Intimate partner violence, Post-traumatic stress, Treatment, Group intervention, Follow-up
National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-82637 (URN)10.1016/j.chiabu.2019.05.002 (DOI)000473123300023 ()31125853 (PubMedID)2-s2.0-85065829855 (Scopus ID)
Available from: 2019-05-21 Created: 2019-05-21 Last updated: 2019-08-29Bibliographically approved
Pernebo, K. (2018). Children in group interventions after exposure to violence toward a caregiver: Experiences, needs, and outcomes. (Doctoral dissertation). Växjö: Linnaeus University Press
Open this publication in new window or tab >>Children in group interventions after exposure to violence toward a caregiver: Experiences, needs, and outcomes
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis consists of three empirical studies, all part of the same research project, with a general aim to explore interventions for children exposed to intimate partner violence (IPV). Because witnessing violence toward a caregiver is associated with negative impact on children’s health and development, effective interventions for children exposed to IPV are necessary.

The aim of Study I was to elucidate young children’s experiences of participating in group interventions for children exposed to IPV. Nine children, aged 4 to 6 years, were interviewed after participating in group programs designed for children exposed to IPV. The interviews were analyzed using interpretative phenomenological analysis. Five master themes embracing the children’s experiences were identified: joy; security; relatedness; talking; and competence.

The aim of Study II was to investigate young children’s accounts of their abused parent. Interviews were conducted with 17 children between 4 and 13 years old who had witnessed IPV. Thematic analysis identified three main themes: coherent accounts of the parent; deficient accounts of the parent; and parent as a trauma trigger.

Study III was an effectiveness study investigating the outcomes of two group interventions for children exposed to IPV and their non-offending parent: one psycho-educative community-based intervention (CBI) and one psychotherapeutic treatment intervention. The study included 50 children between 4 and 13 years old and their mothers. Child and maternal mental health problems and trauma symptoms were assessed before and after treatment. The results indicate that although children benefited from both interventions, symptom reduction was larger in the psychotherapeutic intervention. Despite these improvements, most of the children’s mothers still reported child trauma symptoms at clinical levels post treatment. Both interventions, however, significantly reduced maternal post-traumatic stress.

The results showed that children generally appreciated and benefited from both interventions studied, but most still showed symptoms at clinical levels post treatment and a possible need for additional and/or different support and interventions. These results indicate not only the need for continuous and post-treatment assessment of children’s symptoms in routine clinical practice, but also the value of including children as informants in research.

Abstract [sv]

Att som barn bevittna våld mot en förälder är förknippat med negativ påverkan på barns hälsa och utveckling, vilket medför att det finns ett behov av verksamma interventioner för barn som exponerats för våld mot en förälder. Denna avhandling innehåller tre empiriska studier som alla är del av ett sammanhållet forskningsprojekt. Det övergripande syftet är att undersöka interventioner för barn som exponerats för våld mot en förälder.

Studie I syftade till att belysa små barns upplevelser och erfarenheter av att delta i gruppinterventioner riktade till barn som bevittnat våld mot en förälder. Nio barn, 4 till 6 år gamla, intervjuades efter att de deltagit i gruppverksamhet för barn som bevittnat våld i sina familjer. Intervjuerna analyserades med interpretativ fenomenologisk analys, och fem huvudteman identifierades: glädje, trygghet, att vara i relation, att prata och kompetens.

Syftet med studie II var att undersöka hur barn berättar om en våldsutsatt förälder. Intervjuer genomfördes med 17 barn mellan 4 och 13 år som bevittnat våld mot en förälder. Tematisk analys identifierade tre huvudteman: sammanhängande berättande om föräldern, bristfälligt berättande om föräldern och föräldern som trigger för traumareaktioner.

Studie III var en utfallsstudie som undersökte utfallet av två olika gruppinterventioner för barn som bevittnat våld mot en förälder, en psykoedukativ och en psykoterapeutisk. Studien inkluderade 50 barn mellan 4 och 13 år och deras mammor. Symtom på psykisk ohälsa och posttraumatisk stress skattades före och efter interventionerna. Resultaten tyder på att barnen drog nytta av båda interventionerna, men förbättring av symtom var störst för de barn som deltagit i den psykoterapeutiska gruppinterventionen. Trots symtomförbättringarna rapporterade en majoritet av barnens mammor kvarstående symtom på klinisk nivå efter interventionerna. Mammorna visade signifikant lägre nivåer av egna symtom på posttraumatisk stress efter båda interventionerna.

Resultaten tyder på att barnen uppskattade och drog nytta av båda de studerade interventionerna, men en majoritet uppvisade symtom på klinisk nivå även efter behandling och ett möjligt behov av kompletterande och/eller alternativt stöd och behandling. Dessa resultat tydliggör såväl behovet av rutiner för att bedöma barns symtom under och efter behandling som värdet av att inkludera barn som informanter i forskning.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2018
Series
Linnaeus University Dissertations ; 315/2018
Keywords
Children, Intimate partner violence, Children’s experiences, Post-traumatic stress, Treatment, Qualitative research, Outcome research
National Category
Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-71720 (URN)978-91-88761-45-3 (ISBN)978-91-88761-46-0 (ISBN)
Public defence
2018-04-20, Sal Wicksell, hus K, campus Växjö, Växjö, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2018-03-26 Created: 2018-03-23 Last updated: 2018-03-26Bibliographically approved
Almqvist, K., Bäccman, C., Anderzén-Carlsson, A., Norlén, A., Pernebo, K. & Massoudi, P. (2018). iRiSk II: Utveckling av bedömningsinstrument och stödinsatser för våldsutsatta barn - rapport fråm två delprojekt.
Open this publication in new window or tab >>iRiSk II: Utveckling av bedömningsinstrument och stödinsatser för våldsutsatta barn - rapport fråm två delprojekt
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2018 (Swedish)Report (Other academic)
Publisher
p. 34
National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-81671 (URN)
Funder
Swedish National Board of Health and Welfare, RU10
Note

Ej belagd 20190503

Available from: 2019-04-04 Created: 2019-04-04 Last updated: 2019-05-03Bibliographically approved
Pernebo, K., Fridell, M. & Almqvist, K. (2018). Outcomes of group interventions for children exposed to intimate partner violence, 6- and 12-months follow-up of an effectiveness study. In: : . Paper presented at The 10th Nordic Conference on Child Abuse and Neglect, Tórshavn, Faraoe Islands. 19-21 Aug, 2018..
Open this publication in new window or tab >>Outcomes of group interventions for children exposed to intimate partner violence, 6- and 12-months follow-up of an effectiveness study
2018 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Abstract

Introduction: Intimate partner violence is a global public health problem. Many children worldwide are living with a mother who is a victim of intimate partner violence, a situation associated with a serious risk of short- as well as long-term consequences to children’s health and development.

There is a need for effective interventions for children exposed to intimate partner violence. Existing interventions in Sweden have shown positive but insufficient outcomes. Extended knowledge on lasting outcomes, aiming at improving established interventions is needed.

Method: The current study is an effectiveness study investigating the outcomes of two established group interventions for children exposed to intimate partner violence and their non-offending parent. The study included 50 children, 24 girls and 26 boys, aged 4-13 years. Background information, child and parental mental health problems and trauma symptoms were assessed pre- and post-treatment, as well as 6 and 12 months post treatment.

Results: The results indicate that children benefit from the group interventions, although post intervention a majority of mothers still reported symptoms in their children at clinical levels. Late improvements were registered at the follow-up assessments. The findings indicate that mothers benefit from these primarily child-oriented interventions, showing considerable and lasting reduction of symptoms.

Discussion: Currently data from the 6- and 12-months follow-up assessments are being analyzed. Preliminary results include paths of continuous symptoms reduction for children and mothers. Possible associations between child and maternal levels of symptoms, as well as methodological and clinical implications will be discussed.

National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-81823 (URN)
Conference
The 10th Nordic Conference on Child Abuse and Neglect, Tórshavn, Faraoe Islands. 19-21 Aug, 2018.
Available from: 2019-04-10 Created: 2019-04-10 Last updated: 2019-04-12Bibliographically approved
Pernebo, K., Fridell, M. & Almqvist, K. (2018). Outcomes of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence.. International Journal of Child Abuse & Neglect, 79, 213-223
Open this publication in new window or tab >>Outcomes of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence.
2018 (English)In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 79, p. 213-223Article in journal (Refereed) Published
Abstract [en]

Witnessing violence toward a caregiver during childhood is associated with negative impact on children's health and development, and there is a need for effective interventions for children exposed to intimate partner violence in clinical as well as in community settings. The current effectiveness study investigated symptom reduction after participation in two established group interventions (one community-based psychoeducative intervention; one psychotherapeutic treatment intervention) for children exposed to intimate partner violence and for their non-offending parent. The study included 50 children-24 girls and 26 boys-aged 4-13 years and their mothers. Child and maternal mental health problems and trauma symptoms were assessed pre- and post-treatment. The results indicate that although children showed benefits from both interventions, symptom reduction was larger in the psychotherapeutic intervention, and children with initially high levels of trauma symptoms benefited the most. Despite these improvements, a majority of the children's mothers still reported child trauma symptoms at clinical levels post-treatment. Both interventions substantially reduced maternal post-traumatic stress. The results indicate a need for routine follow-up of children's symptoms after interventions.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Child witness of intimate partner violence, Children, Domestic violence, IPV, Outcome research, Post traumatic stress, Treatment
National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-71710 (URN)10.1016/j.chiabu.2018.02.014 (DOI)000436522200022 ()29482108 (PubMedID)2-s2.0-85042369490 (Scopus ID)
Available from: 2018-03-21 Created: 2018-03-21 Last updated: 2019-08-29Bibliographically approved
Pernebo, K., Fridell, M. & Almqvist, K. (2017). Outcomes of a psychotherapeutic and a psychoeducative group intervention for children exposed to intimate partner violence. In: : . Paper presented at ESTSS 2017 – XV Conference of the European Society for Traumatic Stress Studies, Odense Denmark 31/5 – 4/6 2017.
Open this publication in new window or tab >>Outcomes of a psychotherapeutic and a psychoeducative group intervention for children exposed to intimate partner violence
2017 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Introduction: Experience of violence towards a caregiver during childhood is associated with a risk of negative impact

on children’s health and development, and there is a need for effective interventions in clinical as well as in community

settings. Research has shown that existing interventions in Sweden for children with experience of violence towards a

caregiver are associated with positive but insufficient outcomes. In addition to implementation of new evidence based

interventions expanded knowledge is needed on outcomes of established interventions aiming at identifying possible

needs for improvement.

Method: The current study is an effectiveness study aiming at investigating the outcomes of two established group

interventions for children exposed to intimate partner violence and their non-offending parent, one community based

psychoeducative intervention and one psychotherapeutic treatment intervention. The study included 50 children, 24

girls and 26 boys, aged 4-13 years. Background information, child and parental mental health problems and trauma

symptoms was assessed pre- and post-treatment as well as 6 and 12 months post treatment.

Results: The results indicate that children benefit from both interventions, yet mothers of a majority of the children still

reported child trauma symptoms at clinical levels post treatment. Preliminary results from the follow up assessments will

be presented, such as outcomes in symptoms reduction and possible associations with confounding variables.

Discussion: Theoretical, methodological and clinical implications will be discussed.

National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-71712 (URN)
Conference
ESTSS 2017 – XV Conference of the European Society for Traumatic Stress Studies, Odense Denmark 31/5 – 4/6 2017
Note

Ej belagd 20180327

Available from: 2018-03-21 Created: 2018-03-21 Last updated: 2018-03-27Bibliographically approved
Pernebo, K. & Almqvist, K. (2017). Young Children Exposed to Intimate Partner Violence Describe their Abused Parent: A Qualitative Study. Journal of family Violence, 32(2), 169-178
Open this publication in new window or tab >>Young Children Exposed to Intimate Partner Violence Describe their Abused Parent: A Qualitative Study
2017 (English)In: Journal of family Violence, ISSN 0885-7482, E-ISSN 1573-2851, Vol. 32, no 2, p. 169-178Article in journal (Refereed) Published
Abstract [en]

The negative impact of intimate partner violence (IPV) begins early in the child’s relationship with a caregiver. Children’s relationships with, and internal working models of, abused parents have rarely been documented. The aim of this study was to collect and interpret young children’s accounts of their abused parent. Interviews were conducted with 17 children aged 4 to 12 years who had witnessed IPV. Thematic analysis identified three main themes and seven sub-themes: “Coherent accounts of the parent” (sub-themes of “general benevolence”, “provision of support, protection, and nurture”, and “parental distress”); “Deficient accounts of the parent” (“vague accounts” and “disorganized narrations”); and “The parent as a trauma trigger” (“avoidance” and “breakthrough of intrusive memories and thoughts”). The results indicate these children may hold integrated, deficient, or blocked internal representations of an abused parent, and they illustrate the benefit of including young children as informants in research.

Place, publisher, year, edition, pages
Springer, 2017
Keywords
Child, Children witnessing intimate partner violence, Domestic violence, Qualitative research, Children's accounts
National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-60334 (URN)10.1007/s10896-016-9856-5 (DOI)000393040500004 ()2-s2.0-84987662437 (Scopus ID)
Available from: 2017-01-30 Created: 2017-01-30 Last updated: 2019-09-06Bibliographically approved
Pernebo, K., Fridell, M., Svensson, I. & Almqvist, K. (2016). Utvärdering av två svenska gruppinterventioner för barn med erfarenhet av våld i föräldrarnas nära relation.. In: : . Paper presented at Den 9:e nordiska konferensen om barnmisshandel och omsorgssvikt, Stockholm 22–25 maj 2016 Are we making a difference for abused children?.
Open this publication in new window or tab >>Utvärdering av två svenska gruppinterventioner för barn med erfarenhet av våld i föräldrarnas nära relation.
2016 (Swedish)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [sv]

Utvärdering av två svenska gruppinterventioner för barn med erfarenhet av våld i föräldrarnas nära relation.

Karin Pernebo¹², Mats Fridell 3, Idor Svensson1 and Kjerstin Almqvist4

¹ Department of Psychology, Linnaeus University, Sweden

² Department of Research and Development, Region Kronoberg

3 Department of Psychology, Lund University, Sweden

4 Department of Psychology, Karlstad University, Sweden

 

Abstract

Erfarenhet av våld mot primär omsorgsgivare medför risk för negativ påverkan på barns hälsa och utveckling och det finns ett behov av genomförbara och verksamma interventioner för dessa barn. Tidigare studier visar att befintliga insatser i Sverige till barn med erfarenhet av våld i föräldrarnas nära relation är uppskattade av barn och föräldrar samt är förknippade med positivt men otillräckligt utfall. Ökad kunskap behövs för att bättre förstå vad som är verksamt och hur insatser kan förbättras. I en pågående studie granskas två väletablerade och manualiserade gruppinterventioner som erbjuds inom ramen för ordinarie etablerad klinisk verksamhet för barn med erfarenhet av våld mot primär omsorgsgivare. Den ena interventionen är tydligt psykoedukativ och den andra har sin grund i utvecklingspsykologi, traumateori och psykodynamisk teori. Interventionerna innehåller parallella grupper för barn och för den våldsutsatta föräldern med ett besök per vecka, vid 12-15 tillfällen. 50 barn i åldern 4-13 år ingår i studien. Barn och föräldrar har inkluderats kontinuerligt under en tvåårsperiod. Kontextuella faktorer, förekomst av våld (dvs. förälderns utsatthet, barnets exponering för våld mot föräldern och barnets egen våldsutsatthet), generell symtombelastning samt symtom på posttraumatisk stress hos barnen och generell symtombelastning samt symtom på posttraumatisk stress hos den våldsutsatta föräldern mäts före och efter intervention, samt efter 6 månader och efter 1 år.

 

Preliminära resultat från före och eftermätning presenteras vad gäller traumasymtom och generella symtom på psykisk ohälsa hos barnen. Eventuella samband med exempelvis typ av gruppintervention, barnets egen våldsutsatthet, förälders psykiska ohälsa, pågående rättsliga tvister och umgänge diskuteras.

National Category
Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-54391 (URN)
Conference
Den 9:e nordiska konferensen om barnmisshandel och omsorgssvikt, Stockholm 22–25 maj 2016 Are we making a difference for abused children?
Available from: 2016-06-29 Created: 2016-06-29 Last updated: 2018-05-17Bibliographically approved
Pernebo, K. & Almqvist, K. (2016). Young children's experiences of participating in group treatment for children exposed to intimate partner violence: A qualitative study. Clinical Child Psychology and Psychiatry, 21(1), 119-132
Open this publication in new window or tab >>Young children's experiences of participating in group treatment for children exposed to intimate partner violence: A qualitative study
2016 (English)In: Clinical Child Psychology and Psychiatry, ISSN 1359-1045, E-ISSN 1461-7021, Vol. 21, no 1, p. 119-132Article in journal (Refereed) Published
Abstract [en]

The risk of exposure to intimate partner violence (IPV) between caregivers is increased during early childhood. The adverse effects on the health and development of the youngest children may be severe. Effective and promising interventions for children who have experienced IPV have been developed and evaluated. However, there is a lack in knowledge about how the children themselves experience the interventions. The aim of this study was to contribute to the evaluation of group treatment designed to improve the psychological health of young children in the aftermath of family violence by elucidating the children's experiences of participating. Nine children, aged 4 to 6 years, were interviewed after participating in group programmes specifically designed for children who have been exposed to intimate partner violence. A semi-structured interview guide with open-ended questions was used. The interviews were transcribed and analysed using interpretative phenomenological analysis, to ensure a focus on the children's own views and experiences. Five master themes embracing the children's experiences were identified: joy - positive emotional experience of participation; security - feeling safe; relatedness - relationships within the group; to talk - externalised focus on the violence; and competence - new knowledge and skills. Theoretical and clinical implications and the benefit of including very young children's views and experiences in research are discussed.

Keywords
Preschool children, children’s experiences, treatment, intimate partner violence, qualitative research
National Category
Applied Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-39709 (URN)10.1177/1359104514558432 (DOI)25410886 (PubMedID)
Available from: 2015-02-04 Created: 2015-02-04 Last updated: 2018-03-23Bibliographically approved
Pernebo, K. & Almqvist, K. (2015). Children with experience of intimate partner violence describe their abused parent: A qualitative study.. In: : . Paper presented at The 7th International Attachment Conference,August 6th – 8th, 2015,New York, USA.
Open this publication in new window or tab >>Children with experience of intimate partner violence describe their abused parent: A qualitative study.
2015 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Children with experience of intimate partner violence describe their abused parent: A qualitative study.

 

Karin Pernebo¹² and Kjerstin Almqvist³

¹ Department of Psychology, Linnaeus University, Sweden

² Department of Research and Development, Region Kronoberg

³ Department of Psychology, Karlstad University, Sweden

 

Abstract

It has been shown that negative impact of intimate partner violence (IPV) on the child begins early in the realm of the relationship between child and caregiver. Understanding how children experience and relate to an abused parent is essential for theory and to optimize interventions. The aim of this study was to elucidate how children describe their abused parent in the aftermath of IPV. Face-to face interviews were conducted with 17 children with experience of IPV, aged 4 to 12 years, using a semi-structured interview guide. The interviews were analyzed using thematic analysis. Three main themes were identified: Coherent telling about parent; Deficient telling about parent and Parent as trauma trigger. The results indicate that children may carry integrated as well as deficient or blocked inner representations of the abused parent and illustrate the benefit of including young children in research. Theoretical and clinical implications are discussed.

Keywords
children, children witnessing intimate partner violence, intimate partner violence, qualitative research, children’s accounts
National Category
Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-54389 (URN)
Conference
The 7th International Attachment Conference,August 6th – 8th, 2015,New York, USA
Available from: 2016-06-29 Created: 2016-06-29 Last updated: 2017-01-17Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4831-4266

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