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Children in group interventions after exposure to violence toward a caregiver: Experiences, needs, and outcomes
Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.ORCID iD: 0000-0002-4831-4266
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 [en]
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: urn:nbn:se:lnu:diva-71720ISBN: 978-91-88761-45-3 (print)ISBN: 978-91-88761-46-0 (electronic)OAI: oai:DiVA.org:lnu-71720DiVA, id: diva2:1192826
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
List of papers
1. Young children's experiences of participating in group treatment for children exposed to intimate partner violence: A qualitative study
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
2. Young Children Exposed to Intimate Partner Violence Describe their Abused Parent: A Qualitative Study
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.

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 ()
Available from: 2017-01-30 Created: 2017-01-30 Last updated: 2018-05-31Bibliographically approved
3. Outcomes of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence.
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)
Available from: 2018-03-21 Created: 2018-03-21 Last updated: 2018-07-13Bibliographically approved

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Doctoral Thesis (Comprehensive Summary)(3615 kB)1985 downloads
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