Domestic Violence

The Medicalisation of Distress:

Children, Trauma and Domestic
Violence

Arlene Vetere, Ph.D

Council of Europe (1986)

Any act or omission committed within the
framework of the family, by one of its
members that undermines the life, the bodily
or psychological integrity, of the liberty of
another member of the same family, or that
seriously harms the development of his or her
personality.

People are more likely to be killed, physically

assaulted, hit, beaten up, slapped or spanked
in their own homes by other family members
than anywhere else, or by anyone else in our
society
Gelles and Cornell (1990)

APA Task Force on the Effects of

Violence on Children
Interpersonal violence, especially violence

experienced by children, is the largest single

preventable cause of mental illness. What
cigarette smoking is to the rest of medicine,
early childhood violence is to psychiatry.
Steven Scharfstein (2006)

Domestic Violence & Family Safety

What are the Children Learning?....

Teaches children aggressive styles of

Safety first the stable third

Difference between responsibility &

explanation

conduct

Reduces restraint & increases arousal to

aggressive situations

Safety strategies & signs of safety

Desensitises to violence

No-violence contract

Distorts views about conflict resolution

No confidentiality

Working with alcohol and drug use

Browne and Herbert (1997)

Child Witnesses to Domestic Violence

Child Witnesses to Domestic Violence

Estimated 2/3 of assaults witnessed

Risk of harm to children 4-9 times higher

Trauma: exceptional experience of

powerful and dangerous stimuli
overwhelm childs capacity to
regulate emotions

The Dunedin Study (1972)

Risk of traumatic responses

Frequency and intensity of physical conflict

between parents linked to worse behavioural

outcomes for children

Children show same signs of distress when
exposed to violence as when physically
abused

Child Witnesses to Domestic Violence

Effects of exposure depend on.

Monitored from birth: health, social, behavioural,

environmental measures

At risk group of 3 year olds compared at age 21

Men: 47% abused partner vs 9.5%

x 3 anti-social personality
x 2.5 criminal convictions (severity +)

Women: 30% teenage birth vs none
43% in violent relationships
(Moffitt & Caspi, 1998)

Characteristics of violence

Developmental phase of the child

Proximity to violence
Familiarity with victim/perpetrator
Family and community support
Response to violence exposure by family,
school, community groups

Child Witnesses to Domestic Violence

Working with Domestic Violence

When you see a picture of.

Any approach/description of children in families where

they are victims of assault and violent behaviour should
include:

Somatic symptoms

Lack of interest in activities

High activity level (constantly moving, highly

distractible)

Numbing and inability to comfort self

Repetitive play

PTS symptoms (new fears, behaviour changes, sleep

difficulties)

.consider whether violence may be the cause!

An understanding of betrayal of trust & lack of adult

responsibility

Abuse of power and use of intimidation

Inability of children to consent

An indication of the wide range of violent, intimidatory
and bullying activities involved in the abuse

Working with Domestic Violence cont.

Child Witnesses to Domestic Violence

An understanding of the creation of fear & the

How can we help?

power of secrets

If the child was involved in the adult abusive
interactive process how did that happen?

Childs perception of threat either spoken, or
threatening behaviour

Resilience what is their view or belief?

Prioritise safety

Knowing how to talk to young children and

their parents/carers

First task to help child feel safe

Support relationships and strengthen

relationships e.g. post adoption consultation

Child Witnesses to Domestic Violence cont.

Child Witnesses to Domestic Violence

Going back to routines following trauma

Children benefit from:

Psychoeducation to raise awareness of

effects on children

Parents may be traumatised support them
in listening to their children

Reassurance & encouragement

Knowing that they are safe and do not have

Child Witnesses to Domestic Violence cont.

Families and Trauma

to worry about the safety of other family

members

Opportunities to explore, express and
process their feelings

Meeting other children/young people and
realising they are not the only ones!

Help to communicate with the non-violent parent

?

about what has happened

Opportunities to disclose abuse to someone they

know and trust

30

Positive male/female role models

Work that challenges gender stereotyping or

tolerance of sexual/physical violence

Help in dealing with behaviour problems & help to
catch up at school

Contact with the perpetrator if they want this but
with safety

40

43

Mrs B

12

Mr B

13

11

Claire

Lizzie

Reading List
1.

Cooper, J and Vetere, A. (2005) Domestic Violence and Family

Safety: A systemic approach to working with violence in families.
London: Whurr/Wiley

2.

Vetere, A. and Cooper, J. (2001) Working systemically with family

violence: Risk, responsibility and collaboration. Journal of Family
Therapy, 23, 378-396

3.

Vetere, A. and Cooper, J. (2003) Setting up a domestic violence

service. Child and Adolescent Mental Health, 8,61-67

4.

Vetere, A. and Cooper, J (2005) Children who witness violence at

home. In A. Vetere & E. Dowling (eds) Narrative Therapies with
Children and Their Families. London: Routledge

5.

Vetere, A. and Cooper, J. (2006) Keeping fathers visible: men and

domestic violence, Context, 84, pp33-35