Intervention Paper

Introduction

Each year in the United States several million children experience some extreme traumatic event. Some of these events include natural disasters, death of a loved one, vehicle accidents, physical and/or sexual abuse and witnessing domestic violence. Children are increasingly exposed to violence in society. Many of these children may develop some form of psychological problems that can significantly impair their emotional, academic, and social functioning. Research has noted that many of these children will become fearful of their environment and develop expectations that their future will be unhappy. These children are in need of interventions to help them develop productive modes of coping. Over the years there have been many therapies and interventions researched in treating children with various behavior, emotional and psychological problems. Many children are treated for Post Traumatic Stress Disorder after witnessing traumatic events. It is my hypothesis that there is no one therapy alone, but that a combination of therapies would prove to be successful in helping children who have witnessed domestic violence. Also I believe that age, gender and severity of exposure will have an effect on how successful the intervention will be. Current literature addresses traumatic experiences that children have faced. This paper will explore interventions that have been used to treat children who have witnessed domestic violence, a traumatic experience, and discuss the effectiveness of the interventions.

Review of Literature

Gathered research data shows that child exposure to domestic violence deleteriously affects children's social, emotional and cognitive development (Groves,1999). Witnessing domestic violence may lead a young boy to view the abuse as male dominance while also viewing females as weak or submissive. Not all will children need treatment for exposure to domestic violence, but some clinicians have adapted models developed to treat posttraumatic stress disorder (PTSD) in children. Several types of child maltreatment are associated with increased evidences of PTSD (Cohen, Mannarino, Murray, & Igelman, 2006). Not all children exposed to domestic violence in the home show symptoms meeting the criteria for diagnosis of PTSD (Gewirtz & Edleson, 2007). Children of different ages and gender may be affected in different ways and require multiple treatment modalities. There are contributors, such as domestic violence that cause traumatic experiences for children and each child reacts in a different manner. Some internalize the event and some externalize the event (Martin, 2002). Studies conducted over the years have shown that most counseling programs for children exposed to domestic violence are delivered by battered women's shelters and community domestic violence agencies (Peled & Edleson, 1999). Cohen and colleagues (2006) noted that new research has shown that many maltreated and violence exposed children have experienced multiple forms of trauma and that they receive no treatment at all or are treated by community therapists who do not typically provide evidence-based treatments.

Compared with the number of studies in which interventions for child abuse have been evaluated, there is little adequate research on interventions for children exposed to domestic violence. The few studies that do exist show problems with design and method, for example, poorly defined samples, inappropriate or no comparison groups, and reliance on small samples that reduce confidence in results (Prinz & Feerick, 2003). There are few interventions in which treatment manuals are used that offer consistency in implementing protocols and/or goals (Graham-Bermann, Lynch, Banyard, DeVoe, & Halabu, 2007). Graham-Bermann and colleagues (2007) research said that evidenced based intervention studies for children exposed to domestic violence have only begun to develop.

Interventions used to treat children who have witnessed domestic violence need to consider the inclusion of the family (Ziegler & Weidner, 2006). Zeigler and Weidner (2006) note that parents must be held to a standard of safety and accept the reality of the child's feelings. In a study on toddlers and preschoolers (Lieberman, Van Horn, Grandison, & Pekarsky, 1997) used the dyadic approach of parent-child intervention and assessed the parent-child functioning along with their relationship. Other research has noted this approach in working with the parent-child with notable outcomes (Lieberman, Van Horn, Grandison & Pekarsky, 1997; Cohen, Mannarino, Murray & Igelman, 2006; Ziegler & Weidner, 2006; Graham-Beermann et al, 2007.) This psychotherapy approach is also influenced by attachment theory and has been noted to be promising (Lieberman, Van Horn, Grandison & Pekarsky, 1997). On the other hand Gewirtz and Edleson (2007) noted that some children develop successfully, performing at least as well as their low risk peers across a variety of domains. The children have been labeled competent, resilient and even invulnerable (Gewirtz & Edleson, 2007). There is a correlation to resilience found when a child has a good parent-child relationship and good assets (Gewirtz & Edleson, 2007).

Interventions

Graham-Bermann, Lynch, Banyard, DeVoe, & Halabu, 2007 research

Graham-Bermann and colleagues (2007) conducted a study, with children ages 6 to 12 years old, on a community based intervention for children exposed to domestic violence. In the study the researchers used an ecological approach in the intervention. The research theory consisted of social-cognitive theory, social learning theory, and trauma theory. Mothers and children were provided support by addressing their needs with a community program. They used a child-mother (CM) group, child only (CO) group and a wait list group for comparison. The parenting program was designed to support mothers by empowering them to discuss the impact of the domestic violence on their child's development, to build parenting competence, provide a safe place to discuss parenting worries and fears, and to build connections for the mother in a supportive group (Graham-Bermann et al, 2007). They hypothesized that children who received the intervention would show lower levels of externalizing and internalizing problems and show more improved attitudes about violence (Graham-Bermann et al, 2007). This hypothesis was only partially supported, post treatment, according to the researchers. They did find greater success in improving attitudes and reducing aggression when treating both the parent and child.

The child-mother intervention was found to work with aggressive children, oppositional defiant