19. Abnormal Inter-Hemispheric Connections in Maltreated Children • Corpus Callosum - mid sagital region and areas 4, 5, 6, & 7 were smaller in maltreated children with PTSD • Decrease correlates with: Intrusive thoughts, avoidance, hyperarousal & dissociation • Effects boys > girls
It was important to us that partners just didn’t feel like people sitting in chairs around a table. We wanted it to be engaging and win-win. Biggest surprise is that people looked forward to meetings—even orgs who don’t get $ contracts from us to implement services. For 9 years, excited has been maintained and that has been the biggest surprise to me. It speaks to mutual benefit—either in form of contracted services, leveraging funds in indiv org’s grant writing, or exposing orgs to new research and guest speakers (i.e. we brought in LIST THAT LADY FROM HARVARD) and we brought in Dr. Tom Boat to do presentaiton
Research resulted in need to address all forms of family violence Prohibited continuation in our community to operate in silos and increased collaborative environment
Spectrum of Prevention Implementation Model
1,979 children are placed in custody About 500 people are arrested for intimate partner violence
Public health model—layering of services—connection between bullying, teen dating violence, community violence. Work in schools.
Lessons Learned: Never assume professionals truly understand impact of CEFV Evaluation of train-the-trainer model occurred right at the end of the program Participants may not have had time to reflect on the training and use it in the “real world.” Evaluating trainers’ mastery of curriculum & effectiveness in training others is time consuming. 0 Consulting or contracting with experts in this area is helpful in developing a valid measure of learning. Measuring systems impact is time consuming &requires significant expertise to implement
Chronic severe stress impedes brain development during critical periods in children aged 7 and younger. Enormous efforts have been expended to cope with the public health emergency of children’s lead exposure. Living with the terror of battering appears to be twice as toxic to kids.
(De Bellis et al, 1999)
Davidson et al., 2000, p 592
Many battered women stay for economic reasons. It is impossible to support a family on the minimum wage jobs available to many women. (Shipler, 2004) In one family violence shelter survey, over half the women reported that their partner had harmed or killed a pet. 21% reported that they did not seek shelter sooner in order to protect their pets. (Ascione & Arkow, 1999) Estimates of battering generally omit questions about the sexual and physical violence that takes place after separation and so may underestimate the prevalence. Court-ordered visitation exchanges with violent ex husbands can endanger women and subject children to further battering exposure.
KEYS TO SUCCESS: Develop solid “core” curriculum Feedback Forums Identify strengths & areas to improve Involve in process of adapting curriculum Re-train trainers Continuous technical assistance & communication with trainers/ needs
Two agencies have instituted a policy that all new employees receive training in CWWDV ProKids & JFS
Smaller target audience = greater concentration & eval of impact Put in how many trained and how many hours LESSONS LEARNED Allow time to build relationships (buy-in) with home visitation program supervisors Materials must be cultural competent Resources must be culturally accessible Emphasize safety planning for home visitor Develop products & pilot pre/post tests before training implementation
KEYS TO SUCCESS Build on success from Phase I Expert recommendations & time from CWWDV committee (8 organizations) Excellent evaluators Strong funder support
This approach is based on the research of Betsy McAlster Groves, Director of the Child Witness to Violence Project at Boston Medical Center[i]. While Phase I and II narrowed the gap in training Large gap still remained as many caregivers of CEFV do not access services provided by crisis intervention service providers. Obstacle: Securing school time for services Strategy: Focus conversation on benefits of peace education: decrease violence / increases time to teach / increases educational performance Lessons Learned Referral process: Work with Jobs & Family Services first and have JFS staff ask court system for referrals to program Do not have FVPP service providers first asking court to do referrals Reduce financial barrier to families by offering services free to families
As researchers Bancroft and Silverman contend, “the damage that family violence can cause to mother-child relationships may be the most serious cause of distress for children of battered women”[ii]. Treatment goals: Improvement in the quality of the parent-child relationship Decrease in child behavior problems with an increase in pro-social behaviors Increase in parenting skills, including positive discipline which leads to a decrease in parenting stress Trauma Treatment Training Center at Cincinnati Children's Hospital Medical Center The emphasis is on changing negative parent child patterns
Group processing beneficial for this cohort because teens learn best from peer behavior defining norms.
As Betsy McAlister Groves states, “such children feel trapped in the middle of intense and prolonged interparental conflict and experience confusing feelings of loyalty and respond with h eightened levels of stress, fear, and anger” Address lack of structure & stability for the children which creates an environment of anxiety and insecurity about what will happen to them and to their family members. sibility….groups can help these children to understand family members' roles in the separation and to develop their own perspectives on the conflict.” KEYS TO SUCCESS Offer diverse services in program model Not cookie cutter approach: referrals based on child’s specific needs Use well-known, well-respected community service providers Children’s Hospital Beech Acres Parenting Center
Discuss data from courts and anecdotal cases This intervention is mastery-based so we move the parent on when she has met mastery or is close to it ( eg., in 5 minutes of CDI with child , the parent can give 10 labeled praises, 10 reflections and 10 behavioral descriptions and no more than 3 questions, commands or negative talk). PCIT is neat because the outcome data is part of the program.
