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The Journey

CHILDREN IN PARTNER VIOLENT HOMES, INTERVENTIONS AND VIRTUAL REALITY Ernest N. Jouriles FAMILY RESEARCH CENTER SOUTHERN METHODIST UNIVERSITY. The Journey. The Journey. The Journey. Partners. Overview. Scientific knowledge on intimate partner violence (IPV) and children Definitions

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The Journey

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  1. CHILDREN IN PARTNER VIOLENT HOMES, INTERVENTIONS AND VIRTUAL REALITYErnest N. JourilesFAMILY RESEARCH CENTERSOUTHERN METHODIST UNIVERSITY

  2. The Journey

  3. The Journey

  4. The Journey

  5. Partners

  6. Overview • Scientific knowledge on intimate partner violence (IPV) and children • Definitions • Prevalence and correlates • Interventions • How we are helping • Project Support • What it is • What it does • Prevention of Sexual Assault

  7. Conflict Tactics Scales (CTS) Items In the past year, how often has your partner. . . ? 1. Discussed an issue calmly 2. Got information to back up his side of things 3. Brought in or tried to bring in someone to help settle things 4. Insulted you or swore at you 5. Sulked or refused to talk about an issue 6. Stomped out of the room, house, or yard 7. Cried 8. Did or said something to spite you 9. Threatened to hit you or throw something at you 10. Threw or smashed or hit or kicked something 11. Threw something at you 12. Pushed, grabbed or shoved you 13. Slapped you 14. Kicked, bit or hit you with a fist 15. Hit or tried to hit you with something 16. Beat you up 17. Threatened you with a knife or gun 18. Used a knife or fired a gun

  8. How Prevalent is IPV? Each year, men’s violence toward women occurs in 12%-14% of US couples • Lower income families • Younger couples Some claim that IPV is more common among military families • Selection biases • Military training? • Stress of military life? • Demographics

  9. How many children live in families with IPV? • Common estimate: 3-10 million • Underestimate

  10. How Many Children Live in Families with IPV? • 52,000,000 children • 15,500,000 exposed to at least one act of physical IPV • 7,000,000 exposed to at least one severe act of physical IPV McDonald, Jouriles, Ramisetty-Mikler, Caetano, & Green, 2006

  11. How many children in military families live with IPV? • Not clear? • Like other estimates, at least as high as 30%

  12. CTS: Community Sample In the past year, how often has your partner…?

  13. CTS: Domestic Violence Shelter In the past year, how often has your partner…?

  14. Where do shelter families fit in? Nonviolent Families Violent Families Violence Frequency and Severity Shelter Families 1 million children are estimated to be brought to a domestic violence shelter in US over the course of a year

  15. Does IPV Increase Risk for Child Problems? • 87 couples requesting marital therapy • Participants had a child between 5 & 12 • Conflict Tactics Scales • Short Marital Adjustment Test • IPV + Marital Discord vs. Marital Discord • Outcome Variables • Behavior Problem Checklist • Conduct disorder • Personality disorder • Inadequacy immaturity • Socialized delinquency Jouriles, Murphy, & O’Leary, 1989

  16. Things We Know: • Child problems are associated with: • Frequency of IPV • Severity of IPV • Kicked, bit or hit you with a fist • Hit or tried to hit you with something • Beat you up • Threatened you with a knife or gun • Used a knife or fired a gun • Broader conceptualization of IPV is more powerful in the prediction of child problems Jouriles, Norwood, McDonald, Vincent, & Mahoney (1996); Jouriles, McDonald, Norwood, Ware, Spiller, & Swank (1998): Jouriles, Spiller, Stephens, McDonald, & Swank (2000)

  17. Conflict Tactics Scales (CTS) Items In the past year, how often has your partner. . . ? 1. Discussed an issue calmly 2. Got information to back up his side of things 3. Brought in or tried to bring in someone to help settle thin 4. Insulted you or swore at you 5. Sulked or refused to talk about an issue 6. Stomped out of the room, house, or yard 7. Cried 8. Did or said something to spite you 9. Threatened to hit you or throw something at you 10. Threw or smashed or hit or kicked something 11. Threw something at you 12. Pushed, grabbed or shoved you 13. Slapped you 14. Kicked, bit or hit you with a fist 15. Hit or tried to hit you with something 16. Beat you up 17. Threatened you with a knife or gun 18. Used a knife or fired a gun

  18. What are the problems? Broad-band problem areas • Externalizing • Behavioral/Conduct • Problems • Noncompliance • Aggression • Lying/cheating • Rule Breaking • Internalizing • Emotional • Problems • Trauma • Anxiety • Depression • Withdrawal • Social and Other Problems • Academic difficulties • Cognitive difficulties • Health problems • Peer problems

  19. How many children have significant adjustment problems? • Children in domestic violence shelters: • No apparent problems 31% • Mild problems 18% • Moderate to severe problems 51% Grych, Jouriles, Swank, McDonald, & Norwood (2000)

  20. What Else? IPV is associated with: • Problems for children of all ages • Psychological and family processes important for child problems • Parenting • Appraisals of conflict Very little longitudinal research • Conduct problems persist • Co-occurring emotional problems tend to get better Jouriles & LeCompte (1991); Jouriles & Norwood (1995); Jouriles et al., (2000); McDonald et al., (2007); Ware et al., (2000)

  21. What treatments have been evaluated for children exposed to IPV?

  22. Project Support • Empirically-based treatment designed to reduce conduct problems among children aged 4-9 exposed to frequent and severe domestic violence • Families who sought shelter at a domestic violence agency • Clinical levels of conduct problems • Applicable to other families (not just shelter families) in which violence is an issue

  23. Why are conduct problems so important? • Mothers are concerned • Very prevalent among children brought to domestic violence shelters • Early onset conduct problems • Persist into adulthood • Best single predictor of later antisocial behavior • Must be addressed early • Great costs to society • Law Enforcement & Criminal Justice systems • Education • Social services

  24. Research Base for Project Support • High quality research on: • Correlates of IPV • Causes and maintaining factors for conduct problems • Effective treatments for conduct problems • Practical & clinical experience • Input from the women themselves • Input from shelter staff • Our own experiences with families • Including offering parenting groups in shelters

  25. Components of Project Support? • Structural components • Home-based services • Child care offered • Flexible schedule • Weekly appointments • 8-month/6-month duration • Substantive Components • Social and Instrumental Support • Parenting and the Parent-Child Relationship

  26. Social and Instrumental Support • Access to community resources • Access to goods through • Community resources • Donated goods • Problem-solving and decision-making skills • Demonstrate that we care

  27. The “Adversity Package” Multiple Risk Factors: • Poverty • Parental low education • Parental employment problems • Transience/school changes • Move-related needs • Legal issues • Separation/Divorce • Child custody and visitation • Child support • Protective orders • Antisocial fathers/father figures • Poor quality child care • Child maltreatment The more risk factors, the greater the risk for mental health problems.

  28. Services that target children’s problems II. Parenting and the Parent-Child Relationship

  29. Besides the skills, what else is important in Project Support? • Skills are cumulative • Focus on skill mastery at each step • Role plays • Review and Repetition • Homework and corrective action

  30. And what else? • Working hard to keep them! • Transience • Crises and stress • Lack of interest, time, or competing demands • Small caseloads • Cases are time consuming • Burnout prevention • Internal support mechanisms for therapists • Mechanisms for tracking/locating families • Safety policy and procedures for home visits • Family safety – Always trust the woman’s sense of danger • Staff safety

  31. Program Evaluation:Does Project Support Help? PILOT STUDY • 36 families • Randomized clinical trial (RCT) • Assessments every 4 months • 2½ year follow-up period

  32. Project Support Group 60 CBCL Ext. T-Score 20 Shelter Residence 16 Months After 32 Months After Shelter Shelter Assessment Treatment Effects “Treatment as Usual” Comparison Group 60 CBCL Ext. T-Score 20 Shelter Residence 16 Months After 32 Months After Shelter Shelter Assessment

  33. Summary of 1st Evaluation: How “good” is it? • Significant group differences in: • Child Externalizing Problems • Observations of Parenting • Clinically significant findings: • Project Support group: • 83% no longer at clinical levels • Comparison group • 55% no longer at clinical levels • Effects persisted for 2 years • In context: • Maintenance of effects over 2 years is exceptional • No other samples have been followed • Only a pilot

  34. So, can you do it again? • NIMH treatment outcome study • 66 Shelter Families • Assessed every 4 months for 2 years • All had ODD/CD diagnosis • Mother, Teacher, Observational Data Treatment as usual Project Support Pre to Post-Tx Follow-up period Asst. #

  35. Summary and New Directions • Strong results with shelter families • Pilot • NIMH RCT • Similar results with CPS-referred families • Focus on parenting • Reductions in re-referrals • Next Steps • Can we improve upon our treatment effects? • Talking with the children about the violence • Dissemination

  36. Continuing the Journey… Older Children

  37. Relationship Violence, Sexual Coercion and Rape: The Problem • Have you ever been physically forced to have sexual intercourse when you did not want to? • Females - 10.3% vs Males - 4.8% • 12th Graders: 12.2% vs 5.8%

  38. Sexual assault in the military • Source: 2006 Gender Relations Survey of Active Duty Members • Unwanted sexual contact • Rape • Non-consensual sodomy • Unwanted fondling • Prevalence: 5.1% - 6.8% • Unwanted sexual attention • Unwanted attempts to establish a sexual relationship • Prevalence: 31%

  39. CNN News Report • Sexual assault in military ‘jaw-dropping,’ lawmaker says • Prevalence: 41% female veterans at VA hospital

  40. Sexual assault is associated with… • Depression • Anxiety • Trauma • Substance use • “In an era when the military relies on women for invaluable and difficult frontline duties, the threat to their morale, performance and long-term well-being is starkly clear.”

  41. Sexual assault prevention programs • Classroom-based didactic interventions • Bystander interventions • Criminal justice interventions • Empathy-and/or skills-based programs • Most lack strong theoretical grounding • Few have been evaluated and found effective in reducing violence • Knowledge, Attitudes vs. Behavior

  42. Developing Skills to Prevent Acquaintance Assault • Assertive, active resistance strategies • Clearly setting boundaries • Yelling at a potential attacker • Leaving situation • Substantial research evidence • Research on sexual predators

  43. Skills Training & Role Plays • Make it engaging for adolescents • Teach the skills more effectively • Increase realism • Sexual coercion is threatening • Generalize skills to threatening situations • Learning vs. performance

  44. Role Plays • Designed with assistance of college-aged women to make it realistic • Instructions: You were at a party where you met a guy. He offered to give you a ride home. He seemed nice enough, so you agreed. On the way home, it started to rain, so he pulled over to let the storm subside. • Involved a trained male actor • Duration 9 -10½ min • 4 phases: • Getting Acquainted (3 - 3½ min.) • Beginning Advances (2 - 2½ min.) • Escalation (2 - 2½ min.) • Anger (2 min.)

  45. Role Play Setting 10’ by 12’ room 2 adjacent car seats

  46. Research Goals • Create a role play perceived as realistic … threatening • Evaluate whether VR can enhance perceived realism

  47. Participants & Design • 62 college-aged women • Random assignment • Role Play (RP) • Male Actor • Virtual Role Play (VRP) • Virtual “date” controlled by male actor • VR goggles and headphones (what they were seeing was the inside of a car)

  48. Measures • Realism and effects of the virtual role play compared to the conventional role play • Self-Report • 5 negative affect items from the PANAS • 2 questions about the perceived “realism” of the role play • Observation • Behaviors and displays of emotion reflecting immersion • Hostile responses • Strong verbal protests • Physiology • Heart rate

  49. Results: Ratings of Actor Behavior • The RP & VRP conditions did not differ on: • Duration of role plays • Each of the 4 phases • Total duration • Frequency of sexual advances, threats/insults by actor • Observer ratings of actor persistence or hostility

  50. Results: Group Differences

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