Tuesday, July 24, 2018

Refugee Children Exposed to Intimate Partner Violence: Facilitating their Resilience


Part One of this two part series discusses the effects of exposure to intimate partner violence (IPV) on refugee children and ways to reduce this exposure by helping their mothers achieve safety. This piece discusses how to work directly with refugee children impacted by IPV to boost their resilience and recovery.

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Identifying Children Exposed to Intimate Partner Violence (IPV)

While many behaviors signal a child in distress, no behavior in and of itself is diagnostic of a child exposed to Intimate Partner Violence (IPV). Some children have difficulty concentrating and under-achieve academically, while others flourish in the safety of the classroom. Some evidence post traumatic symptoms such as traumatic arousal (difficulty sitting still or problems sleeping), numbness, intrusive memories, and a reduced ability to cope with stress. Some children have mostly internalizing behaviors such as low self-esteem, depression, anxiety, and social withdrawal, while other show externalizing behaviors including aggression, delinquency, substance abuse and tantrums. Children in homes with IPV are hospitalized more than other children, and are more likely to suffer from physical symptoms such as colds, bed-wetting, and sore throats. Frequent visits to the school nurse may be a sign that a child has been exposed to IPV or other trauma.

We should be especially concerned if we see a child who acts out IPV in imaginary play, who is aggressive or overly submissive with their peers, or a child who shows an exaggerated startle response to loud noises or voices. The best way to determine if a child has been exposed to IPV is to ask directly. Depending on the child’s age and how guarded they are, children might respond with important information to a general prompt such as:
  • Tell me about your family
  • Tell me how your mom is doing
  • Tell me about how things are at home
You’ll notice, these “questions” are phrased as open-ended prompts, so children will be more likely to respond with a narrative rather than a single word such as “fine.”

Inquiring about people’s families is common in cultures throughout the world, and some children will respond openly to this kind of prompt. However, many children have been told not to discuss family matters with outsiders. If we have a reason to suspect that IPV ocurrs in a child’s home, or if we see a child who is unusually aggressive, passive or sad, we can ask direct questions. For instance:
  • Tell me about what worries you
  • Tell me about what scares you
  • Who fights with whom in your home? What usually happens?
  • Who is the boss in your family? How do you know?
Mandated Reporting
©istockphoto.com/TzahiV

In many but not all states, exposing a child to domestic violence is considered a form of child abuse or neglect, and requires reporting to child protective services (CPS) or the police. People in those states who are mandated reporters of child abuse are therefore required by law to report children who they suspect or know are exposed to IPV. People who work in states that do not require the reporting of children exposed to IPV may still do so if they believe the exposure is potentially dangerous or traumatizing for the child. Whether CPS will intervene for exposure to domestic violence without other forms of child abuse depends on local practices and the perceived level of risk to the child.

Many people equate reporting a family to child protective services with forcing a child into foster care, but that is always a last resort. More commonly, CPS will do one of the following instead (NCANDS 2015): 1) screen out the report (42%); 2) investigate and decide a child is no longer at risk, sometimes providing a family with voluntary services; or 3) provide ongoing services to a family including regular social work visits. Phrased another way, out of 4.1 million referrals to CPS in 2016 alleging 7.4 million maltreated children, fewer than 204,000 (2.8%) ended up in foster care. More than 1.3 million children and their families received some kind of service as a result of the reports, even if no abuse was confirmed. This is a lot of services reaching many people through those reports, including psychotherapy, medical attention, access to subsidized childcare or housing, help with an abusive spouse, and parenting classes.

Children who are exposed to IPV are also more likely to be abused themselves than other children. Therefore, making that call to CPS about suspected IPV may bring to light other problems that need intervention. As much as we hate to make that call, it is far worse to receive a call from a fatality investigation team and know that we failed to intervene when we could have saved a life.

The following tips are designed to boost the resilience and recovery of children exposed to IPV. That is, their ability to bounce back and achieve their potential after this traumatic exposure:

Support Academic Success: Collaborate with classroom teachers and school counselors to improve refugee children’s likelihood of succeeding academically. This may involve helping with class selection, accessing tutors and interpreters, and establishing regular “check-ins” with school counselors. Teachers and administrators from elementary through high school are often grateful for information about refugee families and the challenges they face.

Lower Stress at Home and School: Children exposed to IPV may be triggered by a generally loud environment, sudden loud noises, uncertainty, and interpersonal conflict. Teachers and administrators who understand this may be able to make changes to support the traumatized children in their building (see https://traumasensitiveschools.org). Additionally, we can help teachers and families understand that predictability reduces anxiety in traumatized children. A predictable sequence of activities including regular mealtimes and bedtimes allow children to relax.

Support Reading: Not only are strong reading skills a key to academic success, but many traumatized children find safe haven and behavioral models in books. Bring refugee children to the public library, help them get library cards and understand the library’s rules. Also bring children to their schools’ library and help them bond with librarians. Teach refugee parents the importance of supporting their children’s reading in general and accessing books through libraries in particular.

Support Social Success: help refugee children access outlets when they can excel such as sports, chess club, performing and visual arts, scouts, and others. The adults who facilitate these activities are often willing to waive the usual fee if approached by a refugee advocate. These activities enhance children’s social success, self-expression, and bonding with helpful adults. Choosing the right activities can also help traumatized children and teens with their particular areas of deficiency. For example, aggressive children learn self-control and discipline through studying martial arts, and shy children learn social skills through sports, dance, theater, chorus, or other group activities.

©istockphoto.com/TracyWhiteside
Provide Access to Counseling: individual, group, family, or sibling group counseling can help children cope. Children can access these services in school or in the community. Children who have been exposed to IPV should have opportunities to discuss the IPV explicitly. Many children also benefit from support groups for children whose parents have recently divorced or separated (called “the banana splits” in my children’s elementary school), or more general groups where children can discuss their issues. Such groups help them establish bonds with other children as well as with the group facilitator, and can provide tremendous relief. Cognitive behavioral therapy may especially help children who are aggressive, withdrawn, or powerless.

Many children from refugee families grow up into remarkable adults—successful in their work and personal life and contributing to society. This is also true for children who grow up in homes with IPV. Once they are safe, the children benefit from allies and from information and programs to help them overcome their trauma, and thrive.

For more on Family Strengthening check out our Highlighted Resources List.

This month's guest blogger: Lisa Aronson Fontes, Ph.D., is a senior lecturer at the University of Massachusetts, Amherst, and the author of Invisible Chains: Overcoming Coercive Control in Your Intimate Relationship, and Child Abuse & Culture: Working with Diverse Families.

Refugee Children Exposed to Intimate Partner Violence: Protection through Reducing Their Exposure

This piece discusses the effects of exposure to intimate partner violence (IPV) on refugee children and ways to reduce this exposure by helping their mothers achieve safety. A second piece outlines ways to boost the resilience of children who have been exposed to IPV.

©istockphoto.com/Juan Monino
Children suffer when they witness conflict and violence, especially when it involves their parents. The stress of this exposure overwhelms their developing bodies and brains, contributing to a range of negative social, medical, and mental health outcomes. In fact, “mother treated violently” is one of the ten original Adverse Childhood Experiences (ACES) known to impact children’s health and well-being into adulthood (see https://www.cdc.gov/violenceprevention/acestudy/index.html).

Children who are refugees or whose parents are refugees often endure multiple ACES including the death or disappearance of close family members, traumatic dislocations, and disruption of their support systems. Facing culture shock, discrimination, poverty and racism compound their difficulties (Cronholm et al, 2015). Add exposure to parental violence into the mix, and they may be devastated. The more of these stressors children face, the more their development will be impacted, unless they receive exceptional support and intervention.


Children’s Exposure to Intimate Partner Violence (IPV)

Because they often do not speak the language of their host country and may know few people beyond their community, refugee women who are victims of IPV may not know where to turn. Their children suffer the consequences, alongside the abused moms.

Research shows that children do know about violence between their parents, even when parents think they are keeping it secret. Children may view an abusive incident or hear it from another room. Children often suffer the disturbing after effects, such as witnessing a parent’s bruises or swollen eyes, seeing broken objects in the home, or suffering from the absence of one parent after a violent incident.

IPV consists of much more than physical assaults; it may include isolating, verbal abuse, stalking, manipulating a partner financially, and sexual assault or coercion. Exposure to these coercive control tactics also harms children. A child who views his father dominating his mother and curtailing her freedom learns this way of interacting. In school, he may try to mimic the authoritarianism and heavy hand he has witnessed at home by fighting when he cannot get his way. In contrast, some children exposed to IPV become overly submissive and self-blaming, modeling themselves on their victimized mothers.

IPV also interferes with the parent/child bond. Overwhelmed by the abuse, victimized mothers sometimes withdraw from their children and become emotionally unavailable, or they may be irritable and respond harshly. Often, men who abuse women also abuse their children, sometimes as a means to control their wives. In all these ways, IPV damages the attachment between children and their caretakers, placing them at risk for a variety of behavior and relationship problems throughout their lives.
©istockphoto.com/Gerville

Exposure to IPV terrorizes children, and can lead to post traumatic symptoms such as traumatic arousal (difficulty sitting still or problems sleeping), numbness, intrusive memories, and a diminished ability to cope with stress. The emotional effects of IPV exposure include depression, anxiety, low self-esteem, traumatic stress reactions, school failure, and social withdrawal. Some children also show externalizing behaviors including aggression, delinquency, and substance abuse.

Ending IPV Helps Refugee Children

If we can help a mother live free from IPV, then we are protecting her children from the pernicious effects of that abuse. Sometimes abusers can learn to change; but most are unwilling or unable to do so unless they receive substantial pressure from their communities and the law, and participate in Batterer Intervention Programs (BIPS). Anger management classes are not as effective as BIPs for someone who abuses his partner since control—rather than anger—is at the root of IPV (Klein, 2009).

Clergy within refugee communities are often ill equipped to handle domestic violence in families, and yet they are the first authorities many women consult when distressed. Often these clergy are exclusively men; and they interpret religious texts in ways that either condemn or support domestic violence, depending on their own perspectives. If the clergy member does not know what to do or where to refer a victim for further support, he may urge a victim to be patient, thus encouraging her to remain in a situation that is dangerous for her and her children. We must help clergy and other refugee community leaders understand IPV and see how it not only harms women and their children, but also hurts the reputation of entire communities.

Build Trust with IPV victims:
Many refugees have experienced discrimination by neighbors and hateful speech by politicians both in their original countries and in the U.S. Why should they trust us concerning intimate family matters such as IPV? We build trust with families over time by showing ourselves worthy: putting in the hours with them, and bringing them concrete help with practical matters such as housing, food, school supplies, etc.

Explain the Effects of IPV on Children: In many refugee cultures, community members, extended family, and religious leaders will all pressure a woman to maintain her marriage at all costs—even when she is being victimized by her husband. However, the idea of protecting her children may motivate her to accept the resources she needs to break free. When we speak with a woman about IPV, we must emphasize the risks for her children as well as for her. Children’s school performance, and physical and mental health all suffer in homes with IPV.

Provide Access to Resources: IPV victims are often unfamiliar with their rights and the services available in their new country, especially if these do not exist in their country of origin. Help them establish links with DV advocates, legal aid, women’s shelters, hotlines, knowledgeable and sympathetic clergy, and relevant websites.

Coordinate with Other Agencies: Refugee resettlement professionals often strive mightily to keep families away from child protective services. However, sometimes CPS’s resources and leverage prove useful in keeping refugee children safe.
Elena was determined to stay with her abusive husband, for the sake of her family’s reputation. A concerned teacher called child protective services (CPS) about Elena’s daughter’s reports of her father’s abuse of her mother. When CPS understood the extent and frequency of the abuse against Elena, they asked her to kick her husband out of the home, which she felt unable to do. CPS then temporarily took custody of the children and ordered Elena to attend a series of classes on domestic violence (DV) as part of the plan to regain custody. The course helped Elena realize all the ways her children were affected by their exposure to her victimization. She engaged fully with child protective services, the police, and the DV agency so she could live in safety with her children, without her husband.
Initially, Elena’s participation in the DV support group was difficult because the DV agency did not provide an interpreter. The refugee resettlement advocate interpreted for Elena in the first couple of sessions, while pressing the DV agency to fulfill their legal obligation to provide an interpreter, which they eventually did.
After the father was removed from the home, the children spoke more freely about the ways in which he had also abused them. The father was obliged to participate in a Batterer’s Intervention Group, but refused to do so and never returned to Elena’s home. He saw his children mostly at community events, and on occasional supervised visits. Elena and her children also received family counseling, which helped them speak more openly with each other. The children’s school performance improved, and they all agreed they were better off without their father in the home. While the ending to Elena’s story is far from ideal, she and her children were able to achieve safety and freedom from abuse.
©istockphoto.com/Mr_Khan
Professionals from outside a given community sometimes reflexively decide that the IPV is “cultural” and walk away from it, considering it unsolvable or beyond their purview. The tools that support all couples with IPV—including safety planning, counseling, economic empowerment, protective orders, batterer intervention groups and the arrest of perpetrators—should be considered for refugee couples, just like other couples. Certainly, we should not deny refugee victims access to these resources simply because we assume the violence is normative or acceptable in their culture. All women in the U.S. deserve the same protections from control and assault in their homes.

Important warning: The period in which a woman separates from a violent or controlling man is particularly risky for her, especially if he has access to a gun; if he has previously strangled, raped, or threatened her with a weapon; and if he has been controlling Spencer & Stith, 2018). For this reason, it is essential to join with domestic violence advocates for safety planning. Clients and their advocates can go to www.domesticshelters.org for information about local resources.

Children need affection, stability, and guidance, as much as healthy food, rest, and stimulation. But above all else, children need to be safe and protected. Eliminating their exposure to IPV is a step toward providing that safety.

In Part Two, we examine how to work directly with refugee children impacted by IPV to boost their resilience and recovery.

For more on Family Strengthening check out our Highlighted Resources List.

This month's guest blogger: Lisa Aronson Fontes, Ph.D., is a senior lecturer at the University of Massachusetts, Amherst, and the author of Invisible Chains: Overcoming Coercive Control in Your Intimate Relationship, and Child Abuse & Culture: Working with Diverse Families.
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Cronholm, P.F., Forke, C.M., Wade, R., Bair-Merritt, M.H., Davis, M., Harkins-Schwarz, M., Pachter, L.M., Fein, J.A. (2015). Adverse childhood experiences: Expanding the concept of adversity. American Journal of Preventive Medicine, 49, 354-361.

Klein, A. R. (2009). PRACTICAL IMPLICATIONS OF CURRENT DOMESTIC VIOLENCE RESEARCH: FOR LAW ENFORCEMENT, PROSECUTORS AND JUDGES, NIJ Special Report, Washington, D.C.: National Institute of Justice.

Spencer, C.M., Stith, S. M. (2018). Risk factors for male perpetration and female victimization of intimate partner homicide: A meta-analysis. Trauma, Violence & Abuse, 19, 1-14.