The Effects of Exposure to Domestic Abuse on Children in the UK
The Problem
Domestic Abuse (DA) is a prevalent issue world-wide with an estimated 1 in 3 women affected in their lifetime (WHO, 2021). Within the UK, DA has been described by Chief Superintendent of the Metropolitan Police as the single greatest cause of harm in society (BMA Board of Science, 2014), reflecting the impact it has not only on the victim but on the wider community they are a part of. As DA takes place within the home, any children living within the household are usually caught up in the violence even if none is directed at them. In 90% of cases of DA, children will be in the same room or in a neighbouring one (Women’s Aid, 2021) bearing witness to the violence unfolding between their primary caregivers.
Abuse between parents has been cited as the most frequently reported form of trauma for children (BMA Board of Science, 2014). Unfortunately, lock downs that occurred in response to the Covid Pandemic in 2020 and 2021 are known to have exacerbated the already prevalent issue. Many have described the increase as the ‘shadow pandemic (Dawsey-Hewitt et al, 2021; Kale, 2021) as during this time, both victims and witnesses of abuse were likely to be trapped inside their homes and cut off from vital support networks (Syal, 2022). The NSPCC reported an increase of 35% of calls related to their helpline from children experiencing DA (White, 2022). Schools, one of the most common communication channels to social services for children, were closed for large parts of the lockdowns, meaning that potentially many more cases went unreported (Dawsey Hewitt et al., 2021).
‘Wicked problems’ are defined as problems within a social context that have multiple, often interacting, causes and no single solution (Rittel & Webber, 1974). DA can be seen to be a ‘wicked problem’ as, although there has certainly been an increased awareness the past 50 years (Cuevas & Rennison, 2016), it remains a prevalent, yet hidden issue and one often shrouded in shame (BMA Board of Science, 2014). In 2021, the children’s commissioner highlighted the hidden nature of the problem, warning that an ‘invisible group’ of some 800,000 children were at risk of DA in the home and called for new laws to protect them (Hymas et al, 2021).
Violence at home creates environments that are unstable, inconsistent, and model solving conflict through aggression (Hall, 2019). Growing up in a violent household has been proven to put children at much higher risk for a range of adverse outcomes, including conduct problems, anxiety and depression, cognitive dysfunction, poor school performance, low self- esteem, and difficulties with peers (Jaffee, 2018). There is a significant risk of ‘intergenerational violence’, with adults who were exposed to intrafamilial violence more likely to engage in domestic violence themselves (Cuevas and Rennison, 2016). McMullen (2021) also found that children witnessing DA had an increased likelihood of either being a victim of or a perpetrator of violence in adolescence or adulthood.
Conflict between a child’s two main caregivers can be extremely difficult for children to process as they may be torn between wanting to connect with their abusive parent but also protect themselves emotionally (Hall, 2019). These confusing feelings have been shown to particularly affect children in early childhood, who show higher levels of psychological disturbance and lower self-esteem (Hall, 2019). Timings of adversity have been shown to influence outcome in numerous other studies, with many finding that adversity in the earliest years of life have the greatest impact (Hambrick et al., 2019). These findings suggest that earlier intervention may be particularly important when attempting to mitigate the long-term effects of DA on children.
Although exposure to DA can be seen to put children in danger of a host of negative outcomes, it is important to take note of resilience factors in order to understand how individuals and families may best be supported in DA situations. Individual susceptibility can vary greatly between victims due to factors that are not always easy to control e.g., biology and individual genetics. However, there do seem to be both environmental and social factors that have shown positive effects on resilience which could be promoted in policy and intervention.
Strong relationships with others have proven to be a protective factor for children facing adversity, including DA. The attachment relationship, an idea first formulated by Bowlby in 1958, has had a powerful impact on current understanding of child development and countless studies have highlighted its critical nature to optimal development (Breidenstine, 2011). Attachment describes the emotional bond that promotes and preserves closeness between a young child and a small number of adult caregivers responsible for supporting, nurturing, and protecting the child. Infants form attachments to caregivers whom they have learned through experience are available and dependable (Breidenstine, 2011). A wealth of research has demonstrated the benefits secure attachment relationships have in buffering against adversity (Allen et al., 2007; Antonucci et al., 2018).
In cases of DA, the child may have been able to form a secure attachment with at least one of their caregivers. Where this is the case, this is likely to be a significant protective factor in the adversity they face. However, in many DA situations, the attachment relationship can be significantly compromised due to the abusive situation. The victim may not be able to offer the dependable nurturing care needed for a healthy attachment due to a myriad of factors. The abuse experienced may have impacted on their mental health, their sense of competence and their parenting capacity (BMA Board of Science). As a result of this compromised care, the mother child relationship has been shown to suffer in households with DA (Smith et al., 2015) and children may suffer from a range of difficulties associated with insecure attachment.
There can be cases where the formation of an insecure attachment relationship may be mediated by other protective factors. Other relationships that children make may help to lessen the effects that a less than ideal attachment relationship can have. Although early life experiences are seen to be particularly impactful, research suggests that relationally enriched environments act as a buffer and provide some of the same benefits that a secure attachment does (Hambrick et al., 2019). In particular, the number of sources of emotional support children are able to draw on in early and middle childhood has been shown to be a clear protective factor. This support may be provided by alternative caregivers such as the extended family but also other community members such as teachers and peer friends (Werner, 2014).
These additional ties to the community could be seen to promote family resilience. Family resilience can be described as an interaction between the family and community networks where the family receives information, companionship, services, and respite (Sheridan et al., 2014). Promoting family resilience may be especially helpful in DA scenarios as relationships outside of the home could be an essential source of relief for the DA victims, perhaps providing emotional support and encouraging them to receive help for their situation (Gregory and Williamson, 2021). In the discussion of solutions, both the minimising of trauma and the promotion of resilience will be addressed as both contribute to preventing maladaptive outcomes and support optimal health and development.
Current Solutions
Historically, DA has been seen as a private problem, kept silent and behind closed doors. It was only in the 1970s that activists and women’s rights groups raised greater awareness of it as a social problem. Over the past 30 years there have been major changes in the national policy and understanding of DA in the United Kingdom driven in part by the campaigns of women’s movements (Matczak et al, 2011). In 1986, the Home Office published the first circular regarding DA called “Violence against women” which obligated police to ensure the safety of women and children in domestic deputes (Applegate, 2006).
More recent changes to legislation related to DA were introduced in 2021, perhaps as a result of multiple charity campaigns and the surge of DA cases through the pandemic. A new Domestic Abuse Act was passed which recognised for the first time the role that children can play as victims (GOV.UK, 2022). The NSPCC verbalised hopes that this would make it more likely that children’s needs are considered by all professionals working with them (Syral, 2022). The new Domestic Abuse Act also highlighted the aim to improve the effectiveness of the justice system in providing protection for victims of DA and bringing perpetrators to justice (GOV.UK, 2022).
This acknowledgment and response to the escalating situation is promising. However, as ‘bringing perpetrators to justice’ is a large part of the new reforms, it is worth examining the research exploring police involvement in DA. It is estimated that domestic disputes consume more police time than any other situations, yet they may not have the greatest capacity and qualifications to deal with such matters effectively (Sherman, 2018). Some studies suggest that making arrests or removing perpetrators of violence by force can create temporary peace but rarely solve the problem (Sherman, 2018). In addition, arresting a parent or household member without subsequent support for children in the household is likely to cause shock, anxiety and trauma (International Association of Chiefs Police, 2014). Police involvement usually occurs only once the abuse has caused great harm, therefore more preventative, or early actions could a better course of action for the reduction of trauma.
Women’s Aid, a national charity working against domestic abuse, have highlighted the importance of preventative work, stating that all young people should have access to domestic violence preventive education programmes (BMA Board of Science). This could be seen to be a primary prevention strategy as the aim is to prevent violence from happening at all. However, a 2019 meta-analytic review found that a range of interventions have been piloted with varying degrees of success (Cleaver et al., 2019). Early, school-based interventions have had little evaluation, so it is unclear how many schools are implementing such programmes. For these strategies to be as far reaching as possible, it may be necessary for programmes with proven success to be compulsory in schools. However, a 2005 study found that multi-agency support was important as teachers may lack the subject knowledge and confidence to teach the subject effectively (Cleaver et al., 2019).
A multi-agency approach with inter-professional understanding has also been shown to be effective in early intervention work aiming to stop abuse soon after it begins: a secondary prevention strategy. The Cheshire Domestic Abuse Project took such an approach, and it was found that over 70% of victims reported reduced risk after exiting the service. The project involved police, social services and local voluntary services which provided a single point of access for victims and were effective in building a coordinated community response (Cleaver et al., 2019). Services which avoid using criminal justice responses in favour of early outreach and community-based interventions have also been successful and may encourage victims to report the abuse and access intervention at an earlier stage (Cleaver et al., 2019). However, a multi-agency approach can have its challenges: in some cases, professional differences in understanding problems and approaching work with families can create barriers to a coordinated approach. These challenges should be recognised and managed in order for this approach to be most effective (Cleaver et al., 2019).
Under disclosure of abuse is a problem that many policies have attempted to address (Mackenzie et al., 2015). Research has indicated that victims of abuse are more likely to reach out to the people around them (such as friends and family) rather than professionals (Gregory & Williamson, 2021). However, when this informal support is positive, it can lead to further support being sought from professionals. As a result, some UK initiatives have tried to develop community awareness and support to promote this further. Ask me community ambassador training is an initiative run by Women’s Aid to encourage communities to demonstrate solidarity with those experiencing DA (Gregory and Williamson, 2021). Other specialist DA services have produced resources for members of the public and have shared messages on social media to increase awareness (Gregory and Williamson, 2021). This approach could be worth promoting, as community members may have some particular advantages over professionals. Informal support can be much easier to access and, through the already established relationship, feel safer than professional support. As a result of the established relationship, the victim is likely to feel able to disclose information openly and continue seeking support from the relationship in the long term (Gregory & Williamson, 2021). This continuity is likely to help both the victims and children involved.
It can be seen that there are a number of prevention and early intervention strategies that, if enacted, could prevent much trauma from occurring in the first place. However, where abuse and trauma has already occurred, it is important that actions are focused on re-building resilience in the victims. This may differ from a criminal justice approach where the focus may only be on stopping the abuse and punishing the perpetrator (Sherman, 2018).
As referenced earlier, relationships are a core aspect in individual and family resilience. Therefore, programmes which are aimed at jointly supporting parent and child victims may be particularly beneficial in the recovery process and the rebuilding of relationships. In many DA cases, the abuse may not have been talked about or mothers may have underestimated the effects it had on the child. In some cases, the perpetrator may even have encouraged the child to be abusive to their mother or the child may feel the mother is partially responsible (Smith, 2015). In all scenarios, it is likely that the parent child relationship will have suffered so support in rebuilding this is a key priority.
One example of this type of intervention is the Domestic Abuse Recovering Together (DART) programme which began in the UK in 2010. This is a 10-week programme designed to work with children by helping the non-abusive parent to support their recovery. The joint sessions allow mothers and children to participate in activities designed to strengthen their relationship and support recovery. Studies have shown that the programme achieved its desired outcomes of increasing the self-esteem of mothers and reducing behavioural and emotional problems amongst the children (Smith et al, 2015). These findings suggest the intervention could be worthwhile to offer when these difficulties are present.
Another intervention which can be successful in addressing trauma on a more individual level is play therapy. Child-based play therapy in particular has had numerous studies demonstrating the benefits it can have to children who have been exposed to violence (Lin, 2015; Ogawa, 2004). Both externalising and internalising symptoms of trauma, often seen in DA situations, can be addressed effectively though the symbolism of play (Hall, 2019). Symbolic play allows children to experience mastery over traumatic events and regain control over emotions, confusion, and anxiety (Hall, 2019). Play therapy may be particularly helpful when children have been taught to keep the abuse, they witness secret. The process offers an alternative to verbal expression and allows preverbal and nonverbal traumatic events to be revisited, manipulated and integrated into a more manageable experience (Hall, 2019).
Proposed Solutions
In the development of solutions, prevention or early intervention have been shown to have much wider reaching benefits than later intervention: both in terms of human and economic costs. DA causes a notable financial burden to the NHS as a result of the physical and psychological impacts on the victims and their families. Therefore, even marginally effective interventions are likely to make huge savings to both public services and human harm caused (Sivarajasingam, 2021).
Raising public awareness of Domestic Abuse is an important primary prevention strategy and one that could be utilised most effectively through a mandatory educational framework taught in schools. Through the education of young people, attitudes towards DA could be altered for both potential perpetrators and victims. An awareness of early signs of abuse and pathways for support could also allow for much earlier intervention. As highlighted earlier, this approach is likely to be more effective if delivered through a multi-agency approach. This enables professionals working directly with DA to share their expertise and support teachers in delivering a very sensitive subject matter (Cleaver et al., 2019).
Education in schools is one way of raising awareness in the public but there have been some promising interventions aimed at raising a more general awareness. Programmes like the Ask me community ambassador training could be utilised across more local authorities to empower many more members of the public to offer community support. Raising awareness of both the prevalence and the support in place for DA victims could have the added benefit of reducing the shame and stigma that continues to be prevalent for domestic abuse victims and encourage earlier disclosure and relief.
A multi-agency approach within the community has also been shown to be particularly effective and may help to promote speed and efficiency when referring and supporting victims (Cleaver et al., 2019). Although there are recognised challenges associated with varied professionals working together (Cleaver et al., 2019), the benefits are likely to far exceed the difficulties. When cases of DA are addressed earlier the burden on both the police and the NHS can be significantly reduced. The Cheshire Domestic Abuse Project has been shown to be very effective in offering timely support to DA victims. However, it only addresses DA within its own particular community. Easy and safe access to support for victims should arguably be available to all victims regardless of their location or varying circumstances. This could be achieved by creating a multi-agency approach on a more national scale.
Finally, although the goal may be to stop the occurrence of DA through prevention and early intervention, even if these systems are fully in place, there will still almost certainly be unavoidable cases of DA and the resulting trauma for young people. In such cases, it is important that support is given to escape the abusive environment as early as possible, but equally important is the follow up care. This care needs to be trauma informed and allow for the rebuilding of resilience in all those who may have been affected. Such services can help to build both family and individual resilience, hopefully mitigating the long-lasting impact that the adverse experiences may otherwise have had on the young people involved.
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