Children Exposed to Domestic Violence: Building Safety in Child Welfare*
By Anne-Marie Duguay, Dr. Peter Lehman and Dr. Catherine Simmons

Child protection workers are no strangers to the dangers when children are exposed to Domestic Violence (DV) and it is well known that such exposure is one of the most stressful work-related areas of professional life.  Despite the ever expanding body of knowledge detailing the relationship between childhood exposure and DV, the field continues to grow, developing new and better “best” practices vital to the safety of children and their families (Merkel-Holguin, 2004).  Focusing on professional knowledge, the current article first provides a summary review of the recent literature detailing how DV impacts children. Next, components of one “best” practice as found in the Signs of Safety approach is addressed.  Five practice skills are highlighted for workers having clients where DV is a concern. These skills may be considered an important part of child protection work that aims to help families build safety from violence and harm. Further, they reflect the strengths, engagement and purposeful planning and management side of a differential response model of child welfare currently practiced in Ontario and elsewhere (Sawyer and Lohrbach, 2005).

Professional Knowledge

Each year in Canada and in the United States upwards of 15 million children see, hear, intervene in and/or cope with the aftermath of DV (McDonald et al, 2006).  Although the immediate/short term concerns of physical and emotional safety dictate an intervention of some kind, for some children the effect of this exposure can last longer. As stated above, the literature detailing the impact of exposure to domestic violence on children is well documented (e.g. Buckley, Holt, and Whelan, 2007; Cunningham and Baker, 2004; Edleson, Ellerton, and Seagren, 2007; Fantuzzo and Fusco, 2007; Geffner, Jaffe, and Suderman, 2000; Holden, Geffner, and Jouriles, 1998; Jaffe, Wolfe, and Wilson, 1980; Peled, Jaffe, and Edleson, 1995).  Six themes continue to summarize what is already known (Carlson, 2000).  First, a number of theoretical perspectives explain children's diverse behavioral, emotional, and cognitive responses to DV exposure (Carlson).

Second, some children’s reactions to DV exposure include emotional distress, anger, fear, anxiety and a desire to intervene (Carlson). Third, children’s short-term reactions can include externalizing, internalizing, and social problems (Carlson).  Fourth, children exposed to domestic violence can experience long-term adjustment problems (Carlson).  Fifth, a number of mediating factors affect children’s responses (Carlson). Sixth, a link between exposure to domestic violence and trauma responses exists for some children (Carlson).  

Responses to DV Exposure

In the province of Ontario, a referral where the only allegation is exposure to domestic violence does not in itself meet the definition of a child in need of protection under The Child and Family Services Act.  The challenge for child protection workers then, may be to better identify which children are at most risk   Thus,  it is helpful to cluster child exposure responses into two categories: typical responses and trauma responses. The first of these clusters, typical response refers to problems many children report.  Although these typical responses are often problematic, they are considered to be normal responses to abnormal situations, thus not technically diagnosable. As illustrated in Table 1, these responses can be further divided into three subcategories; (a) immediate concerns, behavioral and emotional, (b) physical functioning, and (c) long-term concerns, behavioral and emotional.

Table 1: Typical Childhood Responses to Domestic Violence

It is important to note that these responses may be impacted by mediating and protective factors. As seen in Table 2, mediating factors are those aspects of the child’s environment and life that work to buffer risk. Protective factors are the strengths, competencies, and/or resources that can be observed or accessed in family members.  Essentially, every child and family’s experience is unique thereby allowing each child protection worker avenues in which to focus on factors that can either help or hinder how a child/family might cope.

Table 2: Child Exposure: Mediating and Protective Factors

 The second cluster of responses can be grouped into trauma developmental disorders (Cook et al., 2005; NTSN, 2003; van der Kolk, 2003). This specific cluster goes beyond assessing typical PTSD symptoms (re-experiencing, avoidance, arousal) (Rossman, 1994; 1998; Silvern & Kaersvang, 1989) taking into account some children may display more complex behaviors illustrated in Figure 1, trauma developmental disorders are organized around three major issues how children might respond to traumatic events:  (1) emotional and/or behavioral upset typically follows exposure to traumatic events, (2) many children experience a sense that the violence will continue, and therefore (3) organize their behaviors to avoid the impact of the traumatic event.

Two important conclusions can be made from the literature summarized above. The first is that as knowledge at assessing risk in children exposed to DV has expanded, child protection workers have greater access to specific information that is likely to increase or decrease child safety. Second, workers are now in a position to develop their own “best” practice at  intervention  that can be safety-focused (e.g. aimed at reducing risk and/or its impact), protection-focused (e.g. counterbalancing risk by resource building), and process-focused (e.g. building child and family competencies) (Masten and Coatsworth, 1998).

Intervention: Building Child and Family Safety

 In response to the needs of children exposed to DV, a number of interventions have been developed.  Among them are population specific group therapy approaches (Loosley, Drouillard, Ritchie, and Abercromby, 2006), crisis intervention (Lehmann and Spence, 2007) individual, and/or play therapy (Osofsky, 2004), and family therapy (Brendler, 2006) to name a few.  The timeliness and clinical importance of these practice models have signaled a shift in the professional field including child welfare; one that has moved the child protection worker/client relationship from being defensive (Connolly and Doolan, 2007), rescue-based (Patti, 2000), and paternalistic (Turnell and Edwards, 1999) to one  that promotes competencies and strengths (Chapman and Field, 2007), involves the family in decision-making (Connolly, 2007), with a focus of seeing all family members as capable of solving their circumstances (Chapman and Field).  Consequently, the final section of this paper summarizes the Signs of Safety, one additional model child welfare workers may find useful with children and their families.

The Signs of Safety approach (Turnell and Edwards, 1997; 1999; Turnell, 2003; Turnell, 2007; Turnell and Essex, 2007; Turnell, Elliott, and Hogg, 2007) has been developed as a compassionate and safe yet rigorous child protection risk assessment guide to be used within child welfare. Underlying the Signs of Safety approach is a purposive attempt to find and create more constructive ways to engage families in the development of creative strategies to address risk or worrisome situations.  Koziolek (2007) has also explained the Signs of Safety approach as being firm and fair with families but also helping them to think through and find their own safety solutions. Consequently, in keeping with a safe-from-harm perspective, attempts are made to create a balance between (a) potential dangers and risks, (b) recognizing the safety/competency the family demonstrates and (c) setting goals with the family to build enough safety and ultimately close the case.

An important idea with respect to children and domestic violence, but also one underlying the Signs of Safety approach is that the worker is always cognizant the risk for potential harm and danger is never minimized.  Yet, because the approach is seen as a “safety organized practice”, (Chapman and Field, 2007, p. 23), one can also focus on and ask about times or moments of safety that do exist in families.  Questions such as “tell me about some of the happy times with mom and dad”, “what is something you’ve done to keep the kids safe when tensions build”,  “have there ever been situations where you could have gotten angry and lost it but instead did something else” let the family know the worker is looking to find a balance and is interested in hearing about positive aspects of their life, not simply the incident that brought them to the attention of the child welfare agency.  With this perspective, the child protection worker uses the momentum from the strengths and safety side as energy to deal with the risk factors or danger the child faces (Turnell, 2003) (see Figure 3 for a visual explanation).  Safety organized practice is specific and evidence-based and requires the careful analysis and evaluation of data gathered.  Using a collaborative and respectful approach is likely to yield more detailed and candid information than a more forensic approach.  The Signs of Safety model encourages workers to harness the expertise of their clients and their extended families/networks to help them better understand the meaning of this information and to engage in a plan to address the risks.  Rigorous safety planning while being solution focused does not involve merely accepting a person’s promise not to repeat a certain action, but to have all parties think through the risk factors and work together to develop strategies to mitigate the future harm.

For the purposes of working with children exposed to DV, the Signs of Safety approach may be seen as an applied intervention that is built on the work of Masten and Coatsworth (1998) and focused on two fundamental notions of “best” practice; aspiring to partnership and solution building.  A child protection interview can be used as a forum for change and provide family members with customized, supportive intervention.

Aspiring to Partnership

A central feature of the Signs of Safety approach is to develop partnerships with children and/or their caregivers (Turnell, 2000). Partnership is “a notion that promotes participation, cooperation, and collaboration” (p.8) between the worker, child and/or family.  The worker abandons the “expert” position and genuinely elicits the family’s opinions regarding their situation, as well as their suggestions to address the difficulties or danger.  A Signs of Safety notion then, views partnerships as learned professional skills that stems from (a) encouraging the caregiver and child’s participation in defining the issues and treatment planning, (b) providing a safe environment for the expression of feelings, (c) eliciting caregiver input that will build at providing stability/consistency and (d) building nets of safety with the caregiver from violence in the home, school or community.  Furthermore, Turnell and Edwards (1999) specified five fundamental tasks that help child protection workers develop successful partnerships including (a) being detailed about getting accurate information, (b) being mindful of properly planning with the child and family, (c) being goal focused on what the child/family wants, (d) recognizing all families have signs of safety and are able to keep their kids safe at least some of the time and (e) working to create small changes with children and/or families. One outcome of good partnerships is that it invites caregivers to detail their own ideas/solutions/plans about what needs to happen as opposed to relying solely on professional expectations.

Solution Building

 A Signs of Safety approach also includes a second notion of “best” practice, that of creating helpful conversations around building safety with children and families.  To accomplish this, Turnell uses a solution-focused brief therapy (SFBT) approach.   SFBT is a goal-directed and non-deficits approach to practice developed by Insoo Kim Berg, Steve De Shazer and colleagues at the Brief Therapy Center in Milwaukee, Wisconsin (de Shazar et al, 2007).  SFBT develops respectful relationships with clients, working to recognize their strengths, exceptions to problems (in this case danger/risk), and what solutions may exist (in this case, signs of safety) that will be helpful to what concerns them.  An important feature of SFBT helps clients define their goals (however small) for change by attending to “solution talk” rather than “problem talk” (de Shazer et al, 2007). As illustrated in Figure 2, SFBT is operationalized by a number of assumptions that can be incorporated into specific interventions that are referred to as Practice Skills.

Practice Skills

A Signs of Safety approach incorporates five practice skills child protection workers can use when building safety with families where domestic violence is an issue. To aid in this process, the worksheets (Figures 3 and 4) have been adapted from the Signs of Safety Assessment and Planning Form (Turnell and Edwards, 1999) and can be filled in by workers together with families.  The worksheet and practice skills have an advantage of helping workers recognize the potential clinical issues (e.g. Table 1, Figure 1) a child faces when considering the worry or danger side. At the same time, the forms and practice skills below can be used effectively to help determine the impact of the violence, to elicit information regarding the worries held by each family member, and to start to take small steps towards shared safety goals.

 Practice Skill 1:  Understanding the position of each family member

The first practice skill, understanding the position of each family member helps the child protection worker recognize the potential impact DV has on the child and/or all family members as they unpack the values, beliefs, and meanings of violence (Turnell and Edwards, 1999). The key to practice skill 1 is for workers to not just listen for and notice clinical issues but also give family members a chance to talk about experiences.  For example, asking how the child feels about what happened, where “dad” may fit into the picture or how the violence has affected  them at school gives the child a chance to answer in a way where she/he feels heard.   These questions in effect ask the “how, what, where, or when” of past violence that details what is important to the child/family. Thus, a partnership can develop by talking about (a) what happened and what a caregiver’s ideas are about being safe, (b) the impact on the child/ and what worries the caregiver, and (c) what it is the child or family would like to see changed.

Practice Skill 2:  Discovering exceptions and strengths

The second practice skill, discovering exceptions and strengths helps the child welfare worker improve their skill of listening for, asking about, and finding exceptions to danger or risk in children and family members. There will be times when a child or adolescent does not experience typical symptom responses or when a mother has found a way to soothe her anxious child.  Asking questions such as those from Figure 5 individualizes helpful behaviors, however small but effective.  Because children and families who experience DV can feel hopeless and demoralized, identifying strengths and exceptions can be another way to help build competencies that already exist (Macdonald, 2007; Turnell and Edwards, 1999).

Practice Skill 3: Goal setting

The third practice skill, goal setting helps the child welfare worker and family build an understanding about what needs to happen for everyone to be safe.  This practice skill is predicated on the idea that successful work with clients depends on knowing what small goal(s) family members want to accomplish (George, Iveson and Ratner, 2000). Inquiring about what one wants out to “work on” or “what their best hopes are” is an important place to start. Asking the questions included in Figure 6 can facilitate goal setting with children or their families exposed to DV.  Goal setting should be detailed and specific, ultimately becoming the central focus of work. Further, one should have a sense goals are doable, can be practiced, and small enough to be accomplished.  The worry to good things form (Figure 3) is one example how goal(s) can be charted as part of an action plan.

Practice Skill 4: Scaling safety and progress

The fourth practice skill, scaling safety and progress is a user-friendly SFBT tool that rates the position of the child/parent on a particular point of view, behavior, feeling, etc. Although scaling responses from 0 through 10 are subjective, family members can provide information in real time about where one stands (Figure 7). 

Macdonald (2007) has also characterized scaling as helping clients take action;

moving from an unlikely all-or-nothing position to something small yet manageable.  For example, consider the question, “what other helpful things will you be doing when you get to a 6 from your current 5 of managing your anger when you feel others are pushing your buttons?”  The “managing” is rated in its current form and while listing what they’ve done to get to their point, new actions might be identified for taking the next step.

Practice Skill 5: Asking about willingness, confidence, and capacity

The fifth and final practice skill, asking about willingness, confidence, and capacity is based on the assumption that human change is ongoing.  Therefore workers are in the position of helping family members decide which direction they want to go (Iveson, 2007).  Consequently, asking questions from Figure 8 builds an understanding of the client’s willingness, confidence, and capacity to move forward from where they are. 

Carrying out plans of safety, setting new rules for nonviolence in a family, saying no to drugs or alcohol, or agreeing to speak softly to one’s upset child may be hard for clients to accomplish. At the same time, questions in the final skill are intended to move a child or family towards more safety and ultimately, in small concrete ways, build their belief in themselves and hopes for a non violent future.

Conclusion

Children who have been exposed to DV has come to represent a real safety issue for the child welfare profession. Thus, the problems surrounding the impact are broad, requiring one to have an informed understanding of all the issues. This paper has focused on two sections; a summary of behavioral and traumatic indicators of exposure to violence and a series of interventions that can build safety in the lives of children and their families. To this end, a Signs of Safety approach based on the “best” practice of partnership and solution building was considered. Five signs of safety practice skills were included for child protection workers to use with children and their families.

About the Authors

Dr. Peter Lehmann teaches social work at the University of Texas at Arlington and co-directs  the Community Service Center (CSC), a campus/community mental health center. He also trains Child Protective workers in Texas and Oklahoma.

Dr. Catherine A. Simmons is an assistant professor at the University of Tennessee, College of Social Work.

Anne-Marie Duguay is an intake supervisor at Peel Children’s Aid Society.

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*By permission of Oxford University Press portions of this manuscript are re-printed by the authors from the chapter "Children Exposed to Domestic Violence: Assessment and Treatment Protocols" by P. Lehmann and C. Simmons included in  the Social Workers' Desk Reference, 2nd edition, edited by  Roberts, A., and Greene, G.

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