Supporting children exposed to domestic violence: call for stronger evidence base

East of England, WestChild Health
Published Date: 20 Dec 2017

Supporting children exposed to domestic violence: call for stronger evidence base

Services for children who are exposed to domestic violence and abuse are vital, but NIHR- funded researchers have found that there is little evidence for what support works best.

While there is much good quality evidence for the support offered to adult survivors of domestic abuse, there is very little evidence for what might help children from these families.

Children living in a home where there is domestic violence, even if they don’t directly witness violent acts, are more likely to suffer problematic behaviour, anxiety, depression, post-traumatic stress disorder, and educational problems. As adults they are more likely to have mental health problems, be unemployed, and perpetrate or experience domestic violence.

Researchers from the universities of Bristol, Cambridge, Central Lancashire and Canada’s McMaster University have examined all the existing studies on this issue, as well as interviewing parents, children and professionals in the field.

They recommend that there should be more in-depth studies in the UK to understand which programmes work, and which don’t.

They also recommend that the programmes’ effectiveness should be measured against outcomes that children, parents, service providers and policymakers think are important.

What we did

This evidence synthesis was made up of several linked studies, including:

  • A systematic review of studies on interventions for children or families where domestic violence featured

  • A systematic review on how ‘acceptable’ children and families found services

  • Modelling the clinical and cost effectiveness of interventions evaluation in trials

  • A review of the services already on offer in the UK

  • Focus groups with children who have been given an intervention

What we found

There are programmes for these children, or children and their non-abusing parent, that can improve behaviour and mental health in the short term. Some of them have been tested in rigorous research studies, mostly in North America. There is little evidence about whether short term

benefits are maintained in the long term.

The UK has a number of programmes for children exposed to domestic violence, but it’s not clear whether they work as they haven’t been properly evaluated.

The programmes that seem promising and should be prioritised for further research in the UK are:

  • Group based ‘psychoeducation’, where children (with or without their non- abusive parent) discuss and learn more about their situation and the effect it has on their mental health, with the help of a trained professional
  • Parenting training with ‘advocacy’ for parents, where they are given practical support to understand their options and rights, and explore their reactions to their situation

Programmes that take a ‘whole family’ approach, where the perpetrators of abuse are involved, also require evaluation as these are being implemented without any good evidence of their effectiveness.

What next?

Studies focusing on the complex environments in which interventions are delivered should be a priority. Tailored services should be explored. Professionals must agree a standard way of measuring success and ‘outcomes’ for these children.

There should be a pause in developing new interventions, unless they meet a clear gap, and existing programmes should be evaluated systematically.

The researchers call for stakeholders, and the children and parents, to come together to address the barriers that have hampered the development of the UK evidence base.

Read the report

IMPRoving Outcomes for children exposed to domestic ViolencE (IMPROVE): an evidence synthesis Emma Howarth, Theresa HM Moore, Nicky J Welton, Natalia Lewis, Nicky Stanley, Harriet MacMillan, Alison Shaw, Marianne Hester, Peter Bryden, and Gene Feder bit.ly/ChildrenDomesticViolence

Contact 
CLAHC West
clahrcwest@nihr.ac.uk
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