What is the relevance to MFT’s and therapists in general?

4 Mar, 2019

Of Clinical Interest To All

Thank you USA Today for your article entitled "The startling toll on children who witness domestic violence is just now being understood" (January 29,2019)! This article offers powerful research and findings linking children in DV situations to a whole host of serious mental health challenges. Challenges such as PTSD, academic failure, addictions, suicidality, depression and a life-long trajectory of threats and failures in life's dreams are presented. Developmental tasks are derailed or sidetracked by the primary and secondary trauma of witnessing and/or experiencing abuse. This experience is compounded for children who live in neighborhoods regularly decimated by structural violence. The USA Today article, in it's entirety, can be read here:

What is the relevance to MFT's and therapists in general?

Triaging for DV in work with couples and families is a necessity. Given that the potential of self-report is little to none (especially in the presence of perpetrators), it is essential to use creative ways to identify patterns of abuse and coercive control.  Conventional wisdom suggests that unless children are directly harmed, it is not necessary to bring those who are caught in the crossfire of DV into the healing endeavor. This position defies best practices.

Domestic violence can be physical, psychological, sexual, financial or emotional. The sustained and interconnectedness of these factors create a web of coercive DV.

"Coercive control," is a term developed by Evan Stark to help us understand domestic abuse as more than a "fight." It is a pattern of behavior, which seeks to systemically curtail the victims' freedom and strip away their sense of self. It is not just a womens' bodily integrity that is violated, but also their human rights. Courts in Britain and Wales view coercive control as a domestic violence crime: (Detail Here)  New Jersey, like many other states, mandates reporting to DCPP when there are children living in the home during a DV incident, even if the victim drops the restraining order.

Consider the following scenario:

Following a DV incident, a woman receives a final restraining order. Her three children, ages 7, 9 & 11, witnessed the incident. The incident included aggressive gestures and accusations against her, followed by the fathers' statement to the children that he would slit their mothers' throat while she was asleep. The children were terrorized.  Crying and screaming, one child reached for the phone to call the police. The mother intervened and the father left the house but was picked up by police shortly thereafter and the mother was granted an FRO. The mother drops the FRO and asks for couples counseling.

FAQ: Is couple's counseling ethical and safe at this point?

A: No

FAQ: The therapist obtained details about the incident, is there other information relevant to the assessment?

A: Yes. The therapist needs to gather historic patterns of coercive control prior and subsequent to the physically violent incident.

FAQ: Should the children be assessed for impact of trauma regardless of whether or not they were directly targeted?

A: Yes.

FAQ: Do children typically report their experiences of trauma?

A: Children rarely reveal experiences of DV and are usually unaware of its impact until it appears in their daily lives in various forms.

FAQ: What are some typical symptoms that children might show prior to identifying DV in the home?

A: Aggressive behavior, night terrors, enuresis, clinginess, academic challenges, difficulties with peers & substance abuse, many of which do not show up immediately.

FAQ: Should therapists use a template that follows a healing trajectory for ALL children who witness and are direct targets of DV?

A: Yes.

FAQ: Shouldn't the non-offending parent be able to care effectively for the children once the offender is removed from the home?

A: It takes time for the non-offending parent to shift from a space where they are preoccupied with shielding themselves and the children from daily targeting by the offending parent.  With time and therapy, they are able to attend to the specific and differentiated needs of the children from a place of authority and security.

Central Chapter member Rhea Almeida, founder of Instituteforfamilyservices.com, is a family therapist, trainer and educator. Her most recent book, "Liberation Based Healing Practices," is due out in April, 2019.

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