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Stöd till barn som upplevt våld mot mamma; Preliminära resultat från en nationell utvärdering

Rapport
Författare Anders G Broberg
Linnéa Almqvist
Kjerstin Almqvist
Ulf Axberg
Åsa K Cater
Maria Eriksson
ISBN 978-91-633-8050-1
Förlag University of Gothenburg
Förlagsort Göteborg
Publiceringsår 2010
Publicerad vid Psykologiska institutionen
Språk sv
Länkar www.gu.se/digitalAssets/1325/132517...
Ämnesord Barn som bevittnat våld mot mamma, Stödinsatser, Utvärdering
Ämneskategorier Psykologi

Sammanfattning

To physically assault or in other ways abuse your child’s other parent constitutes a betrayal, not just against the adult: it is also a betrayal against the child. In the majority of cases of serious and systematic intimate partner violence it is the father, or another man living with the mother, who is physically or in other ways violent to the mother. Today, there is extensive knowledge about the impact of such violence upon children. For example, witnessing violence can be traumatic in itself with serious consequences for the child’s attachment as well as psychological well-being. The risk for the development of serious mental health problems increases significantly. The raised awareness about the risks for children associated with violence against their mothers has been followed by a number of policy initiatives. Amongst others, the social services responsibilities have been emphasised through changes to the Social Services Act. In 2008 the University of Gothenburg was commissioned by the National Board of Health and Welfare to evaluate the effects of support interventions for women subjected to intimate partner violence and for children who have experienced such violence. In Sweden, support interventions for children who experience violence from one parent against the other are almost exclusively aimed at children who experience violence against their mothers. Therefore the evaluation focuses upon this group of children. Internationally, knowledge about children’s victimization through violence against their mothers has been followed by practical measures, such as support and treatment aimed at children and/or parents. These interventions are shaped by different perspectives: a) a focus upon trauma, b) to reduce specific symptoms such as behavioural problems, c) to increase the child’s general level of functioning and ability to cope with stress, d) to strengthen and improve the mother-child relationship, and e) general support measures directed towards practical help to mothers and children. In many cases, the realisation that the violence also affects the mother-child relationship has led practitioners to combine interventions aimed at parents and children. Additionally, in Sweden a number of agencies have been established in recent years which provide different kinds of support to children who experience violence against their mother, and support to the mothers. However, the effects of such interventions have only been evaluated in a couple of cases, and with only a few children and mothers as participants. The aim of this report is to present preliminary results from a national evaluation study of support interventions: for children who have experienced violence against their mothers; and for the abused mothers. The results concern children’s and mothers’ experiences of violence, mental health and self-reported quality of life. The support interventions investigated are the ones offered by agencies focused specifically upon children who experience violence (adapted interventions) and the interventions offered to children and mothers by the local governments’ social services, the child- and youth psychiatry, and shelters for battered women (standard interventions). Method; The evaluation study, which is ongoing from the 1st of July 2008 to the 30th of June 2011, is based upon information about in total 222 mothers and their 302 children, 3 to 13 years old. The children and mothers have participated in support interventions offered either as adapted interventions or as standard interventions (the comparison group). The possible effects of the support interventions are also compared with the development over a one year period of a group of children and mothers who have not been offered support (standard interventions without support, Family law investigation and mediation). This report is based upon information from mothers concerning the 144 mothers and 200 children who by the 30th of June 2010 had been in contact with the evaluators before and after coming to one of the 15 agencies participating in the study – and also one year after the intervention. Results; The results indicate that agencies focusing upon children exposed to violence constitute a valuable complement to agencies providing standard interventions to children and families. Firstly, the mothers were more satisfied with the support provided by the violence-focused agencies. Secondly, the development of the mothers’ assessments of children’s symptoms (which were reduced) and capabilities (which were strengthened) were more positive, compared to children who were offered standard support or children who only had been going through a family law investigation. As regards the mothers, the picture is more mixed. Mothers who were in contact with agencies providing adapted interventions were more satisfied. However, there were no significant differences in the development of mental health problems, compared to the other two groups of mothers. A result which gives cause for concern is that the mothers’ self-reported symptoms of posttraumatic stress increased during the period they received support. Continued analyses will explore which mothers, and if possible which agencies, risk increased levels of symptoms of posttraumatic stress. The different support interventions may have to change to reduce the risk of such deterioration. This result also raises the question of access to adequate treatment for mothers, and which treatment needs (both as regards mothers and children) are not met by the agencies focusing on children exposed to violence. Conclusions and recommendations; Drawing upon contacts with the agencies participating in the evaluation study and the preliminary results from the mothers’ descriptions of their own and their children’s situation before, after and one year after contact with the agencies, we give the following recommendations: • Agencies which offer support interventions adapted to the group of children who have experienced violence to their mothers constitute a valuable complement to agencies which offer standard interventions for children and families. The adapted support interventions are appreciated by the mothers and they also seem to contribute in a positive way to children’s mental health. Therefore there are good reasons for further support to the continued development of adapted support interventions. • Children who have experienced violence against their mothers are a group of children at risk, with a high level of mental health problems, compared to children in general. Thus children who have experienced violence against their mothers need to be made visible and recognised, in order to assess their needs of support and treatment. Any agency aimed at children and families should develop routines and methods which make it possible for children and mothers to disclose experiences of violence. • In many cases, systematic risk assessments are lacking. This is in spite of the fact that in most cases, children continue to have regular contact with the father who has previously been violent to the mother and sometimes also the child. There is a need for improved knowledge amongst social services and child- and youth psychiatry, about different models for systematic risk assessment and how they can be used when children have experienced violence against their mothers. • Opportunities to get treatment at a specialist level of psychiatry are lacking today when it comes to children who have experienced violence against their mother and who have also developed psychiatric problems of their own. Small, often voluntary, organisations offer support interventions, which are intended to be universal and supportive measures where children are made visible and get recognition and validation of their experiences of violence. However, there is a risk that these support interventions are used as a replacement for psychiatric treatment, either due to the fact that there is a lack of adequate treatment methods within child- and youth psychiatry, or due to the fact that fathers are not giving consent to treatment of the child. The access to adequate treatment for children with more severe difficulties needs to be improved in order to create a chain of interventions which offers children interventions at the right level.

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