Miriam Ehrensaft is Professor of Clinical Psychology at the Columbia Medical School in New York. Her work has advanced understanding of how aggression and violence to resolve family conflict adversely affect children’s health and development. It has also involved developing and testing programs designed to prevent conduct disorder by using family processes to help adolescents reflect on their own romantic relationships.
Time for a new message on family violence?
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There are variations on the theme, but most conflict resolution researchers recognize a model that links exposure to family violence in childhood with conduct disorders in adolescence, substance abuse in early adulthood, and violence in later relationships.
Outlined by Miriam Ehrensaft at the Society for Prevention Research conference in Washington, last week, these and other links in the chain of effects are considered to be potentially the most fruitful targets for preventative activity.
On the protective side are strategies for boosting children’s impulse control and social cognition so that they are able to recognize tensions in relationships and to react more effectively.
Both avenues run counter to the perspective which regards family violence as the fault of a wayward masculine impulse to exercise power and control. And the preventative programs they point to consequently depart significantly from the dominant domestic violence intervention known as The Duluth model.
The increasingly controversial creation of Minnesota Program Development Inc., Duluth has been found to work not much better than court ordered treatment, mainly as a result of its high drop-out rates.
The contrast with Duluth was well illustrated at last week’s meeting by Vangie Foshee and her work on the Safe Dates program.
Foshee has focused on the abuse encountered during an adolescent’s first romantic relationships. Her studies show that about 12 per cent of adolescents are likely to say they have been physically maltreated during a date in the last 18 months. Nearly 30 per cent disclose psychological abuse.
The consequences of fights in these early relationships are associated with an increased risk of depression, drug, alcohol or substance misuse and poor sexual health. Hitting a date in adolescence is strongly linked with risks of later domestic violence.
Curiously, despite these promising opportunities for effective prevention, there has been little investment in finding out how to stop violence in relationships before it starts. Foshee found that of the 56 reported prevention programs in this area, only 13 had been evaluated and just six had been subjected to a randomized controlled trial.
Safe Dates represents Foshee’s reading of the evidence. Her intervention sets out to change typical adolescent attitudes towards gender and to give young people the skills to resolve conflict.
Randomized controlled trials in the schools where it has been offered indicate that it reduces psychological aggression over a three-year period and physical abuse over four years, arguably more than sufficient purchase to make inroads into the risk of later domestic violence.
Variations on the program are currently being tested. Families for Safe Dates provides materials designed to be convenient for busy families to use at home.
Prevention in this area is in its infancy. But a challenge is being mounted to orthodox child protection and domestic violence systems that seem to be reserved for impoverished families and which intervene when it is often too late to make much difference.
[See also: "If the one you’re with hits you twice, you oughta ditch ‘em"]
Explainers
Vangie Foshee is Professor of Health Behavior and Health Education in the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. Her research has contributed towards better understanding of the causes of violence between adolescent dating couples, and of effective ways of preventing such violence. She has also studied adolescent smoking and alcohol use.
The Duluth Model is a method for coordinating community responses to domestic violence through an inter-agency approach that combines justice and human service interventions with the primary goal of protecting victims from ongoing abuse.
Based on the feminist theory that patriarchal ideology causes domestic violence, the program helps men to confront their attitudes about control and teaches them other strategies for dealing with their partners.
There have been a number of evaluations, but most are limited by methodological flaws. Two (the Broward and Brooklyn experiments) suggest that it has had no demonstrable effect on offenders’ attitudes, beliefs, or behavior relating to battering. A recent meta-analysis which pooled the results from 22 studies (Babcock et al. 2004) found that Duluth performed marginally better than standard court intervention but that there was high drop-out.
The model forms the basis for the Domestic Abuse Intervention Programs founded in 1980 by Minnesota Program Development, Inc.
Safe Dates is a school-based program designed to prevent psychological, physical, and sexual abuse in adolescent relationships. It sets out to change typical adolescent attitudes toward gender and to give young people skills to resolve conflict. Safe Dates can be used with drug and alcohol prevention and general violence prevention programs.
The Safe Dates curriculum comprises nine 50-minute sessions, a 45-minute play to be performed by students and a poster contest. Family members are involved by means of a letter and brochure and resources regarding teen dating abuse. Teachers are encouraged to locate community domestic violence and sexual assault services.
Evaluation rests primarily on a random allocation of 14 public schools in rural North Carolina involving 1,886 students. Results showed change in the intervention group three years after students participated.
Safe Dates is a SAMHSA Model Program.
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