According to the National Coalition Against Domestic Violence (NCADV, 2015), every minute almost 20 people are being physically abused by their intimate partners in the United States. Over the course of a single year, more than 10 million men and women experience this type of domestic violence. In fact, 1 in 3 women will be victims of intimate partner violence within their lifetimes, and contrary to common belief, 1 in 4 men will also be victimized. In one year, 1 out of every 15 children will live in a home where there is domestic violence, and 90% will see violence with their own eyes. Clearly, domestic violence is a serious problem in the United States.
Children do not have to be physically abused themselves to be affected by violence in their families. The aggression they see may include destruction of property, verbal humiliation, attacks, and threats, assaults with guns and knives, homicide, and suicide. These horrible events may even be associated with interactions that appear loving and loyal. A child raised in such a home may have difficulty trusting people or be unable to feel stable and safe in the world. They may become depressed, anxious, withdrawn, or hostile, and may experience physical complaints, sleep disturbance, and separation anxiety (Thompson & Trice-Black, 2012).

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It is crucial, for several reasons, to provide therapy to children who have witnessed domestic violence (DV). According to Kitzmann and colleagues (2003), a meta-analytic review of studies of children who witnessed DV revealed that two-thirds of the children experienced significant psychological and social effects, including dysfunction in all areas of functioning. The effect was slightly larger for preschool children, which may be related to their developmental lack of ability to talk about their feelings.

Cognitive-behavioral therapy is a form of mental health treatment that emphasizes the individual’s thought processes and behaviors. The therapist and the client work together to examine which thoughts lead to negative feelings and how those thoughts can be changed. Similar, a person’s behavior causes him or her to have feelings of guilt, pleasure, self-esteem, sadness, and so forth. Traditionally, CBT focuses on mistaken thinking that is causing bad feelings, so that when the mistaken thinking is corrected, the feeling can dissipate. For example, children may blame themselves for domestic violence, causing them to feel sad and guilty. If the therapist can help the child understand that he or she has not caused the violence, then the guilt and sadness will diminish.

Sometimes, however, the child’s thoughts are correct given the situation. For example, children who are in the midst of continued trauma may believe they are unsafe in their homes. This is a true thought so there is no correction applicable. However, a specific type of CBT, trauma focused cognitive behavioral therapy (TF-CBT), is still applicable. According to Murray, Cohen, and Mannarino (2013), TF-CBT includes “psychoeducation, relaxation, cognitive coping, trauma narrative and reprocessing, in-vivo exposure, conjoint parent-child sessions and enhancing safety skills.” Several randomized, controlled studies have suggested that this program is effective in treating childhood trauma, including domestic violence.

Children who are younger than 5 years ago, as well as some that are older, may not have the cognitive development that is sufficient for a TF-CBT program. Therefore, play therapy is a very important type of therapy for children who have witnessed DV. Child-centered play therapy is considered to be the “gold standard” because it is the least directive and most beneficial for younger children who have experienced trauma (Lindo, 2013). One of the tenets of CCPT is that the child must feel accepted and safe in the context of his/her relationship with the therapist. In fact, CCPT have been extended into a model in which parents are taught to develop that kind of relationship with their children. The Child Parent Relationship Therapy (CPRT) 10-session Filial Model has helped many parents learn to bond thoroughly with their children so that they will develop and grow properly (Landreth & Sweeney, 2013).

The term “cycle of violence” is commonly used to describe the observation that domestic violence runs in families. It may take different forms in each generation or vary among couples within a generation, but the bottom line is that something keeps violence occurring until everyone involved receives psychological treatment. This is why it is crucial for the entire family – batterer, victim, and children – to be treated either individually or in a conjoint program. Arias, Arce and Vilariño (2013) conducted a meta-analysis of treatment for batterers. The two main treatment models were the Duluth model and the CBT model. The Duluth model is based on a feminist approach to psychoeducation in order to counteract the patriarchal, sexist ideology that permits and condones male aggression. The CBT model, like those discussed earlier, views DV as a learned behavior that must be unlearned and replaced. Less-used treatments for batterers include mind-body techniques, anger management, and psychodynamics. The authors (Arias et al., 2013) found moderate effect sizes for both of the main treatment models, suggesting that new methods should be examined.

Finally, it is essential to treat the victim him- or herself. Intimate partner violence is more likely to occur if the person has been a victim of violence either as a child or earlier in adult life. Victims can be very good at covering up what they are experiencing, and sometimes the home situation is first revealed through a child. Although there are DV hotlines and shelters, they are insufficient and it is not uncommon for women and children (and possibly men as well) to be further victimized at shelters, whether financially, verbally, physically, or sexually (Arroyo et al., 2015).

    References
  • Arroyo, K., Lundahl, B., Butters, R., Vanderloo, M., & Wood, D. S. (2015). Short-Term Interventions for Survivors of Intimate Partner Violence A Systematic Review and Meta-Analysis. Trauma, Violence, & Abuse, 1524838015602736.
  • Kitzmann, K. M., Gaylord, N. K., Holt, A. R., & Kenny, E. D. (2003). Child Witnesses to Domestic Violence: A Meta-Analytic Review. Journal of Consulting and Clinical Psychology, 71(2), 339-352.
  • Landreth, G. L., & Sweeney, D. S. (2013). Child-centered group play therapy. Innovations in Play Therapy, 181.
  • Lindo, N. A. (2013). Play Therapy and Beyond: An Interview with Garry Landreth. Journal Of Professional Counseling: Practice, Theory & Research, 40(1), 2-11.
  • Murray, L. K., Cohen, J. A., & Mannarino, A. P. (2013). Trauma-focused cognitive behavioral therapy for youth who experience continuous traumatic exposure. Peace And Conflict: Journal Of Peace Psychology, 19(2), 180-195. doi:10.1037/a0032533
  • National Council Against Domestic Violence (NCADV). (2015). Domestic Violence Statistics. Retrieved from http://ncadv.org/learn-more/statistics
  • Thompson, E. H., & Trice-Black, S. (2012). School-based group interventions for children exposed to domestic violence. Journal of family violence, 27(3), 233-241.