3502 Scotts Lane June 1, 2009 Building 1, Suite 4 Philadelphia, PA 19129 phone: 215.843.2046 fax: 215.843.2049 [email protected] www.instituteforsafefamilies.org Greetings, This Guide is a culmination of years of work. Some time ago, in our commitment to creating “safe families,” we realized that those who worked at the intersection of child welfare, domestic violence and batterers’ intervention didn’t always talk – or listen – to each other very well. Practitioners from each of these systems -- talented, earnest and dedicated – seemed to view families affected by domestic violence from their own, system-bound perspective. Yet, the families with whom they ISF BOARD OF DIRECTORS worked lived their lives in the intersection, in the messy terrain of trauma (oftentimes years of it), JANICE ASHER, MD ASSISTANT CLINICAL PROFESSOR impacted grief, curious loyalties, and patterns of behavior that, while hurtful, seemed to be the only UNIVERSITY OF PENNSYLVANIA available path. We came together to teach and learn from each other, to argue, to sit in the messy SANDRA BLOOM, MD PRESIDENT AND CEO ambivalence, and finally, to identify a way towork together for the health and healing of whole COMMUNITYWORKS KAREN BLOUNT, RN, MS, PNP families. At the center was always our concern for the children. We knew that we needed CHIEF NURSING OFFICER ST. CHRISTOPHER’S HOSPITAL to help parents show their children a new way. FOR CHILDREN JAYNE BROWN, MD Children who have been exposed to domestic violence need our help, but more MEDICAL DIRECTOR importantly, they need their parents’ help. There are some parents who are simply unable to set QUALITY COMMUNITY HEALTH CENTER PATRICIA DEITCH, MBA aside their own hurts and make themselves available for the kind of deep listening and relationship PRESIDENT AND CEO that is necessary for their children’s healing. But many more are, if we provide them with the DELAWARE VALLEY COMMUNITY HEALTH JOEL FEIN, MD, MPH - CHAIR opportunity to be heard themselves, and teach them skills to be better listeners to and for their ASSOCIATE PROFESSOR OF PEDIATRICS AND EMERGENCY MEDICINE children. CHILDREN’S HOSPITAL OF PHILADELPHIA ANASTASIA GRAY, CRNP This Guide for Parenting After Violence suggests that listening is an essential ingredient GENERAL INTERNAL MEDICINE TEMPLE UNIVERSITY in working with parents and children in the aftermath of domestic violence. It introduces JEFFREY JAEGER, MD ASSISTANT PROFESSOR OF MEDICINE readers to a number of available curricula to guide this work and integrates knowledge of trauma UNIVERSITY OF PENNSYLVANIA theory and stages of change (especially for individuals and families traumatized by domestic violence), NATALIE LEVKOVICH EXECUTIVE DIRECTOR though always the listening is central. The Guide contains specific suggestions for techniques that HEALTH FEDERATION OF PHILADELPHIA enhance listening. Practitioners working with parents who have experienced violence must model, KARIN RHODES, MD, MS DIRECTOR, DIVISION OF HEALTH CARE and teach them explicitly, how to better listen to their children in order for healing to occur. POLICY RESEARCH DEPARTMENT OF EMERGENCY MEDICINE The Guide provides some basic information about domestic violence; however it assumes that UNIVERSITY OF PENNSYLVANIA JOHN RICH, MD, MPH practitioners have such an understanding, which is crucial for this work. While the information and CHAIR, HEALTH MANAGEMENT & POLICY DREXEL UNIVERSITY SCHOOL OF PUBLIC exercises may also be appropriate for other kinds of family experiences (loss, separation, divorce, HEALTH other kinds of violence, and/or substance abuse, to name a few), if domestic violence has been ANN RICKSECKER, MPH ASSOCIATE EXECUTIVE DIRECTOR a factor in the life of the family or families with whom one is working, it is important to HEALTH FEDERATION OF PHILADELPHIA keep this central to the work of reparation and healing. It is sometimes easier for other issues ELLEN TEDALDI, MD PROFESSOR OF MEDICINE to become the focal point when there is domestic violence, which often contributes to the continued TEMPLE UNIVERSITY denial and silence about domestic violence in our society. ISF NATIONAL ADVISORS ELAINE ALPERT, MD, MPH Please take the time to read the introduction to the manual. This will give you a more in-depth BOSTON UNIVERSITY SCHOOL OF MEDICINE description of the theoretical underpinnings of this effort. It also offers a “narrative road map” for JUAN CARLOS AREAN the guide and how you might use it. FAMILY VIOLENCE PREVENTION FUND SARAH BUEL, ESQ. UNIVERSITY OF AUSTIN We offer this to you with our most heartfelt gratitude to the families and practitioners who are ANNE GANLEY, PHD dedicating their lives to transforming histories of family violence into stories of healing and wholeness. UNIVERSITY OF WASHINGTON ANGELO GIARDINO, MD, PHD MEDICAL DIRECTOR Sincerely, TEXAS CHILDREN’S HEALTH PLAN BETSY MCALISTER GROVES, MSW, LICSW Darla Spence Coffey, West Chester University DIRECTOR, CHILD WITNESS TO VIOLENCE PROJECT Martha Davis, Institute for Safe Families CLAIRE RENZETTI, PHD Sandra Dempsey, Institute for Safe Families EDITOR, VIOLENCE AGAINST WOMEN OLIVER WILLIAMS, PHD EXECUTIVE DIRECTOR, INSTITUTE ON DOMESTIC VIOLENCE IN THE AFRICAN AMERICAN COMMUNITY Acknowledgments Parenting After Violence: A Guide for Practitioners has been a collaborative effort of many individuals and organizations. I would like to thank the Institute for Safe Families, the Philadelphia Department of Human Services, the members of the Parenting After Violence Clinical Network, and those practitioners who participated in the “pilot” training program for the support, wisdom, and cooperation that has gone into producing this Guide. A decision was made early in its conception to inform this Guide with experiences of children, mothers, and fathers who have been affected by domestic violence. In order to do this, focus groups were conducted at seven agencies in Philadelphia: Anti-Violence Partnership, Congreso de Latinos Unidos Domestic Violence Program, Lutheran Settlement House Domestic Violence Program, Menergy, Men’s Resource Center, People’s Emergency Center, and Youth Services, Incorporated. In addition, four adults who grew up with domestic violence in their homes as children were interviewed individually. I would like to extend my deepest gratitude to the interviewees for their willingness to share their experiences and lend their “voices” to this work. It is my wish that this Guide reflects the experience, strength, and hope that they were so courageously willing to share. Thank you, too, to the practitioners who facilitated the focus groups and for facilitating the process of capturing these important perspectives. Thanks to Peter Cronholm, MD, for analyzing the survey data, and Malathie Dissanayake, for transcribing the interviews. Finally, I am grateful to the women of Mothers Empowered, who allowed me to accompany them on their journey to reclaim their lives after domestic violence. Their fierce and unwavering devotion to their children has taught me a great deal about love. Table of Contents Chapter 1: Introduction.......................................................................................................5 What Mothers, Fathers, and Children Have to Say: A Focus Group Study ........................6 Philosophical Foundation .................................................................................................9 Guiding Principles............................................................................................................9 Guide Overview .............................................................................................................11 Gender and Culture.........................................................................................................12 Chapter 2: A Theoretical Framework for Working with Parents...................................14 Stages of Change (or Readiness for Change) ..................................................................14 Parental Readiness for Accepting Children’s Experiences of Domestic Violence............19 Understanding the Effects of Trauma on Readiness for Change ......................................19 Chapter 3: A Model for Listening .....................................................................................22 The Value of Listening ...................................................................................................23 Chapter 4: Working with All Parents ..............................................................................26 Educating Parents about Domestic Violence...................................................................27 Teaching Parents about the Effects of Domestic Violence on Children ...........................27 What Children Need To Heal..........................................................................................33 Talking to Children About The Violence ........................................................................35 Chapter 5: Special Issues when Working with Victims/Survivors...................................43 The Effects of Domestic Violence on the Victim/Survivor..............................................45 The Effects of Domestic Violence on Parenting..............................................................45 Safety Planning for Victims/Survivors of Domestic Violence .........................................48 Chapter 6: Special Issues When Working With Abusers .................................................52 History of Childhood