Contexto político institucional

A professional faced with a referral involving the serious disruption of individu-als in the throes or aftermath of a divorce has a many-sided problem to assess:

whether their needs are for any or all of the services of conciliation, support of various kinds or a therapeutic intervention. If the latter, what form of treat-ment is likely to be most effective? The dissolution of a marriage or long-term cohabitation is not a time-limited isolated event. The main and side effects are cumulative and possibly unremitting. In addition, the diversity of reactions to divorce is a function of the interaction of many risk and protective factors, rang-ing from individual attributes of the child and parents to dynamic features of the family’s lifestyle and history.

Whether the consequences are benign (for some, divorce means an escape from a partner’s abuse of the children, domestic violence, addiction or criminal activities) or malignant depends on a host of moderating influences: predispos-ing, precipitating or maintaining variables (e.g. Amato and Booth,1997). Among the important changes that beset custodial parents (usually mothers) are the following:

(1) adjusting to being single after being one of a couple;

(2) becoming the solitary head of a single-parent family with the main, and often sole, responsibility for decisions, discipline, caring and providing for the children;

(3) coping with children’s grief, bewilderment and (not unusually) with their emo-tional and behavioural problems;

(4) frequently having to leave the family home to set up house in an unfamiliar neighbourhood;

(5) having to make new friends, while sometimes losing old ones;

(6) having (in many cases) to deal with some degree of impoverishment;

(7) having to cope with the disorganization and disruption of family life;

(8) experiencing corrosive emotions such as jealousy, anger, bitterness and loss of self-confidence; and

(9) later, perhaps, adjusting to the strains of reconstituted family life.

Numbers (4)–(9) are difficulties also experienced by the children.

11.3 Transitions

A ‘transition’ constitutes a discontinuity in a person’s life flow. The crucial point about major transitions is that no matter what life crisis an individual faces (the disintegration of a family, life in a new family or substantial changes in attach-ments and relationships) successful adaptation depends on the child and/or adult discovering new adaptive behaviours (different tactical and strategic responses) to meet changed and changing circumstances. Therapists’ understanding and explication of the typical reactions of children of different ages to transitional events should help them to create new ‘stories’ (reframing/cognitive restruc-turing) about themselves and their lives, and about the processes of change

‘submerging’ them during these unsettling times. The successful treatment of children relies on a choice of interventions that are congruent with the child’s stage of development and on the commitment of support from the family. In the Wallerstein and Kelly studies of the 1970s and early 1980s, it was clear that children responded to divorce in different ways, related to their ages (Wallerstein and Kelly, 1975, 1980). An examination of the characteristic reactions and behavioural changes revealed that typically:

(1) young preschool children (aged 2¹₂–3¹₄ years) tended to manifest regressive behaviour;

(2) middle preschool children (aged 3³₄–4³₄) showed irritability, aggressive behaviour, self-blame and bewilderment;

(3) older preschool children (aged 5–6 years) displayed increased anxiety and aggres-sive behaviour;

(4) younger latency-aged children (aged 7–8 years) reacted with sadness, grieving, fear, fantasies of responsibility and reconciliation, plus anger and loyalty towards both parents;

(5) older latency-aged children (aged 9–10 years) demonstrated feelings of loss, rejection, helplessness, loneliness, shame, anger and loyalty conflicts; and (6) adolescents (aged 11 years and over) portrayed sadness, shame, embarrassment,

anxiety about their future and about marriage, worry, individualization and independence from parents and withdrawal.

Additionally, Wallerstein and Kelly (1980) found that somatic symptoms such as headaches and stomach-aches were reported by children in the 9–12-year-old group, with chronic asthma sufferers experiencing intensified and more frequent attacks.

Adolescents are clearly not immune to suffering when their parents sepa-rate. The results of a 2-year study by Sun (2001) of more than 10 000 American adolescents (798 children of divorce) revealed that negative effects on every indi-cator of psychological functioning examined – well-being, school attendance, behavioural disturbance and drug and alcohol abuse – were evident at least 1 year before the marriage ended. These consequences were accompanied by a decline in parental interest in and commitment to their offspring.

A 20-year longitudinal study of 2000 couples and 200 of their children who had reached 19 years of age (Amato,1993) revealed that 40% had divorced by the previous year. A small majority appeared to be ‘very good’ marriages. Children were more harmed by parents who argue rarely and then divorce unexpectedly than by those whose parents confronted each other bitterly and frequently prior to breaking up. Forty per cent of divorces involved marriages in which the child’s parents were in constant and violent conflict, but did not separate. Theirs was the worst plight of all.

As with other investigations, there was evidence that children benefit from the ending of violent, disharmonious partnerships, although they suffer grave disadvantages from the actual ‘sound and fury’ of the break-up itself. Children report a sense of relief when the conflict between the parents ends. Neverthe-less, one likely result of marital separation is children’s reappraising their own relationships with their parents and, indeed, questioning the nature of all social and intimate relationships. For younger children in particular, there is the painful

realization that some family relationships may not last forever. Many childish reactions at such a time are expressions of the fear of being abandoned by one or both parents. Such fears are likely to be most acute if contact has been lost with a parent. If relationships between parents and child remain intact, and supportive, these fears are lessened (Neugebauer,1988/89).

Children who consider themselves most damaged are (e.g. Walczak,1984):

(1) those whose parents are not able to talk to them about divorce (apart from blaming their ex-spouse); (2) those who do not get on well with at least one parent after separation; and (3) those who are dissatisfied with custody and access arrangements. Among teenage and adult populations of females, parental divorce has been associated with lower self-esteem, precocious sexual activity, delinquent behaviour and more difficulty establishing gratifying, lasting adult heterosexual relationships (e.g. Capaldi and Patterson,1991; Hetherington et al., 1998; Hetherington and Stanley-Hagen,1999). Following a divorce, decreased financial resources are the fate of children from all social classes. However, children from low-income families are quite likely to experience real poverty, particularly where their mothers lack employable skills. Children from upper-income families may experience the greatest relative reduction in resources and lifestyle (Furstenberg and Cherlin,1991).

Divorced and single-parent mothers are most likely to be the custodial parents, and are confronted not only with financial losses but also employment and career worries, plus constant care-giving demands. Young children need special attention and nurturance but the parent may have little choice but to seek employment. Finding satisfactory substitute caregivers can be both difficult and expensive. Housing is also a common and costly problem. Many unresolved difficulties may deplete the last emotional resources of the mother or father left to cope with a family alone.

11.4 Interventions

When families present themselves with post-separation adjustment difficulties, a multimodal, systemic intervention package based on a thorough assessment and treatment plan is a necessary course of action. An intervention may not only involve therapy. The man or woman alone will need financial, practical and personal help. Another need is for good, accurate information about their children’s ongoing development given these fraught circumstances.

Multilevel programmes may involve work with the previous and new fam-ily systems, including the original and reconstituted families, new partners and their children. It may also include an intervention with a variety of subsystems, including individual family members. There are many therapeutic programmes

for the clinician to choose from, including: psychodynamic psychotherapy, narrative- and solution-focused therapy, no-talk therapy, cognitive and non-cognitive play therapy, conflict resolution approaches and non-cognitive behaviour therapy (CBT) (e.g. Stuart and Abt,1981; Rossiter,1988; Webster-Stratton,1999).

There is a paucity of evaluative research on most of these treatment models. Nev-ertheless, reviews of group-based, child-focused and adult interventions suggest that some of them, notably CBT, achieve significant improvements in personal and family adjustment. Reviews by Lee et al.,1994and Fonagy et al.,2002are particularly valuable as they suggest which therapies are effective for what, which do not work and which as yet lack validation.

Family-based interventions (e.g. behavioural and non-behavioural family ther-apy, parent skills training and counselling) have been strongly recommended as ways of helping family members adjust to their new roles, child management difficulties and other problems of the kind listed earlier. The most common divorce-related adjustment problems in children include: disturbances of con-duct in early childhood (see Chapter13); anxiety problems (see Chapter 18);

depressive reactions (see Chapter16); and delinquent activities in adolescence (see Chapter25).

In most of the other problems of adjustment following separation and divorce, there is a role for CBT, behavioural family therapy or parent training (see Herbert,2002). These problems include:

r marital conflict (Cummings and Davies,2002);

r bereavement (Herbert,1996);

r deterioration of academic performance (Bisnaire et al.,1990);

r drug and alcohol abuse (Sun,2001);

r relationship difficulties with step-family members (Bray,1995);

r diminished self-concepts (self-esteem, self-confidence) (Parish,1987);

r self-injurious behaviour (Bogolob,1995);

r truancy (Blagg and Yule,1994);

r divided loyalties (triangulation by parents) (Herbert and Harper-Dorton,2003);

r access by non-custodial parent difficulties (Parish,1987); and r developmental problems (Herbert,2003).