Bloque IV. El mundo actual
HISTORIA DE ESPAÑA. PROGRAMACIÓN DIDÁCTICA
From the process of ‘translating’ the second-order constructs across the papers that included child respondents, we developed three broad, overarching (third-order) constructs that related to how children engaged with and experienced interventions, each with a range of subconstructs (see Table 11). The three overarching constructs shaped by the interests of the review team, based on the review objectives, were (1) readiness, (2) dimensions of benefit (including factors that facilitated benefits), and (3) barriers, challenges and tensions, each containing a range of subconstructs inductively generated from the papers
including parent and stakeholder respondents, we developed similar overarching third-order constructs of readiness, benefits and tensions, whereas the subconstructs within the overarching constructs varied with respondent type (see Appendices 11–13). Below, we present the three overarching third-order constructs with their range of subconstructs, for all three respondent groups. In naming the overarching constructs, we emphasise that they are not mutually exclusive. For example, aspects of readiness may also be interpreted as benefits or barriers. We summarised the barriers, facilitators, tensions and benefits for all three groups in Tables 12–15.
Readiness to engage with interventions
Readiness from children’s perspectives
All of the papers including child respondents highlighted personal readiness as an important factor for children. We identified three key facets of readiness from the perspective of children: (1) change and adaptation as the context for readiness; (2) willingness to break the secret of violence; and
(3) understanding and acknowledging DVA. In thinking about readiness and what it means for children who may engage in an intervention, it is important to acknowledge that readiness is a process.
Children may come to an intervention at various stages of readiness and may become more ready to
TABLE 12 Barriers, facilitators, tensions and benefits for children
Barriers Facilitators Tensions Benefits
Differential readiness for an intervention (e.g. children ready but parents not ready)153
Group process sharing and trust130,157,162
Realisation of their family situation (i.e. father as abuser can be a burden to children)130,158
Talking about DVA157,158
Situational readiness: families need to be beyond the upheaval of moving or having to deal with separation, in order to make time49,153
Group process, free play time, making friends130,157,158
Management of conflicting images of fathers as loving parents and understanding the effect of fathers’ abusive behaviour on families130,158
Realising that you are not alone (reduces shame and guilt)130,158
Expectations of the intervention: children perceive that it would be ‘like school’ or ‘really really hard’49
Having fun, enjoyable
activities130,157,158 Learning about sexual
abuse; safety planning was uncomfortable for children130
Naming abuse130,157,158
Having to miss television,
school or activities49,131 Mother facilitating work
with children (e.g. helping them with the pain of remembering)51
Unlearning secret keeping158
Learning that abuse is not OK130,162
Unwillingness to reveal or talk about a shameful secret130
Modelling of prosocial behaviour from adult group facilitators162
Empowerment to speak out against abuse may put children in danger, especially if they are still in contact with the perpetrator of DVA130
Spending time with their mother49,51,130
Unwillingness to talk about the past51,153,162
Altruistic motivations: to help their mothers and to help other children51
Learning to appreciate their own and their mother’s feelings130,158
The pain of
remembering158 Not having to share in the
group was reassuring and added to feeling of safety130
Correct attribution of responsibility for violence130,158
Child–mother relationship (if they think their mother is responsible)157,158
Stakeholder who can be an adult confidante for the child162
TABLE 12 Barriers, facilitators, tensions and benefits for children (continued )
Barriers Facilitators Tensions Benefits
Power dynamic between children, adoption of customary roles of victim or taking control over the group. Adoption of passive resistance, or use of aggressive, conflictual play157,162
Prosocial and caring behaviour of facilitators towards children130
Self-esteem; learning that they are worth respect and care130,162
Power dynamic between adults and children; children may perceive adults as powerful and may be less able to speak up51
Practitioners being able to assist children through the process of engaging with difficult thoughts and emotions130
Improved behaviour management; better able to understand, name, express and manage their emotions.51,130,161,162
Unlearning the need to keep secrets and go against family norms. This may be why it takes children a long time to share and trust157
Priming may be a helpful precursor both to developing readiness to engage and to providing preparatory information to aid children’s understanding of the intervention. Improved understanding of an intervention may enhance its acceptability to potential participants51,158
Resocialising and learning to practise prosocial behaviour, and being able to link this behaviour to outcomes130,158,162
The time children require to develop sufficient trust to share in a group situation [e.g. if an intervention is short (< 6 weeks)]157 Improved mother–child communication51
Free from contact with abusive parent, thus reducing the tension that children and parents felt about managing communication about participation in the intervention51
Having fun, enjoyable activities, making friends, free play
TABLE 13 Barriers, facilitators, tensions and benefits for parents (mothers)
Barriers Facilitators Tensions Benefits
Not wanting to talk about DVA (as a way of protecting the child from upsetting memories)51
Working in a group together facilitated mothers to realise that they were not alone160
Mothers found it hard to hear their children’s views of DVA for the first time130
Realising that they are not alone (in the experience of being in a DVA situation and being a parent)160
Mothers who had left a family situation to escape DVA must be situationally ready (i.e. able to devote time to attending an intervention once the shock and upheaval of leaving an abusive relationship have passed)49,51
Recognising that DVA can affect their children’s lives negatively49,159,160
Confidentiality of children’s groups, as some parents felt excluded and wanted to know more about their child’s progress130
Parents’ understanding of the effect of DVA on children160
TABLE 13 Barriers, facilitators, tensions and benefits for parents (mothers) (continued )
Barriers Facilitators Tensions Benefits
Concern about having to take their child out of school or to miss activities49,51,130,159
Mothers’ attitudes of actively
seeking help for their child51 Improved mother–childcommunication49,51
Ability to look beyond their own needs to those of the child51,159,160
Learning to master their own negative emotions160
Stakeholders able to offer support to mothers through the process of engaging with their own difficult thoughts and emotions (especially important if mother is not receiving an intervention alongside her child)49,157
Enjoying spending time with their children49
Rules about confidentiality were considered reassuring and important in terms of creating trust and ‘breaking the secret’130
Enhanced parental sensitivity160
Development of relationships of trust with those delivering the interventions49,51,160
Resilience (e.g. children’s knowledge of safety planning)130
Priming may be a helpful precursor both to developing readiness to engage and in providing preparatory information to aid parents’ understanding of the intervention. Improved understanding of an intervention may enhance its acceptability to potential participants51,158
TABLE 14 Barriers and tensions for parents (fathers/perpetrators) when intervention included both parents
Barriers Tensions
Fathers not yet ready to acknowledge that they were in a relationship affected by DVA159
Some fathers felt that they were being nagged or manipulated157
Concern of parents (mother and fathers) about the rejection of or lack of a place for fathers in interventions159
Some fathers were able to continue to control their partner through the use of ‘veiled threats’, and some were able to use the insight gained during their sessions to derail the attempts of their partner to bring about change157
Concern of parents (mother and fathers) about the effects on their children of being in a group session with children who had been exposed to more severe abuse159
Fathers mentioned finding it difficult to work in the group and felt that they had to respond ‘as the facilitators wanted them to’ rather than with their ‘own’ responses157
Fathers mentioned that it was difficult for them to organise a service/intervention for their child when they did not have custody rights159
Use of established gendered power dynamics in joint (mother and father) group work allowing perpetrators to control group sessions157
Fathers reported not agreeing with the feminist perspective of one programme and refused to attend159
Ability of fathers to use knowledge from the interventions to gain additional control157
engage with and receive aspects of the intervention as it progresses. Increased readiness to engage is a benefit of participating in an intervention (see Figure 4).
Change and adaptation: the context for children’s readiness
Children coming to interventions in the aftermath of DVA have experienced considerable change as their family adjusts to a new reality. This change is not only in their physical and material world – ‘the move implied a change of neighbourhoods, school, and general social environment’158
– but also in relationships with parents and other family members, as a result of often traumatic separation from the abusing parent.158Children may experience changes in their own thoughts and feelings about their parents – both
abusive and non-abusive – and about their family. Such situational and relational change is an ongoing and complex process and continues ‘long after the immediate aftermath of violent incidents’.158Change
thus forms part of the context within which children come to an intervention.
Change is accompanied by processes of adaptation for children. Peled158observed that children have to
learn to adapt quickly to their new surroundings in the setting of a shelter. This can be stressful and may result in behaviours such as bed-wetting.158Having to adapt may also cause conflict with mothers at a time
when children need maternal support. As a consequence, children may need additional support from shelter staff to adjust to the new reality of shelter life. Although some change is difficult for children, a change in living circumstances can bring positive benefits, including safety and emotional and material support, which may prepare a child and parent to begin to acknowledge and deal with the aftermath of abuse.158
Adaptation includes coming to terms with a changed relationship with an abusive father. A child may develop new and confusing feelings about their abusive and non-abusive parents in the aftermath of DVA.
TABLE 15 Barriers, facilitators and tensions for stakeholders
Barriers Facilitators Tensions
Stakeholders’ ability to understand abuse and its impact on mothers and children. A lack of understanding of the degree of trauma experienced by mothers, or why the mothers are not yet able to put their children first, was seen to affect the workers’ ability to help women engage with the intervention51
Stakeholders have a key role in assisting mothers to engage, especially in situations in which culture might take a role in affecting the mother’s readiness51
Stakeholders were concerned that parents would think children would be ‘fixed’ by an intervention, when the intervention, for some children, may be just one step in a long journey130
Organisations within which
interventions are delivered need to be ‘ready’; staff need to be trained appropriately, and management need to be committed to the intervention51
The confidentiality of the group was important to women. Of particular concern to them was the safety of children when perpetrators were involved in the programme51
The importance of cultural awareness in the facilitators when introducing interventions to mothers and children130
Organisations ‘in crisis’ were not seen to be ideally placed to facilitate the delivery of such an intervention51
Organisations already providing similar support (e.g. counselling) were seen as more ready and as having a better foundation on which to deliver interventions51
Facilitator concerns that children may feel bad in a group setting if their experience of DVA has been more severe than that of other children130,159
Care in the training of staff and roll-out of a new intervention were necessary Stakeholders’ ability to facilitate engagement depends on their own personal traits, training and understanding of the trauma of DVA and its effects on families51
and the child may not understand, or may resent, this limitation. Children may have to adapt to seeing their fathers as the perpetrators of abuse as well as the caring fathers whom they love, and they may need to work out how to cope with and reconcile these conflicting images of their fathers. It is possible that children’s perceptions of the core problem may shift from ‘the abuse itself to the consequences – the difficulties in relationships with fathers’.158Relationships with their fathers may remain a difficult issue for
children, both throughout their participation in an intervention and beyond.
Relationships and feelings towards mothers may also change. Children may sometimes blame their mothers for their new and unpleasant situation, including restricted access to their fathers. However, children may also develop new understandings of the emotional and practical difficulties that their mothers face, such as having to re-educate themselves to acquire work to provide for their children. This may change the dynamics of their relationship, as the child wishes to demonstrate care and empathy for his or her mother.158
These various changes and adaptations are part of the context in which a child enters an intervention and they may impact on his or her readiness to engage.
Children’s readiness: being willing to ‘break the secret’
Willingness to ‘break the secret’ of DVA is an important aspect of children’s readiness to start, and to continue to engage with, an intervention. Initial willingness to engage in an intervention was sometimes motivated by altruism, with some children citing the desire to help their mothers and understand their experiences, alongside a wish to help other children in the future, as reasons for joining an intervention.51
Breaking the secret of DVA was, however, consistently difficult for children who were often hesitant to talk about their experiences. Particularly in the early stages of an intervention, children often did not want to talk about the past or their fathers. Their mothers’ presence facilitated children’s engagement with an intervention and helped the children to recognise the value of therapeutic activities.130
Children typically required time to develop trust before they felt safe to share their experiences: ‘they were willing to discuss violence after several weeks had passed rather than during the first few sessions of the program’.157Consequently, although children who had engaged in an intervention often wanted to talk
about the abuse, it was not unusual for considerable time to pass before they were ready to talk. In group interventions, it took some time for children to build sufficient trust in one another to enable them to behave and play more spontaneously and to proceed to disclose their experiences and feelings. Developing trust enabled children to feel safe within the group. Group rules, including rules about confidentiality (‘whatever was said in the group, stays in the group’130), provided reassurance for children and were an
important precursor of willingness to ‘break the secret’.
Once children had begun to share the secret of DVA, talking about it was usually experienced as beneficial and as a form of stress-relief. During the interventions, children learned that it was acceptable and helpful to break the silence or secret about DVA within their family. Sharing the secret helped children to realise that they were not alone and that there were other children in their situation, and contributed to reducing their sense of shame and guilt.130Just being listened to was a new and welcome experience for some children.
However, remembering and talking about the past also carries costs for children. These costs are discussed under the third overarching construct, that is, barriers, tensions and challenges (see Tensions associated with sharing the secret of abuse).
Importantly, there may also be differential readiness between children and their mothers, which may impact on engagement with interventions designed to help both children and parents. For example, in Humphreys and Skamballis,51a mother described her own reluctance to acknowledge and talk about
the effects of DVA, while acknowledging that her daughters had been ready to talk about it for some time, having already discussed it with a special educational needs co-ordinator at their previous school.
This differential readiness between mother and children had delayed their engagement with a family-based intervention.
Children’s readiness: understanding and acknowledging domestic violence and abuse
A gradual process of coming to understand and acknowledge DVA was also an important facet of children’s personal readiness to take up and continue with an intervention. Public responses of mothers to abusive situations, such as entering a shelter, are not always accompanied by a shift in children’s understanding and awareness of DVA.158Children in a shelter may not yet understand the role of DVA in
bringing them to the shelter. In addition, children may not conceive of abuse as the most significant problem in their lives; they may be more engaged with other, more immediate, issues including ‘feelings of being rejected by their fathers’ and ‘normal developmental challenges’.158The relative ‘marginality’ of
DVA among the array of challenges facing a child may be a barrier to initial readiness to engage with an intervention.
At the start of interventions, children not only may be hesitant to share their experiences but may have limited ability to express what has happened. Children have to learn the language of abuse and how to talk about what they have witnessed or heard. As children engage with interventions, they begin to learn that abuse is not acceptable and to ‘de-normalise’ the domestic violence to which they have been exposed.157,158Part of this process includes attributing responsibility for the abuse to the perpetrator.
Some children need assistance in acknowledging that their fathers are responsible, as well as support in recognising the impact of DVA on their mother and the children in the family. Through engaging in supportive interventions, children learn to define and label types of abuse, which helps them to talk about and process what has happened in their lives.130
Readiness from parents’ perspectives
All of the papers that included parent respondents highlighted readiness as important. Parents not only had to be ready themselves but also had to be ready to allow their children to access interventions. The nature of readiness differed for fathers and mothers. In the papers reviewed, all fathers were identified as ‘perpetrators’ of domestic abuse (in one paper, the terminology used was ‘batterers’) and all mothers were ‘victims’. When fathers were involved in decisions about child engagement in an intervention, this was in respect of programmes aimed at entire families affected by DVA.
For parents, readiness took four forms: (1) fathers had to be ready to acknowledge that they had been in a relationship affected by DVA; (2) parents had to recognise that exposure to DVA can affect children negatively; (3) parents had to be able to look beyond their own needs to those of their child; and (4) parents needed to have recovered from any immediate traumas arising from separation and to be able to create time to attend an intervention (see Figure 4).
As is also the case for children, parents’ readiness should be seen as a process: parents may become more