Docstoc

Services Assessment Children's DV Services 1 A Comprehensive

Document Sample
Services Assessment Children's DV Services 1 A Comprehensive Powered By Docstoc
					                                                        Services Assessment: Children’s DV Services 1




             A Comprehensive Assessment of Services Provided in Santa Clara County

                              for Children Exposed to Domestic Violence1

                                              Mario W. Victor

                                                ABSTRACT

        Historically, children have been the “invisible” victims of domestic violence (DV). As
women’s shelters grew in the 1970’s, social workers began to notice the deleterious effects of
DV were present not only in the victims, but in the overlooked witnesses; the children. Research
has indicated that children exposed to DV are more likely to experience social, emotional, and
behavioral problems. Furthermore, children who witness intimate partner violence are more apt
to repeat the cycle of violence as adults by either entering into violent relationships, or being
abusive towards their partners. Despite these glaring and profoundly negative effects resulting
from exposure to DV, there is an absence of DV treatment services that address the specific
needs of children. Treatment models have been created and are being utilized in select mental
health agencies to treat DV exposed children, and show promising outcomes. This research
explored and described the services that are available in mental health agencies throughout Santa
Clara County for children exposed to DV. The data describing these services was gathered by
administering a questionnaire to 34 mental health agencies in Santa Clara County. A
combination of qualitative and quantitative methods was utilized in the questionnaire, which
collects thorough and pertinent information about DV treatment services. The compilation of
this data served to describe what is currently available and identify the possible gaps in services.
This is the first step in mobilizing the community’s response to the problem.

Findings from the study demonstrate that although the majority of mental health agencies in
Santa Clara County offer direct services to adult DV clients, unfortunately very few of them are
comprehensive (less than one fifth), and even fewer have specific programs to address the
distinct therapeutic needs of children affected by DV and the quality of parenting they receive.
Additionally, the data shows that many service providers have minimal professional training in
the area of DV and do not screen adequately for DV in the families they see. With the exception
of Spanish and English-speaking facilities, services are seldom available in the diverse languages
and cultures of the clientele. Common themes from the qualitative responses suggest that
although agency managers believe there is an increased need for DV services for children and
families, lack of funding, lack of training, and politics are significantly impacting the inability to
create more services. These findings are relevant for social and mental health services; this study
reviews the effect of DV on children, assesses the services available, and provides evidence to
support advocacy for the funding of more comprehensive and competent DV services.



1
 A Social Work 298 Special Project presented to the faculty of the College of Social Work, San José State
University in partial fulfillment of the requirements for the degree of Master of Social Work. The author
acknowledges Dr. Fred Prochaska, 298 Project Chair & Dr. Jan Johnston, agency field instructor. Submitted May,
2006, revised and edited by Dr. Johnston in February 2007.
                                                    Services Assessment: Children’s DV Services 2




                                             Introduction

       Domestic violence (DV) is an issue of concern the profession of social work has invested

energy attempting to prevent and treat. The battered women’s movement in the 1970’s initiated

the growth of treatment centers, shelters, therapies, and other supportive resources for women

who were abused by their partners (Saathoff & Stoffel, 1999). DV has been described as a

recurring cycle, as numerous studies have indicated that boys who grow up in violent households

have an increased likelihood of battering their partners as adults (Bancroft & Silverman, 2002;

Saathoff & Stoffel, 1999). Fantuzzo, Mohr, & Noone (2000) conducted a multi-city study based

on the demographics of DV. Results indicated that children, particularly those under the age of

five, were disproportionately present in households experiencing DV. These homes were likely

to present other risk factors as well, such as substance abuse, and poverty.

       DV has a profound impact on the family system, which can be explicated by the

ecological systems theory. This theory explains that the negative effects of intimate partner

violence touch everyone living in the family system. For a young child in particular, to see their

parent battered by their spouse or partner can cause severe psychological distress. Behrman,

Carter, & Weithorn (1999) state that DV exposed children experience an increased rate of

aggression, phobias, insomnia, low self-esteem, and depression. If the profession of social work

hopes to break the DV cycle, it is crucial to start with treating the possible future batterers or

victims--the children. Given that children are not direct participants in domestic violence

between parents, they tend to be overlooked in the intervention process. By not addressing their

therapeutic needs, we are supporting a system that will promote the perpetuation of family

violence. Based on the negative consequences that result for children exposed to DV, there is a

present need to intervene by providing children with various therapeutic approaches and
                                                   Services Assessment: Children’s DV Services 3


supportive resources. This is a social problem that has existed parallel to domestic violence, but

has only recently begun to garner attention in regards to an organized intervention.

       A growing body of research has demonstrated that exposure to domestic violence is

detrimental to children's social, emotional, and cognitive development (Groves, 1999).

Furthermore, data suggest that such exposure has long-term consequences for children's well

being, ultimately affecting their adult functioning. Given the negative repercussions of children's

exposure to domestic violence, there exists a need for programs that can intervene in these

children's lives to improve the chances of healthy psychological adjustment. Awareness of the

impact of domestic violence has increased, nevertheless, the needs of the children who witness

violence have not been fully recognized. Yet, some interest in children’s DV issues appears to

be growing in mental health agencies (Carter, George, Kay, & King, 2003). The mental health

professions are increasingly identifying the special needs of these children, and literature that

will be reviewed contains information about these children's experiences and needs, as well as

descriptions of model intervention programs and approaches.

       Before any effort is made to implement existing or proposed models for treating children

exposed to DV, it is vital to conduct thorough research to assess services that currently exist.

Investigation into the availability of services for children exposed to DV is a necessary primary

step. In addition, it needs to be determined to what extent the services are available, and to what

degree are they lacking or non-existent. By assessing the gaps in service, a focus can be

channeled toward the treatment required to address the deficiencies.

       The intention of this research was to explore and describe the services available to

children who are exposed to DV in Santa Clara County, to determine what extent the services are

being utilized, and to assess the overall need for DV services targeting children. Both

quantitative and qualitative means will be utilized through a survey that will measure and
                                                  Services Assessment: Children’s DV Services 4


describe the services, trainings, and agency protocol that are used in an agency’s the treatment

DV situations.

       Data accumulation was obtained through contacting mental health agencies and

administering a brief survey/questionnaire. The survey was semi-structured, with both open-

ended short answer items, and yes or no questions. It has high face validity as it is asking

objective information-seeking questions about services provided by mental health agencies. The

questionnaire targets public information concerning the existence, availability, and need for

services and training to work with DV exposed children and their mothers.

       The findings provide an evidence-base that can guide social workers and human service

professionals in Santa Clara County toward providing essential services for the needs of these

children and families. It is important for our society, and for the human service professions, to

address these needs in hopes of reducing both the negative effects of DV on children and

families, and the cycle of abuse. Compiling a report on what is available and the gaps in services

is the first step in improving the community’s response to the problem.

                                        Literature Review

Effects of DV on Children

       As stated, DV can deeply impact a child’s overall functioning. Exposure to community

violence occurs less frequently for children who live in higher SES neighborhoods, but exposure

to family violence crosses socioeconomic and cultural boundaries, occurring throughout our

society (Carter, et al., 1999). It has been estimated that between 25% and 30% of American

women are battered at least once in the course of an intimate relationship (Geffner, Igelman, &

Zellner, 2003). One study estimated at least 1.8 million women were severely beaten by their

partners yearly, while others indicate the percentage of women experiencing dating violence,

sexual assault, physical violence, or emotional abuse, can be as high as 65% (Ho & Rossman,
                                                  Services Assessment: Children’s DV Services 5


2003). Research shows that more than 3.3 million children witness physical and verbal spousal

abuse each year, with behaviors ranging from insults and hitting, to fatal assaults with deadly

weapons (Geffner et al., 2003). Additionally, as many as three million children themselves are

victims of physical abuse by their parents. In homes where domestic violence occurs, abuse and

neglect of children occurs at a rate 15 times higher than the national average. Several studies

have found that in 60% to 75% of families in which a woman is battered, children are also

abused (Geffner, et al., 2003; Gruber, Kalil, Rosen, & Tolman, 2003). This is important as DV

and child abuse co-occur, and children exposed to both domestic violence and child maltreatment

tend to show higher levels of distress than children exposed only to domestic violence (Carter, et

al., 1999). Results from a study by Armenta, Rodriguez, & Romero (2003) on 300 families in

Mexico showed that DV and child abuse influenced delinquent and antisocial behavior, produced

attention problems, anxiety, depression, sadness and the experience of physical symptoms. These

results seems to indicate that both child abuse and exposure to marital violence result in harmful

consequences on children's behavior and well-being.

       Exposure to chronic or severe family violence may result in symptoms consistent with

post-traumatic stress disorder, such as emotional numbing, or obsessive and repeated focus on

the event (Allen, Bybee, Sullivan, & Wolf, 2003; Fantuzzo & Mohr, 1999). A study of the

psychological effects of DV on children by Carlson, Chemtob, & Claude, (2004) show very high

rates of PTSD among children and mothers in the sample (40% and 50 %, respectively). They

state that PTSD is an acute anxiety disorder that results from exposure to or witnessing events

that threaten life or injure, and create strong fear or helplessness. Furthermore, psychological

and physiological distress occurs when exposed to situations that relate to the trauma (Carlson, et

al., 2004). Problems caused by PTSD due to exposure to DV include hyper-vigilance, sleep

disorders, or inappropriate anger (Carlson, et al., 2004). El-Sheik & Whitson (2003) studied the
                                                   Services Assessment: Children’s DV Services 6


emotional outcomes among children exposed to DV. They found that children who are exposed

have difficulty regulating their emotions. The research states that emotional regulation is an

important process “in that they (children) utilize emotion to facilitate an adaptive response” (El-

Sheik & Watson, 2003, p. 48). Ho & Rossman (2000) explain that PTSD in children exposed to

DV in the home presents similarly to PTSD symptoms as reported by soldiers in the Vietnam

War. How a child copes with DV can vary depending upon personal resiliency factors, but these

results indicate that DV exposed children may not be able to use their emotions to soothe

themselves.

     Children who live with domestic violence may also have academic difficulties. Many

factors contribute to these problems, including the impact of domestic violence on cognitive and

behavioral functioning, and the level of emotional distress these children experience (Saathof &

Stoffel, 1999). Due to many mothers fleeing from their batterers, a child experiences drastic

change and insecurity about their future stability--which only magnify these problems.

       In some respects, children who witness domestic violence have unique emotional needs.

Typically, children turn to their parents for protection in times of stress or fear. Research

indicates that if children have access to a parent, they are more resilient in response to trauma

than are children who do not (Allen et al., 2003). Children exposed to community-based

violence, or trauma caused by an accident, often have access to one or both parents for

psychological support. Regrettably, children who witness domestic violence may not have such

emotional refuge—the perpetrating parent is unsafe and the battered parent may be emotionally

unavailable because of her own trauma (Bancroft & Silverman, 2002). Furthermore, these

children suffer cumulative losses when they must leave their home to seek safety. In addition,

children in a family affected by domestic violence often have complicated, ambivalent, and

overwhelming feelings toward the parent who perpetrates the violence. Batterers tend to have
                                                   Services Assessment: Children’s DV Services 7


methods of parenting that also contribute to negative outcomes for the child. Bancroft &

Silverman (2002) assert that batterers tend to have an increased rate of physical, sexual, and

psychological abuse. Their parenting style is described as authoritarian, neglectful, and

undermining the mother’s parenting. The negative effects of these parenting methods can

compound for children if they are already experiencing exposure to acts of intimate partner

violence. In addition to the psychological effects of children exposed to DV, the batterers

modeling can shape the value-system of children in the home, including their outlook on the

normalcy of abuse in relationships, their attitude in regards to violence and aggression, and sex-

role expectations (Bancroft & Silverman, 2002).

       The cycle of DV is directly influenced from the effects on children who witness it at

home. Significant research has elucidated that boys who grow up in abusive homes had an

increased likelihood of being physically abusive towards their own wives (Straus, Gelles, &

Steinmetz, as cited in Dutton, 2000, p. 61). As previously stated, there is a high co-occurrence of

DV and child abuse/maltreatment. Dutton (2000) explains that children who themselves who are

physically abused are more apt to be abusive to their intimate partners in the future. He asserts

that boys tend to “externalize this by being disruptive, acting aggressively towards objects and

people, and throwing severe temper tantrums” (Dutton, 2000, p. 61). This research also suggests

that boys tend to identify with and model the aggressor in the abusive home, which helps to

provide evidence of how the cycle of violence is perpetuated.

       Bowlby (as cited in Dutton, 2000, p. 62) explains that secure attachment is a necessary

buffer against trauma, but is compromised when the child sees the victim as unable to provide

security and protection. For girls who grow up in environments where DV occurs, not only are

they are more likely to become the recipients of intimate partner violence later in life, but they

are also more likely to be physically violent with others during their life (Armenta, et al., 2003).
                                                   Services Assessment: Children’s DV Services 8


Overall, traumatized children have difficulty controlling their aggression, and tend to act

destructively towards themselves. Research indicates that many children exposed to DV have

increased temper tantrums and fights with peers and siblings (Dutton, 2000). Kalmuss (as cited

in Dutton, 2000, p. 64) found that witnessing family violence did not just effect the boys in the

family, but “children who witnessed either parent hitting the other became more violent

regardless of their gender.” A very interesting outcome of studies looking at child abuse vs.

interparental abuse shows that witnessing intimate partner violence correlates higher with the

generation of abuse cycles than being abused directly. These outcomes suggest that

interventions need to address the effects of witnessing DV, not just the effects of direct abuse.

       Even before researchers documented the harmful effects of domestic violence on

children, battered victim’s advocates experienced that the children were suffering (Saathoff &

Stoffel, 1999). Historically, however, children initially were considered "secondary" victims of

domestic violence, therefore were not the primary targets of interventions. Limited financial

resources required social workers to focus intervention efforts on their central, crisis-oriented

goals, and left little for meeting the children’s needs. The flow of children coming into the

shelters with their parents overwhelmed staff, who were initially unequipped to satisfy the

children's various and severe needs (Catallo, Moore, & Pepler, 2000). Catallo, et al., (2000)

explained that because children's well-being is linked to that of their mothers, shelter workers

believed that if the needs of battered adults were adequately served, special services for children

would not be unnecessary. As previously stated, data supports the conclusion that the well being

of children who witness domestic violence is tied closely to that of their mothers.

       As mentioned above, research indicates that there is a high co-occurrence in families of

child abuse and domestic violence. Yet, separate service systems with different histories and

treatment philosophies have developed to address each form of violence (J. Johnston, personal
                                                  Services Assessment: Children’s DV Services 9


communication, September 5, 2005). Child welfare agencies are mandated by state and federal

laws to investigate reports of child abuse, offer services to families, make case recommendations

to the juvenile court, and place children in adoptive and foster homes (Saathoff & Stoffel, 1999).

Ensuring the safety of the child is the mission of Child Protection Services (CPS). In contrast,

though many community-based domestic violence programs offer services to children, they

focus mainly on providing support to battered women. Despite these differences, increasing

identification of the co-occurrence of child maltreatment and domestic violence has resulted in

greater willingness on the part of CPS staff and domestic violence service providers to work

together. “Collaborative efforts to date have identified beliefs common to both systems: (1) the

presence of domestic violence in families is harmful to children, (2) the safety of the mother

affects the safety of the child, and (3) perpetrators must be held accountable” (Behrman, et al.,

1999, p. 90). Some strategies could be to screen for domestic violence in all child maltreatment

cases, have a battered women's advocate liaison with CPS to provide case consultation to

workers and domestic violence services to families. Also, given that police officers are the first

people to intervene in a domestic violence case, having protocol that would guide them to

investigate if the children were also abused or affected by witnessing the abuse.

       Mental health system approaches to children exposed to domestic violence range from

crisis interventions to individual, group, and family therapy programs (Carter, George, Kay, &

King, 2000). Crisis interventions may be mental health professionals providing on-site

counseling in the home following a domestic violence incident, or immediate assistance to a

child who is having trouble in the shelter. Group programs can offer children a safe venue in

which to talk about the violence, improve self-esteem, and develop safety skills (Johnston,

2003). Carter, et al., (2000) describes that some programs emphasize the development of social

problem-solving skills that are often impaired by chronic exposure to domestic violence, while
                                                  Services Assessment: Children’s DV Services 10


others employ therapy techniques used to treat post-traumatic stress disorder. Family therapy

may include counseling for mother and child, and referrals to appropriate family support

services.

        It is not identified how many mental health programs for children exposed to domestic

violence have been established, or how many children participate in them (Groves, 1999). This

shows how important it is to conduct community needs assessments, in order to describe the

services in the community. Most mental health professionals do not receive training in

identifying, assessing, or treating children exposed to domestic violence (Saathoff & Stoffel,

1999). Funding for mental health interventions is limited, and often only supports short-term

treatment that may not address the long-term symptoms these children can exhibit, or the host

other stressors in the families.

                There are three interventions of particular interest for those working to ameliorate

the harmful effects of DV on children. Psycho-educational support groups for children and

mothers are utilized in some battered women’s shelters. These groups have cognitive-behavioral

theories that guide the treatment. Graham-Berman (as cited in Johnston, 2003, p. 207),

documented the effectiveness of such groups. She found that in terms of an increase in

knowledge and a decrease in anxiety, they were successful, but in terms of behavior, attitudes,

and skills, the results were mixed. Such short-term group interventions are sometimes available

to children living in shelters, as well as to nonresident children (Saathoff & Stoffel, 1999). The

group curriculum attempts to meet some of the children's immediate emotional needs and to

teach positive coping skills. Goals may include helping child participants to express their

feelings, to develop certain cognitive and social skills, and to address issues relating to violence.
                                                 Services Assessment: Children’s DV Services 11


       Another treatment modality being utilized currently for children exposed to DV is the use

of post-traumatic stress therapy for traumatized children in mental health clinic settings. With

this therapy, the child is de-sensitized to the terror and trauma and they are supported to express

their feelings about their trauma in a safe place (Johnston, 2003). Johnston (2003) states that

there has not been published any empirical evaluation of the post-traumatic stress therapy

approach. Victimized mothers may find it difficult to tolerate their children's expressions of

sadness and loss for the abusive parent, but this therapy can provide a safe haven where children

can express these emotions.

       One encouraging treatment approach used for children exposed to DV is called

“Developmental Psychotherapy for Children of Chronically Conflicted and Violent Families”

(Johnston, 2003, p. 209). It was created for children who witness interparental abuse

consistently through their development. The understanding of the developmental influence of

trauma is the basis of this treatment model. Its goal is to assist exposed children to develop

interpersonal trust and decrease hypervigilance through games, role-playing, and guided imagery

(Johnston, 2003). An evaluation on this approach was carried out by Johnston, (2003). She

sampled 488 children and parents served by the model, and found that the positive effects on the

sample were statistically significant. This model addresses the collective history of stressors on

a child, and is an acceptable model for parents who see a stigma in bringing their child to a

mental health clinic. It is also economically feasible. Johnston (2003) asserts that this group

program costs 43% of what a similar number of hours of individual therapy would cost.

       These groups have been implemented in school and agency settings in Marin County

(e.g. Bahia Vista Elementary School in San Rafael) and in San Mateo County (e.g. Family

Service Agency in Burlingame). The model has also been adapted in an unknown number of

other settings. An example of a successful adaptation of this group treatment approach is
                                                  Services Assessment: Children’s DV Services 12


occurring at the Center for Domestic Violence Prevention in San Mateo, California. It is an on-

site art therapy program that seeks to help shelter children cope with their exposure to domestic

violence (Saathoff & Stoffel, 1999). As children are sometimes unwilling or unable to speak

about their experiences, art provides a vehicle through which children can tell their stories and

begin to work through the impact of DV experiences.

       To respond best to children exposed to domestic violence, it will also be necessary to

expand the knowledge base about service and population trends. Presently, there are no

comprehensive sources of national data that provide quantitative and qualitative information

about the types of services provided, or the individuals served by the programs (Behrman, et al.,

1999). In addition, very few programs have been evaluated to determine if they are achieving

their goals (Johnston, 2003). Research in the past decade already has greatly increased our

understanding of the needs of children exposed to domestic violence. The potential for even

greater understanding in the future is high, particularly if governmental and other funding

sources desire to meet the needs of this population by assessing services provided. Groves

(1999, p. 146) states that “because service provisions to children who witness domestic violence

are in the early phases of development, uniform standards of care do not yet exist and there is no

comprehensive listing of programs.” Due to this lack of understanding about current programs

that exist, their extent of implementation, and degree of utilization, it is imperative that research

be conducted to assess the services and needs of the community. This research project describes

these deficiencies in knowledge can be an important component in the movement towards

recognizing the needs of children who are exposed to DV.

       The ecological and family systems frameworks are appropriate theoretical models that

can help explain why children are so profoundly affected from being exposed to DV. Systems

theory can be very useful in illustrating how change is produced in families that experience DV.
                                                 Services Assessment: Children’s DV Services 13


The fundamental ideas of the systems theory propose that all systems are made up of subsystems,

and also are part of greater systems. When one system is changed, the effects can be felt

throughout the other subsystems (Payne, 1997). When the trauma of witnessing DV occurs, it

reverberates throughout the child’s development, and as stated, correlates with aggression, socio-

emotional reactions, and PTSD. In order for the child to maintain homeostasis within the family

system, there is a reaction, or adjustment the child makes to explain to integrate these

experiences in their lives. It is clear that the trauma associated with witnessing DV affects the

child’s system by causing behavioral and social problems, academic difficulties, psychological

distress, and emotional dysregulation. Social modeling also occurs as children see their parent’s

relationship as a model for their future relationship dynamics. Data supports this as previously

mentioned, children are more likely to be abusive as adults if they witness DV in the home

(Dutton, 2000).

                                           Methodology

Study Design

       For the purposes of this exploratory and descriptive research study, this project utilized

both quantitative and qualitative research approaches to assess DV services in Santa Clara

County. Given that the project assessed of DV services at one point in time, it was a cross-

sectional survey research design. As the survey identified services that are currently

implemented in mental health agencies, the information gathered was representative of existing

services that may or may not have existed in the past or will exist in the future. The qualitative

elements of the study were analyzed using cursory content analysis, with the identification of

common themes that emerge from the open-ended survey questions.

Sampling Method and Size
                                                 Services Assessment: Children’s DV Services 14


       The procedure for selecting agencies was straightforward. Purposive sampling was used

to identify between 30 and 40 mental health agencies, ranging from agencies such as Next Door

Solutions to Domestic Violence to County Mental Health and Kaiser. As the research was

focused on DV services provided by mental health agencies, a purposeful identification of these

agencies was required for data collection. The goal was to obtain a response from every mental

health agency in Santa Clara County. An exhaustive sample was considered sampling the entire

population. By surveying the entire population, the resulting assessment had high external

validity, and provided a complete assessment of the services offered. Agencies assessed were

identified through several existing resource guides, such as United Way, and DFCS and the

Internet. A digital database was created to log each agency’s name and corresponding survey

code number, and is kept under password protection. Initially, each agency was sent an email

stating the purpose of the study--in order to prepare them for the impending call. It indicated the

need to speak with an agency representative that oversees or manages services, and to please

respond if there is a specific time to call. This email was not required, but a respectful way to

alert them about the upcoming phone contact. The interviewer phoned the agency within the

next two weeks to administer the questionnaire. In order to ensure the access of appropriate

information, it was necessary to speak with a representative such as director/manager of services

who has knowledge of the services the agency delivers. Given that most mental health agencies

have regular business hours, there was a large time frame with which to call. As the data

collected is public information, most representatives were not resistant to providing the answers

to the questionnaire. Although sampling the entire population of mental health agencies is

desired, the reality is that some do not respond or cannot be reached. A sample of at least 30

mental health agencies in Santa Clara County was appropriate to provide a thorough assessment.

Variables and Measures
                                                 Services Assessment: Children’s DV Services 15


Quantitative

      The survey utilized in this study is called “Services Assessment: Children’s DV Services.”

It was created by the Children’s Issue Committee of San Mateo County, and modified by the

author of this report. It is a 15-item (71 variables) questionnaire designed to obtain pertinent

information on DV services for children and families. There are both quantitative and qualitative

items, designed to identify the existence and describe the extent of services provided. The

central focus of the survey assessed whether agencies offer direct services to DV clients, if the

services are for children, the extent of the services, and other variables such as how the services

are paid for, who provides the services, if there are employee trainings about DV, and what the

agency’s procedures are concerning DV. Additionally, it was imperative to determine if the

respondent sees a need for DV services for children. The fist key variable was whether or not

the agency offers direct services for DV clients. It is a categorical and nominal variable

measured by researcher asking the Yes/No question, Does your agency offer direct services for

DV clients? If yes, the next key variable is whether or not the services are for children exposed

to DV, which is a categorical and nominal variable measured by the researcher asking the

Yes/No question, Are these direct services for children of DV? Additionally, if they offer these

services for teens of DV and for parenting and DV are measured by similar categorical questions.

Other key categorical measurement questions were: Do you screen cases for DV? Have you

used a DV consultant for child and parenting issues? Do you send staff out for training on

children & parenting in DV families? If you do not have training, would you utilize it if it were

available? Does your agency refer children and parents in DV situations to outside services? To

determine if the respondent sees a need for DV services the Yes/No question was asked, Do you

see a need for developing specialized services for children and parents of DV? There were in

total 21 categorical variables. There were 11 categorical and nominal variables (1=Yes, 0=No),
                                                 Services Assessment: Children’s DV Services 16


from which the scores will be summed. Higher scores represent more DV services, procedures,

and support the agency provides. The other categorical questions such as, How is the DV

screening conducted? 1. Questionnaire 2. Interview 3. Combination of both 4. Other, are

designed to described the extent to which the services exist and procedures were implemented.

Qualitative

      The purpose of the qualitative aspect of the study is to further describe the main themes of

services provided, and agency need. The qualitative elements to this research addressed in the

questionnaire serve to supplement and explore the answers to the quantitative items. As each

mental health agency may had specific ways to address issues or provide services based on their

organizational mission and values, the survey contains questions that induce descriptive answers

about their services, procedures, and view of DV service needs. These answers were obtained

through open-ended questions on the survey which follow Yes/No items and questions asked

were determined by whether the respondent answers Yes or No. For example: B. Are these

direct services for children of DV? If yes: What are these services? Describe:

      The majority of the qualitative items of interest for this research required the respondent to

describe services in each area of DV. This included having the respondent describe services for

children, teens, and parents. Additionally, other open-ended questions such as What keeps your

agency from developing these specialized services? served to provide an opportunity to gather

information about barriers to service delivery. Common themes were identified from the

qualitative descriptions that aid in deepening the understanding of the agency’s services.

Reliability and Validity

Quantitative

      Although the instrument utilized for this assessment was new and untested, the

straightforward inquisitions yield both high reliability and validity. The categorical questions
                                                  Services Assessment: Children’s DV Services 17


elicited objective, factual information that cannot be misinterpreted. For instance, the question

Does your agency offer DV services? contains high face validity as the answer can only be yes or

no. If an agency representative stated that they provide DV services, it was likely that the

statement is accurate and valid, and indeed they do provide DV services. In addition, the high

external validity created by sampling the entire population supports the accuracy and of

comprehensiveness of the information obtained. A specific threat to validity was the

respondent’s knowledge. If the respondent is unaware of all of the services provided, their

answers may not be accurate. To counter this, ensure the representative interviewed has the

appropriate knowledge. Furthermore, the interviewer needs to state the questions in a coherent,

objective manner and restrain from suggestive tones.

      The reliability of the instrument utilized also was felt to be sound. The questions that are

asked are objective and if asked again, should yield consistent valid answers. Therefore, test-

retest reliability was probably high. For the purposes of this study, the survey assessed current

services at one point in time, and does not account for transformations in service provisions.

Qualitative

      Although qualitative items tend to have less reliability and validity, the open-ended items

in the DV services questionnaire lend themselves to high validity and reliability coefficients.

Given that the open-ended questions ask the respondents to describe services, their descriptions

contained objective information about the extent of services, and details of services. There

would be no reason for the respondent to be dishonest about services the agencies provide. It

was plausible for there to be issues of reliability and bias in the open-ended questions, as it

required the respondents to describe in their own words. It was possible that these descriptions

could have varied slightly depending on a number of variables.

Subjects
                                                 Services Assessment: Children’s DV Services 18


      This research project did not employ individual subjects, but gathered public information

about DV services offered by mental health agencies in Santa Clara County. In total, data from

33 of the 34 agencies was available for this report (after data from one survey was lost). By

contacting agency representatives via telephone and asking them survey questions, an individual

person was the vehicle by which agency service descriptions are conveyed. However, the

agency representatives themselves were not studied as subjects or participants, and are merely

sources from which the data is gathered. There are no anticipated risks to mental health agencies

surveyed for this study given that the information they are providing is public. The mental

health agencies themselves are identified by coding the surveys 1-34 and have a corresponding

database key that shows which agency goes with each completed survey. With agency consent,

in the future, a resource list can be created that will identify agencies who provide DV services.

The first question in the survey asked if agencies would give implied consent to be surveyed and

identified as service providers. Due to the public nature of these agencies, information about the

services they provide is not confidential (see appendix ‘ for SJSU IRB and SJSU agency signed

consent).

       As public information about services provided by agencies was attained, there were no

direct subjects to be protected. The interviewer administered the questionnaire in a private,

confidential location, and locked the completed surveys in a file cabinet, placing the key in a

secure location. After entering the data into a password protected SPSS program, the surveys

were destroyed by shredding them. Given that the agencies are coded, the database that matches

the code with the agency will be in a locked/password protected computer folder that could only

be accessed by the researcher. The names of persons providing the information were not

identified, to ensure anonymity.
                                                 Services Assessment: Children’s DV Services 19


       Mental health agencies can benefit from this in that they are contributing to a study that

may eventually result in increased funding for programs in these agencies. Additionally, if a

program is identified that provides effective services for children exposed to DV, they could be

used as a model for other agencies. Furthermore, in the future, with agency consent, the names

of the agencies that provide DV services could be listed and provided for children and families

who need to access these services. This could attract more clients for these agencies.

Procedures

      An email is sent to the director/manager/coordinator of services to inform them of the

research and the interview request. Within two weeks of the email, in a private and confidential

space, agencies are phoned and surveyed. Interviewer asks to speak with the director, manager,

or coordinator of services; or someone who can provide information about services and service

needs. Protocol on the survey directed the interviewer to ask the representative to give consent

to the interview and to have their agencies included in a possible future resource guide.

Agencies are coded by having numbers on every survey that will correspond with the agency

names listed in a separate database. As stated, this database was kept confidential in a password-

protected folder. After completing the questionnaire, interviewer thanks the representative for

their time and asks them if they would like a summary of the report from this survey to please

provide their email address.

Analysis of Data

      Descriptive data from the questionnaires was analyzed using SPSS to generate sum scores

and frequencies for the categorical variables, and mean scores from the continuous variables.

For the qualitative items, cursory content analysis was utilized to identify themes that are

common and emerge from the descriptions. Findings from the qualitative items were also
                                                  Services Assessment: Children’s DV Services 20


reported in the results section, as the central themes are conveyed from the open-ended

questions.




                                               Results

Consent

      Part of the consent obtained from the agencies surveyed was collected for the purpose of

creating a resource guide for DV services. This guide may be formed in order to highlight

agency differences in service provision, and assist social workers and other mental health

professionals in the referral process. As was discovered through this research, DV services can

widely vary in terms of program components, services available, and how direct services are

provided. Descriptive statistics pointed out that 24 of the 33 agencies sampled were open to

providing consent for their agency’s information to appear in a resource guide. Most

representatives expressed contentment for the opportunity for increased exposure. The eight that

did not provide consent had a common theme of either not being an agency that serves DV

clients, or not an agency that is open for public referrals, and only accepts referrals from the

county. Therefore, their inclusion in the resource guide would not have been appropriate.

Direct Services

      Descriptive statistics found that of the 33 agencies in the sample population, 26 offer direct

service for DV clients in general (78%). Direct services, at the minimum is at least individual or

group counseling, or direct legal aid. Children are eligible to receive direct services in 21 of the

34 agencies in the sample. Adolescents are offered direct services in 22 of the 33 agencies. Data

indicates that direct service specifically for parenting and DV exists in 14 of the 33 agencies
                                                 Services Assessment: Children’s DV Services 21


(42%). The question “what are these services? Describe:,” allowed agency representatives to

elaborate on the specific direct services provided within each population. These qualitative items

elicited data that describes depth of services, and highlighted agency differences in service

provision. For the agencies that offer direct services to children, the services widely vary. All of

the 26 agencies that offer direct services for DV clients at least offer individual counseling. Nine

of the 26 agencies offering direct service solely provide individual and/or group counseling; 18

of these 26 agencies offer individual and group counseling, and additional services. These

additional services include but not limited to: shelter and transitional housing services for women

and children, legal aid and advocacy, support groups, activity groups, psychoeducational groups,

skill building, crisis intervention, and prevention education. Some variant of group counseling

services are offered by 14 of the 26 agencies. These range from basic support groups, to specific

skill-building groups such as one agency has called “Kids Power-Self Esteem Building.” This

type of group specifically targets symptom reduction associated with exposure to DV. Two

agencies offer anger management for children and teenagers, while four offer transitional

housing or shelter services for women and their children. For the parenting and DV component,

services provided in this area are groups that range from “Parenting Without Violence,” to

certified batterers programs, and general parenting workshops. Other parenting components

were described in the context of women’s groups, and family therapy. For teenagers, the service

descriptions varied from the children’s service descriptions. Many of the teen services are

groups for teen batterers, and youth in the juvenile justice system. For children, there are fewer

groups, and more individual and family counseling services. Five agencies surveyed offer legal

aid or advocacy services. Other services mentioned in the descriptions included referral services,

case management services, and activity groups.

Service Providers
                                                  Services Assessment: Children’s DV Services 22


      The data describing who provides the direct services varied widely from agency to agency.

Twenty six of the 33 agencies surveyed have at least one FTE licensed clinician. Three agencies

surveyed had as many as 20 employed clinicians. On average there are 8.1 FTE clinicians (sd =

7.33), 8.5 FTE interns (sd = 9.34), 1.4 DV advocates (sd = 5.47), and 3.9 other providers (sd =

6.15) such as social workers and case managers.



Table 1
Payment of Services (N = 32)
           Fees for    Sliding     Third      Victim   Private Medi-cal       Seed or Renewable Other
           service      Scale      Party      Witness Insurance                 pilot  Grants payment
                                  Funding                                      grants           sources
      NO          24         19          31        19         28         21         25        24      24
     YES           9         14           1        14          4         12          8         8       8

Other payment sources may include “no fees for service,” or county funded services.

Screening and Training

      In this study, 29 of the 33 (88 percent) agencies sampled reported providing screening for

DV situations; 18 reported that the screening was routine, and 11 reported that it was only

completed if DV was suspected in the situation. Of the 29 agencies that screen cases for DV, 23

use solely an interview to complete the screening, while five use a combination of interviews and

questionnaires. No agencies use solely a questionnaire for screening cases for DV. In addition,

none of the agencies use any other screening method.


Table 2
Training for DV (N = 32)
           Mandated 40 hr. DV      Depends Other DV     Agency     In house   Contract  Other     Send
              DV     advocacy      on intern training   require    training    with    training  staff to
            training training          or               training              outside conducted trainings
               for                supervisor                                  agency
           licenses                 interest
     NO            2         20          31        26         24         24         29        33      25
    YES           30         11           1         6          9          9          3                 8
unknown            1          2           1         1                                1
                                                 Services Assessment: Children’s DV Services 23


       Twenty nine of the 33 agencies surveyed responded that they would utilize training if it

were made available to them (88 percent). In regards to what would make them most likely to

complete trainings, 26 of the 29 agencies reported that having trainings on-site would make them

more likely to participate in trainings; 23 reported that having trainings that are low-cost would

make them more likely to engage in them. Eight reported that having trainings short in

duration—less than four hours would be favorable.

Protocol

       All 33 agencies sampled reported that they have a distinct protocol to follow when DV is

identified. The various protocols utilized are presented in Table 3.

Table 3
Protocol When DV was Identified (N = 32)
              Protocol Therapist  Safety     Use of Confident- Refer to Use of     Other    Refer
             for when assignment planning   conjoint  iality    other consultants protocol    to
               DV is                        sessions           services                    outside
             identified                                                                    services
        NO                   18        10         31         20          4         33        30       4
       YES         33        15        23          2         13         29                    3      29

Consulting/Referrals

       Fourteen of the 33 agencies sampled have used a consultant for assistance with DV

situations (42 percent). Two agencies uses DV consultants on a regular basis, while 12 of the 14

only use consultants on an as needed basis. It was found that 29 of the 33 agencies reported that

they refer out to other agencies in DV situations when appropriate (88 percent).

Need

       Twenty nine of the 33 agency representatives responded that they see a need for

developing specialized services for children and parents of DV situations (88 percent). Three

agencies reported they could not answer, and were coded unknown. One agency representative

reported that they do not see a need for the development of more specialized DV services. In the

open-ended portion of this question, the agency representatives were asked “what keeps your
                                                  Services Assessment: Children’s DV Services 24


agency from developing these specialized services?” There was minimal variation in the

answers to this question. The common thread that ran throughout all 29 agencies was that

funding constraints were the key reason why agencies are prevented from developing these

services. Three agencies identified that legal aid for DV situations is necessary, but very costly.

One reported that they used to offer legal aid, but funding streams ended, which ended the

service. One reported that they used to have a kids skill-building program that was heavily

attended, but the early prevention money was cut, which affected the groups availability. Other

answers to this question were more political in nature. Three agency representatives expressed

that DV is a morally charged topic that “flies under the radar” and “professionals do not want to

touch the DV issue.” One representative explained that many women are reluctant to seek help

and although the need for DV services is apparent, many women do not seek it out, and therefore

do not create a demand.

            The question, “what would it take for your agency to develop these services?” was

responded to in a similar manner. All 29 responded that they would need increased funding.

Five reported that the issue of DV is under-exposed, and more exposure and understanding is

needed on the effects of DV on children. One agency representative reported that it is an “act of

will” –“ if more social workers took on this issue, it would create the availability of service

provisions. Finally, as shown in Table 4, although Spanish speaking therapists or translation

services were predominantly available in 30 of the 33 agencies (ninety percent), other languages

were sparsely available.


Table 4
Translation Services (N = 32)
           Translation Vietnamese Mandarin   Spanish    Tagalog    English      Other
            services                                                          languages
      NO           1         18         22          3         25                     13
     YES          32         15         11         30          8         33          20
                                                 Services Assessment: Children’s DV Services 25


                                            Discussion

      The results show dramatic differences between the agencies that are identified as domestic

violence agencies, and the remainder of the sample. The others are agencies either identified as

general mental health agencies, or specifically serve other domains, such as agencies specializing

in severe mental illnesses for adults. The six agencies that specifically label themselves as DV

agencies offer a wider range of services for DV situations. Instead of solely providing individual

and group counseling, as the majority of the agencies sampled do, the DV specific agencies are

multi-dimensional. The literature shows that DV exposure can correlate with decreased self-

esteem, depression, and anger problems. This research project indicates that the DV specific

agencies contain services that directly address self-esteem, and anger control. For example, at

one DV agency, there are counseling services, groups, psychoeducational groups, self-esteem

building workshops, parenting without violence classes, legal services, and shelter services. This

agency offers a comprehensive program designed to address and alleviate many of the issues that

arise due to DV situations.

            It is not plausible for every agency to develop such a rich quality of services, but

many that solely provide counseling could take the next step and address more specific issues

such as interpersonal trust, or anxiety reduction associated with PTSD. It is misleading to

assume that an agency can address the effects of DV on children with just counseling.

Counseling is considered direct service to DV clients, even if DV is only discussed once in the

context of someone’s therapy. The statistics show that 88 percent of agencies offer direct service

to DV clients, but the level and quality of the service can be very minimal. For this reason, it is

imperative that the descriptions of services were addressed. From this question, the data

illustrates that less than one fifth of mental health agencies offer services beyond counseling.
                                                 Services Assessment: Children’s DV Services 26


This demonstrates that very few agencies are set up to meet the needs of DV exposed children

and families.

      Of all the items on the questionnaire, the items inquiring about numbers of FTE clinicians,

interns, advocates, and other are the least valid. Upon speaking with agency representatives, it

was apparent that many did not know how many employees there were in each category, and

were providing approximations for these numbers. This may explain why the standard

deviations are so high. The agencies that have the most FTE clinicians were county agencies,

with the not-for-profit agencies typically having fewer employees.

      Although most agencies (29 of 33) screen cases for DV, only about half have routine

screening methods, and less than one half only screen when they suspect DV. Unless the proper

questions are asked, or the client describes DV, there would be no reason to suspect DV. This

indicates that only about half of the agencies specifically are concerned with filtering out the DV,

and providing the appropriate referrals or treatment. In regards to the manner by which cases are

screened, only 5 of the 33 agencies use a combination of both questionnaire and interview. Most

agencies solely rely on interviews to screen for DV. Unless the screener specifically asks about

DV, it may not arise. A questionnaire which is standardized will make direct inquires into DV

situations. This will be a much more valid and consistent measure for screening DV. It is

apparent from this research that many DV situations may not be identified through screening

with just an interview.

      The results indicated that the training service providers receive in DV is extremely limited.

Only licensed clinicians are required to take mandatory DV trainings, and it is not necessarily

training on DV and children; one third of the 32 agencies participate in the 40-hour DV advocacy

training. Besides that, only one fifth of the agencies require their employees to complete DV

trainings, and only one fourth send staff out to trainings. These limited training opportunities
                                                 Services Assessment: Children’s DV Services 27


impact the quality and competency of treatment services. Only two of the six DV specific

agencies have monthly DV trainings. Due to this shortage in training, qualified DV treatment

providers are sparse, which lowers the overall effectiveness of the services provided. Trainings

are a fundamental aspect of providing appropriate services, and it is apparent that service

providers in Santa Clara County do not have an adequate level of training in this area.

      The overwhelming majority of agencies surveyed refer clients out to access DV services.

The most commonly cited referral sources were Next Door Solutions to Domestic Violence,

Support Network for Battered Women, and Community Solutions to Domestic Violence. Given

that so many agencies refer out, it is assumed that they do not have the appropriate or adequate

services to address the need. By referring, clients have to go to another agency, which may be

outside of their community. For a population of clients that already is reluctant to utilize

services, this is another barrier for which they have to overcome. If more agencies offered

substantial DV services, this may not be as much of an issue. Services would be more efficient,

and comfortable.

      The questions, “Do you see a need for specialized services for children and parents of

DV?” and “What keeps your agency from developing these services?” elicited some fascinating

information. Interestingly, 88 percent of the sample responded that there is a need for expanded

DV services. When they were asked the second question, all of them replied, “increased funding

is needed.” Although this answer was expected, others that also arose provided a different

glimpse into the issue. One representative was insistent that not enough social workers and

mental health professionals were interested in DV, and showed a desire to work in the area of

DV. They reported that the legal aspects of DV, involving the courts, lawyers, and custody

caused “social workers to not want to touch DV issues, it is too emotionally charged.” Other

representatives maintained that increased exposure of the problem to society was needed. It is
                                                Services Assessment: Children’s DV Services 28


apparent that due to the reluctance of victims to seek help, and the high co-occurrence of DV and

child abuse, the impact of DV on children is not as understood as needed.
                                                Services Assessment: Children’s DV Services 29




                                           References

Allen, N. E., Bybee, D. I., Sullivan, C. M., & Wolf, A. M. (2003). Diversity of Children’s

       Immediate Coping Responses to Witnessing Domestic Violence. In R. A. Geffner, R. S.

       Igelman, & J. Zellner (Eds.), The Effects of Intimate Partner Violence on Children, (pp.

       123-148). New York: The Haworth Press, Inc.

Armenta, M. F., Rodriguez, I., & Romero, J. C. G. (2003). Behavioral and Social Effects of

       Family Violence in Mexican Children. Psychology Review, 21 (1), 41-69.

Bancroft, L., & Silverman, J. G. (2002). The Batterer as a Parent. Thousand Oaks, CA: Sage

       Publications, Inc.

Behrman, R. E., Salcido-Carter, L., & Weithorn, L.A. (1999). Domestic Violence and Children:

       Analysis and Recommendations. Future of Children, 9 (3), 87-93.

Carlson, J. G., Chemtob, C. M. (2004). Psychological Effects of Domestic Violence on

       Children and Their Mothers. Journal of Stress Management, 11 (3), 204-226.

Catallo, R., Moore, T. E., Pepler. D. C. (2000). Consider the Children: Research Informing

       Interventions for Children Exposed to Domestic Violence. In R. A. Geffner, P. Jaffe, &

       M. Sudermann (Eds.), Children Exposed to Domestic Violence (pp. 37-57). New York:

       The Haworth Press, Inc.

Carter, L., George, J. A., Kay, S. J., & King, P. (2003). Treating Children Exposed to Domestic

       Violence. In R. A. Geffner, R. S. Igelman, & J. Zellner (Eds.), The Effects of Intimate

       Partner Violence on Children, (pp. 183-202). New York: The Haworth Press, Inc.

Dutton, D. (2000). Witnessing Parental Violence as a Traumatic Experience Shaping the

       Abusive Personality. In R. A. Geffner, P. Jaffe, & M. Sudermann (Eds.), Children

       Exposed to Domestic Violence (pp. 59-68). New York: The Haworth Press, Inc.
                                                Services Assessment: Children’s DV Services 30




El-Sheikh, M., & Whitson, S. M. (2003). Domestic Violence and Children’s Adjustment: A

       Review of Research. In R. A. Geffner, R. S. Igelman, & J. Zellner (Eds.), The Effects of

       Intimate Partner Violence on Children, (pp. 11-46). New York: The Haworth Press, Inc.

Fantuzzo, J. W., & Mohr, W. K. (1999). Prevalence and Effects of Child Exposure to Domestic

       Violence. Future of Children, 9 (3), 20-26.

Fantuzzo, J. W., Mohr, W. K., & Noone, M. J. (2000). Making the Invisible Victims of Violence

       Against Women Visible Through University/Community Partnerships. In R. A. Geffner,

       P. Jaffe, & M. Sudermann (Eds.), Children Exposed to Domestic Violence (pp. 9-25).

       New York: The Haworth Press, Inc.

Geffner, R. A., Igelman, R. S., & Zellner, J. (2003). Children Exposed to Interparental Violence:

       A Need for Additional Research and Validated Treatment Programs. In R. A. Geffner, R.

       S. Igelman, & J. Zellner (Eds.), The Effects of Intimate Partner Violence on Children,

       (pp. 1-9). New York: The Haworth Press, Inc.

Geffner, R., Jaffe, P. G., & Sudermann, M. (2000). Emerging Issues for Children Exposed to

       Domestic Violence. In R. A. Geffner, P. Jaffe, & M. Sudermann (Eds.), Children

       Exposed to Domestic Violence (pp. 1-7). New York: The Haworth Press, Inc.

Groves, B. M. (1999). Mental Health Services for Children Who Witness Domestic Violence.

       Future of Children, 9 (3), 143-151.

Gruber, G., Kalil, A., Rosen, D., & Tolman, R. (2003). Domestic Violence and Children’s

       Behavior in Low-Income Families. In R. A. Geffner, R. S. Igelman, & J. Zellner (Eds.),

       The Effects of Intimate Partner Violence on Children, (pp. 75-102). New York: The

       Haworth Press, Inc.
                                               Services Assessment: Children’s DV Services 31




Ho, J., & Rossman, B. B. R. (2000). Posttraumatic Response and Children Exposed to Parental

       Violence. In R. A. Geffner, P. Jaffe, & M. Sudermann (Eds.), Children Exposed to

       Domestic Violence (pp. 85-106). New York: The Haworth Press, Inc.

Johnston, J. R. (2003). Group Interventions for Children At-Risk from Family Abuse and

       Exposure to Violence: A Report of a Study. Journal of Emotional Abuse, 3 (3/4), 203-

       226.

Payne, M. (1997). Systems and ecological model. In Modern social work theory.

       A critical introduction (2nd ed. pp. 137-156). Chicago: Lyceum Books.

Saathoff, A. J., & Stoffel, A. (1999). Domestic Violence and Children. Future of Children, 9

       (3), 4-14.

Sweeney, J. (2005). Retrieved on February 14, 2006 from

       http://www.thegreenbook.info/santa_clara.htm.
                                                   Services Assessment: Children’s DV Services 32




                                           Appendix A

1.

Services Assessment: Children’s DV Services
                               COMPLETE DATA ENTERED
The Children’s Issues Committee of the Santa Clara County Domestic Violence Council is
undertaking a brief survey to find out what services are available in the county for children from
families where there has been domestic violence. The committee plans to compile a report on
what is available and what are the gaps in services as this is the first step in improving the
community’s response to the problem. Could I please speak with the
director/manager/coordinator of service programs in your agency to ask a few questions? It
would take about 10 minutes of his or her time.

WILL YOU PROVIDE CONSENT FOR YOUR AGENCY TO BE LISTED IN A RESOURCE
GUIDE FOR DOMESTIC VIOLENCE SERVICES?
YES__25___     NO___8_____


A. Does your agency offer direct services for DV clients?           _____DIRECTDV

            1. Yes (if yes, continue with question B)        26
            0. No (if no, GO TO G).                          7

B. Are these direct services for children of DV?                    _____DIRECTCH
           1. Yes                                            21
           0. No                                             12

     If yes: What are these services?
     Describe:




C. Are these direct services for teens of DV?                       _____DIRECTT
          1. Yes                                             22
          0. No                                              11

     If yes: What are these services?
     Describe:
                                           Services Assessment: Children’s DV Services 33



D. Are these for parenting and DV?                          _____DIRECTPAR
           1. Yes                                     14
           0. No                                      19
   If yes: What are these services?
   Describe:




E. Who provides your direct service to children & parents of
(check all that apply) FTE = full time equivalent positions.
    1. licensed clinicians    How many FTE? __170__ ______CLINPROV

   2. interns                How many FTE? __179__    ______INTPROV

   3. DV advocates            How many FTE? _30___    ______DVPROV

   4. Other (describe)        How many FTE? _82___    ______OTHPROV

       Unknown (3 agencies)




F. How are these DV services for children and parents paid for?
   (check all that apply)
    1. Fees for service                                   ___ 9__FEES
    2. Sliding scale                                      ___14__SS
    3. Third party funding                                ___1__3rdP
    4. Victim witness                                     ___14__VW
    5. Private insurance                                  ___5__PI
    6. Medi-Cal                                           ___12__MC
    7. Seed or pilot grants                               ___8__SP
    8. Renewable grants (ex. MCH, OES)                    ___8__GRANTS
    9. Other (describe)                                   ___8__OTHER$




G. Do you screen cases for DV?                        _____SCREENDV
   1. Yes                                             29
   0. No                                              4
   If yes, is the screening
1. Routine                                     __18___ROUTINE
            2. Only when suspected                   ___11__SUSPECT
                                                Services Assessment: Children’s DV Services 34


   How is the screening conducted?
     1. Questionnaire                               ___0__QUESTION
              2. Interview                                ___24__INTER
              3. Combination of both                      ___5__COMB
              4. Other                                    ___0__OTHSCR


H. What is the training of your staff in DV? (Check all that apply)
      1. Mandated DV training for clinical licenses         ___30__MANDDV
      2. 40 hour general DV advocacy training               ___11__DVADVOC
      3. Depends on:
                          a. Supervisor interest            ___1__SUPINT
                          b. Intern interest                ___0__INTINT
     4. Other (describe)                                    ___5__OTH


I. Does your agency require training regarding children and DV? _____AGREQUIR
       1. Yes                                              9
       0. No                                              24
   If yes, How many hours in each of the following?
              Children and DV ____                        _____HRSCHILD
              Parenting and DV____                        _____HRSPAR
   If yes, how is the training conducted?                 _____TRAINCOND
              1. In-house                                 __9___1
              2. Contract with outside agency             __3___2
              3. Other (describe)                         __0___3


J. Have you used a DV consultant for child and parenting issues?_____DVCONSULT
        1. Yes                                             14
        0. No                                              18
   If yes, is this on a
        1. Regular basis                                   ___1__REGCONSULT
        2. As needed basis                                 ___13_ASNEED



K. Do you send staff out for training on children & parenting in DV families?
                                                             _____STAFFOUT
       1. Yes                                                8
       0. No                                                 25
       If yes: Do you monitor content of the training?       _____MONITOR
               1. Yes                                        __7___1
               2. No                                         __1___2
               If yes: What is the content of the DV training on children & parenting?
               (Check all that apply):
               1. Effects on children                        ___5__CHEFFECT
               2. Effects on parenting                       ___1__PAREFFEC
                                                 Services Assessment: Children’s DV Services 35


               3.   Assessment of individual children       ___3__AIC
               4.   Assessment of parenting                 ___2__AP
               5.   Community resources and services for children of DV___1__COMRES
               6.   Treatment of children                   ___4__TREATCH
               7.   Parenting education about DV and children__1___PARED
               8.   Other (describe)                        ___0__OTHTR


L. Once DV is identified, does your agency have in place any policies and protocols?
                                                          _______PROTO
      1. Yes                                              33
      0. No                                               0
   (Check all that apply):
      1. Therapist assignment                             ___15__PROTTHER
      2. Safety planning                                  ___23__PROTSAFE
      3. Use of conjoint sessions                         ___3___PROTCS
      4. Confidentiality                                  ___13__PROTCONF
      5. Refer to other services                          ___29__PROTREF
      6. Use of consultants                               ___0___PROTCONS
      7. Other (specify)                                  ___3___PROTOTH


M. Does your agency refer children and parents in DV situations to outside services?
                                                   _____REFER
     1. Yes      29        Where?
      0. No       4       Why not?


N. Do you see a need for developing specialized services for children and parents of DV?
                                                   _____NEED
     1. Yes                                                29
     0. No                                                 1

       If yes: What keeps your agency from developing these specialized services




              What would it take for your agency to develop these specialized services?




O. If you do not have training, would you utilize training if it were available?
                                                              ______TRAIN
       1. Yes                                                        29
       0. No                                                           3
                                                Services Assessment: Children’s DV Services 36


       If yes: What would make it more likely that you would require staff to complete training?
       (Check all that apply)
       1. On-site                                         ___26___ONSITE
       2. Low cost                                        ___23___LOWCOST
       3. Length less than 4 hours                        ___8____LESS4
       4. Length less than 8 hours                        ___0____LESS8
       5. Other                                           ___0__OTHER

P. Does your agency provide translation services for some or all of the other four standard Santa
Clara languages?
                                                          ______TRANSL8
        1. Yes                                                     32
        0. No                                                      1
        If yes: Check all that apply
        1. Vietnamese                                     ___15___VIET
        2. Mandarin                                       ___11___MAND
        3. Spanish                                        ___30___SPANISH
        4. Tagalog                                        ___8____TAGALOG
        5. English                                        ___33___ENGLISH
        6. Other Lang.                                    ___20___OTHERLANG

COMMENTS: (Is there anything I did not ask you about that you think I should know?)




THANK YOU FOR YOUR TIME.
IF YOU WOULD LIKE A SUMMARY OF THE REPORT FROM THIS SURVEY, PLEASE
PROVIDE YOUR EMAIL ADDRESS.
                                               Services Assessment: Children’s DV Services 37



                                         APPENDIX B
Date

Mario Victor
San Jose State University, MSW program
(619) 807-3274
marvicsc@hotmail.com


To whom it may concern,

My name is Mario Victor, I am a SJSU Masters of Social Work student who is currently
researching Domestic Violence (DV) services. I am emailing your agency to let you know that I
will be calling in the next week to ask a few questions about the services that your agency
provides. This email serves to notify you of my impending call. If you have any questions or
would like clarification, please do not hesitate to call me or send an email with any questions.



Sincerely,



Mario W. Victor
                                                  Services Assessment: Children’s DV Services 38




                                           APPENDIX C

                                   Implications for Social Work

      The findings contain significance and relevance for the field of social work in key domains

of the profession. This study has reviewed the literature describing the negative effects of DV on

children and families. DV presents as a significant risk factor that correlates with various mental

and behavioral problems, and the continued cycle of violence. If social workers and other

mental health professionals are educated about the effects of DV on children, they may direct

energy toward attending to the needs of children. An increased knowledge base leads to the

identification of DV exposed children as requiring increased intervention efforts. When

undergoing counseling or therapy in a clinical setting, social workers need to assess history of

family violence and understand it can be a major contributor to the child’s current problem.

With this understanding, a clinician may tailor therapy or treatment planning for the special

needs of DV exposed kids. For example, they may focus on anger management, healthy

communication skills, anxiety reduction, or other personal issues impacted by DV. This

knowledge can also help the provider make informed referrals to groups, psycho-educational

classes, and DV resources in the community. Understanding the impression DV can make on

children is the first step in providing competent and appropriate services, and it is imperative that

service providers recognize this impression, and not overlook the problems it can cause.

      As this issue becomes increasingly exposed, it is possible that more social workers and

mental health professionals will demonstrate a desire and willingness to work in DV treatment

domains. As stated in the results, 29 of the 32 agencies sampled refer DV clients to outside

services. If advocacy efforts can improve funding for DV programs, and service providers show

increased interest, many of these mental health programs would be able to treat the DV cases
                                                  Services Assessment: Children’s DV Services 39


without having to refer out. This streamlines service delivery, and improves access. For

instance, in south Santa Clara County, there is one program that has adequate DV treatment

services and also treats children. If other mental health agencies in the area can create or

improve existing DV services, clients in the community can better access services.

      This project provided insight into DV services available, and the depth of those services.

It is apparent that although most of the agencies in the sample provide direct service to DV

clients, the services are typically very minimal. Only five in the sample provide holistic services,

and have programs that exceed just counseling. With this data, advocates can have evidence to

support the issue. Funding sources can be educated about the unfulfilled service needs of

children. Programs can be designed that replicate currently effective and established treatments

such as those utilized by the “model” agencies outlined in the discussion. Although it is not

plausible or necessary for every mental health agency to provide comprehensive DV services for

children, this assessment illustrates that current services are not meeting the needs of children.

       Identification of barriers to service helps social workers target advocacy and promotion

efforts. Through this research, gaps in services were addressed. As explained, it was found that

very few agencies offer children’s programs with healthy communication/anger management

components. Most agencies offer direct service only in the form of individual counseling and

some group counseling. The gap would be in the depth of services provided and the treatment of

specific issues associated with exposure to DV, such as treatment for interpersonal trust. This

research also presented the findings showing that although most clinicians and service providers

have completed the mandatory DV trainings, very few complete or are required to complete any

additional training in the specific needs of children exposed to DV. This significant gap in

training prevents services from achieving the level of competence that is possible. It shows that
                                                  Services Assessment: Children’s DV Services 40


social workers are not trained to meet the needs of children, and this lack of training serves as a

major barrier for the provision of appropriate services.

      As previously discussed, barriers to services were identified through open-ended questions

such as “What would it take for your agency to develop these specialized services?” The most

common barrier, a theme woven into most answers from agencies, was funding—or lack thereof.

The identification of funding as a major barrier can help social workers target this specifically.

Advocacy efforts can be tailored to the early prevention needs of children, and social workers

and other mental health professionals can lobby for increasing funds to support more

comprehensive programming. They will have the ability to illustrate a need, the gaps in service,

and the appropriate programs that could address these service needs and gaps. They would also

be able to advocate for increased training opportunities, showing the data that illustrates a lack of

comprehensive training providers receive.

      Although this study carries significant relevance for the field of social work, it is not

limited to social and mental health services. Violence is a problem in many capacities. Early

prevention efforts with kids exposed to DV could help alleviate violence and aggression in

general, and create a more peaceful environment not only in the home, but in the community.
                                         Services Assessment: Children’s DV Services 41


                                    APPENDIX D

                          LIST OF AGENCIES SURVEYED

1) Santa Clara County DFCS
2) MAITRI
3) Alum rock counseling
4) Support network for women
5) Bascom Mental Health
6) Community Solutions, System of Care
7) Downtown mental health center
8) East Valley Mental health center
9) Children’s health council
10) Chamberlain’s Mental Health
11) Adult and Child Guidance (ACG)
12) County Mental Health Clinic (County MH)
13) Children’s Shelter MH clinic
14) Fair Oaks MH clinic
15) Family and Children’s Services
16) Gardner Family Care Corp.
17) Mekong Community Center
18) Rebekah’s Children’s Services
19) EMQ
20) S.A.V.E
21) AACI
22) Kaiser Permanente MH services
23) Domestic Violence Counseling and Intervention Services
24) Community Health Awareness Council
25) East Valley Mental Health Center
26) Las Plumas Mental Health Center
27) North County Mental Health
28) Adolescent Family Life Program-San Martin Public Health
29) DADS-Children, Family,and Community Services
30) Next Door Solutions to Domestic Violence
31) The Bill Wilson Center
32) Ujirani Family Resource Center
33) Nuestra Casa
34) Center for Healthy Development

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:3
posted:1/7/2012
language:
pages:41