Indian Journal of Health Social Work
Lived Experiences Of Children Exposed To Family Violence: An In-depth Analysis
Chinnadurai Periyasamy1 & Sinu Ezhumalai2
1Doctoral Scholar, 2Associate Professor, 1,2Department of Psychiatric Social Work, NIMHANS, Bangalore.
Correspondence: Dr E.Sinu, e-mail id : firstname.lastname@example.org
Background: Family violence is a significant public health problem worldwide. Exposure to family violence affects children’s mental health. Aim: To examine the perception of the needs and impact of family violence on children of alcohol dependents. Materials and Methods: Qualitative method was used. Based on the inclusion criteria, 20 participants were recruited by consecutive sampling techniques. The researcher used a semi-structured interview schedule for data collection. Data were analysed using in-depth analysis. Thematic approaches were used for coding and emerging the themes, and the researcher used the Atlas, Ti software. Results and Conclusion: Three main themes were generated from an in-depth interview 1) Impact of family violence on children 2) Needs of the children 3) Protective factors. Psychiatric social workers have a vital role in identifying and addressing family violence, screening mental health issues, providing psychosocial intervention for children exposed to family violence, training the parents for the safety of their children.
Exposure to family violence is distressing to children and is associated with many mental health problems in childhood and later life. Exposure of a child or adolescent to any incident of violent or threatening behaviour or abuse between adults who are, or have been, intimate partners or family members is defined as a form of child maltreatment (Gilbert et al., 2009). It is associated with an increased risk of psychological, social, emotional and behavioural problems. Family violence includes physical aggression, such as hitting, kicking and beating, and emotional abuse, through behaviours such as humiliation, intimidation, and controlling actions (e.g., isolation from family and friends).
There are significant short-term and long-term physical and mental health consequences for those exposed to family violence (Devries et al., 2011). Alcohol consumption is consistently linked with family violence perpetration and victimisation (Devries et al., 2014). Children exposed to intimate partner violence (IPV) are at risk of developing symptoms or sub-clinical problems.
Exposure to family violence often has severe emotional, economic, physical, and social consequences on children of alcohol dependents. Children’s exposure to family violence is strongly associated with a broad range of emotional and behavioural problems, including internalising and externalising symptoms, as well as increased risk- taking behaviour and academic difficulties (Tavish et al., 2016). Children exposed to family violence show a heightened prevalence of disorganised attachment and later controlling attachment patterns (Levendosky et al., 2013).
Silverman et al. ( 2008) reviewed the psychosocial treatments for children and adolescents exposed to trauma. Commonalities in goals across interventions for IPV-exposed children are learning about and dealing with family violence. Few studies that have randomised children to trauma-focused treatment with or without exposure conclude that direct exposure may not be decisive for sustainable improvements (Salloum et al., 2012). Parents need to be included in treatments for young children (3–6 years), exposed to family violence in which parents were perpetrators themselves, or unhelpful trauma beliefs (Dorsey et al., 2017). Psychoeducational interventions are more effective for children to cope with the trauma of family violence exposure. Community-based interventions for children exposed to IPV include individual interventions, group interventions, combined interventions for children and their parents, and psycho-education (Graham- Bermann et al., 2015).
There is a paucity of literature in India on the needs of children exposed to family violence. Hence, the present study was conducted to examine the impact and needs of children of alcohol dependents exposed to family violence.
MATERIALS & METHODS
The study used a qualitative research design, mothers of children exposed to family violence were selected using a convenient sampling method from the centre for addiction medicine, a government-run de-addiction centre in tertiary care teaching hospital based on the criteria that there was a history of family violence in the last 12 months.
Twenty participants were interviewed till data saturation. The sample size was considered sufficient as no new themes were emerged. A semi-structured interview guide was used for the in-depth interview. The researcher prepared the interview questions. The interview guide had open-ended questions related to mothers’ perspectives of the impact of family violence on children and the means they used to handle the same. In-depth interviews were conducted. The interviews were conducted in different regional languages in Tamil and Kannada. Informed consent was obtained for collecting data and audio recording of the in-depth interview. Each individual face-to-face interview lasted for 30 -40 minutes. The field notes were made simultaneously. After each interview, the transcriptions and field notes were translated into English. The researcher’s observations about the interview – experiences, impressions, challenges, and comments about the data, were recorded as memos.
Data analysis: A thematic approach was used to analyse the transcribed interviews. Data analysis was done based on deductive and inductive methods. The researcher initially coded the interviews independently, and the codes generated were compared to integrate similar codes and subthemes. The codes with similar patterns were merged to form the categories/ sub-themes. The interviewer compared codes and subthemes and organised them under three major themes.
Ten participants have two children, and four have three children. Three main themes and eight sub- themes emerged from the thematic analysis based on the in-depth interview with mothers of children exposed to (witness) intimate partner violence.
Themes 1: Impact on children exposed to family violence
Participants reported that when the children are exposed to family violence, they have appetite problems, injuries, and swelling. The psychological impact of family violence are unable to concentrate on studies, sleep disturbances, fear, and not being interested in eating food. The impact of family violence on children’s education was that they could not go to school regularly, school absenteeism due to non-payment of school fees, changing the schools, and poor concentration on their studies.
Sub-themes 1.1: Physical impact
The participants reported that their children witnessed family violence. When their father comes intoxicated, he used to beat and verbally abuse them for seeing everything (witnessing violence). He will not eat the food. They used to report tiredness. Few participants said that children have scratches, body pain, and swelling due to violence.
“When he comes under intoxication, sometimes he used to talk to himself, and physically abuses my children and threatens me with a knife”. (Participants 3).
Sub-themes 1.2: Psychological impact
Participants reported that their children are getting psychological problems due to exposure to violence; children fight each other and do not listen to us. Children are fearful at night whenever their father comes under intoxication; they get bad dreams and know when their father creates problems at home. Children cannot concentrate on their studies, do not get sleep, and are not interested in eating food. Children have
“Most of the time, I will be anxious, and my children are frightened regarding what would happen today, how their father would react. My son, studying in the seventh standard, is afraid of his father. He used to tell me how his father would physically or verbally abuse him. today is also going to happen, something like last time what happened. (Participants 3, 35 years).
Sub-themes: 1.3: Impact on children’s academic performance
Victims reported that their children could not concentrate on education. Few participants said they could not pay the school fees, so shifting from one school to another will affect their studies.
“If we have a big house, we both can quarrel in a separate room, but we have a small house, we used to fight in front of my children. Children are studying, and they are young. It is too difficult to manage the young children at home. They cannot concentrate on their studies I have changed their schools due to financial difficulties” (Participants 13).
“I sleep late at night, and can’t work properly at the office, next day. I get tiredness and not concentrate too much am not sure my children are in school.” ( Participants 20)
Theme 2.0: Children’s Need:
Most participants have concerns about their children’s safety and education.
Sub-themes: 2. 1. Children’s safety: Most participants have mentioned that their children’s safety is a primary concern. When their father comes under intoxication, he beats and hits them. Participants reported that they would not allow the children to be exposed to family violence because their mental health would get affected. “When my husband comes under intoxication, he uses to beat me he is unaware of what he is doing. Sometimes my son also gets injured, and he gets angry that time. I would close the door, then my husband and myself used to fight”( Participant 8).
Sub-themes 2.2: Children’s education:
The respondents reported that their need was to give proper education to the children. “Once he starts drinking alcohol, I can’t pay for my daughter’s school fees. As a result, I changed my daughter’s school from a private to a government school. Sometimes she cannot concentrate on her studies due to her father’s behaviour, but I am unhappy to shift my daughter from one school to another. I want to give good education for my children” (Participants 8)
Themes: 3.0: Protective factors
Participants revealed the protective factors that help them cope and handle the situation. They said that spending quality time, teaching them safety plans, and strong bonding were the protective factors that helped them manage the situation.
Sub-themes 3.1: Spending time with children
Participants reported that they could communicate their feelings when spending quality time with their children.
“I used to spend time with my son and daughter because they would tell stories, and we used to go to the temple that time they used to share with me about their difficulties in studies and other problems with me” (Participants 13).
Sub-themes: 3.2: Teaching them safety plans
Participants reported that whenever the mother is unavailable at home, he would create problems when the father is intoxicated. At that time, children should know how to handle him, protect them from violence, and ask for help from others.
“Once, when I went to the market, I left my daughter, and my son stayed at home. At that time, my husband came intoxicated. He could not walk properly; he was verbally abusing the children, and he tried to jump from the building. During that time, they do know what to do” (Participants 11)
Subthemes: 3.3: Strong parent-bonding
Participants report that if the parents do not take adequate care of their children, their bonding will not happen. It will affect the relationship with the children.
“Whenever my husband does not speak and spend time with my children, they will feel they are unfortunate, and he will not talk to us”. Especially my daughter, when her father comes under intoxication, she would not have dinner” (Participants 19).
The present study aimed to examine the impact and needs of children exposed to family violence from their mothers’ perspectives. Results revealed that children exposed to family violence had physical and psychological problems such as not feeling hungry, sleep disturbances, fear, anxiety. This finding is similar to previous study findings (Soczynska et al., 2012; Winsper et al., 2012). The present study revealed that children had difficulty concentrating on studies and financial hardship to pay the school fees.
This finding was similar to previous study findings, which reports that the children with parental alcohol use show poor performance in reading, spelling, and math during early childhood compared to their peers (Chassin et al., 1997). The present study revealed that spending quality time with children and parenting emerged as key mediating and moderating factors (Fong et al., 2019).
Social work interventions should be tailored to the psychosocial needs of children exposed to family violence. It is vital to detect the child exposed to violence when persons with alcohol use disorder seek treatment (Rodríguez et al., 2015). Screening is an essential prerequisite to determine the intervention required in children of alcohol dependents exposed to violence. However, an array of different intervention models are available (Howarth et al., 2016).
Group-based interventions for children exposed to family violence are more effective for improving mental health than other types of intervention. Group and community-based
interventions are designed to promote children’s emotional regulation (Fariña et al., 2009). Trials of a home visit (as has been used for child maltreatment) focus on women experiencing family violence. Safe shelter might be an option for secure protection, particularly in resource- poor settings. Research should be carried out to establish the minimum content and duration of training on intimate partner and sexual violence for healthcare providers.
A wide range of psychosocial interventions may help mothers and children exposed to family violence. The study highlights the psychological impact of children exposed to family violence. It is crucial to reduce the impact of adverse childhood consequences while working with children of persons with AUD. It is of paramount importance to promote safe, stable, nurturing relationships and environments where children live, learn, and play.
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Conflict of interest: None
Role of funding source: None