working with children affected by domestic violence: good practice and the new evidence base....
TRANSCRIPT
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Working with children affected by domestic violence: good practice and the new evidence
base.Webinar July 2013
Karen WilcoxAustralian Domestic & Family Violence
Clearinghouse
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This morning’s workshop
• The ‘new’ evidence base and a lay person’s ‘neuroscience and trauma 101’
• Practice Implications• Further research, further training options• Questions and discussions
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Latest Findings from the Literature• Effects • Exposure of children to dfv• Impacts on healing and resiliency
• Trauma triggers, abuser contact and shared care
• Mother/child relationship – protective cocoon• Belonging• System-created trauma
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From the new evidence base• Neuroscience - 3 key points
– Sequential development– Impacts of DFV as complex trauma– Plasticity
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Sequential development
• Bruce Perry– Neuro Sequential Model of Therapeutics (NMT)
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• First three years – rapid development of brain synapses in healthy child
• Develops from experiences, particularly attachment experiences
• Brain develops sequentially
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(c) 2012 Karen Wilcox
‘
‘reptile’(brainstem)
• Survival - ‘safe’ or ‘unsafe’
• Basic functions – heart, breathing, temp, etc
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‘primate’
‘mammal’
‘reptile’(brainstem)
• cognitive• includes pre-frontal
cortex
• emotional• attachment, relational• Includes limbic
• Survival - ‘safe’ or ‘unsafe’
• Basic functions – heart, breathing, temp, etc
‘primate’
‘mammal’
‘reptile’(brainstem)
• cognitive• includes pre-frontal
cortex
• emotional• attachment, relational• Includes limbic
• Survival - ‘safe’ or ‘unsafe’
• Basic functions – heart, breathing, temp, etc
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Trauma & Brain development• Three ways:1. Limit experiences for healthy brain
connections/wiring2. Over-active alarm response3. Impacts of cortisol
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Trauma, impairment, brain development:1
1. Disrupted healthy growth• Effects depend on when child exposed
– which part is developing– Damage at earlier stages effects growth of later
stages – Negative/disrupted attachment experiences
(emotional regulation)
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Impairment of brain development:2
Alarm response over-activated• Baseline arousal level is higher and
more easily triggered‘on the lookout’ for
danger
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Trauma and the Alarm System
• Freeze • Fight or• Flight
• Fight response - ?temper tantrums• Dissociation – inner flight• Freeze – can look oppositional
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More frequent activation of alarm response =
More frequent bypassing of higher brain –> child functions in lower levels
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‘primate’
‘mammal’
‘reptile’(brainstem)
• cognitive• includes pre-frontal
cortex
• emotional• attachment, relational• Includes limbic
• Survival - ‘safe’ or ‘unsafe’
• Basic functions – heart, breathing, temp, etc
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• Lower parts of brain activate• Repeated/constant activation in
infancy – pathways formed– –> becomes automatic – non-conscious– Window of feeling calm and ok is narrowed– adaptive – we’d all do it
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‘trauma triggers’• Constant arousal of alarm system
Baseline state is already aroused
Diagram used for presentation purposes, not for publication
Adapted from Perry 2012
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Impairment of brain development:3
Cortisol production•toxic to brain if too much • mechanisms for activation/ deactivation damaged by overload
As if the ‘Switch’ doesn’t work properly
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Domestic Violence is complex traumaAttunement – mother’s emotional response = child’s
“even where the violence is not physical or visually witnessed” (Morgan 2011)
-> threat to the attachment figure = threat to baby -> alarm response activated
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Trauma is most damaging when…“ 1. Trauma occurs at a young age and cannot be consciously remembered
2. Trauma is repetitive, not just one-off
3. Trauma is severe and terrifying
4. Trauma is unpredictable
5. No support or comfort is offered to the child afterwards”
Morgan 2011
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constant and overwhelming threat
constant emotional arousal
impairs brain development
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Living with DFV – children need to be:
“ - Hyper-vigilant (Alert to cues signalling threat) - Screen out other cues (not listening) - Hyperaroused (Respond quickly to threat) - Able to act quickly and impulsively - Agitated, impulsive, poor concentration”
- Morgan 2011
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DV Trauma impacts -Relational issues –
• identity • Emotional ‘intelligence – identifying own and
others feelings• expressing feelings verbally - ‘act out’• attachment – relationships and friendships
-rejecting, over-attaching • empathy• responsibility/guilt – right/wrong• stress mg’t– impulsive reactions,
dissociation, numbing (drug and alcohol)
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Impacts cont’d• Behaviour - externalised
– Aggression, antisocial behaviour• Internalised
– Anxiety (including separation anxiety), depression, generalised distress, sleep disturbances
– Feelings of sadness, confusion, fear, anger• Infant behaviours:
– Crying, unsettledness, irritability– Eating and sleeping problems– Developmental impairment
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Impacts cont’d• Gender of child - boys more likely externalise;
girls more likely internalise (including dissociation)
• neurobiology underpins the behavioural impacts
–> need to explore underneath the behavioural presentation
• Culture - Aboriginal children – greater risk of harm– Layers of trauma – Tactics – cultural isolation, deprivation
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Living with DFV• ‘Living with’; ‘affected by’; ‘witnessing’; ‘exposed’;
‘experiencing’...?• ‘co-morbidity’ of domestic violence and child
abuse• 1 in 4• 2006 – almost 823,000 women who had
experienced DFV had dependent children• 239,000 during pregnancy
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Plasticity• Brain forms depending on how it is used• Changes through repetition,
– Skills, emotional responses, thought processes etc become ‘hardwired’ through use
• Higher parts more ‘plastic’, so easier to change
• Good News Story:– healing and recovery of children
- thru repetition and healthy stimulation of region affected by trauma
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– Huge implications for educators, carers, services working with mums and kids• learning• behaviour management• relationships
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More from the evidence base...resilience
• Attachment + belonging = resilience• ‘Sage warning’ –
‘resilience training’ is no substitute for– trauma-informed interventions, and – protection from ongoing harm
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System-created victimisation• Or ‘secondary victimisation’
– For children: ‘behaviour management’ that re-traumatises or heightens fear response
– Blaming mothers/victims, not holding perpetrators accountable
– Support service gaps or ‘hoops’– Legal abuse, financial abuse – system aiding an
abetting– Service ‘silos’
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Practice Implications• Screening and Risk Assessment• Training in understanding DFV - particularly
DFV and trauma; post separation exposure; abuser tactics – – attacks on mother/child bond; – parenting time; – financial abuse and impacts on children’s
wellbeing
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What works...Children exposed to dv can recover when:• Their primary protective attachment is
preserved and strengthened;• Their primary attachment figure is safe and
supported;• Specialised, trauma-informed programs are
available and provided for long enough;• System supports child/family need for
protection from ongoing exposure to abuser
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Further Training• Australian Childhood Foundation
www.childhood.org.au
• Berry Street (Childhood Institute)www.childhoodinstitute.org.au
• Child Trauma Academywww.childtrauma.org
• ASCA (Adult Survivors of Childhood Abuse) www.asca.org.au
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Questions??Email for reading list
And subscribe... to the ADFV Clearinghouse
www.adfvc.unsw.edu.au