RAMONA ALAGGIA MSW, PH.D., RSW ASSOCIATE PROFESSOR FACTOR-INWENTASH CHAIR IN CHILDREN'S MENTAL HEALTH FACULTY OF SOCIAL WORK, UNIVERSITY OF TORONTO How Does Resilience Reveal Itself in Children & Youth Exposed to Intimate Partner Violence (IPV)

Child Exposure to Intimate Partner Violence Children exposed to IPV can exhibit greater depression, anxiety, social withdrawal, hyperactivity, aggression, lower social competence, diminished school performance, more post-traumatic stress symptoms and difficulties in regulating emotions than their non-exposed peers (Holt, Buckley & Whelan, 2008; Kitzmann, Gaylord, Holt & Kenny, 2003; Martinez-Torteya, Bogat, Von Eye & Levondosky, 2009). These are serious child mental health issues and are also indicative of emotion regulation problems –the inability to appropriately express and effectively deal with intense feelings that can arise from IPV exposure leading to internalizing or externalizing problem behaviours.

Are All Children Negatively Effected? However a number of children do not exhibit negative effects to IPV exposure and do well over the long-term into adulthood. While some children’s functioning may be disrupted in the short term, other children show no negative effects over time thought these numbers are unclear (Edlesohn, 2004; Holt, Buckley & Whelan, 2008) More focus is needed on understanding the mediating and moderating influences on children’s responses (Renner & Slack, 2006) Who are the resilient?

Problems in the Research The research on negative child effects has been plagued by methodological limitations with an over-reliance on mothers as sole sources of information, inadequate child input, and lack of contextual data (Overlein, 2009) Most studies are based on clinical samples Over the last decade there have been calls to research resilience in IPV exposed children (Edlesohn, 2004) while a more recent review of the literature notes “a disappointing level of attention to such a serious problem.”(Rizo, Macy, Ermentrout & Johns, 2011 p. 163) We need better theory and research to guide more effective practice for children exposed to IPV

Let’s Consider Theoretical Premises for IPV Exposure Inter-generational transmission of violence: theory proposes that through learned behaviour victim and perpetrating behaviours might be passed onto children, and may play out in their future adult relationships –cycle of abuse; social learning theory Not been well validated (Margolin et al., 2003; Stith et al. 2000) Child welfare policies are built on this premise giving professionals authority to intervene and interrupt these processes, to ward off further harmful exposure, and make appropriate referrals for intervention; practice is based on remediating effects and recidivism Trauma theory: understanding trauma effects on victims including exposed children and treating –more focus on infant mental health Attachment theory: repairing mother-child relationships towards secure attachment –IMH Intra and inter-personal explanatory theories

The Social Ecology of Resilience Ungar’s (2011) social ecology of resilience model offers a useful guiding framework recommends moving beyond a narrow focus on child characteristics and parent-child relationships to include broader contextual and cultural factors—factors that may explain more variance in resilience than individual traits alone 4 principle conceptualization of SER  Decentrality (don’t mix up processes with outcomes)  Complexity (no single factor)  Atypicality (interaction of environment)  Cultural relativity (values and norms)

“ Resilience…successful navigation through significant threat.” (RIRO, 2010) Trait, state, process or outcome... Resilience is not a personality trait; it is something that happens—a dynamic process or pattern where an individual (or family or community) uses internal and external resources to navigate through significant threat Involves a dynamic interplay between the individual, family, community and society and each aspect of resilience has strong temporal, cultural and individual meanings attached (Reaching In/Reaching Out (RIRO, 2010)

What We Know Already Resilience in general – to any adverse event –not IPV exposure specific Numerous individual and relational factors have been found to be associated with competence in the face of adversity among vulnerable children: temperament, emotion regulation, ego control, self-efficacy and intellectual functioning, persistence, close friends, maternal warmth, the absence of maternal depression, and a positive home environment Research mostly focused on child attributes, intelligence, parent-child relationship, and maternal characteristics without fully exploring important environmental contexts

What’s the Bigger Picture for IPV Exposure? Most research has looked at micro/personal characteristics and factors for clues about resilience in the face of IPV exposure Equal consideration has not been given to contextual factors for sources of resilience. In the few studies conducted with adults who were exposed to IPV as children, participants identify abilities to overcome negative effects and develop adaptive coping strategies but these have not been fully explored (Anderson & Danis, 2006)

How is Resilience Defined IPV Exposure Research? A multidimensional concept that is evidenced when individuals are able to maintain a healthy state of functioning when faced with adversity (Kim, Lee & Lee, 2013) A multidimensional, dynamic process that includes the following characteristics: positive coping, adaptation and recovery from negative experiences (Gonzales et al., 2012) Martinez-Torteya and colleagues define resilience as a dynamic process containing two elements: adversity and positive adaptation (2009). Ability to overcome the negative effects associated with exposure to IPV (Suzuki, Geffner & Bucky, 2008) Resilience defined as the absence of both aggression and depression. Non-dichotomous levels  non-resilience  near resilience  resilience (Kassis et al., 2013)

Children Exposed to IPV: Expanding Understanding of Vulnerabilities & Resilience* Working from a social ecological theory of resilience that is trauma informed and grounded in a life course perspective and using a mixed methods design: Why do some children exposed to IPV have better psycho-social outcomes than others? What factors contribute to those who do not repeat the cycle of violence? What are resilience factors for child IPV exposure How do we identify resilience factors that might help inform assessment, interventions and program planning ? *Alaggia, Fallon, Jenney, Morton, & Scott Funded by the Social Sciences and Humanities Research Council of Canada

What contributes to resilience (or lack of) Maternal mental health (no depressions) Maternal warmth;;parental warmth One supportive parent to talk to One supportive safe adult Peer connection Parent criminality predicts lack of resilience (The Long Shadow) Neighbourhood factors are suspected to have impact Safe vs. dangerous Resource rich vs. depleted Safe haven from IPV Easy temperament, optimism, curiosity, hardiness, extraversion, self-efficacy, persistence, co- operativeness, intelligence, sense of humour;, high self-competence and emotion regulation; empathy. Compassion, positive coping strategies, social attachment Poverty predicts lack of resilience (The Long Shadow) Migration associated with higher levels of IPV Mothers with secure jobs impacts child resilience Macro/structural Factors Individual Factors Inter-personal Factors Meso Level Factors

L ife Course Perspective Interviewing Adult Survivors For the first phase of the study a grounded theory (GT) method was chosen for theory development (Charmaz, 2006; Oktay, 2012). Using theoretical sampling qualitative interviews of adults who were exposed as children are being conducted for this first phase to explore theoretical sensitivity of resilience. Questions such as “What got you through the difficulties…?” “What about resources outside of the family?” “In the community?” begins to take us beyond the more common focus of individual level factors, to those reflecting a social ecological framework Turning points –what are these and how do these interact i.e. adolescence, launching, marriage, parenting, etc., etc. Cradle to college Turning points Adulthood Young, middle and senior Turning Points End of life Turning Points

Research Procedures & Sample Description 15 interviews -12 useable that were analysed Data analysis included open, axial and selective coding -N*Vivo supported 2 independent coders Preliminary analysis towards theme development Sample description  6 females/6 males  Mean age 32.5 (range 18 – 47)  Higher education overall but with lower income (high number of students)  Over half in university; auto-salesman, visual artist, contractor, social worker; half non- white  7 single; 3 married; 2 divorced  7 with children (1-2)  2 identified mothers as perpetrators of IPV; 1 described mutuality of IPV  3 self-identified as victims of IPV –1 male victim  2 self-identified as perpetrators of IPV (males)

Results: Emergent Themes Escaping Escaping Ability to see the violence as unhealthy Ability to see the violence as unhealthy Conviction to not repeat the violence surfaced as resilience factors Conviction to not repeat the violence surfaced as resilience factors Our findings start to fill out a social ecological model of resilience for DV exposure Connections to social networks and school (neighbourhood/community level factors) Connections to social networks and school (neighbourhood/community level factors)  Expression of a skill or talent (access to activity based extra-currcular programs)  Relationship with a supportive safe adult outside of the immediate family *Co-occurring child maltreatment had differential impact 1) sexual abuse; physical abuse

Escaping escape escape I felt when I went to school and if I saw my friends there I would pretend it was okay and then I was in this space where I could escape for a little while... I did treat school like an escape (01 m) When I was older I would just go to my friend’s house, you know and stay there until you know. I’d make up a –just lie something like that (011 m) escape But I think I was depressed because of the signs, like I didn’t have friends, I was very lonely, and my escape was to study. Like if I study then I can start working and then I can leave (04 f) escape I was an A student, I was always reading, writing, writing. It was actually my escape (04 f) escapism So like I said I was a bookworm -so for me a lot of it was escapism. So trying to find an alternative from the reality I lived in (06 f)

Seeing the violence as unhealthy Probably just like an instinct –it just seems to be an instinctual feeling of this is not a right way to handle a situation. It could be empathy for the person on the receiving end of abuse that things were terrible (02 m) I was disconnected from my family because I had a sense that there was something not normal about the way we operated (05 f) I was just self-motivated to look into things that my parents told me and I was very surprised to find they weren’t necessarily true all the time (08 f) One I tried confronting my parents to let them know it’s not okay what they were doing (06 f) I realized that my childhood was pretty abusive and that’s hard to accept. I have a difficult relationship with my mom mainly because I realized just recently that I was trying to save her and I realized that she does not want to be saved (04 f)

Conviction to not repeat the violence... I got out because I felt I don’t want this to replicate this in my own life, so I thought once I’m old enough I need to leave. I need to have a normal life (06 f) I immediately turned to books, to friends who are professionals, to doctors, because I did not want her to have the childhood I had (04 f) I did some research for the speech and my memory today is that there was so many problems because of alcohol and I decided that I didn’t want it in my personal life (07 f) In terms of my boyfriend I basically picked someone who is the complete opposite of my father. So he’s very reliable, dependable (06 f)

Social connections and activities I was a kid who worked really hard... I was very into music. Music was a big part of my life (015 m) Writing in a journal. I did a lot of that. I’ve always been a writer. I’ve always had close friends. They never had a problem with me so why did my mom have such a problem with me? (02 m) I have a lot of faith in myself and my abilities, and you know, the sort of ability to make friends and that kind of thing you know? (012 m) I think stubborn has strength, I mean if I want to do something I would focus on doing it (07 f) I was into wrestling & martial arts. These things protected me (013 m)

Relationships with supportive adults The good thing about my family is that I had a large extended family and I had my grandmother and two other aunts (04 f) All these women they were these kind women, and they were just kind of in the community, but not right in the community –they helped me – they validated me, they made me feel worthy again (03 f) I started to talk to the social worker at school (015 m) I had to find a way to not get sucked into his negative energy to anything. Resilient in not losing myself in or getting influenced too much by the environmental factors around me (06 f)

Programming thoughts Service providers can promote resilience by: 1. facilitating esteem building activities through talents and skills 2. making connections to supportive adults 3. labeling and validating feelings about the violence 4. educating about healthy relationships 5. healthier communities with access to child and youth activities Further research needs to investigate contextual/environmental impacts and barriers/facilitators to supports