working with families impacted by ipv ipv-fair · 01-01-2016 · abusive behavior inventory ....
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Working with Families Impacted by IPV IPV-FAIR
SUSIE DIVIETRO, PHD INJURY PREVENTION CENTER CONNECTICUT CHILDREN’S MEDICAL CENTER
MARY PAINTER, LCSW, LADC DEPARTMENT OF CHILDREN AND FAMILIES
Overview of Presentation
IPV in CT Agency IPV Practice Transformation IPV Service Array Evaluation & Outcomes Recommendations
Families Impacted by IPV & Children Exposed to Trauma: In families where there is IPV children are at a
higher risk for maltreatment…from both parents In a study of preschoolers (N=397), mothers who
endorsed physical IPV were more than 4 times more likely than non-victims to endorse behaviors characteristic of physical (31% vs. 10%) and emotional (61% vs. 18%) maltreatment of children
40-60% of men who abuse their partner also abuse their children
6138 5760 6322
22667 23303 24244
0
5000
10000
15000
20000
25000
30000
2012 2013 2014
# of DCF Intake Reports
IPV indicated No IPV indicated
21% 20% 21%
Age of Victims Associated with Reports w/ indicator of IPV
46% 44% 45%
36% 38% 37%
18% 18% 18%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
2012 2013 2014
Age 0 - 5 Age 6 - 12 Age 13 - 17
• Office of
IPV/SA Established
• RFI Released • IPV PDOC • Internal IPV
Specialists • Expand
Access POR
• Evaluation by IPC Starts • EBPS Launched
(MOMS Empowerment, Kids Club)
• Develop & Start IPV-FAIR
2012 2013 2014 2015 2016
• Expand FAIR • Develop MST-IPV • Offer Safe Dates
@ Solnit • Promote Safe
Sleep @ Shelters
• Intensive Case Review Complete
• Seek Funding for MST-IPV
• Cross Training in CT • Present @CWLA
In 2012, DCF, after assessing CT’s current IPV landscape, set forth a vision for what a comprehensive and holistic approach to an IPV service system should look like that was grounded in literature and best practice.
PE 1: Office of IPV and SU Intimate Partner Violence Service System Development
Working with the IPC on IPV
Evaluation and Recommendations of Service Array
Procedure IPV-Specialist Utilization Training Strategies Assessment tools and strategy
Policy Reviewing National Best Practices Training competencies Update IPV Policy at DCF
Data Collection and Analysis
PE 1: Office of IPV and SU - Intimate Partner Violence Service Array
Age Prevention
Low Moderate
High Capacity
Fathers for Change 0-10
IPV-FAIR 0-18
MOMS Empowerment/Kids Club 0-18
SAFE DATES 10-18
MST-IPV* 6-18
Risk
220-330 220-330
All schools
shelters
21
• Fathers for Change – Innovative model designed in CT – Emphasizes engaging & serving men.
• FAIR – Connecticut designed model based on best practice – Unique design – CT in forefront.
• Moms Empowerment & Kids club – Collaboration with CCADV Shelters. • Safe Dates – Collaboration with CCADV – Training provided to Ct Municipal Schools. Plus
one group run at Solnit North. • MST-IPV – Collaboration with Casey Services and Model developers of MST-BSF. Funding
needed for Implementation (development pending)
8
IPV-FAIR: Family Assessment Intervention Response Statewide, Voluntary Intensive community based intervention Engage and Assess all family members Individualized treatment & safety plans (EBP: VIGOR) Direct services for all family members: in home and clinical setting Care coordination & Family Navigation to other services Fathers for Change
Intimate Partner Violence
►15.5 million children in the US live in households were IPV occurred in the last year
►16% have witnessed IPV at least once ►Adjustment problems, cycle of violence
McDonald et al. 2006; Finkelhor et al. 2015
IPV in CT 90% of women seeking shelter services are
mothers 75% of children involved with DCF have
documented IPV exposure 57% of IPV-related arrests involve children
present 50% of youth involved with juvenile justice
services have a history of IPV exposure 25% of women receiving prenatal services
report ongoing IPV
DCF Reports (2014) Total Reports: 29,313
Reports with allegations of IPV: 6,324 (20.7%)
Substantiation Rates All reports: 22.7% IPV reports: 48.0%
Case reviews have shown up to 70% of families have a history of IPV
IPV-FAIR Model 4-6 month intervention; 1-3x/week Assessment and engagement of ALL
family members Priority: children 0-5
Individual and family interventions based on assessed needs
Began July 2015
Safety Planning: VIGOR Developed by Sherry Hamby, Ph. D. and
Sarah Clark Personalized, detailed safety plan Can be used/revisited multiple times Identifies goals, risks, strengths,
resources, and protective strategies http://www.thevigor.org/vigor-safety-
planning-tool/
Clinical Interventions May include, but not limited to:
Fathers for Change Cognitive Behavioral Therapy Genograms Trauma Focused Cognitive Behavioral
Therapy Psychotherapy “Beyond Trauma” (Stephanie Covington) “Seeking Safety” (Lisa Najavits) “Child and Family Traumatic Stress
Intervention” (Berkowitz, Stover, & Marans)
Fathers for Change One aspect of IPV-FAIR Acknowledges status of men as
fathers in delivery of IPV intervention Addresses co-morbid substance
abuse disorders and IPV perpetration
Emphasis on paternal parenting
Non-Clinical Interventions for Family Navigators Case management Psycho-education Family engagements Skill-building Addressing logistic barriers to
accessing treatment Connections to community resources
FAIR Data: Year 1 168 families, 237 children 133 Moms, 70 Dads
46 youth assessments completed 14 post assessment completed for youth 24 post assessments completed for Dads 36 post assessments completed or Moms
113 discharges 58% meet all treatment goals
Demographics
Black 18%
Latino 34%
White 41%
Other 7%
Dads’ Ethnicity
Black 12%
Latino 33% White
44%
Other 11%
Moms’ Ethnicity
Mom Age: 19-52 (ave. 30, median 29) Dad Age: 21-66 (ave. 33, median 32)
Youth Assessments
0
2
4
6
8
10
12
14
16
18
20
under 7 7 to 9 10 to 11 12 orover
Youth Ages
male 67%
female 33%
Youth Gender
Prior Experience With IPV (%)
AttendedFamily
Violence orAnger
management
Police tohome for IPV
incident
Children athome whenpolice came
for IPV
Arrested forIPV
Childrenhome when
arrested
Protective/restraining order
Dad 65 81 59 70 60 86Mom 33 87 83 34 74 70
0
10
20
30
40
50
60
70
80
90
100
Child Exposure to Violence Have adults in your home ever slapped, punched, shoved, or kicked you?
25.6% yes Have you ever thought someone was going to hurt or kill someone you love?
16.3% yes Have adults in your home ever hit you so hard you had bruises or red marks?
14% yes Has anyone ever made you feel so scared that you thought they might badly hurt or kill you?
11.6% yes Has anyone ever told you they were going to hurt or kill you?
9.3% yes
Home and Office Based Intervention
0%
10%
20%
30%
40%
50%
60%
70%
80%
Home Office Other A mix of all
Where were most of your sessions held?
Dads Moms
Intervention Sessions 68% of clinicians reported conducting
sessions with dad and children together
58% of dads and 29% of moms attended sessions with their partner
40% of dads and 35% of moms are reported to have stopped engaging in treatment
Engagement
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Never Rarely Sometimes Often All of the time
How often did the client cancel appointments?
Dads Moms
Engagement, by race How often did this client cancel an appointment with you?
0
5
10
15
20
25
30
35
40
45
Black White Latino Other
Percent of clients who have met treatment goals, by race
[VALUE]% (n=6) [VALUE]%
(n=4)
[VALUE]% (n=9) [VALUE]%
(n=22)
[VALUE]% (n=6)
[VALUE]% (n=19)
[VALUE]% (n=5)
[VALUE]% (n=7)
0
10
20
30
40
50
60
70
80
Dads Moms
Black White Latino Other
Emotional Regulation
0
10
20
30
40
50
60
Pre Post
Difficulties in emotional regulation (Dad)**Difficulties in emotional regulation (Mom)**
PTSD: Full and Partial
0
10
20
30
40
50
60
Partial (Moms) Partial (Dads) Full (Moms) Full (Dads)
Pre Post
% of sample who meet clinical criteria for PTSD
Parental Functioning
0
20
40
60
80
100
120
140
Pre Post
Parental Rejection (Mom)**Parental Rejection (Dad)**Parental Reflective functioning (Mom)**Parental Reflective functioning (Dad)**
Hostile Automatic Thoughts (Dad)
13
4
20
3
17
4
46
10
Physical Aggression** Derogation of Others**Revenge** Total**
Youth Strengths and Difficulties
PrePost
0
5
10
15
20
25
30
Pre Post
Abusive Behavior (self)**Abusive behaviors (partner)**
0
2
4
6
8
10
12
14
16
18
20
Pre Post
Abusive Behavior (self)**Abusive behaviors (partner)**
Abusive Behavior Inventory
Episodes of IPV during treatment
How do you know the IPV occurred?
Next steps working with DCF families impacted by IPV Strengthen workforce capacity Increase cross agency collaboration &
communication Improve data infrastructure Support the implementation of data driven practice Increase public awareness Case Review Analysis Feedback from IPV-FAIR participants Model refinement
