Joseph McGill, Robin M. Deutsch, and Robert
A. Zibbell, Visitation and Domsetic Violence: A Clinical Model of Family
Assessment and Access Planning, 37 Fam. and Conciliation Courts Rev. 315
(1999).
With increasing frequency, courts and legislatures
are focusing attention on visitation disputes in which there are allegations
of domestic violence. This article explores the requirements for a careful
assessment of the domestic violence issues, the parenting capacities of the
adults, and the coping skills of the children. It then proposes a decision
tree model of access recommendations that incorporates the information gathered
from the evaluation procedures.
With increasing frequency, American trial courts
are promulgating guidelines for child visitation in divorce cases that include
allegations of domestic violence. Of particular concern to the courts is "the
risk of harm and potential for continuing abuse through the children ... when
making visitation orders" (Irwin, 1996). In Massachusetts, Custody of
Vaughn (1996) requires trial judges to make detailed findings of fact regarding
the domestic violence and its effect on the child. If physical or legal custody
is awarded to the perpetrator of abuse, the judge must indicate how this award
advances the best interests of the child.
Vaughn is consistent with research that suggests
that high levels of parental conflict, a history of domestic violence in the
family, and/or witnessing domestic violence may each, independently, predict
maladjustment in children (Famularo, Fenton, & Kinscherff, 1993). In a
study of juvenile court involved children, Famularo et al. (1993) found
that witnessing violence was one of three predictors of post traumatic stress
disorder in children. In that study, children who witnessed domestic violence
or who were sexually maltreated had a much greater likelihood of developing
post traumatic stress disorder than did those whose histories of maltreatment
did not include such incidents. Studies have also suggested that early exposure
to violence tends to decrease prosocial behavior, fosters the understanding
that violence is an acceptable form of conflict resolution, and increases
the potential for violent behavior (Jaffe, Wilson, & Wolfe, 1988).
Children in homes where domestic violence occurs
are at an increased risk for abuse. It is estimated that that there is a 40%
overlap between witnessing *316
battering and being directly abused (Appel & Holden, 1998; Finkelhor,
1983). Partners who are being abused may also be psychologically unavailable
to their children. This can increase the likelihood of abuse or neglect of
their children (Straus & Gelles, 1990). In a review of 29 empirical studies
of the effect of witnessing domestic violence on children, the authors concluded
that children who witness domestic violence are at risk for difficulties in
behavioral and emotional development (Kolbo, Blakely, & Engleman, 1996).
Assessing the impact of family violence on
children and creating safe and effective parenting plans is a challenge facing
professionals across several disciplines. In this article, we first describe
the scope of the investigation that must be undertaken to address the issues
of domestic violence and child access. We then discuss a comprehensive assessment
of the family and offer a basis on which one may determine parents' access
to, and safety planning for, children.
ASSESSING DOMESTIC VIOLENCE
A comprehensive evaluation of domestic violence
requires two things. First, the evaluator must identify the type and extent
of the violence. Second, various systems internal and external to the family
must be analyzed and an assessment made regarding what role these systems
played in contributing to or perpetuating the violence. Third, the evaluator
must assess the effects of the violence on both parents and children.
The evaluator has a number of tools available
for gathering information about domestic violence. The evaluator may review
police reports and criminal records, conduct structured interviews with family
members and significant others, and use instruments designed to assess the
nature and frequency of the violence. Three such tools will be briefly discussed
here: the Conflicts Tactics Scale (CTS) (Strauss, 1979), the Assessment of
Conflict (ACS) (Garrity & Baris, 1994a), and the Domestic Violence Visitation
Risk Assessment (DVVRA) (Trial Court, Commonwealth of Massachusetts, 1994).
The CTS is appropriate for use with both victim
and perpetrator. This scale measures a range of conflict resolution methods
and is divided into three major categories: reasoning, verbal aggression,
and violence. The CTS subdivides verbal aggression into passive and active
forms, and physical violence into minor, moderate, and severe. These more
narrowly defined subcategories allow a more precise understanding of the nature
and frequency of family violence. The method selected for scoring the CTS
serves to further assess violence. The simplest scoring process totals the
respondent's scores *317 in each
category. However, this method uses a numerical scoring of a one point increase
per type of answer and offers little raw score information based on the frequency
of the violence. The recommended scoring method is the frequency weighted
method, which provides useful information and a clearer understanding not
only of the violent acts but of their frequency over time.
The ACS consists of five levels of conflict:
minimal, mild, moderate, moderately severe, and severe. This assessment relies
on the completion of an extensive social and relationship history of both
partners. Information thus gathered is used to determine the level of conflict
through use of descriptors within each category. However, the evaluator must
be well schooled in the area of domestic violence in order to use the form
effectively. The evaluator must accurately define and distinguish between
types of behaviors. For example, the ACS defines the occasional berating of
the parent in front of the child as mild conflict, while categorizing verbal
abuse as moderate conflict. However, the evaluator is offered no specific
guidelines with which to distinguish these behaviors. Similar to this, the
authors categorize occasional quarreling as a mild degree of conflict and
loud quarreling as moderate conflict. Garrity and Baris (1994a) include some
behaviors not found in the CTS, specifically, family dynamics that triangulate
the child into the parental conflict or attempt to control the other parent
through the child. Their references to attempts to form coalitions with the
child, whether occasional or ongoing, are useful to the investigator in assessing
these dynamics.
The DVVRA is the third tool. As with the ACS,
evaluators gather information to assess the level of violence through detailed
interviews and record reviews. This tool expands upon the CTS and the ACS
by including an even broader range of violent and/or controlling behaviors.
It advises the evaluator to secure information about the destruction of property,
forced sexual contact, the sadistic infliction of pain, and threats to abduct
the child. It includes an extensive array of psychologically and economically
coercive behaviors, including isolation from family and friends, the sabotaging
of friendships, accusations of sexual infidelity, persistent telephone calling,
and stalking. Generally, the descriptors used to define behaviors are more
specific than those in the ACS, making it easier for some evaluators to categorize
behaviors. However, unlike the other two measures, the DVVRA does not categorize
varying levels of conflict or violence, offering only a rough continuum of
behaviors. Contained in this publication is a categorical breakdown of types
of violence based on the work of Johnston (1992): chronic pervasive control
reinforced by severe violence, violence associated with psychiatric illness,
assertion of control by physical intimidation by the primary caregiver, and
isolated violence engendered by separation. To gain a more accurate assessment*318
of the nature and extent of violence in a family, the evaluator should combine
the continuum of behaviors presented with the categories in order to use this
tool.
Access or visitation planning, however, should
usually go beyond an analysis of the nature and extent of violence. The evaluator
must also obtain a clear understanding of any other factors that may have
contributed to the violence as well as the effects the violence has had on
all members of the family, especially the children. Only then can a comprehensive
plan be developed to safeguard the children, provide for their emotional healing
as well as that of the primary caretaker, and address needed change by the
perpetrator.
CONTRIBUTORY FACTORS IN DOMESTIC VIOLENCE
Social science research indicates that a number
of psychological and social factors contribute to domestic violence. The evaluator
should assess these factors in the perpetrator. Psychological factors associated
with domestic violence include psychopathology, personality disorders, and
depression. Although it is only an occasional factor in domestic violence,
psychopathology, or the presence of a major psychiatric illness in the perpetrator,
should be explored as a possible causative or contributing factor in family
violence. Moreover, the evaluator should consider the presence of those personality
disorders that have a high correlation with domestic violence, such as the
antisocial (Kempe & Helfer, 1972) and borderline (Prodgers, 1984) personality
disorders and passive aggressive personality. The antisocial personality is
characterized by a diagnosis of conduct disorder during childhood or adolescence,
disregard for social norms, lack of remorse, poor insight, failure to adhere
to a life plan, and other traits that indicate a general lack of appreciation
or understanding of societal norms. The borderline personality is characterized
by impulsive behavior, a history of intense and/or unstable relationships,
intense anger with poor control, frequent mood swings, and physically self
harming or damaging behavior. The passive aggressive personality has the
traits of procrastination, intentional inefficiency, stubbornness, and difficulty
in developing or maintaining trust (American Psychiatric Association, 1994).
Bolton and Bolton (1987) noted that depression
was the most consistently identified affective disorder in violent families.
Many individuals suffering from depression, especially a major depressive
episode or chronic depression, experience suicidal ideation. Mohr and McKnight
(1971) found that many suicidal parents have a tendency to also be homicidal.
Other psychological *319 factors
common among those who perpetrate domestic violence are helplessness or hopelessness,
poor impulse control, and the inability to experience pleasure.
Moving beyond the psychological processes of
the perpetrator, the evaluator should also examine the perpetrator and family's
wider social system. There are a number of environmental and societal risk
factors associated with abuse in families, including unemployment, use of
illegal drugs, spouses of different religious backgrounds, and a history of
domestic violence in the family of origin that was witnessed by the perpetrator
(Gelles, Lackner, & Wolfner, 1994). Assessment of the presence or influence
of alcohol on family interactions is an important contextual factor. The relevance
of the presence of substance abuse within the family in which domestic violence
has occurred is highlighted by a recent report by the Office of the Commissioner
of Probation of Massachusetts. This study of civil restraining orders in Massachusetts
indicates that more than 50% of restraining order violators have a drug and/or
alcohol abuse problem (Adams & Powell, 1995). This is not surprising given
that marital violence is directly related to information processing, decision
making, and behavioral choices. Other social factors found to have a correlation
with domestic violence include multiple environmental stressors such as underemployment
and unemployment, stress in the workplace, a belief system that incorporates
corporal punishment or physical abuse as effective means of shaping behavior,
and social isolation of the perpetrator and/or family.
None of these contributing factors are exculpatory.
However, a thorough understanding of them permits an evaluator to make specific
recommendations for further treatment or to design interventions that may
safeguard the children and decrease the possibility of future violence. For
example, the evaluator may recommend that the batterer not only attend a program
for abuse perpetrators but participate in a parenting class to learn more
effective means of influencing a child's behavior. Involvement of the aggressor
in other forms of self help groups, such as Alcoholics Anonymous, can decrease
isolation. In addition, psychiatric treatment to relieve depression or mitigate
the impact of psychopathology may also serve to interrupt the cycle of violence
and further safeguard the children.
EFFECTS OF DOMESTIC VIOLENCE ON CHILDREN
The third factor that requires investigation
is the effect of violence on the children. Children living in homes where
there is violence between adults are two to three times more likely than other
children to be abused (Jouriles, *320
Murphy, & O'Leary, 1989; McCloskey, Figueredo, & Koss, 1995; Straus
& Smith, 1990). Even if they are not the direct targets of the violence,
the children suffer as witnesses to aggression between their parents (Berry,
1996). Children who have witnessed domestic violence present a variety of
emotional factors, sense a lack of control over their life circumstances,
and experience feelings of hopelessness and helplessness. Children from violent
families may experience depression, anxiety, and an increase in somatic complaints,
or they may externalize their distress through aggression and delinquency.
Sibling relationships may be compromised by family violence, and intersibling
aggression may result from prolonged exposure to violence (Moore et al., 1990).
Peer relationships may be problematic, and these difficulties, if left untreated,
may contribute to further personal adjustment problems.
Children from violent homes are at greater
risk for experiencing severe forms of corporal punishment and intense verbal
aggression from parents than are children from nonviolent homes (Jouriles
& LeCompte, 1991; McCloskey et al., 1995; Straus, Gelles, & Steinmetz,
1980). In addition, mothers, who are typically the primary caregivers post
separation, may experience depression if they are victimized. This may disrupt
their ability to attend to and monitor the behaviors of their children (Jouriles,
Barling, & O'Leary, 1987). A thorough investigation of the children's
and caregivers' responses to the violence may produce recommendations for
treatment of the children and the caregiver and may be incorporated into the
report to the court. Such recommendations may have a significant impact on
the postdivorce adjustment of the children.
Although witnessing violence between one's
parents is associated with poorer adult psychological and social functioning
(Henning, Leitenberg, Coffey, Turner, & Bennett, 1996), it is not clear
that there is a direct, linear relationship between witnessing violence and
diminished adult psychological and social functioning. Recent research has
focused on variables that may mediate the effects of witnessing parental violence
on short term and long term development and functioning. These variables
include conflict resolution strategies that do not expose the child to verbal
aggression and conflict, and perceived parental caring and support (Henning
et al., 1996). Parenting capacity is clearly an area to consider when assessing
the impact on the children of witnessing parental violence.
ASSESSMENT OF PARENTAL CAPACITIES
Research on family violence suggests that partner
abuse, specifically wife abuse, results in significant stress on the woman,
who may respond with increased *321
physical and psychological symptoms as well as diminished competence in child
management behaviors (Jaffe, Wolfe, & Wilson, 1990). The combination of
exposure to traumatic events, the stress on parenting, and decreased parental
effectiveness results in increased stress for the children. Therefore, consideration
must be given to the possibility that parenting capacities have been directly
compromised by the violence perpetrated on that parent and that without that
stressor more effective parenting can be fostered. An important component
of this assessment should be a consideration of the primary parent's coping
responses. In the case of battered women who describe extreme anxiety and
other stress related dysfunctional behaviors, children are more likely to
be described as having adjustment problems in the clinical range (Wolfe, Jaffe,
Wilson, & Zak, 1985). However, there is some literature that suggests
that the mental status of the primary parent in these circumstances may not
mediate the effects of violence on the children (McCloskey et al., 1995; Richters
& Pellegrini, 1989).
Adequate parenting capacities are important
mediators of developmental risk to children who have been exposed to ongoing
violence. The baseline parenting capacity is to provide adequate food, shelter,
clothing, and health care for children. The consistency of that care can be
affected by the presence of family violence. Particularly in the cases of
classic battering, a woman may avoid leaving the house if she has visible
signs of having been battered. Basic caretaking tasks might be compromised.
Those basic caretaking tasks may be reconstituted after a parent separates
from the other parent. In a safer setting, a parent has the opportunity and
responsibility to provide for the children's basic needs consistently and
predictably. Depression, other psychiatric illness, and substance abuse need
to be ruled out as factors contributing to dysfunction as well.
The ability to keep children safe from harm
is clearly suspended when children are witnesses to and/or the subjects of
violence at home. How parents attempt to protect their children from these
exposures should be assessed. Children who witness their parents engaged in
physical conflict tend to perceive their parents as less caring than do children
who have not lived with that stressor (Henning et al., 1996). The first level
of protection comes from an understanding that family violence is a problem
for the children. The evaluator should determine if the parent understands
that it is acceptable that his or her children are learning that violence
is a way to get what one wants, manage stress, regulate emotion, and resolve
conflict. Further assessment focuses on the parent's ability to meet the children's
needs. Children exposed to physical conflict between their parents are more
likely exposed to verbal conflict as well, and long term social and emotional
functioning is worse with *322 this double exposure (Henning et al., 1996). Assessment questions
focus on the parent's repertoire of strategies for managing anger and conflict.
Some parents who engage in physical and/or
verbal aggression attempt to engage the child in the conflict. The parenting
capacity of separating one's own needs from the needs of thechild is quite
limited during these occurrences. In these cases, the parent's hostility for
the spouse is not submerged, and the child is enlisted as a partner to endure,
witness, and participate in the hostility and abuse. Evaluation of the parent's
capacity to separate the child's views and needs from his or her own will
help the evaluator assess that parent's capacity to parent in the face of
the special emotional needs the child may have as a result of interparental
conflict.
As well as understanding that violence is problematic
for a child, can that parent take the child's perspective and respond to the
child's needs? Domestic violence affects children in serious ways. For infants,
exposure to noises, tensions, and rapid shifts in posture or physical stance
can precipitate irritability, sleep disturbance, and inability to settle themselves.
Exposure to domestic violence at early ages compromises children's sense of
safety and security as their needs may be unreliably or unpredictably met
by the caretakers whom they are supposed to trust. Long term exposure to
violence for preschoolers interferes with the process of reaching out and
exploring and developing independence. In addition, preschoolers exposed to
family violence have relative deficits in interpersonal sensitivity, or identifying
the feelings of another (Hinchey & Gavelek, 1982; Rosenberg, 1987). Symptoms
of whining, withdrawal, muteness, and sleep disturbance may be related to
the domestic violence. For school age children, the symptom picture may be
mixed. Living with high conflict may result in aggressive, oppositional, controlling,
and anxious behaviors, or both undercontrolled and withdrawn constricted behaviors
(Davis & Carlson, 1987; Jaffe, Wolfe, Wilson, & Zak, 1986; Wolfe et
al., 1985). Distracting and intrusive thoughts and fears may interfere with
attention and concentration. Children of this age may learn that conflict
is resolved through violence and that rules may be arbitrary and unpredictable.
Parenting capacities are a critical domain
for assessment in order to make appropriate recommendations about coparenting
and visitation arrangements. Of primary concern is whether parents recognize
the problem and have an understanding of the impact of the conflict or violence
on their children. Risk factors include (a) an absence of strategies for managing
conflict or protecting the children from it, (b) incapacity to take responsibility
for self or children, and (c) misuse or inadequate acceptance of resources
or support to contain the conflict and respond appropriately to the children's
needs. These factors suggest that the children will remain at risk for further
exposure *323 to high conflict
or violence and will be vulnerable to poor social and emotional functioning
in adulthood.
ASSESSMENT OF THE CHILD
Evaluation of the child requires data from
multiple sources. From the parents, information about the child's presence
during conflictual events is necessary. Conflictual events include tension
at transitions, exposure to negative comments about the other parent, and
observation of physical aggression.
Tension at transition can range from parents
restrained from having contact with each other, thus indicating to the child
that one or both parents are dangerous, to witnessing parents provoke, lash
out, or assault one another. Exposure to negative comments can be subtle,
for example, "Make sure your father does not come up to the door if he
knows what's good for him," to more overtly threatening, "I'm going
to kill your mother." Threats to take the child from the other parent
can strike fear into the child's heart.
If a child has witnessed violence between the
parents, certain information is necessary to understand what the child may
have processed and how the child has encoded the events in memory. This information
includes the child's whereabouts during these events, the communication between
the child and each parent subsequent to theseevents, and whether the child
has previously disclosed this information to anyone.
Parents can also provide useful information
about the child's eating and sleeping patterns, peer relationships, and behaviors
at home and school. Completion of a child behavioral inventory such as the
Child Behavior Checklist (CBCL) (Achenbach & Edelbrock, 1991) by each
parent provides information about the child's emotional and behavioral functioning.
Scores that are in the clinical range of significance indicate that the severity
and/or frequency of the targeted behaviors require some form of therapeutic
intervention. What needs further determination is whether the presence of
these symptoms is related to the level of conflict between the parents or
to exposure to violence, which may have been traumatizing to the child. In
many studies where children exposed to family violence have been compared
to children who have not witnessed interparental violence, results of the
CBCL indicate a significantly higher score on both the internalizing and externalizing
behaviors of the former group (Kolbo et al., 1996; McCloskey et al., 1995).
Information from the child includes the reports
of exposure to parental aggression; the experience of anxiety, depression,
or fearfulness; the presence of aggressive, violent themes; and the child's
report of coping skills. Coping *324
skills are defined as the child's attempts to gain control or a sense of mastery
over the abusive situation witnessed or efforts to protect self, siblings,
or parents. Radovanovic (1993) found that children who had more coping strategies
and who could use cognitive redefinition, that is, thinking positively and
flexibly, had better adjustment by parent report.
Children may attempt to intervene in the conflict,
thus distracting the parents and refocusing attention on themselves. This,
like avoidance, can be a functional form of coping with this major stressor.
However, it can compromise the development of the child's self esteem, self
confidence, and ability to proceed along a normal developmental trajectory.
Information from the child's school and school
records can indicate whether the child's school performance has been affected
on particular days or during particular periods of time. This source may also
have information about parents' participation or involvement in the schooling
of the child. The composite of information about the child is used to assess
the level of dysfunction or maladjustment the child is experiencing as a result
of the conflict or violence between the parents. The child's level of stress
in relation to his or her coping skills must be considered in making determinations
about parenting and access plans.
PRELIMINARY ISSUES IN MAKING ACCESS RECOMMENDATIONS
Once the evaluation determines the existence,
frequency, and intensity of any alleged domestic abuse; its impact on the
children; and the capacities of the parents to support the children, there
remains the challenge of making recommendations to the court regarding parental
access to the children. There are, however, some minimum protective considerations
general principles that serve as a framework within which individualized
plans will be made. First, parenting plans need to be based on the unique
fact pattern of the family. One should assign priority to creating a situation
in which "the children must be safe and feel safe in the care of their
parents" (Garrity & Baris, 1994b, p. 88) while attempting to preserve
whatever positive aspects of parent child relationships are possible (Johnston,
1992). Moreover, "the well being of the children must be the primary
consideration over and above the parents' right to visitation" (Garrity
& Baris, 1994a). Thus, there is a balance that must be struck between
the children's need for physical and emotional security, the parent victim's
safety needs, and the abusing parent's rights to access to the children (Massachusetts
Continuing Legal Education, 1996).
*325 Second, where custody is in dispute and domestic
abuse has been confirmed, preference should be given to that parent who has
not perpetrated violence or abuse and who can provide a violence free environment
for the children (Johnston, 1992). If violence has been mutual, close evaluation
is necessary to determine whether or how much of the violence of the victim
was defensive or retaliatory (Custody of Vaughn, 1996).
Third, as addressed earlier in this article,
victims of violence often suffer from diminished parenting, which may be evident
at the time the violent relationship is terminated. Special considerations
should be given to allowing that parent to reconstitute him or herself before
determinations that have long term implications are made (Johnston, 1992).
Even with therapy, some psychological problems may be resistant to short term
improvement, such as the presence of substance abuse or a serious mental disorder
that demonstrably diminishes parenting capacity. Third parties (e.g., family,
close friends), if they are available and appropriate, should be given preference
for temporary custody if a parent has been either moderately or severely abusive
(Johnston, 1992). In some instances, abusive spouses will have circumscribed
their partners' friendship or family networks, thus limiting the range of
useful alternatives (Trial Court, Commonwealth of Massachusetts, 1994). If
there are no other available, appropriate persons, and the violence or threat
is not recent (and the children were not victims themselves), then custody
should go to the abusive parent, perhaps with a referral to the child protective
agency for services, a treatment appropriate to deal with the nature of that
abuse, and a parenting program. Johnston and Campbell's typology adopted by
the Association of Family and Conciliation Courts suggests that all abuse
is not alike and that the kind of treatment needed for an abuser should vary
with the nature and circumstances of the abuse (Massachusetts Continuing Legal
Education, 1996). If the children were themselves mistreated by the victim
of domestic violence, or the domestic violence was recent, ongoing, and the
children continue to witness the abuse, then foster care (or willing and capable
relatives of the victim), perhaps with a care and protection petition, might
be indicated until the abused partner recovers enough capacity to parent effectively
and protect the children. These are, of course, arguable solutions, as foster
care has its own share of difficulties (Mnookin & Weisberg, 1995). Where
ongoing conflict and a potential for violence exists, access plans approaching
shared physical custody should be discouraged (Depner, Leino, & Chun,
1992; Johnston, Kline, & Tschann, 1989).
Fourth, where access is the primary issue,
all arrangements for parent child contact should be made with the goal of
limiting the child's exposure to potential violence and to ensure the safety
of the parent victim. Where ongoing conflict and a potential for violence
exists, and the child manifests stress
*326 reactions to transitions, the frequency of the exchanges should be
minimized (Johnston, 1992). If the violence in the family was both ongoing
and severe and threatened to continue after the separation (for some women,
this period can be the most dangerous), the location of the victim parent
and child may need to be kept secret until that danger is no longer likely
(Zorza, 1995).
Fifth, supervised access should be arranged
where there is an indication of quite recent or current violence or threats
to inflict serious harm (American Bar Association, 1994). Removal of supervised
access would require termination of violence or threats, successful completion
of an approved course of counseling for the ending of violence, and some level
of reasonable comfort for the children. One would have to establish that there
was no pattern of involvement of the children in the conflict, such as occurs
when one parent denigrates or threatens the other.
Last, because the emotional andphysical safety
of children are paramount, a suspension of parental access would result from
the failure of the alleged perpetrator to contain violence or threats to commit
violence (or to kidnap the child), repeated noncompliance with the rules of
supervised visitation (whether or not in an approved center), or significant
distress on the part of the child as part of the visitation process (despite
counseling to minimize these reactions).
FROM CLINICAL ASSESSMENT TO PARENTING PLAN
The evaluation of the family should generate
data about family protective factors, such as parent and child strengths,
and about family vulnerability factors, such as parent and child weaknesses,
including the nature of parental conflict, history of possible violence, contributory
factors (such as substance abuse), and external variables (such as extended
family support). Research on clinical judgment would suggest that the linear
addition of reliable factors gathered from clinical investigation may be the
simplest valid method of prediction (Dawes, 1994; Grove & Meehl, 1996).
However, there is currently insufficient data to permit any evaluator to base
recommendations on any formula. The decision trees (see Figures 1, 2, and
3) are a suggested clinical approach to basing parenting plans on a few variables
that can be reliably assessed through the methods discussed above.
The developmental assessment should result
in an understanding of the child's coping abilities. Dividing these abilities
into two categories, adequate and inadequate coping, would allow for some
estimate of the current coping ability of the child. For example, a CBCL (Achenbach
& Edelbrock, 1991) T *327 score
below 60 would indicate adequate coping, whereas a score above 60 would signify
inadequate adaptive skills. This manner of behavioral survey would also serve
as a check on the reporting elsewhere of any post traumatic stress disorder
symptoms that would be explored in greater depth through various interview
formats. As an alternative, a clinical determination of coping ability could
also be made from interview and collateral data. Inadequate coping would trigger
a referral for child therapy. Depending on the level of conflict or existence
of domestic abuse, it might also warrant a more restrictive type of access
arrangement, as it would suggest that the child could not handle much more
stress. One should explore the specific symptoms in some detail in the developmental
evaluation as they might offer some clue as to the nature of problems and
causation.
The parenting plans suggested by the decision
trees represent a continuum of choices, with the range being from lesser to
greater restrictiveness, much as special education prototypes are defined.
The goal is to create the least restrictive or "least detrimental"
(Goldstein, Freud, & Solnit, 1979) plan appropriate to the needs of the
children and the interests of the parents. In these plans, the range of access
can vary from normalized, overnight and weekend contact to daytime only access,
to short visits, and on the other end, to a suspension of contact between
child and parent. The level of restrictiveness can span a continuum of totally
unsupervised contact, to supervision by family or friends, to professional
supervision of visitation, including therapeutic supervision where clinical
intervention is necessary to repair a parent child relationship. The spectrum
of services supplied to the family would run the gamut of traditional therapy
for children and/or parents, to batterer's treatment groups, substance abuse
counseling, parenting education, and possibly, the installation of a parenting
coordinator or special master to monitor the family for the court and make
interim recommendations as needed.
INTEGRATION OF EVALUATION MODEL AND DECISION
TREES
Decision trees require logical connections
at the branching points. The pathways are not rigidly set because the research
data to support that approach are not available. However, they do offer some
systematic and understandable maps for the parents to appreciate how they
can reach a more normalized postseparation and divorce arrangement and create
peace for their children. Parents might also be able to envision the steps
they will need to take to reach their goals. One might conceptualize these
connections as choice points or filters that require certain data to be sifted
in order to decide *328 which route
to select. The decision trees in Figures 1, 2, and 3 require the evaluator
to use the data from the assessments to categorize several factors that research
has shown to be related to the well being of children after separation or
divorce. Although this may diminish some of the richness and uniqueness of
the family information in a clinical sense (and seem sterile to the clinician),
it should increase the reliability and reproducibility of clinical decisions,
assuming, of course, that the classifications reflect real differences among
people, which only research can inform. The evaluation data allow the clinician
to answer the following filter questions in a systematic (and repeatable)
way:
1. What is the level of conflict? (low/moderate/high)
2. Was the child a witness? (yes/no)
3. Was the child a victim? (yes/no)
4. What is the parenting capacity of the
adults? (adequate = +/ inadequate = )
5. Is the child currently "caught"
in the conflict? (yes/no)
6. What is the current level of the child's
coping skills? (adequate = +/ inadequate = )
As a general rule, the greater the level of
conflict, the more recent it was, and the more it has involved the children,
the more restrictive would be the resulting recommendation for access. The
degree of restrictiveness of these arrangements can be mitigated by the absence
of children being either victims or witnesses or by the adequacy of the children's
ability to cope. The general skills of the parents can be considered separately
from the specific issue of whether they involve the children in the conflict,
but generally adequate care by a parent would be considered a protective mediating
factor. A court appointed monitor, such as a parenting coordinator (Garrity
& Baris, 1994a), can serve to modify the restrictiveness of access over
time. That professional would structure clear time intervals for reassessment
and clarify for the family the kinds of issues under review through that form
of family oversight. The status of the various criteria at the next review
can enable the parenting coordinator to gauge the safety and security of the
children, on which he or she would base subsequent recommendations. The decision
trees in Figures 1, 2, and 3 include these factors in a logical sequence that
can make access determinations more reliable and systematic.
In the end, after thorough evaluation, the
determinations of the nature and extent of the violence, the parenting capacities
of the adults, and the psychological status and coping skills of the children
are all a mixture of clinical judgment and the limited science in this area.
The decision trees are, likewise, clinical tools to create a logical sequence
of recommendations for child access in separating or divorcing families in
which domestic violence has *332
played a part. As research in this field provides more answers about how children
cope with family aggression, it will be possible to create more detailed plans
to provide for their security and healing.
TABULAR
OR GRAPHIC MATERIAL SET FORTH AT THIS POINT IS NOT DISPLAYABLE
TABULAR
OR GRAPHIC MATERIAL SET FORTH AT THIS POINT IS NOT DISPLAYABLE
TABULAR
OR GRAPHIC MATERIAL SET FORTH AT THIS POINT IS NOT DISPLAYABLE
REFERENCES
Achenbach, T., & Edelbrock, C. (1991).
Manual for the Child Behavior Checklist 4/18 and 1991 Profile. Burlington:
University of Vermont Department of Psychiatry.
Adams, S., & Powell, A. (1995). The tragedies
of domestic violence: A qualitative analysis of civil restraining orders in
Massachusetts. Boston: Office of the Commissioner of Probation, Massachusetts
Trial Court.
American Bar Association. (1994). The impact
of domestic violence on children: A report to the president of the American
Bar Association. Washington, DC: Author.
American Psychiatric Association. (1994). Diagnostic
and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Appel, A. E., & Holden, G. W. (1998). The
co occurrence of spouse and physical child abuse: A review and appraisal.
Journal of Family Psychology, 12(4), 578 599.
Berry, D. (1996). The domestic violence sourcebook.
Los Angeles: Lowell House.
Bolton, F. G., & Bolton S. R. (1987). Working
with violent families: A guide for clinical and legal practitioners. Newbury
Park, CA: Sage.
Custody of Vaughn, 422 Mass 590 (1996) (SJC).
Davis, L., & Carlson, B. (1987). Observation
of spouse abuse: What happens to the children? Journal of Interpersonal Violence,
2(3), 278 291.
Dawes, R. (1994). House of cards: Psychology
and psychotherapy built on myth. New York: Free Press.
Depner, C., Leino, E., & Chun, A. (1992).
Interparental conflict and child adjustment: A decade review and meta analysis.
Family and Conciliation Courts Review, 30(3), 323 341.
Famularo, R., Fenton, R., & Kinscherff,
R. (1993). Child maltreatment and the development of posttraumatic stress
disorder. AJDC, 147, 755 760.
Finkelhor, D. (1983). Common features of family
abuse. In D. Finkelhor, R. Gelles, G. Hotaling, & M. Straus (Eds.), The
dark side of families: Current family violence research (pp. 17 28). Beverly
Hills, CA: Sage.
Garrity, C., & Baris, M. (1994a). Caught
in the middle: Protecting the children of high conflict divorce. New York:
Lexington Books.
Garrity, C., & Baris, M. (1994b). Custody
and visitation: Is it safe? How to protect a child from an abusive parent.
Family Advocate, 17(3), 40 45, 88.
Gelles, R., Lackner, R., & Wolfner, G.
(1994). Men who batter: The risk markers. Violence Update, 4(12).
Goldstein, J., Freud, A., & Solnit, A.
(1979). Beyond the best interests of the child. New York: Free Press.
Grove, W., & Meehl, P. (1996). Comparative
efficiency of informal (subjective,
impressionistic) and formal (mechanical, algorithmic) prediction procedures:
The clinical statistical controversy. Psychology, Public Policy, and the
Law, 2(2), 293 323.
Henning, K., Leitenberg, H., Coffey, P., Turner,
T., & Bennett, R. T. (1996). Long term psychological and social impact
of witnessing physical conflict between parents. Journal of Interpersonal
Violence, 11(1), 35 49.
*333 Hinchey, F., & Gavelek, J. (1982). Empathic
responding in children of battered mothers. Child Abuse and Neglect, 6(4),
395 401.
Irwin, J. (1996). Guidelines for judicial practice:
Abuse prevention proceedings. Boston: Massachusetts Trial Court.
Jaffe, P., Wilson, S., & Wolfe, D. (1988).
Promoting changes in attitudes and understanding of conflict resolution among
child witnesses of family violence. Canadian Journal of Behavioral Science,
18, 356 366.
Jaffe, P., Wolfe, D., & Wilson, S. (1990).
Children of battered women. Newbury Park, CA: Sage.
Jaffe, P., Wolfe, D., Wilson, S., & Zak,
L. (1986). Similarities in behavioral and social adjustment among child victims
and witnesses to family violence. American Journal of Orthopsychiatry, 57,
186 192.
Johnston, J. (1992). High conflict and violent
divorcing families: Findings on children's adjustment and proposed guidelines
for the resolution of disputed custody and visitation (Final report to the
Judicial Council of the State of California, Grant No. 891826). San Francisco:
Judicial Council of the State of California.
Johnston, J., Kline, M., & Tschann, J.
(1989). Ongoing postdivorce conflict: Effects on children of joint custody
and frequent access. American Journal of Orthopsychiatry, 59(4), 576 592.
Jouriles, E., Barling, J., & O'Leary, K.
(1987). Predicting child behavior problems in maritally violent families.
Journal of Abnormal Child Psychology, 55, 155 173.
Jouriles, E., & LeCompte, S. (1991). Husband's
aggression toward wives and mothers' and fathers' aggression toward children:
Moderating effects of child gender. Journal of Clinical and Consulting Psychology,
59(1), 190 192.
Jouriles, E., Murphy, C., & O'Leary, K.
(1989). Interspousal aggression, marital discord, and child problems. Journal
of Abnormal Child Psychology, 57, 453 455.
Kempe, C., & Helfer, R. (Eds.). (1972).
Helping the battered child and his family. Philadelphia: J. B. Lippincott.
Kolbo, J., Blakely, E., & Engleman, D.
(1996). Children who witness domestic violence: A Review of empirical literature.
Journal of Interpersonal Violence, 11(2), 281 293.
Massachusetts Continuing Legal Education, Inc.
(1996, September). Custody and visitation issues in cases of domestic violence.
Seminar presented in Boston, MA.
McCloskey, L., Figueredo, A., & Koss, M.
(1995). The effects of systematic family violence on children's mental health.
Child Development, 66, 1239 1261.
Mnookin, R., & Weisberg, D. (1995). Child,
family, and state: Cases and materials in family law Boston: Little, Brown.
Mohr, J., & McKnight, C. (1971). Violence
as a function of age and relationship with special reference to matricide.
Canadian Psychiatric Association Journal, 16(1), 29 53.
Moore, T., et al. (1990, June/September). Research
on children from violent families. Canada's Mental Health, pp. 19 22.
Prodgers, A. (1984). Psychopathology of the
physically abusing parent: A comparison with the borderline syndrome. Child
Abuse and Neglect, 8(4), 411 424.
Radovanovic, H. (1993). Parental conflict and
children's coping styles in litigating separated families: Relationships with
children's adjustment. Journal of Abnormal Child Psychology, 21(6), 697 713.
Richters, J., & Pellegrini, D. (1989).
Depressed mother's judgments about their children: An examination of the depression
distortion hypothesis. Child Development, 60, 1068 1075.
Rosenberg, M. (1987). Children of battered
women: The effects of witnessing violence on their social problem solving
abilities. Behavior Therapist, 4, 85 89.
Straus, M., & Gelles, R. (Eds.). (1990).
Physical violence in American families. New Brunswick, NJ: Transaction.
*334 Straus, M., Gelles, R., & Steinmetz, S. (1980).
Behind closed doors: Violence in the American family. Garden City, NY: Doubleday.
Straus, M., & Smith, C. (1990). Family
patterns and child abuse. In M. Straus & R. Gelles (Eds.), Physical violence
in American families. Brunswick, NJ: Transaction.
Strauss, M. (1979). Measuring intrafamily conflict
and violence: The conflict tactics (CT) scale. Journal of Marriage and the
Family, 41, 75 88.
Trial Court, Commonwealth of Massachusetts.
(1994). Domestic violence visitation risk assessment. Boston: Author.
Wolfe, D., Jaffe, P., Wilson, S., & Zak,
L. (1985). Children of battered women: The relation of child behavior to family
violence and maternal stress. Journal of Consulting and Clinical Psychology,
53, 657 665.
Zorza, J. (1995). Recognizing and protecting
the privacy and confidentiality needs of battered women. Family Law Quarterly,
29(2), 273 211.
Joseph C. McGill, LICSW, is a licensed independent
clinical social worker on the staff of the Child and Family Forensic Center
and an instructor in psychiatry in the Department of Psychiatry at the University
of Massachusetts Medical Center in Worcester.
Robin M. Deutsch, Ph.D., is a licensed psychologist
and director of training in the Children and the Law Program at Massachusetts
General Hospital, Boston. She is an instructor in psychiatry in the Department
of Psychiatry at Massachusetts General Hospital and Harvard Medical School
and is in private practice in Wellesley, Massachusetts.
Robert A. Zibbell, Ph.D., is a licensed psychologist
in private practice in Framingham, Massachusetts. He is also an associate
in psychiatry with the Child and Family Forensic Center at the University
of Massachusetts Medical Center, Worcester.