Children who have been exposed to domestic abuse and are on or above the threshold for child protection services require significant support. A range of domestic abuse interventions have been developed, but review-level evidence has not yet focused on interventions for children, parents or families in which the child is on or above the threshold for children’s social care services. This review sought to identify ‘what works’ in improving outcomes for children; identify barriers and facilitators to implementing and evaluating services for children exposed to domestic abuse and their families and what is needed to help achieve fundamental changes; and to identify what makes it more difficult or easier for parents, children or families to get involved in a service, complete it and achieve their goals.
A range of domestic abuse interventions have been developed over the past two decades, many of which aim to improve outcomes for children exposed to domestic abuse. Some effective interventions and practice models have been identified. However, review-level evidence has not yet focused on interventions for children, parents or families in which the child is on or above the threshold for children’s social care services.
This review has three aims. The first is to identify ‘what works’ in improving outcomes for children (for example, children’s emotional wellbeing). The second is to identify barriers and facilitators to implementing and evaluating services for children exposed to domestic abuse and their families, and what is needed to help achieve fundamental changes. The third aim is to identify what makes it more difficult or easier for parents, children or families to get involved in a service, complete it and achieve their goals.
We worked with the University of Oxford to conduct a rapid systematic search and review to identify literature summarising either quantitative or qualitative data that addresses these questions:
Children who have been exposed to domestic abuse and are on or above the threshold for child protection services require significant support. Many interventions in this report (particularly those that involve mothers and children or children alone) focus on improvements in children’s trauma symptoms, and externalising and internalising behavioural problems.
While there is some evidence to support trauma-informed treatments that target parent and child (such as PCIT) or the child directly (such as TF-CBT with expressive therapies), other approaches designed for children on or above the threshold for children’s social care need to be more rigorously evaluated. There is some evidence that an intensive psychoeducational parenting intervention, combined with advocacy, can result in reduced use of Child Protective Services, but this does not report on child mental health or trauma symptoms. There is also evidence to suggest that attachment and trauma-informed interventions with fathers (such as Fathers for Change) can reduce the need for children’s social care/Child Protective Services involvement.
Many of the whole family and multi-agency approaches developed in the UK over the past decade also require further rigorous evaluation. The available evidence about barriers and facilitators provides a rich source of evidence on promising methods of working, but these also need further evaluation.
Rated 1: Set up and delivery is low cost, equivalent to an estimated unit cost of less than £100.
Rated 2: Set up and delivery is medium-low cost, equivalent to an estimated unit cost of £100–£499.
Rated 3: Set up and delivery is medium cost, equivalent to an estimated unit cost of £500–£999.
Rated 4: Set up and delivery is medium-high cost, equivalent to an estimated unit cost of £1,000–£2,000.
Rating 5: Set up and delivery is high cost. Equivalent to an estimated unit cost of more than £2,000.
Set up and delivery cost is not applicable, not available, or has not been calculated.
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Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing child maltreatment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Enhancing school achievement & employment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing crime, violence and antisocial behaviour: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing substance abuse: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing risky sexual behaviour & teen pregnancy: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing obesity and promoting healthy physical development: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Rated 2: Has preliminary evidence of improving a child outcome from a quantitative impact study, but there is not yet evidence of causal impact.
Rated 2+: Meets the level 2 rating and the best available evidence is based on a study which is more rigorous than a level 2 standard but does not meet the level 3 standard.
Rated 3: Has evidence of a short-term positive impact from at least one rigorous study.
Rated 3+: Meets the level 3 rating and has evidence from other studies with a comparison group at level 2 or higher.
Rated 4: Has evidence of a long-term positive impact through at least two rigorous studies.
Rated 4+: Meets the level 4 rating and has at least a third study contributing to the Level 4 rating, with at least one of the studies conducted independently of the intervention provider.
Rating has a *: The evidence base includes mixed findings i.e., studies suggesting positive impact alongside studies, which on balance, indicate no effect or negative impact.
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