A range of domestic abuse interventions has 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.

Objectives

This review has three objectives. The first objective is to identify ‘what works’ in improving outcomes for children (for example, children’s emotional wellbeing).  The second objective 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 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.

Research questions

1. What is the state of the evidence on the effectiveness of interventions for families where the child has been exposed to domestic abuse and also has current involvement with children’s social care services (that is, a Child in Need or Child Protection Plan)?
2. What are the facilitators and barriers to implementing and evaluating the above group of interventions?
3. What are the mediators and moderators of the above group of interventions?

Methods

We worked with the University of Oxford to conduct a rapid systematic search and review to identify both published and grey literature, summarising either quantitative or qualitative data that address the above questions. The review only included studies that targeted children (aged 18 years or under) who had been exposed to domestic abuse and where at least 50% of the sample also had a social worker (that is, where the child was on a Child in Need Plan, Child Protection Plan or in Local Authority Care).

Findings

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.