Mediators and Treatment Factors in Intervention for Children Exposed to Interparental Violence

Abstract

Changes in children's emotion differentiation, coping skills, parenting stress, parental psychopathology, and parent-child interaction were explored as mediators of treatment factors in two selective preventive group interventions for children exposed to interparental violence (IPV) and their parents. One hundred thirty-four IPV-exposed children (ages 6-12 years, 52% boys) and their parents were randomized to an IPV-focused or common factors community-based group intervention and completed baseline, posttest, and follow-up assessments for posttraumatic stress (PTS). A multilevel model tested mediators that included children's ability to differentiate emotions and coping skills, parenting stress, parental psychopathology, and parent-child interactions. In both conditions, exposure to nonspecific factors, specific factors unrelated to IPV and trauma-specific intervention factors was coded from videotaped child and parent sessions. Improved parental mental health mediated the link between greater exposure to nonspecific treatment factors and decreases in PTS symptoms. In addition, an increase in emotion differentiation and a decrease in parenting stress were associated with a decrease in PTS symptoms. Greater exposure to trauma-specific factors in child sessions was associated with a small decrease in emotion differentiation, an increase in coping skills, and a decrease in PTS symptoms over time. Greater exposure to nonspecific treatment factors in child and parent sessions was associated with more positive parent-child interaction. Parental mental health appears to be an important mechanism of change that can be promoted through exposure to nonspecific factors in parent intervention. For children, the effect of greater exposure to trauma-specific factors in intervention is less clear and may not have clear benefits.

Children Exposed to Intimate Partner Violence: Conduct Problems, Interventions, and Partner Contact With the Child

“…Jouriles and colleagues (2009) found that changes in mothers’ inconsistent and harsh parenting partially accounted for Project Support’s effects on children’s conduct problems during treatment. In addition, consistent with the results of research on other interventions for children exposed to IPV (Graham-Bermann et al, 2007; Overbeek, De Schipper, Willemen, Lamers-Winkelman, & Schuengel, 2015), reductions in mothers’ trauma symptoms and psychological distress contributed to treatment effects. Yet, a sizable proportion (46.4%) of Project Support’s effects on children’s conduct problems cannot be attributed to changes in maternal parenting and maternal symptoms of trauma and distress, raising the question of what else might account for the improvements in child conduct problems.…”

Mechanisms of change in psychological interventions for posttraumatic stress symptoms: A systematic review with recommendations

“…However, this does not preclude the study of crucial change processes during therapy, which indeed is also on-going both in terms of examining insession client responses (e.g., de Kleine et al 2017;Sripada and Rauch 2015) and particular treatment components (e.g., Deblinger et al 2011;Sack et al 2016). Mechanisms of change and treatment elements can also be studied in tandem, as Overbeek et al (2017) did among children who had experienced interparental violence. Their approach of studying the effects of different degrees of exposure to specific and non-specific treatment elements as potentially mediated via different mechanisms can be recommended as highly informative about the relationships between therapy change processes and mechanisms of change beyond therapy.…”

“…all lead to reduction in symptoms. At the same time, isolating more treatment-specific mechanisms can boost our confidence in particular interventions, as we are able to ascertain that their effectiveness is indeed due to the mechanisms of change they specifically target (Kazdin 2007;Overbeek et al 2017). Such particular evidence may also help persuade clinicians to adopt empirically supported treatments (Tryon 2005).…”

The effectiveness of trauma-focused cognitive-behavioural therapy in the treatment of depression of divorced women

“…1 Hence, the divorce affects the compatibility of couples and their children in all aspects (psychological, physical, social and emotional) and decreases the performance and inefficiency of family members after divorce. 2 As one of the most stressful resources, divorce can disrupt the cognitive structures of individuals making them unable to use stress management methods. 3 This phenomenon has economic, social and, especially psychological harmful effects on women.…”