Nonviolent Resistance: Helping Caregivers Reduce Problematic Behaviors in Children and Adolescents

Are All Child-to-Parent Violence Profiles Associated with Exposure to Family Violence? Findings from a Sample of Spanish Adolescents

Exposure to family violence (EFV) is proposed as a relevant antecedent of child-to-parent violence (CPV). However, both previous research and practitioner experience suggest that not all cases of CPV involve EFV. This study aimed to identify profiles of adolescents according to their degree of involvement in CPV and their EFV. A sample of 1647 adolescents (mean age = 14.30, SD = 1.21; 50.5% boys) completed measures of CPV, witnessing family violence, victimization by parents, permissive parenting, parental warmth, and several measures of cognitive and emotional characteristics. Latent profile analyses based on measures of CPV and family characteristics supported a four-profile solution. Profile 1 (82.2%) consisted of adolescents with very low scores on both CPV and exposure to family violence. Profile 2 (6.2%) was characterized by medium scores on psychological CPV and high EFV. Profile 3 (9.7%) was characterized by severe psychological CPV and very low EFV. Profile 4 (1.9%) included adolescents with the highest scores on CPV, including physical violence, and high EFV. These profiles were found to differ from each other according to several cognitive and emotional variables of the adolescents. Therefore, not all CPV profiles were associated with a history of EFV. The obtained profiles have implications for interventions.

A Systematic Review of Child to Parent Violence Interventions

Objective: To identify, appraise and synthesize research on the interventions used in child to parent violence. Method: A systematic literature review was conducted using the electronic databases of PsycINFO, Scopus, Web of Science and CINAHL Full Text. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, three authors conducted the screening process which was implemented in two stages including screening the title and abstract, followed by screening the full text. Papers were assessed for quality using the Mixed Methods Assessment Tool. The search identified 727 studies which met the inclusion criteria, deduplication resulted in 525 number for review, with 8 articles included in the review. Results: This review identifies six themes from the six unique interventions included to address the research questions: How do practitioners effectively support families experiencing child-to-parent violence? The six themes are: Conceptualising the violence; Assessment of needs and risks; Intervention types and settings; Program techniques and components of interventions; Intervention outcomes and effectiveness; and Research design and methods. Three narratives were iteratively developed from these themes which highlight the main findings of the review: importance of the practitioner and their skills; conceptual clarity of CPV; and CPV interventions. Conclusions: The findings from this systematic review identifies the need for further research into child to parent violence including what makes interventions effective, what needs and outcomes the interventions are addressing, and the implications of classifications of this violence.

Relationships between dynamic risk factors for externalising problem behaviour and group climate in adults with mild intellectual disability in forensic treatment

BACKGROUND

Relationships between dynamic risk factors for externalising problem behaviour and group climate were investigated in 151 adult in-patients with mild intellectual disability or borderline intellectual functioning in a Dutch secure residential facility.

METHOD

Regression analysis was used to predict total group climate score and Support, Growth, Repression, and Atmosphere subscales of the 'Group Climate Inventory'. Predictor variables were Coping Skills, Attitude towards current treatment, Hostility, and Criminogenic attitudes subscales of the 'Dynamic Risk Outcome Scales'.

RESULTS

Less hostility predicted a better overall group climate, better support and atmosphere, and less repression. A positive attitude towards current treatment predicted better growth.

CONCLUSION

Results indicate relationships of hostility and attitude towards current treatment with group climate. A focus on both dynamic risk factors and group climate may provide a basis for improving treatment for this target group.

"I Wasn't Gonna Quit, but by Hook or by Crook I was Gonna Find a Way Through for the Kids": A Narrative Inquiry, of Mothers and Practitioners, Exploring the Help-seeking of Mothers' Experiencing Child to Parent Violence

Purpose

Child to parent violence is a significant concern that has been researched over the last sixty years. However, little is known about the help-seeking pathways of parents experiencing child to parent violence (CPV). Barriers and enablers to disclosing CPV have been explored, and responses to address CPV have been nominally researched. The mapping of a disclosure to a choice of where to get help has not occurred. This study seeks to map help-seeking pathways of mothers and considers these pathways in regards to the relations within families and sociomaterial conditions.

Method

This narrative inquiry utilizes response-based practice and Barad's concept 'intra-action' to examine interviews with mothers (n = 11) who experience CPV, and practitioners (n = 19) who work with families experiencing CPV.

Results

Five help-seeking pathways of mothers are found in this study. Three themes evident across the pathways are explored including: (1) help-seeking within pre-existing relationships; (2) mothers' feelings of fear, shame and judgement entangled with help-seeking; and (3) conditions which enable and hinder help-seeking from family.

Conclusions

This study finds sociomaterial conditions such as single motherhood and judgement limit help-seeking possibilities. Further, this study finds help-seeking occurs within pre-existing relationships along with the entanglement of CPV with other issues such as intimate partner violence (IPV) and homelessness. This study demonstrates the benefits of employing a response-based approach alongside 'intra-action' within a research and practice context.

Parent training for the treatment of irritability in children and adolescents: a multisite randomized controlled, 3-parallel-group, evaluator-blinded, superiority trial

Background

Irritability is common in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD) and with anxiety/depressive disorders. Although youth irritability is linked with psychiatric morbidity, little is known regarding its non-pharmacological treatments. Developing non-pharmacological treatments for children with severe, chronic irritability is an important target for clinical research. To achieve this goal, we will test the benefits of parent-focused therapies in reducing irritability. The aim of the study is to compare Parent Management Training (PMT) and Non-Violent Resistance Training (NVR) programs with treatment-as-usual (TAU) on the improvement of irritability in children and adolescents with a baseline Parent-rated Affective Reactivity Index of 4 or higher, in the context of ADHD and other emotional and behavioural disorders. Additionally, we will assess (i) improvement of irritability at different times and according to different informants (parents, children, clinicians); (ii) improvement of parental strategies; and (iii) acceptability of the interventions, exploring possible mechanisms of the therapeutic effect.

Methods

Two hundred and seventy participants between 6 and 15 years with ADHD and other emotional and behavioural disorders will be recruited and randomly assigned with their parents to the PMT, NVR, and TAU groups. PMT and NVR programs have 10 online sessions and two booster sessions at 1 and at 3 months. The primary outcome measure is the change from baseline at 3 months after completion of the program of the Clinician-rated Affective Rating Scale (CL-ARI) assessed by a blind evaluator. Secondary outcome measures include the change from baseline from those scales: the CL-ARI, the Clinical Global Impression Improvement scale, the Parenting and Familial Adjustment Scales, the Child-rated Cranky thermometers and the Parent-rated ARI. We will assess the parent’s expressed emotions and reflexivity during the online five-minute speech sample, clinical dimensions through the Child Behavior Checklist 6–18 and the Inventory of Callous Unemotional traits. Evaluations will be done remotely at baseline and at 1- and 3-months follow-up visits.

Discussion

We expect a benefit in controlling irritability in the treatment groups. This will constitute an important achievement in promoting parental support programs in the treatment of irritability in the context of emotional and behavioural disorders.

Clinicaltrials.gov. Number: NCT05528926. Registered on the 2nd of September, 2022.

Parent training for dependent, yet abled, young adults

The term Failure to launch (FTL) has been used to describe abled adults who do not work, do not attend school, and live with- and at the expense of-their parents. FTL can be beneficially addressed through parent training, a treatment method that is rarely used with adults (i.e., individuals past the age of majority). The authors first review the goals of parent training programs offered to parents of adults. The review demonstrates that these goals dovetail with key aspects of FTL. The authors then describe a new parent training approach for parents of individuals with FTL, based on SPACE (Supportive Parenting for Anxious Childhood Emotions). They highlight five key components of SPACE-FTL: Psychoeducation, Reducing Parental Accommodation, Increasing Parental Support, De-Escalation, and Engaging Supporters. The authors conclude by discussing SPACE-FTL in relation and comparison to other parent training programs and their components.

'He's out of control, I'm out of control, it's just - I've got to do something': a narrative inquiry of child to parent violence

Families globally experience child to parent violence (CPV). Stories of CPV have been considered at an individual and collective level to ascertain themes in parents' accounts to identify enabling and restraining factors for CPV. However, understanding the societal narratives, defined as discourses, which have a multi-directional and entangled relationship with individual recounts of CPV have yet to be investigated. This research utilizes Narrative Inquiry with participatory approaches to explicate the societal narratives within mothers' recounts of CPV. This analysis, guided by the interactional and discursive view of violence, and response-based practice, identifies societal narratives which set the conditions for what is possible and impossible in relation to CPV. The analysis contributes to understanding the attitudes of minimization and concealment of violence within parents' accounts of CPV. The mothers' recounts were constrained and made possible by the 'good' mother narrative and narratives of adolescence and gender. This research examines the intra-actions mothers' recounts have with the societal narratives, and the performance of their roles as (en)actors of the subject positions 'mother' and 'child'. Implications for practice and research include: consideration to practitioner's views of power and subject positions in a parent and child relationship when working with CPV; and practitioners to be critical of essentialism and gender in working with CPV. This study posits a practical demonstration for using the response-based practice approach in research; and a way of viewing stories which can be incorporated in working with families experiencing CPV.

Non-violent resistance and family accommodation: A trans-diagnostic solution to a highly prevalent problem

The goal of this study is to integrate two areas in recent clinical theory, research, and practice: family accommodation and non-violent resistance (NVR). Family accommodation describes changes that family members make to their own behavior, to help their relative who is dealing with psychopathology to avoid or alleviate distress related to the disorder. Rapidly growing research on family accommodation has established its high prevalence and negative impact across disorders and the life span. NVR is a trans-diagnostic treatment approach that helps parents to cope with child externalizing, internalizing, and other problems in non-escalatory ways. This study reviews empirical research on family accommodation and NVR, and argues that the anchoring function of NVR, a central concept reflecting the stabilization of the parent-child relationship, may provide a uniquely suited framework for reducing family accommodation across disorders and development. The study discusses how the anchoring function may be applied to promote accommodation reduction through a detailed description of SPACE (Supportive Parenting for Anxious Childhood Emotions), an NVR-informed treatment for childhood anxiety and obsessive-compulsive disorder.

Improvement of group climate in a residential setting for juveniles with mild intellectual disability through training of staff in Non-Violent Resistance

BACKGROUND

An open group climate is essential in successful residential care for juveniles with mild intellectual disability (MID). This study examined whether non-violent resistance, adapted for MID (NVR-MID), stimulates an open group climate in time.

METHOD

NVR-MID was implemented in three residential settings in The Netherlands, in a quasi-experimental stepped wedge design. In total, 124 clients with MID (M_age  = 16.39 [SD = 4.95], 49.9% male) participated. Group climate was assessed seven times with the Group Climate Inventory for Children or the Group Climate Inventory-Revisited (GCI-R), during a total of 20 months.

RESULTS

Open group climate scores increased in all three institutions; effect size was medium. Clients with lower IQs experienced group climate as more positive compared to clients with higher IQs. Effects were similar for both groups.

CONCLUSIONS

As NVR-MID appeared to contribute to a positive experienced group climate, it might be advisable to implement NVR-MID on larger scale.

Addressing Aggression in the Residential Setting for Juveniles with Mild Intellectual Disability through Training in Non-Violent Resistance

Background

Levels of aggression are high in residential settings for juveniles with Mild Intellectual Disability (MID). As a result, treatment is less effective, aggression causes injury, traumatic experiences and longer inhabitation for juveniles. Additionally, inpatient aggression has been linked to burnout and stress among group workers, which has negative consequences such as less job satisfaction or poorer work performance

Objective

Therefore, it is crucial to diminish aggressive incidents in these settings and to find a way for staff how to respond to aggression properly.

Methods

As there is no intervention method which tackles all of the referred problems efficiently, a new method Non-violent Resistance for MID was introduced into three residential settings for juveniles with MID, in a quasi-experimental stepped wedge design. Reports of aggressive incidents were assessed seven times before, during and after the training in NVR-MID on group level. Multilevel analyses were carried out in order to assess the development of the aggressive incidents over time.

Results

Aggressive incidents decreased significantly in time during and after training in NVR-MID, this decrease is seen in all three institutions. Thus, regardless of resident’s age, gender or IQ, NVR-MID seemed successful in diminishing aggressive incidents. Furthermore, a significant interaction effect was found between institution and time, indicating that regardless if incidents of aggression were relatively high at baseline, decrease in incidents was similar to institutions where incidents were relatively low on baseline.

Conclusions

Implementing NVR-MID into residential settings for juveniles with MID and comorbid behavioral problems might help to decrease aggressive incidents.