Promoting resilience and wellbeing in children exposed to intimate partner violence: A qualitative study with mothers
Introduction
Approximately one in four children are exposed to intimate partner violence (IPV) during their childhood (Finkelhor, Turner, Shattuck, & Hamby, 2015). Exposure to IPV can be defined as living in a home where IPV is present, with research demonstrating similar detrimental impacts on children regardless of whether IPV is directly witnessed or not (Øverlien, 2010, Kitzmann, Gaylord, Holt, & Kenny, 2003). Children exposed to IPV are at an increased risk of negative health consequences such as emotional-behavioural problems, asthma, and cognitive and language delays (Bogat, DeJonghe, Levendosky, Davidson, & von Eye, 2006; Evans, Davies, & DiLillo, 2008; Holt, Buckley, & Whelan, 2008; Howell, Barnes, Miller, & Graham-Bermann, 2016). Despite these risks, there is a growing body of research documenting healthy development and pathways of resilient outcomes for children exposed to IPV (Graham-Bermann, Gruber, Howell, & Girz, 2009; Howell, 2011; Kitzmann et al., 2003; Martinez-Torteya, Anne Bogat, Von Eye, & Levendosky, 2009).
Understanding what promotes the health, wellbeing and resilience of children exposed to IPV has been of increasing interest (Graham-Bermann et al., 2009; Howell, Graham-Bermann, Czyz, & Lilly, 2010; Martinez‐Torteya, Anne Bogat, Von Eye, & Levendosky, 2009). Key protective factors identified include maternal mental health, parenting style and responsive and sensitive mother-child relationships (Graham-Bermann et al., 2009; Howell et al., 2010; Martinez‐Torteya et al., 2009). Despite the importance of the mother-child relationship in promoting children’s health few studies have explored mothers’ perceptions of how they have supported their children’s health and development. The voices of mothers who have this lived experience are essential in designing appropriate and effective support services for families experiencing IPV.
Defined as the maintenance of successful functioning despite exposure to a significant adversity (Luthar, Cicchetti, & Becker, 2000), resilient outcomes are dependent on interactions between an individual and his/her environment (Masten & Obradović, 2006; Wright, Masten, & Narayan, 2013). Factors which are protective for children exposed to a particular adversity have a strong potential to inform interventions aimed at reducing the onset of psychopathology in those at risk (Masten, 2011, Southwick, Bonanno, Masten, Panter-Brick, & Yehuda, 2014). Recent research seeking to identify protective factors for children exposed to IPV has had a strong focus on factors within the home environment (Kitzmann et al., 2003; Martinez‐Torteya et al., 2009).
Maternal mental health has been at the centre of this research with several studies finding maternal mental health to be a significant predictor of outcomes in children exposed to IPV (Graham-Bermann et al., 2009; Howell et al., 2010; Martinez‐Torteya et al., 2009; Owen, Thompson, Shaffer, Jackson, & Kaslow, 2009). It has been proposed that mothers with good mental health are better equipped to model optimal emotion regulation strategies for their children (Howell et al., 2010; Martinez‐Torteya et al., 2009). Caregiver interactions and attachment are essential in the development of children’s emotion regulation. Maternal depression can disrupt these processes (Goodman & Gotlib, 1999), making it harder for mothers to facilitate this skill development.
Maternal emotion coaching and attunement to children’s emotional experiences are also associated with positive outcomes for children exposed to IPV. Emotion coaching is a way of communicating with children that can facilitate the development of social emotional development (Gottman, Katz, & Hooven, 1996). In a sample of 30 mothers recruited from domestic violence services, attunement to children’s experience of sadness and anger was associated with resilience in behavioural outcomes (Johnson & Lieberman, 2007). A similar study of 95 mothers found that maternal awareness of their child’s negative emotions moderated the relationship between maternal mental health symptoms and children’s externalising and internalising problems (Cohodes, Chen, & Lieberman, 2017). Specifically, maternal emotion coaching of their children’s negative emotions moderated the relationship between maternal mental health symptoms and children’s internalising difficulties (Cohodes et al., 2017). These findings provide some evidence that mothers’ awareness of their children’s emotional experience and their ability to coach their children through emotions may provide a buffer against the negative impacts of exposure to IPV.
Parenting styles and mothers’ responsiveness and sensitivity to their child are significant determinants of secure attachment relationships (Bakermans-Kranenburg, Van Ijzendoorn, & Juffer, 2003; Goodman & Gotlib, 1999). Given this, several studies have investigated parenting as a protective factor in children exposed to IPV. For instance, effective parenting (characterised by warmth, control, child centeredness and consistency) has been associated with positive emotional-behavioural outcomes in children within a sample of 219 mother-child dyads (Graham-Bermann et al., 2009). Similar results were found by Howell et al. (2010) for the role of parenting practices, defined by parenting involvement, positive parenting, supervision and discipline practices. Other studies have found no associations between parenting and positive child outcomes. For instance, in a community sample of 190 mothers, positive parenting (characterised by consistent discipline, nurturing parenting and less harsh parenting) was not associated with positive outcomes for children exposed to IPV (Martinez‐Torteya et al., 2009). Taken together, these studies suggest that although maternal mental health and emotional attunement are protective for children exposed to IPV, the specific parenting practices which are most beneficial for children exposed to IPV remain less clear. There is a need for future research to determine what mothers can do to promote wellbeing in their children following exposure to IPV.
Despite research into the contribution of mother-child relationships on resilience among children exposed to IPV, few studies have explored the voices of mothers and their perception of what promotes positive outcomes for children. A qualitative study of 26 mothers who had experienced IPV emphasised how violence towards women adds unique challenges to mothering including the increased responsibility placed on them to look after their child (Lapierre, 2009). Lapierre (2009) highlighted that the current literature on parenting does not give due acknowledgement to how IPV complicates women’s role as a mother. Research highlighting deficits in parenting within the presence of IPV can contribute to a blaming culture whereby mothers are labelled ‘inadequate’. A qualitative study of 17 lower-income mothers involved in child protection services identified strategies they use to promote their children’s physical and mental health (Haight, Shim, Linn, & Swinford, 2007). These included (a) clear and appropriate communication about the current situation, (b) providing emotional support and reassurance, (c) offering education around relationships, and (d) separating the spousal and parental role of their partner to allow their child to develop their own relationship with their father (Haight et al., 2007). The findings from this study also highlighted the complex nature of trying to protect children’s psychological wellbeing. Specifically, that an individual’s cultural background and life experiences may alter perceptions of what are effective strategies or the need to implement such strategies (Haight et al., 2007). An understanding of the strategies mothers use to promote the wellbeing of their children will inform future policy and interventions for mothers and their children exposed to IPV. Approaches which build on the strengths and strategies mothers are actively practising are essential in ensuring mothers feel empowered when seeking help.
The few qualitative studies on children exposed to IPV have not examined parenting strategies within a community sample of mothers who have experienced IPV, nor have they asked mothers more broadly about what has helped their children stay resilient throughout their experiences. The current study aimed to use qualitative interviews to explore mothers’ perceptions of how their children have coped with IPV exposure, and the strategies they have used to support their children and promote a sense of resilience. This study builds on previous literature by exploring mothers’ perceptions of their child’s resilience within a community sample of women with experiences of IPV. We believe this study provides valuable insight into mothers understanding of resilience processes in their children. This contribution to the field has important implications for working with mothers and children exposed to IPV as well as informing future quantitative research in this area.
Section snippets
The maternal health study
The MHS is a prospective pregnancy cohort study investigating the health and wellbeing of mothers during pregnancy and following the birth of their first child. Approximately 6000 women who were registered to give birth at six metropolitan hospitals across Melbourne between April 2003 and December 2005, were invited to take part in the study. Women were eligible to participate if they were: (a) 18 years or older; (b) nulliparous; (c) had an estimated gestation of up to 24 weeks at the time of
Qualitative analysis
The final themes and subthemes for the current analysis are displayed in Fig. 1. Mothers’ narratives around what was helpful for their children fell into the broad themes of: (1) parenting strategies, (2) reducing the impact of children’s exposure to IPV, (3) making choices around father involvement, (4) importance of interest hobbies and sport, and (5) mothers’ wellbeing. These will now be discussed in turn.
Discussion
Giving voice to mothers with a lived experience of IPV, this study explored their perceptions of children’s resilience, and the strategies they have used to buffer the potential negative impacts on their children. This study is unique in its focus on mothers’ perceptions of their children’s resilience and in its inclusion of a community sample of mothers who have experienced IPV. When reflecting on what has helped children throughout their experiences of IPV, there were five main themes: (1)
Funding
This work was supported by grants #199222, #433006 and #491205 from The National Health and Medical Research Council (NHMRC), a VicHealth Research Fellowship (SB), an ARC Future Fellowship (SB), an NHMRC Career Development Fellowship (SB), Australian Government Research Training Program Scholarship (AF), a grant from the Medical Research and Technology in Victoria Fund (ANZ Trustees) and Murdoch Children’s Research Institute research is supported by the Victorian Government’s Operational
Acknowledgements
We are extremely grateful to all of the women taking part in the Maternal Health Study. In particular we are grateful to the women who contributed their time and energy to share their experiences with us in this sub-study.
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