Programs

Child Witness to Violence Project, Boston Medical Center

Type of Approach:

  • Mixed

Provider Education Level:

  • Masters Degree
  • PhD

Length:

  • Greater than 12 weeks
  • Less than 12 weeks

Trauma Type:

  • Community Violence
  • Disrupted Attachment
  • Domestic Violence
  • Gang Violence
  • Homicide/Familicide
  • Multiple
  • Other

Trauma Symptom:

  • Anxiety
  • Attachment
  • Depression
  • Externalizing Behaviors
  • Internalizing Behaviors
  • PTSD

Setting:

  • Hospital-based

Notes:

Type of services:

Child Parent Psychotherapy (CPP) is the primary intervention provided by this program.

CPP, which has both child and parent components, includes case management/advocacy, parent guidance, and dyadic and/or individual psychotherapy.

The child component addresses symptoms associated with exposure to violence including aggression, sleep problems, conflicts in the child-parent relationship, and difficult peer relationships.

The parent component of the project addresses conflict in the parent-child relationship, lack of understanding/awareness of trauma’s effect on children, disruption of attachment between the parent and child, and the stresses and trauma associated with being a victim of domestic violence.

Service Provider:

Master’s or Doctorate-level mental health clinicians

Program setting:

Hospital

Length of program/number sessions:

Variable, depending on the needs of the child and family.

Type(s) of trauma addressed:

Exposure to domestic or community violence, and other traumas; 75% of the children seen in the program are referred for exposure to domestic violence.

Additional Information:

The Child Witness to Violence Project has established a national reputation for its contribution to the field of domestic violence intervention and prevention and the field of early childhood trauma. Its collaboration with law enforcement was recognized by an “Innovations in American Government” award in 1996; it received the Massachusetts Office of Victim Services’ public policy award in 1998.

Unique/Innovative Characteristics
  • One of the first programs in the country to recognize the impact of exposure to violence on very young children and to provide an intervention that specifically considers the developmental needs of this age group
  • The program has a dual focus on intervention and on policy and program development related to children and domestic violence
  • The staff have dual training in early child development and trauma-focused intervention
  • The program’s philosophy recognizes the central importance of the parent-child relationship as the context in which children develop. Intervention and training emphasize this philosophy as the foundation for working with children

Date Added/Updated:

6/15/12

Age:

  • 0-5 (Early Childhood)
  • 6-12 (Childhood)

Language:

  • English
  • Other
  • Spanish

Ethnic Racial Group:

  • Asian
  • Black or African American
  • Hispanic or Latino
  • White

Caregivers Included:

  • Father
  • Mother
  • Other

Population Adaptations:

Age range of children:

Children up to 8 years old; 65% of the children seen in 2010 were age six or younger.

Parent/adult caregiver included in intervention:

Parent involvement is an integral part of the intervention.

Ethnic/racial and other groups served:

African American, Latino, Caucasian, Asian, and African families account for the majority of referrals to the program.

Specific cultural adaptations:

The Project serves a significant immigrant population whose needs may include advocacy, assistance with concrete services, and a focus on immigration-related trauma. These issues are addressed within the context of therapy with the child and parent.

Training has been conducted in 37 states and three countries. Many programs have adapted components of the Child Witness to Violence Project.

Languages available:

English, Spanish, and Thai

Foundation:

Theoretical basis:

CPP focuses on strengthening the child-parent relationship as a means for mediating the stressors of exposure to trauma.

Outcome indicators:

Decrease in trauma-related symptoms of the child; increase in parental awareness of the impact of the stress on the child, increase in parental confidence in meeting the needs of the child.

Evaluation Studies:

Evaluation studies:

The Child Witness to Violence Project has been cited in numerous publications as a “best practices” site including the National Council of Juvenile and Family Court Judges publication, Emerging Programs for Battered Women and their Children, the U.S. Safe from the Start initiative in 2001, and the most recent U.S. Dept. of Justice Safe Start grant solicitation which listed it as a model program.

The primary intervention used at the Child Witness to Violence Project is CPP which has been extensively evaluated with young children and families and has received the highest rating by the National Child Traumatic Stress Network as an evidence-based treatment. The evaluations of CPP were conducted by the developers of the treatment at San Francisco General Hospital. The Child Witness to Violence Project is linked with their program for evaluation and for dissemination of the treatment.

Outcomes reported:

Decrease in trauma-related symptoms of the child; improvement in cognitive/developmental scores; decrease in maternal trauma-related symptoms.

Published results:

Lieberman, AF, Van Horn P, Ghosh Ippen C. (2005). Toward evidence-based treatment: Child-parent psychotherapy with preschoolers exposed to marital violence. Journal of the American Academy of Child and Adolescent Psychiatry, 44:12 pp. 1241-1248.

Additional Publications (partial list):

Groves B. (2010). Child exposure to community or domestic violence, The Zuckerman Parker Handbook of Developmental and Behavioral Pediatrics, (Eds). Augustyn M, Zuckerman B, Caronna EB, Wolters Kluwer Health ~ Lippincott Williams & Wilkins.

Groves B. & Augustyn M. (2009). Pediatric Care Settings: moving from evidence to action: The Safe Start series on children exposed to violence: Issue brief #2. North Bethesda MD: Safe Start Center, Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, US Dept. of Justice.

Cohen E., Groves B. & Kracke K. (2009). Understanding children’s Exposure to violence: The Safe Start series on children exposed to violence: Issue brief #1. North Bethesda MD: Safe Start Center, Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, US Dept. of Justice.

Groves B. Early intervention as prevention: Addressing trauma in young children. Focal Point: Research, Policy and Practice in Children’s Mental Health. 2009;21 (1):16-18.

Weinreb M & Groves BM. (2007). Child exposure to parental violence. In NB Webb, (Ed). Play Therapy with Children in Crisis, New York: Guilford Press.

Groves, B., Van Horn, P., & Lieberman, A. (2006). Relationships between children and fathers after domestic violence: Implications for treatment. In Edleson, J.L. & Williams, O.J. (Eds.). Parenting by Men Who Batter: New Directions for Assessment and Intervention. New York, NY: Oxford University Press.

Groves, B., & Gewirtz, A. (2006). Interventions with children exposed to domestic violence: Promising approaches. In M. Feerick & G. Silverman (Eds.), Children exposed to violence: research, intervention and policy. Baltimore MD: Brookes Publishers.

Rice KF & Groves B. (2005). Hope and Healing: A Caregiver’s Guide to Helping Young Children Affected by Trauma. Washington DC: Zero to Three Press.

Groves B. (2002). Children who See Too Much: Lessons from the Child Witness to Violence Project. Boston: Beacon Press.

Program replicated elsewhere:

In 2000, the State of Massachusetts Department of Social Services funded eight programs throughout the state that were modeled on the basic premises of the Child Witness to Violence Project.

Rated/Reviewed by Evidence Based Registries:

California Evidence-Based Clearinghouse for Child Welfare

Training Contact:

Maxine Weinreb, Ed.D; maxine.weinreb@bmc.org

Training Notes:

Training manuals/protocols:

“Shelter from the Storm: Clinical Intervention with Children Affected by Domestic Violence;” available at www.childwitnesstoviolence.org

Training available:

Staff from The Child Witness to Violence Project are certified trainers for Child Parent Psychotherapy

Training costs:

Variable depending on the length of training, numbers of participants. Training is available at Boston Medical Center or at the site of the entity requesting training.

Languages:

Spanish and English

Program Contact