A controlled trial was conducted with sequential assignment to three conditions: child-only intervention (CO), child-plus-mother intervention (CM) and a wait-list comparison (no treatment). The study population consisted of 181 children and their mothers. There were two children’s groups determined by age (6-8 years and 9-12 years) and gender mixed. Seventeen percent of mothers were currently living with their abusive partner and 68% had some contact with the abusive partner but were not living together at the beginning of the study. Woman had been in an abusive relationship for an average of 10 years.
The CM condition (child-plus-mother) was most effective in reducing the percentage of children in the clinical range from baseline to post-treatment and at 8-month follow-up compared to children in the child- only intervention (CO):
- Children in the CM condition showed greater levels of improvement in violence-related attitudes and externalizing behavior problems (e.g. aggression, defiance) from baseline to posttreatment compared to children in the child-only intervention
- Children in the CM condition showed a 77% reduction for internalizing behaviors and a 79% reduction for externalizing behaviors from baseline to 8-month follow-up
- Children’s changes in attitudes about violence were maintained for the CM condition at 8-month follow-up while there was a significant deterioration in attitudes among children in the CO condition
- Mothers in the MEP had reduced depression, improved parenting, 85% less PTSD
Graham-Bermann SA, Banyard V, Lynch S, DeVoe ER. Community-based intervention for children exposed to intimate partner violence: An efficacy trial. Journal of Consulting and Clinical Psychology, 2007, 75(2):199-209.
Graham-Bermann SA, Miller-Graff LE. Community-based intervention for women exposed to intimate partner violence: A randomized control trial. Journal of Family Psychology, 2015, 29(4), 537-547.
Graham-Bermann SA, Miller LE. Intervention to reduce traumatic stress following intimate partner violence: An efficacy trial of the Moms’ Empowerment Program (MEP). Psychodynamic Psychiatry, 2013, 41(2), 327-348.
A second controlled trial was conducted with sequential assignment of younger children (ages 4-6) and their mothers to two conditions – CM and a wait list comparison group (CG). The Preschool Kids Club (PKC) and MEP programs were offered twice a week for 5 weeks.
- CM children had reduced internalizing problems
- Reliable change was greater for CM versus CG preschool children at follow-up with 23% no longer in the clinical range (CG = 8%), 22% changed to the normal range (CG = 5%)
- CM children had greater social competence
- Mothers had less exposure to IPV
- Mothers had fewer trauma symptoms at follow-up
- Improved parenting, less use of physical punishment, greater use of positive parenting techniques
Graham-Bermann SA, Miller-Graff LE, Howell KH, Grogan-Kaylor A. An efficacy trial of an intervention program for young children exposed to intimate partner violence. Child Psychiatry & Human Development, 2015, 46(6), 928-939.
Howell KH, Miller LE, Lilly MM, Graham-Bermann SA. Fostering social competence in preschool children exposed to intimate partner violence: Evaluating the Preschool Kids’ Club intervention. Journal of Aggression, Maltreatment and Trauma, 2013, 22(4), 425-445.
Howell KH, Miller, LE, Lilly MM, Burlaka V, Grogan-Kaylor AC, Graham-Bermann SA. Strengthening positive parenting through intervention evaluating the Moms’ Empowerment Program for women experiencing intimate partner violence. Journal of Interpersonal Violence, 2015, 30(2), 232-252.
Miller LE, Howell KH, Graham-Bermann SA. The effect of an evidence-based intervention on women’s exposure to intimate partner violence (IPV). American Journal of Orthopsychiatry, 2014, 84(4), 321-328.
Grogan-Kaylor AC Galano M, Howell KH, Miller-Graff LE, Graham-Bermann SA.
Reductions in parental use of corporal punishment on preschoolers in the Moms’ Empowerment Program. Journal of Interpersonal Violence, 2019, 34(8), 1563-1582.
Additional analyses of the data for the first above-referenced evaluation study indicated that children’s disclosures of exposure to domestic violence within the therapeutic group were associated with gains in those children’s internalizing behavioral adjustment problems and an improvement in attitudes and beliefs about the acceptability of violence. Fifty-two percent of children spontaneously disclosed during therapy.
Graham-Bermann SA, Kulnarni MR, Kanukollu S. Is disclosure therapeutic for children following exposure to traumatic violence? Journal of Interpersonal Violence, 2011, 26(5), 1056-1076.
Another publication by Graham-Bermann et al. (2011) examined the impact of other factors (mediators and moderators) that influenced participation in the intervention and changes in children’s adjustment. A child’s age and ethnicity did not predict change in a child’s adjustment; the number of sessions attended by the mother and child did predict better child total adjustment. Children who were exposed to a greater proportion of violence in their lifetime participated in more sessions and had greater reduction in internalizing problems. Reductions in mothers’ posttraumatic stress symptoms was associated with reductions in children’s internationalizing problems.
Graham-Bermann SA, Howell KH, Lilly M, DeVoe E. Mediators and moderators of change in adjustment following intervention for children exposed to intimate partner violence. Journal of Interpersonal Violence, 2011, 26(9). 1815-1833.
Graham-Bermann, SA (Ed.) Cultural Considerations in Intervention with Women and Children Exposed to Intimate Partner Violence. Nova Science Publishers, Inc., 2018, Hauppauge, NY.
Graham-Bermann, SA, Levendosky, AA (Eds.) How Intimate Partner Violence Affects Children: Developmental Research, Case Studies, and Evidence-Based Treatment. American Psychological Association Books, 2011, Washington, DC.
Graham-Bermann, SA, Edleson, JL (Eds.) Domestic violence in the lives of children: The Future of Research, Intervention, and Social Policy. Washington, DC: American Psychological Association Books, 2001, Washington, DC.
Graham-Bermann SA & Hughes HM. Intervention for children exposed to interpersonal violence (IPV): assessment of needs and research priorities. Clinical Child and Family Psychology Review. 2003;6(3):189-204.
The Swedish government has adapted Kids Club and Mom’s Empowerment for use in Sweden. The program is also replicated in Windsor, Ontario, Canada.
Rated/Reviewed by Evidence Based Registries:
California Evidence-Based Clearinghouse for Child Welfare
Evidence-Based Practices for Children Exposed to Violence: A Selection from Federal Databases