Intimate Partner Violence and Children: A Family Systems Perspective
by John Hamel, LCSW

Mental health professionals are keenly aware that domestic violence, defined as abuse between intimate partners, is a major social problem.  National surveys indicate that 10 to 20 million adults are victims of intimate partner violence each year.  For total assaults, including minor types such as pushing and grabbing, victims are equally divided between men and women (Straus, et al., 1990).  Women are just as likely as men to initiate, and we know that mutual assaults occur in 50% - 85% of violent relationships (Straus, 1996; Langhinrichsen-Rohling, et al., 1995).  We also know that only 10% - 22% of physical assaults are carried out in self-defense, and that attempts to “get through” to one’s partner, or retaliate for a perceived wrong, are much more frequent motives (Sommer, 1994; Carrado, et al., 1996).  Due to their smaller size, women suffer approximately 65% of total physical injuries, and up to 75% of severe injuries (Tjaden & Thoennes, 1998; Archer, 2000).  Men are also far more capable of using physical coercion, and threats of violence, as a means of controlling their partner, but both sexes emotionally abusive one another, and employ a variety of power and control tactics.  In short, domestic violence is not a gender problem, but a human problem.   

Adults are not the only victims.  At least 10 million children are exposed to marital violence each year (Straus, et al., 1980).  Most of them, it appears, are fully aware of most of the fighting (Holden & Ritchie, 1991).  Law enforcement agencies report high numbers of child witnesses to domestic violence.  For instance, the Sheriff office in Contra Costa County, California, reported that in official spousal abuse cases, covering a period from January 1 through September 30, 2000, children were present 73% of the time (Contra Costa Office of Sheriff, 2000).  Research by Fantuzzo & Lindquist (1989) reveals that children raised in homes where the mother has been physically abused by the father are at a 30% - 40% higher risk than children from nonviolent homes for psychopathology.  These children are also at higher risk than children who have only been exposed to neighborhood violence (Litrownik, et al., 2003). Literature reviews suggest that children exposed to marital violence are at risk for exhibiting a host of internalizing and externalizing symptoms and social and school problems.  These symptoms, similar to those suffered by children who have experienced direct physical abuse, include: poor self-esteem, anxiety, depression, stress trauma symptoms, aggression, oppositional-defiant behavior, substance abuse, poor social skills, lack of empathy, poor academic performance, truancy, somatic problems and obsessive-compulsive traits (Kolbo, et al., 1996; Wolak & Finklehor, 1998; Edleson, 1999).  

Children are differentially affected by their parent’s marital violence, depending on their age.  Toddlers are generally the most distressed (Jaffe, et al, 1990).  A gender effect (e.g., whether or not boys have more externalizing problems and girls have more internalizing problems) has not been clearly established, but overall these symptoms are equally prevalent (Kitzmann, 2003).  We know that, for all children, witnessing marital violence has a continuous, cumulative effect.  Children who have witnessed such violence, especially severe assaults, become sensitized rather than habituated over time, and are re-traumatized whenever there is an incidence of any marital conflict (Holden, 1998) 

Effects According to Types of Partner Violence 

For years, the literature on how children are affected by marital violence has been almost exclusively based on interviews with battered women, with the focus on father as perpetrator.  More recently, studies have drawn from broader community samples.  In a New York City study by Salzinger, et al. (2002), the mothers were primarily victims of marital violence; whereas in a large Northeast U.S. study by English, et al. (2003), the mothers were primarily perpetrators. Both studies echo earlier findings by Jaffe, et al. (1990), that children are adversely affected whether the marital violence is perpetrated by the mother, or by the father. 

Johnston & Roseby (1997) examined in much greater detail the effects of partner abuse on children, extending their research beyond a mere description of symptomology, to a systemic investigation of family dynamics, boundaries and alliances.  The results, from extensive interviews, as well as a battery of psychological tests with 160 separated or divorcing couples and their children, were further categorized according to type of marital violence they witnessed (Johnston & Roseby, 1997): 

Ongoing/Episodic Male Battering.  In these families, the man dominates the woman with extreme verbal and physical abuse, in the classic three-phase cycle of build-up, battering event and contrition.  Younger daughters are passive and fearful, clingy with mother.  Fathers may lavish attention on these girls, sometimes in a seductive, sexualized manner, but at other times will ignore them.  This causes them to have a dual image of father, as both loving and scary.  Fathers seek affirmation of their self-esteem from these younger daughters, who “become watchful and oriented toward attempting to manage the father’s equilibrium and anger” (p. 31).  Older, school-age girls more likely to take it upon themselves to protect mother by subtly influencing and managing father.  Some resent the mother for not standing up for herself.  Younger boys display oppositional and aggressive behavior towards their mothers.  At the same time, they worry about her safety.  Older boys are afraid of dad, but also attracted to the power he wields in the family.  They are angry with him because of his marital and parental violence, and his unavailability, but cannot show this overtly.  Instead, they often turn on their mothers, behaving much like their dads.  In many cases, when mom leaves dad, the children often idealize him, repress memories of his violence, and blame mom for his absence. 

Female-Initiated Violence.  Particularly with their sons, these mothers alternate between nurturing and angry, abusive, rejecting behavior. Young daughters may assume caretaker role with mom, helping them fend off some of her rage.  They are often seen by the father as “the good girl”, in comparison with the bad, abusive wife.  However, despite dad’s idealization of them, they typically grow up to be just as temperamental and aggressive as their mothers.  Boys in female-violent homes tend towards passive-aggressiveness and depression.  Unless the father permits more open displays of aggression, these boys suppress the rage they feel towards mom. Younger boys are highly conflicted, unable to separate from the mother. 

Male-Controlling Interactive Violence.  Partner violence of this type is mutual, but dad, due to his greater size and strength, is usually able to gain the upper hand of a physical fight that has gotten out of control.  Children in these families exhibit a range of reactions, but aggression and passive-aggression are the primary ones.  Because of the dual violence, children are left with no positive role model to successfully cope with stress and conflict.  They are conflicted, and their alliances shift back and forth between the parents.  Boys may develop an almost total lack of respect for authority, including mom.  “Fathers often have peer-like relationships with their sons, especially as they grow older...Fathers are inclined to admire their son’s toughness and acting-out, as the son replaces the father around the house” (pp. 37-38)

Separation-Engendered and Post-divorce Trauma.  In this typology, the parents have no significant history of physical assaults upon each other, but act out around the time of separation.  Parents, Johnston found, typically align with the same-sex offspring.  Because of the unexpected nature of the violence, children sometimes show symptoms of PTSD, which may include fearfulness and nightmares.  However, due to the parent’s relative strength and parenting abilities, these children are more able than those in other violent households to overcome their symptoms and eventually heal.

 Partner Abuse and Child Abuse

 Clearly, the effects of partner violence on children should give us cause for alarm.  But what about other forms of family violence?  We know that intimate partners perpetrate severe assaults upon one another (punch, kick, bite, choke, beat up, use of objects or weapons) at a rate of approximately 4-5 per 100 couples.  However, assaults by other family members are far more frequent (Straus, et al., 1980).  Parents perpetrate severe assaults on their children at a rate of 11 per 100.  (Mothers hit the most, largely due to the greater amount of time spent at home.  Assaults by fathers are more often fatal, but mothers cause the greater number of deaths through neglect).  Siblings perpetrate severe assaults against one another at a rate of 53 per 100; and they punch, kick or bite their parents at a rate of 9.0 per 100.  What are the effects of these other forms of violence, and how do they interact with one another?  As the Johnston and Roseby research indicates, we cannot ignore the reciprocal nature of relationships, or the fact that events in one part of the system reverberate throughout the whole.  A well-known finding, for instance, is that children who witness their parents fight are at high risk of being assaulted themselves, and that parents who physically abuse their children are more likely to perpetrate spousal abuse (Straus, et al., 1990).  Another consideration is the relationship between family violence and general dysfunction.  A review of the literature reveals a number of important trends, but no definitive answers. 

Salzinger, et. al. (2002), examining 100 cases of physically abused children in New York City, ages 9-12, determined that the effects of having experienced direct child abuse were greater than having witnessed violence between the parents.  In a Northwest study conducted the following year with a cohort of 261 pre-school children referred to CPS for child abuse and neglect, English, et al. (2003) found similar results.  However, according to the most recent, comprehensive meta-analysis of the literature, conducted by Kitzmann and her colleagues (2003), the overall impact, in terms of both internalizing and externalizing symptoms, of a child having experienced direct parental abuse are no greater than a child having witnessed marital violence.   

In a study by Hershorn & Rosenbaum (1985), children from discordant but nonviolent homes were determined to be just as aggressive and oppositional as those of battered women.  Litrownik, et al. (2003) found that children who witnessed their parents abuse one another emotionally were at higher risk for becoming victims of physical child abuse than if their parents fought physically.  And in a study by Grych & Fincham (1990), children from violent and discordant families exhibited similar internalizing and externalizing symptoms.   Subsequently, Fantuzzo, et al. (1991) compared a group of battered women and their children living in a shelter, with battered women and their children still living at home, and a non-violent control group.  Children from both types of violent settings exhibited more externalizing problems than children from non-violent homes.  However, the shelter children exhibited more internalizing symptoms than the home-violent group: 

The results of our study suggest a direct relationship between interparental conflict and familial disruption and the nature of child adjustment problems for young children.  In this respect, verbal conflict only was associated with a moderate level of conduct problems; verbal plus physical conflict was associated with clinical levels of conduct problems and a moderate level of emotional problems; and verbal plus physical conflict plus temporary shelter residence was associated with clinical levels of conduct problems, higher level of emotional problems, and lower levels of social functioning and perceived maternal acceptance (p. 263). 

According to Wolak & Finklehor (1998), “Pervasive conflict that takes the form of overt verbal hostility or violence harms children by causing stress, impairing effective parent-child relationships, and training children to be aggressive.  Overall, children from violent homes appear to be at greater risk for showing clinical-level behavioral and emotional problems, but it is likely that some symptoms are caused by the conflict and not necessarily the violence” (pp. 91-92). The authors propose that the deleterious effects of marital violence may be direct, or indirect.  Direct effects include physical danger (from being around thrown objects, etc.), and psychological trauma leading to internalizing and externalizing symptoms.  Indirect effects include the harsh parenting associated with marital violence, and other poor parenting practices such as inconsistency, low positive involvement and attachment disturbance.  They also include the accumulated stress that children take on due to the stress, anxiety and depression experienced by maritally-violent parents, as well as the attendant problems of substance abuse, economic difficulties and relationship break-ups.  

In fact, even the possibility of divorce is traumatic to children. Laumakis, et al. (1998) examined the differential impact of physical marital aggression, negative tone, verbal put-downs, and threats to leave on children.  Seventy-four children listened to staged audio fights between couples.  A sophisticated coding system allowed the children to respond with in their own words, rather than choose from a list of response choices.  The most negative emotional reactions were given by children who had listened to couples either physically fight or threaten to leave.  The finding that threats to leave caused as strong a reaction as physical violence or verbal abuse was significant, according to the authors: 

Why are physical aggression and threats to leave more upsetting than conflicts with name-calling and negative voice qualities?...The key feature of these two scenarios is the implied impact on the child, by virtue of the potential for major disruption and change in the marriage and in family life as the child knows it.  These data lead one to examine more closely the commonly stated assumption that exposure to marital aggression and violence is more upsetting than exposure to other forms of marital conflict (p. 280). 

Now the reader is asked to read the vignette below, and to put him/herself in the place of the child.  This exercise is meant to illustrate some points previously made, about the nature of partner violence, and its effects on children: 

Megan would usually be in bed when the fighting started.  The yelling, the name-calling, the threats - there was so much hatred in that voice, a deep, swelling hatred that seemed to press upon her, twisting her up inside, making her sick to her stomach.  “Shut up!,” she’d hear.  “I hate you, you worthless drunk!  Do you hear me?  You’re worthless!”  Sometimes, there were other noises, too, scary noises, of things being tossed around - like lamps and plates, and things she couldn’t identity.  Megan would press her hands over her ears, trying desperately to shut out the noises.  Sometimes she would stand by her door and listen, waiting for the cling-clang of the kitchen drawer, where the knives were kept.  Eventually, she would crawl under her covers, pull them tight over her head as she cried herself to sleep and thought about her baby brother was in the next room.  Did he hear?  Was there was anything she could have done to stop this from happening?  She didn’t know.  Se was scared, and she was confused.  “Me, too,” she would think.  “Me. too - I’m worthless.” 

The reader may want to ponder the following questions: (1) Who is perpetrating the abuse - mother, father, or both?  (2) Is the perpetrator’s gender important?  (3) From the child’s experience, how much does it matter whether the violence consists only of emotional abuse and threats, or actual physical assaults and injuries? 

The Role of Stress 

Families, by their very nature, produce high levels of conflict.  Many tasks need to be carried out, including the generation of income, household chores, and raising children.  At the same time, it is within the family that one seeks to meet such basic emotional needs as belonging and self-esteem.  And yet, families are made up of individuals from different generations, at different developmental levels, and with competing needs and interests.  This results in high levels of stress.  In combination with poor impulse control and insufficient problem-solving skills, family stress can lead to intense conflicts, and sometimes physical violence, among the various family relationships - parent and parent, parent and child, child and child.  The family, according to researcher Murray Straus, et al. (1990), is “the most violent institution a citizen is likely to encounter.”  This is largely due to the higher tolerance for violence in families, especially corporal punishment.  We know, for instance, that parents who use corporal punishment are at higher risk for crossing the line into physical child abuse (Straus & Donnelly, 2001).  And parents who give themselves permission to hit their children are far more likely to turn their aggression against their spouses.  Straus writes, 

The family has different rules about violence than do other groups.  In an academic department, an office, or a factory, the basic rule is that no one can hit anyone else, no mater what they do wrong.  A person can be a pest, an intolerable bore, negligent, incompetent, selfish, or unwilling to listen to reason.  But that still does not give anyone the right to hit such a person.  In the family the situation is different.  There, the basic rule is that if someone does wrong and won’t listen to reason, violence is permissible and sometimes even required (Straus, et al., 1990, p. 184) 

Although some types of assaults are more likely to cause physical injury than others (e.g., husband on wife, parent on child), any use of violence is destructive.  Violence inflates stress to higher levels, and tends to beget more violence, thus gravely undermining the family’s ability to carry out its functions.  Children growing up in such an environment learn that violence is an acceptable way to resolve problems.  More importantly, they learn that love and abuse tend to go together.  As adults, these children are far more likely than those from non-violent homes to become involved in pathological, dependent relationships and become abusive themselves, thus transferring the cycle from one generation to the next.  Domestic violence, therefore, cannot be understood outside of a family context. 

In Wolak & Finklehor’s analysis, there was a correlational relationship between marital violence, family dysfunction, physical child abuse and the various internalizing and externalizing symptoms suffered by children.  Other researchers have proposed a direct causal link between these phenomena, with husband-on-wife battering as the primary cause.  Holden & Ritchie (1991) compared 37 battered women with 37 women from non-abusive households.  The battered women were observed to engage in more conflicted, negative interactions, and were less involved, with their children than those in the comparison group.  Because maternal stress and paternal irritability were the strongest predictors of child behavior and emotional problems, the authors concluded that there is a “spill over” effect from the marital violence, that affects parenting by both parents. 

Moore and Pepler (1998) conducted an ambitious study with four groups of latency-age children and their mothers: 113 in a battered women’s shelter, 82 homeless families in temporary housing,  82 single-parent families (mother only) and 100 intact, two-parent, non-violent families.  Mothers were administered the CTS, the General Health Questionnaire and the Child Behavior Checklist (measuring children’s internalizing, externalizing and social problems.)  The children were given the WRAT-R (scholastic achievement), the Digit Span subscale of the WISC (memory) and the Children’s Locus of Control Scale.  The authors found that low income, less parental education, frequent moves and poor maternal health were characteristics of both shelter and homeless families.  The shelter and homeless children scored significantly lower in social competence than those from two-parent families, and they also scored much lower on the Digit Span test.  The homeless children scored more than one standard deviation below grade level on the Reading and Math tests of the WRAT-R.  The most telling finding, however, was that mother’s verbal abuse toward their children was the strongest predictor of poor adjustment in all groups, more than father’s verbal abuse toward the children or father’s violence against the mother.  “Mother’s verbal aggression,” the authors concluded, “may augment or exacerbate preexisting emotional susceptibility brought about by witnessing interparental violence...Physically abused mothers may become too exhausted, distressed, and distracted to provide their children with the necessary attention, discipline, and affection”(p. 179). 

Thus, marital abuse is seen by some as the primary source of stress in families of battered women, and the ultimate cause of both child abuse and its consequences.  It is assumed that none of the mothers had parenting problems prior to the abuse.  This is unlikely.  But even if this holds for cases of severe, unilateral battering, in most physically abusive relationships the violence is less severe and usually mutual.  Furthermore, there is an equal likelihood that marital discord and violence follows, rather than precedes, parent-on-child conflict.  Lynch & Cicchetti (1998) determined that the existence of child behavior problems prior to having been exposed to marital violence contributes significantly to overall levels of family stress, which in turn may aggravate both marital and parent-child relationships. We have seen how attitudes favorable to corporal punishment are associated with pro-violent attitudes towards spouses (Straus, et al., 1990; Straus & Donnelly, 2001).  We should be careful, then, in making unwarranted generalities.  In a study of 110 Israeli families, Sternberg, et al. (1993) found that children who were both witnesses to marital violence and had experienced physical child abuse did not suffer more psychological damage than children who had only witnessed marital violence, or children who had only been directly abused.  In their review of the literature, Kitzmann, et al., found similar results.  “Violence anywhere in the family,” the authors suggested, “may be sufficient to disrupt child development” (p. 346).  

The New York City study by Salzinger, et al. (2002) sought to identify the relative effects of family stress, partner violence, caregiver distress and child abuse on children’s development.  Caregiver distress was not found to be a function of partner violence.  Partner violence was a mediator of child abuse, not by directly producing poor functioning in the child, but rather by increasing the risk of aggression against the children.  Amongst all the variables, the authors identified two significant causal paths.  In one, family stress increased the risk for partner violence, which increased the possibility of child abuse.  In the other, family stress contributed to caregiver distress, which in turn led to child abuse.  These findings are impressive, and even more so when we compare them with those of Katherine Kitzmann’s meta-analysis.  In looking at the impact of exposure to marital violence on the children, she found that the effect size in studies that controlled for family stress were smaller than in those that did not.  Amongst the  factors hypothesized to negatively impact on child functioning, general family stress stands out as the most significant, the one which can exacerbate any of the other conditions.  In this conception, partner violence is merely one, albeit important, factor in family dysfunction. 

Effects on Adult Functioning 

The effects of intimate partner violence unfortunately persist well into adulthood, when the child grows up and becomes involved in an intimate relationship.  We know that children from abusive families are more likely than children from non-abusive families to exhibit aggressive behaviors later in life.  The mechanisms by which this behavior is thought to be transmitted fall into two categories.  In the first, children learn to become violent through the process of observational learning.  For instance, results of the National Family Violence Surveys (1990) indicate that children who witness marital violence are twice as likely to perpetrate partner violence as adults than those who had never witnessed such violence.  For violent women, the assault rates are generally the same whether they had witnessed violence by the father, by the mother, or both.  Violent men, however, are more likely to have witnessed violence by the mother upon the father. 

The other mechanism involves the effects of child abuse and neglect.  Litrownik and his colleagues (2003) conducted a prospective study from a nationwide sample of 682 abused children, comparing data from interviews at age 4 and at age 6.  Among their findings were that psychological child abuse predicted internalizing symptoms of anxiety and depression, whereas a combination of physical and psychological child abuse predicted aggressive behavior.  These findings dovetail nicely with more recent studies on the intergenerational transmission of violence.  Working with a population of men convicted of spousal battering, Dutton (1998) found that those who had experienced rejection, insecure attachment, shaming and other forms of emotional abuse tend to become rageful, emotionally abusive but often non-violent adults; whereas men who had experienced all of these, in combination with having witnessed or having directly experienced physical abuse, tend to become emotionally abusive, controlling and physically violent. 

Implications for Policy and Treatment 

Violence between intimate partners is a significant social problem, not only because of the physical and emotional harm done to adult victims but also to the children who are witnesses to such violence.  Although public policy and intervention has focused on the most severe types of domestic violence, by male perpetrators, assaults by women upon their partners are equally prevalent.  Female-perpetrated assaults cause far less physical damage upon adult partners than the reverse, and certainly warrant special attention due to safety concerns.  However, it appears that children suffer the same kinds of emotional, behavioral and social symptoms by witnessing mother hit the father as when father hits the mother.  From this perspective, the gender of the maritally-violent parent is not terribly important.  Nevertheless, women who assault their partners are rarely referred to anger management programs.  Only 18% of spousal abuse arrests in California involve female perpetrators, and an even fewer percentage of women are mandated to complete a 52-week batterer program.  For example, in Judge Craddick’s Misdemeanor Domestic Violence Court in Contra Costa County, 95% of defendants mandated to batterer treatment are men.  The women are presumably referred to other types of counseling.  Traditionally, therapy for violent women, whether voluntary or court-ordered, has consisted of supportive individual therapy.  Far too often, they are referred to victim groups.   

In contrast to past decades, when it received scant public attention, intimate partner violence now thoroughly dominates public discussion, policy-making, outreach and intervention strategies on family violence.   There seems to be an exponentially-increasing number of professional seminars and community forums on the subject of partner violence, but few that address child abuse specifically, or family violence in general.  “Family violence” law centers in fact often exclusively address the needs of battered women. Plaintiffs in child custody disputes routinely are granted restraining orders against an ex-spouse on the grounds that they feel “threatened,” gaining custody and causing major disruptions in the children’s lives, even though that same plaintiff may be overly punitive, and sometimes physically abusive to those children.  And shelters only recently are beginning to offer services for children.  This despite the fact that children suffer the greater share of assaults, and the greater share of physical injuries.  In addition, children who are verbally or physically abused by their parents are at an equal, if not greater risk than those exposed to marital abuse, for exhibiting short-term and long-term pathology.  In California, both spousal abusers and child abusers are legally required to complete a certified 52-week treatment program.  Although there are twice as many CFS child abuse reports than spousal abuse arrests, the number of batterer intervention programs far outnumber those targeting child abuse.  Within the four Bay Area counties of San Francisco, Marin, Alameda and Contra Costa, there are approximately 50 of the former, and only three of the latter. 

The mechanisms by which partner violence and child abuse negatively impact on children are complex, but appear to be mediated by family stress.  The “cause” of child symptomology is rarely a unitary one.  It is, instead, the result of overlapping, reciprocal interactions among the various family members.  Physical violence, or even verbal conflict, between any sub-group causes stress throughout the entire system, which leads to conflict between other sub-groups, thus generating additional stress and increasing the probability of further violence.  That is not to say that all types of family violence have equal consequences, or that they should be responded to in the same manner.  Clearly, severe spousal battering is a greater concern than pushing and grabbing, or mild forms of corporal punishment.  However, persistent, high levels of verbal abuse, particularly put-downs and criticism that shames the other, are far more toxic than common types of physical violence.  Likewise, emotional abuse and parental rejection of children warrant more attention than nearly all forms of spousal violence.  The point is that every family is different.  The most damaging forms of abuse will vary from family to family and, often, within the same family over time.   

Accordingly, we make the following recommendations for anyone assessing and treating family violence: 

1. Inquire about possible abuse by both partners, male and female, regardless of physical size or strength.  Ask about violence perpetrated by them, and upon them.  Both men and women minimize the extent of their own violence; but men, in an effort to not appear weak, also minimize the seriousness of assaults perpetrated against them.
    
2. Determine the extent of verbal and emotional abuse, and the use of power and control tactics, using a gender-inclusive questionnaire that includes tactics utilized by both men and women.
    
3. Conduct a thorough assessment of parent-child relations.  At a minimum, this should include the Parent-Child Conflict Tactics Scale, a measure of corporal punishment and child abuse. 
   
   
4. Look for evidence of sibling violence, as well as violence by children upon their parents - in particular by older, more physically threatening adolescents. 
   
   
5. Treat all members of the family, using individual, couples, family and group therapy as needed, but adopt a family systems perspective and strive to avoid rigid distinctions between “perpetrators” and “victims.”  For reasons of treatment and safety, one needs to know when there is a clear, dominant aggressor, and victims of serious violence must be protected.  Keep in mind, however, that the victim of one person’s violence is often the perpetrator towards another - e.g., the violent man who had once been shamed and physically assaulted by his mother, the battered woman who physically abuses and neglects her children, or the abused teen who assaults his/her younger siblings.
    
   
6. Refer all maritally abusive partners to an appropriate anger management or batterer intervention program, depending on the nature and severity of violence.  An individual who perpetrates minor assaults and whose violence is more expressive than instrumental, may not need to enroll in a “batterer” program.
    
   
7. Send abusive parents neither to a short-term generic parenting class or anger management group, nor to a 52-week batterer intervention program, but rather to long-term treatment specifically tailored to their needs - such as the 52-week High-Conflict Family Violence Parent Group offered at our center.   In this type of group, parents not only learn how to manage their own anger and acquire non-violent parenting skills, but also how to prevent their children from acting violently towards other family members and lessen family stress.  They are also educated about the systemic nature of family conflict, and the intergenerational transmission of violence.
    
   
8. When there are major disruptions in the caregiver-child relationship, provide conjoint therapy with the affected parties (Van Horn, et al., 1998).  In these cases, the children typically have ceased to view the primary caregiver as a dependable protector from the other parent’s abuse, and have begun to act-out in various ways. The caregiver in turn, often responds with harsh, punitive parenting, or else rebuffs the child’s solicitations for attention and nurturing.
      
9. Send violent adolescents, when appropriate, to a separate anger management program, where they can learn how to control their own aggressive impulses, even when they may also have been victims of parental abuse. 
   
   
10. Provide supportive psychotherapy for the children who have been traumatized by the marital violence and/or the abuse directed against them.  An excellent treatment model can be found in the book by Johnston and Roseby (1997).   

REFERENCES 

Archer, J. (2000), “Sex Differences in Aggression Between Heterosexual Partners: A Meta-Analytic Review.”  Psychological Bulletin, 126 (5). 

Carrado, M., et al. (1996), “Aggression in British Heterosexual Relationships:  A Descriptive Analysis.”  Aggressive Behavior, 22, pp. 401-415. 

Contra Costa Office of the Sheriff (2000), ACAD Conference, Fall, 2000. 

Dutton, D. (1998), The Abusive Personality. 

Edleson, J. (1999), “Children’s Witnessing of Adult Domestic Violence.”  Journal of Interpersonal Violence, 14 (8), pp. 839-870. 

English, D., et al. (2003), “Effects of Family Violence on Child Behavior and Health During Early Childhood.”  Journal fo Family Violence, 18 (1). 

Fantuzzo, J. & Lindquist (1989), “The Effects of Observing Conjugal Violence on Children: A Review of Research Methodology.”  Journal of Family Violence, 4, pp. 77-94 

Fantuzzo, J.. et al, (1991), “Effects of Interparental Violence on the Psychological Adjustment and Competencies of Young Children.”  Journal of Consulting and Clinical Psychology, 59, pp. 258-265 

Grych, J. & Fincham, F. (1990), “Marital Conflict and Children’s Adjustment: A Cognitive-Contextual Framework.”  Psychological Bulletin, 108, pp. 267-290 

Hershorn, M. & Rosenbaum, A. (1985), “Children of Marital Violence: A Closer Look at the Unintended Victims.”  American Journal of Orthopsychiatry, 55, pp. 260-265 

Holden, G. & Ritchie, K. (1991), “Linking Extreme Marital Discord, Child Rearing and Child Behavior Problems: Evidence From Battered Women.”  Child Development, 62, pp. 311-327 

Holden, G. (1998), “The Development of Research Into Another Consequence of Family Violence.”  In: G. Holden, et al., eds., Children Exposed to Marital Violence 

Jaffe, P., et al. (1990), Children of Battered Women 

Johnston, J. & Roseby, V. (1997),  In the Name of the Child. 

Kitzmann, K., et al. (2003), “Child Witnesses to Domestic Violence: A Meta-Analytic Review.”  Journal of Consulting and Clinical Psychology, 71 (2), pp. 339-352. 

Kolbo, J., et al. (1996), “Children Who Witness Domestic Violence: A Review of the Empirical Literature.”  Journal of Interpersonal Violence, 11 (2), pp. 281-293 

Langhinrichsen-Rohling, J., et al. (1995), “Violent Marriages: Gender Differences in Levels of Current Violence and Past Abuse.”  Journal of Family Violence, 10 (2). 

Laumakis, M., et al. (1998), “The Emotional, Cognitive, and Coping Responses of Preadolescent Children to Different Dimensions of Marital Conflict.”  In: G. Holden, et al., eds., Children Exposed to Marital Violence, pp. 257-288. 

Litrownik, A., et al. (2003), “Exposure to Family Violence in Young At-Risk Children.”  Journal of Family Violence, 18 (1). 

Lynch, M. & Ciccheti, D. (1998), “An Ecological-Transactional Analysis of Children and Contexts.”  Developmental Psychopathology, 10, pp. 235-257. 

Moore, T. & Pepler, D. (1998), “Correlates of Adjustment in Children at Risk.”   In: G. Holden, et al., eds., Children Exposed to Marital Violence, pp. 157-184. 

Salzinger, S., et al. (2002), “Effects of Partner Violence and Physical Child Abuse on Child Behavior: A Study of Abused and Comparison Children.”  Journal of Family Violence, 17 (1). 

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Sternberg, K., et al. (1993), “Effects of Domestic Violence on Children’s Behavior Problems and Depression.”  Developmental Psychology, 29, pp. 44-52 

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