Cathy Humphreys

Neither justice nor protection: women’s experiences of post-separation violence

Post‐separation violence is an issue for a significant group of domestic violence survivors (and their children) leaving abusive relationships. This article draws on research conducted with women who have experienced post‐separation violence. It explores definitions and the nature of post‐separation violence experienced by women and often their children. More than three‐quarters (76 per cent) of the 161 separated women in the study initially suffered further abuse and harassment from their former partners. Much of the violence ceased after the first 6–12 months, often due to the woman moving. However, more than one‐third (36 per cent) of the women suffered continued post‐separation violence. Against this background, womens experiences of legal routes to protection are examined and the effectiveness of the law in tackling the issue of post‐separation violence explored. In so doing, post‐separation violence is used to exemplify and further explore Smarts contention that there are many contradictions and complexities in the practice of the law, particularly as it relates to the on‐going oppression of women (1995: 145). For a group of women, violence escalated over time. These women and their children were seriously at risk of harm. Poor law enforcement, the ineffectiveness of civil protection orders and inadequate prosecution and sanctions left these women (and their children) vulnerable to further assaults and harassment. Child contact was a point of vulnerability for on‐going post‐separation violence and abuse. The implications for future policy and practice are highlighted.

Problems in the system of mandatory reporting of children living with domestic violence

Abstract Historically, the chasm between services for women and services for children has been problematised in the domestic and family violence arena. However, this paper argues that it is now equally, or more problematic, that the recognition of harm to children in the context of domestic and family violence has ‘grafted’ statutory child protection response to intervention in this area. This paper argues that when judged against the criteria for a functional system, one which is effective, efficient, efficacious or ethical then there are a number of areas in which the child protection system fails in relation to children living with domestic violence. The paper raises three issues of particular concern: (a) responding to a widespread social problem through an individualised response at the tertiary end of provision; (b) undermining the voluntary and empowerment model of intervention for women through compulsory, statutory intervention with children; (c) creating a mandatory pathway to an intervention system which is not set up to work with an adult and child victim or intervene effectively with men who use violence.

Ethical and safe: Research with children about domestic violence

Ethics applications to conduct research with children who have experienced domestic violence will frequently raise a red flag to ethics committees about the potential for risk and re-traumatization. On the other hand, such sensitive research can enable a hidden, marginalized population to have their voices heard. It can deliver findings about children’s lives that can inform otherwise adult-centric research, policy and practice initiatives. The authors highlight ethical concerns and practical solutions using examples from domestic violence, family law and child abuse research with children. Ethical planning is explored according to methodologies, context and whether the violence has been named. Also discussed are consent procedures, confidentiality and the development of protocols for disclosure, distress, safety and risk assessment, which support ethical and safe research with children.

Disclosure of Child Sexual Assault: Implications for Mothers

Mothers of sexually abused children frequently report difficulties sustaining a stance of belief, protection and support for their victimised children. Some of the ingredients of the mothers complex struggle, and particularly the relationship between crisis and the attainment and maintenance of a stance of belief, are outlined in this article. The implications for practitioners working with mothers are discussed.

Maternal and child health nurse screening and care for mothers experiencing domestic violence (MOVE): a cluster randomised trial

BackgroundMothers are at risk of domestic violence (DV) and its harmful consequences postpartum. There is no evidence to date for sustainability of DV screening in primary care settings. We aimed to test whether a theory-informed, maternal and child health (MCH) nurse-designed model increased and sustained DV screening, disclosure, safety planning and referrals compared with usual care.MethodsCluster randomised controlled trial of 12 month MCH DV screening and care intervention with 24 month follow-up.The study was set in community-based MCH nurse teams (91 centres, 163 nurses) in north-west Melbourne, Australia.Eight eligible teams were recruited. Team randomisation occurred at a public meeting using opaque envelopes. Teams were unable to be blinded.The intervention was informed by Normalisation Process Theory, the nurse-designed good practice model incorporated nurse mentors, strengthened relationships with DV services, nurse safety, a self-completion maternal health screening checklist at three or four month consultations and DV clinical guidelines. Usual care involved government mandated face-to-face DV screening at four weeks postpartum and follow-up as required.Primary outcomes were MCH team screening, disclosure, safety planning and referral rates from routine government data and a postal survey sent to 10,472 women with babies ≤ 12 months in study areas. Secondary outcomes included DV prevalence (Composite Abuse Scale, CAS) and harm measures (postal survey).ResultsNo significant differences were found in routine screening at four months (IG 2,330/6,381 consultations (36.5 %) versus CG 1,792/7,638 consultations (23.5 %), RR = 1.56 CI 0.96–2.52) but data from maternal health checklists (n = 2,771) at three month IG consultations showed average screening rates of 63.1 %. Two years post-intervention, IG safety planning rates had increased from three (RR 2.95, CI 1.11–7.82) to four times those of CG (RR 4.22 CI 1.64–10.9). Referrals remained low in both intervention groups (IGs) and comparison groups (CGs) (<1 %).2,621/10,472 mothers (25 %) returned surveys. No difference was found between arms in preference or comfort with being asked about DV or feelings about self.ConclusionA nurse-designed screening and care model did not increase routine screening or referrals, but achieved significantly increased safety planning over 36 months among postpartum women. Self-completion DV screening was welcomed by nurses and women and contributed to sustainability.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12609000424202, 10/03/2009

Counselling and support issues for mothers and fathers of sexually abused children

Abstract The needs of mothers and fathers in the aftermath of child sexual abuse disclosure are often overlooked. A group of parents from New South Wales, Australia, were asked about the assistance that they received in the aftermath of the child sexual abuse investigation, particularly focusing upon their experience of counselling and needs for information and emotional support. They highlighted the different reactions and needs of mothers and fathers and drew attention to problems with isolation, the exacerbation of marital conflict, the exclusive nature of individual counselling for the child, and problems in finding support in the statutory context.

Applying normalization process theory to understand implementation of a family violence screening and care model in maternal and child health nursing practice: a mixed method process evaluation of a randomised controlled trial

BackgroundIn Victoria, Australia, Maternal and Child Health (MCH) services deliver primary health care to families with children 0–6 years, focusing on health promotion, parenting support and early intervention. Family violence (FV) has been identified as a major public health concern, with increased prevalence in the child-bearing years. Victorian Government policy recommends routine FV screening of all women attending MCH services. Using Normalization Process Theory (NPT), we aimed to understand the barriers and facilitators of implementing an enhanced screening model into MCH nurse clinical practice.MethodsNPT informed the process evaluation of a pragmatic, cluster randomised controlled trial in eight MCH nurse teams in metropolitan Melbourne, Victoria, Australia. Using mixed methods (surveys and interviews), we explored the views of MCH nurses, MCH nurse team leaders, FV liaison workers and FV managers on implementation of the model. Quantitative data were analysed by comparing proportionate group differences and change within trial arm over time between interim and impact nurse surveys. Qualitative data were inductively coded, thematically analysed and mapped to NPT constructs (coherence, cognitive participation, collective action and reflexive monitoring) to enhance our understanding of the outcome evaluation.ResultsMCH nurse participation rates for interim and impact surveys were 79% (127/160) and 71% (114/160), respectively. Twenty-three key stakeholder interviews were completed. FV screening work was meaningful and valued by participants; however, the implementation coincided with a significant (government directed) change in clinical practice which impacted on full engagement with the model (coherence and cognitive participation). The use of MCH nurse-designed FV screening/management tools in focussed women’s health consultations and links with FV services enhanced the participants’ work (collective action). Monitoring of FV work (reflexive monitoring) was limited.ConclusionsThe use of theory-based process evaluation helped identify both what inhibited and enhanced intervention effectiveness. Successful implementation of an enhanced FV screening model for MCH nurses occurred in the context of focussed women’s health consultations, with the use of a maternal health and wellbeing checklist and greater collaboration with FV services. Improving links with these services and the ongoing appraisal of nurse work would overcome the barriers identified in this study.

Inclusive domestic violence standards: strategies to improve interventions for women with disabilities?

Women with disabilities experience violence at greater rates than other women, yet their access to domestic violence services is more limited. This limitation is mirrored in domestic violence sector standards, which often fail to include the specific issues for women with disabilities. This article has a dual focus: to outline a set of internationally transferrable standards for inclusive practice with women with disabilities affected by domestic violence; and report on the results of a documentary analysis of domestic violence service standards, codes of practice, and practice guidelines. It draws on the Building the Evidence (BtE) research and advocacy project in Victoria, Australia in which a matrix tool was developed to identify minimum standards to support the inclusion of women with disabilities in existing domestic violence sector standards. This tool is designed to interrogate domestic violence sector standards for their attention to women with disabilities.

Family Contact for Children in Kinship Care: A Literature Review

Abstract Kinship care has been growing rapidly across the English-speaking world over the last decade. While family contact is an identified right of children removed from their families and maintains important relationships, contact with parents where there has been child abuse and neglect remains contentious. The evidence base in relation to family contact in kinship care is limited. Therefore, this article presents the current state of knowledge in the form of a narrative review of qualitative and quantitative research. Contradictory theoretical orientations are outlined together with the limits they impose on the development and application of knowledge. While the complexity of parental contact is confirmed, a consistent finding is that kinship care provides children with strong family networks including sustained relationships with parents, siblings, and extended family, and maintenance of childrens culture and identity. Suggestions for the development of the research agenda are made, together with implications for policy and practice.

Perspectives From Young People about Family Contact in Kinship Care: “Don't Push Us—Listen More”

Abstract Kinship care for children as a child protection response is increasing as the preferred care option across the English-speaking world. Research into kinship care is at an early stage, particularly in relation to understanding the views of children, young people and their parents. This paper describes a component of a larger research project on the topic of family contact in kinship care, which was undertaken to inform emerging kinship care support services in Victoria. Twenty-one children, young people and young adults with childhood experience of kinship care were involved in interviews and focus groups to discuss their experiences and advice for workers. The participants indicated their strong wish for greater control over the nature and extent of their contact with family members, including the wider family. Issues in relation to participation of children in the research process are discussed, including ethics, constraints and reciprocity. Participants’ feedback reinforces the call for more genuine involvement of children and young people in decisions about their lives.