London Mayor welcomes ground breaking report into CAPVA

Over the years there have been a number of studies investigating the issue of child to parent violence within defined geographical regions, sometimes in response to specific incidents (Northumbria for instance) and sometimes commissioned by a particular body (this work in Lancashire for instance). In 2013 Condry and Miles published the first major work in the UK, which took as the main source the Metropolitan Police data over a 1 year period. 

Each of these have shed light on our knowledge and understanding of particular aspects of this issue. However, the London VRU report, “Comprehensive needs assessment of Child/Adolescent to Parent Violence and Abuse in London”, launched last week and welcomed by the Mayor of London is the first to offer a comprehensive examination of the prevalence and characteristics of child / adolescent to parent violence and abuse (CAPVA*) within the capital, and to scope out the help available for families affected by this form of violence and abuse.

The comprehensive needs assessment was commissioned to explore the scale and nature of CAPVA in London, to ensure services and support for children, young people and families is grounded in evidence. The research findings will inform the VRU’s public health approach to violence prevention and reduction in London and, specifically, to the development of a Pan-London strategic approach to CAPVA in the coming years. 

The research, authored by Prof. Iain Brennan, Natasha Burnley, Matthew Cutmore, Dr Amanda Holt, Johnny Lillis, Jo Llewellyn, Shona MacLeod, Malika Shah, Rebecca Van Zanten, and Letizia Vicentini, and which took place between December 2020 and October 2021, included a literature review, analysis of data from the MPS and the Crime Survey for England and Wales, interviews with strategic stakeholders and a number of parents / carers and young people, as well as the involvement of a Community Advisory Group. The full report is available to read here

The research, and the response from the Mayor’s office, received significant coverage throughout the UK press, and around the world. (see for instance the Guardian report, Children and Young People Now, and ITV)

London has very far from a homogeneous population, with great disparities of wealth and circumstances across boroughs as well as within them, hindering a full understanding of the significance of some factors under investigation. Yet as in many other situations, it reflects the picture across the country in terms of the difficulties in finding help, which may be available to a family in one street and not in the next, because of boundaries and differences in training and funding.

For those already involved in work within this field, the main findings of the report will not hold surprises, and I do not intend to go over these here – please do read the report to get the full flavour. But it is to be applauded for its breadth, and for the series of recommendations (below). We also welcome the subsequent commitments made by the Mayor as part of his wider strategy to combat violence within the capital. 

  1. Establish the variation in terminology and definitions of CAPVA used by different statutory services and VCS organisations to inform the development of statutory guidance on CAPVA.
  2. Promote an understanding of CAPVA both as form of domestic abuse, as well as potentially symptomatic of other child protection/safeguarding issues such as extra-familial harm as well as exposure to abuse and violence in the family home. 
  3. Statutory guidance on CAPVA to support the development of a longitudinal dataset on the incidence of CAPVA. 
  4. Support all services to identify CAPVA and develop more specialist expertise in understanding the dynamics of CAPVA. 
  5. Encourage tailored responses to CAPVA which recognise the complex dynamics between parent and child and other family members. 
  6. Raise and embed awareness and understanding of CAPVA as a form of domestic abuse distinct from intimate-partner violence. 
  7. Facilitate greater multi-agency collaboration on CAPVA cases and consider the development of a multi-agency information sharing forum, including a review of existing forums for effectiveness & appropriateness, for professionals to discuss high-risk cases. 
  8. Train and develop CAPVA champions in each London borough’s children’s social care / safeguarding team. 
  9. Ensure pan-London coverage of CAPVA specific services for both parents and children/young people by establishing a central ‘helpline’. 
  10. Commission independent evaluation which examines the existing intervention models used to respond to CAPVA across London. 

The importance of developing a joined-up, multi-agency understanding and response to CAPVA cannot be stressed enough, and has been called for over many years, not least by families themselves. The possibility of funding for a central helpline, to both advise and direct families and practitioners, would also be a key win and foundational in building an effective, evidence-based service. Many of those involved in this research are themselves already key players in understanding, promoting awareness, and delivering support to families, and so this comprehensive set of recommendations carries the weight of many years of struggle as well as the specific findings of this research. They represent a logical journey towards a full and effective response to a problem which is finally emerging from the shadows, and receiving the attention it so badly deserves. There are many ready and waiting to implement the recommendations given the opportunity and funding. We look forward to seeing the words of the Mayor coming to fruition. 

*Use of the term CAPVA within this report was a deliberate decision formed through consultation with the CAG.

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A response to the Government’s Tackling Domestic Abuse Plan

Somewhat delayed because of family circumstances, but I thought it would be helpful to have a look at the Government’s recently published Tackling Domestic Abuse Plan, and offer some thoughts.

Before I get started, a couple of caveats. First, the debate continues as to whether it is appropriate to consider child to parent violence and abuse under this umbrella. There are those who feel very strongly that it should be, because of the harm caused and the frequent links to the experience of intimate partner violence and abuse. (Academics such as Wilcox (2012) have made this case. PEGS literature is another case in point.) Others find the terminology and conceptualisation problematic, and shy away, preferring to focus on the age, the trauma and vulnerability of the children and young people themselves (for instance, many within the adoption community would feel this way). My sense from listening to people is that both views have merit, but that the circumstances around the harmful behaviour and family situation need to be taken into account in order to properly reflect each family’s situation.

Secondly, a reminder that the Domestic Abuse Act includes only those over the age of 16, recognising that family members as well as partners can be perpetrators of abuse. It is these clauses which bring children using harmful behaviour towards their parents into the equation. Children under 16 are not included within this legislation as those using harm, but are recognised as victims in their own right. This therefore excludes a large group of families, experiencing harmful behaviour from children as young as three or four, from this legal recognition.

The Plan is informed by the responses to the Call for Evidence (thank you to all who responded), and aligns with the updated VAWG strategy, 2021. The Government has made clear that more attention is needed to combat this “pervasive and insidious crime”, with £230 million allocated to bring about the changes outlined. There is a three-pronged focus: Prevention, Support for victims and survivors, and Holding perpetrators to account, with systemic reform which will lead to a more coordinated and informed response.

The Plan has been broadly welcomed by the leading voices in the Domestic Abuse sector, among them Respect, Safe Lives and Women’s Aid. Indeed, there is much to applaud and, if implemented fully, forthcoming action will build on work already taking place to bring about greater safety and security for all. So what does the Plan have to say about children and young people who use harmful behaviour towards their parents and carers?

First, the main section including commitments regarding child to parent abuse is on page 27:

Tackling behaviours early on is key to preventing future offending, as these learned behaviours can act as a steppingstone towards perpetrating abuse in later life. The Home Office will publish updated guidance for frontline practitioners on child-to-parent abuse (CPA) this year, working with frontline practitioners include those working in the police, health, education, and social care, to name just a few. The Home Office will also work with stakeholders to reach an agreed definition and terminology for this type of behaviour. This will underpin policy development on the response to CPA, and comprehensive guidance to support practitioners and service commissioners.

These are reiterated in the Commitments section in Annex C, and there is acknowledgement (p56) of the £25 million Home Office funding already funnelled in over the last two years, to introduce innovative approaches to addressing DA, including programmes focused on children and adolescents.

This is good news! We have been wondering what had happened to updating the guidance (first published in 2015) for some time, and so it is great to have this firm commitment to concluding the work. Furthermore, the commitment to move towards an agreed definition and terminology is one which has been asked for for as long as I have been involved in the work, most recently in the rapid literature review of 2021. Naturally the funding is very much welcomed and has already been put to good use, developing and rolling out responses across the country. I am slightly unsettled though by the framing of the response to CPA as one to prevent future offending. The experience of families is one which deserves attention very much now, recognising the harm caused now. (But fair enough, this is in the section about prevention).

To mention only these sections though would be shortsighted given what we know about child to parent violence and abuse. And so we welcome the focus on schools both in terms of delivery of the RHSE curriculum and as a place to screen for, and identify early on, children who have been victims of DA with a view to offering evidence based, effective support to child and adult survivors. (I refer back to my previous blog post here in supporting the development of work within schools as ideally placed for prevention, screening and delivery of support.) A stronger system (p58), which has a shared understanding of the issues, collaborates and coordinates responses is particularly needed with CPVA, not least in the area of agreeing what it is and how it comes about. I am excited too by the determination to recognise DA as a Safeguarding issue, with the need to work together effectively to identify and support children and young people exhibiting or victims of harmful behaviour (p65). I would suggest that the individual, interpersonal, and neighbourhood level predictors listed (p84) are as likely to be true for children and young people as they are for adults. A system that recognises these difficulties, and that works together, could be identifying those at risk much earlier on – not just for preventing adult and peer abuse in the future, but in starting to tackle CPVA before it becomes entrenched and builds to a point where children are coming within this legislation.

There are, naturally, things I would like to see more of. Data presented in the Plan suggests that more than twice as many people aged 16 – 74 reported experience of partner abuse than abuse by other family members (Annex B), and so it is understandable that the focus is on work with those who are partners and former partners. This is reflected too in the focus on the police and criminal justice system as the foremost source of help. Nevertheless, the data suggests a sizeable group of people (of all ages) experiencing abuse from family members including children, emphasising the importance of recognising the very specific issues for this group of people. Difficulties in reporting perpetrators who are children, and in making a break in the relationship, have been documented in many places (for instance Difficult) and may require a separate response which recognises these issues. This is true not just for those aged 16 and 17, but right through adulthood, where the peculiarity of the relationship adds stresses, and a sense of responsibility for a perpetrator who may be seen as vulnerable in their own right.

So: strong on prevention; good in parts. And commitments to furthering understanding and responses for the future. Going forward, I would like to see more about the very specific issues facing these families now, whether that be in terms of support for victims and survivors, or holding those responsible to account – and fingers crossed that there is more about this in the updated guidance! In the meantime, the battle to obtain recognition within the policies of other Departments continues, as we seek the formal recognition of the issues of child to parent violence and abuse from younger children as well.

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New work on APVA draws attention to links with sibling abuse and bullying.

In my own book, Child to Parent Violence and Abuse: a Practitioner’s Guide to Working with Families, I included examples of how different individuals had sought to “make real” the issue of data, and prevalence of CPVA for their own work and that of other practitioners and policy makers. Elizabeth McCloud had spoken to me at a conference some years earlier about the project she was undertaking, and she is one of the people referenced in my work. So I was thrilled to hear that her research was completed, and available to all. My one regret is that I did not find the time to read this earlier.

The book is aimed at “academics, professionals and policy makers with an interest in youth offending, contextual safeguarding and domestic violence”. One of the first to undertake a large quantitative study of this size in the UK, McCloud sought to identify specific characteristics and experiences at home and school associated with the experience of adolescent to parent violence and abuse (APVA), and explored whether these could be used to predict its occurrence. As such it includes important new information about both bullying and sibling abuse, two areas which have received less coverage in this country.

Over the course of eight chapters, McCloud sets out the detail of her work and findings in the context of previous research, theoretical approaches, and the development of policy, and makes recommendations for future investigation, as well as the application of her findings to day to day work within services concerned with the safety and well-being of young people and families. As a narrative of the course of her research, it is by its nature an academic work. Indeed, chapter 6 carries a warning: “this chapter is dense with statistics”. Nevertheless, the discussion within each section brings these findings to life and makes the research more accessible to those of us less familiar with statistical language.

Discussing the problem that we still have no agreed terminology or definition, McCloud offers her own definition: Any pattern of intended incidents of controlling, coercive or threatening behaviour, violence or abuse by an adolescent (10 to 18 years old) towards a parent or carer. This can encompass, but is not limited to, the following types of abuse: psychological, emotional, physical, sexual abuse, financial and economic. Through the use of questionnaires undertaken across 2 secondary schools, with 890 young people between the ages of 10 and 18 , she considers three separate categories of abuse, psychological, physical and severe, and examines the influence of personal and family characteristics in each case, for example emotional difficulties, family stress, substance use, and broader aggressive behaviour. Of particular interest, chapter 5 outlines significant associations between APVA behaviour and the experience of bullying, whether as a victim, observer or perpetrator.

The final chapter looks at the implications of the findings, and McCloud recommends that APVA could be screened for in universal settings such as schools. Furthermore, she suggests the need for a holistic whole family approach to assessment, and intervention via a tiered model (universal, early help, targeted and specialist), recognising the escalating levels of APVA.

While McCloud is at pains to locate her findings within the larger body of work, there are also important new insights regarding the links between sibling abuse and APVA; and between bullying, particularly in schools, and APVA behaviour within the home. This latter area of work is one of particular interest to me and so I hope that this will be taken up and developed further. The contributions to understanding are thus significant and timely.

Adolescent-to-Parent Violence and Abuse: Applying Research to Policy and Practice (2021) is published by Palgrave Macmillan and is available in print and as an ebook.

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Adolescent to parent violence: Call for manuscripts

A special issue, “Adolescent-to-Parent-Violence: Psychological and Contextual Influences” is to be published in International Journal of Environmental Research and Public Health over the course of the next year, edited by Dr Ana Maria Martin Rodriguez. (This is an open access journal.)

This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) aims to gather systematic research on CPV, performed from different levels of analysis. Papers combining high academic standards and implications for intervention and assessment are welcome. A special call is made for longitudinal studies, given their relevance in the research of causal relations between risk/protective factors and CPV.

Full details of submission requirements can be found here.

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Research priorities

I was chatting to someone recently and we were pondering the next direction for research in the field of child to parent violence and abuse. We are not without guidance in this respect. Most reports and papers conclude with recommendations, including further research needed to fill gaps in knowledge and understanding, and in the development of good practice.

Indeed, in the recent rapid literature review for the Domestic Abuse Commissioner’s Office (here and here), Victoria Baker and I made a number of proposals for the way forward, with eight separate research priorities which can be summarised as follows: 1) establishing a nationally agreed terminology, 2) collecting robust data, 3) longitudinal research looking at the long term implications including “cost to society”, 4) a focus on young people’s experiences and perspectives, 5) how the experience and presentation of CPV is affected by the intersection of different identifying factors and situations, 6) high risk cases and those involving sexualised behaviour and abuse, 7) robust examination of context, and 8) the impact of COVID-19 for families and support services.

Also recently, I came across this document from the Victorian Government in Australia, laying out priorities for work in family violence, including adolescent violence in the home (AVITH), with a focus around developing a deeper understanding regarding the drivers and types of adolescent family violence and effective responses. Importantly here, there are questions to be asked about the possibility of better early identification and intervention, the impact on adolescents themselves, as well as new emerging forms of abuse and links with other forms of abusive behaviour.

Compared to where we were ten years ago, we have made huge strides in analysis and understanding; in the collection of data and its use in the development of responses; in exploring motivations and challenging stereotypes. But there is still a long way to go, and significant gaps remain in the way we have examined this issue. Thankfully there is also hugely more work taking place in this field, in the UK and across the world.

There are currently 2 requests for help with research in the UK that I am aware of. Giulia Pintus at Middlesex University, hopes to find 2 more participants for her work with mothers of children aged 6 – 12, expressing aggressive behaviour towards them; and Anu Adebogun at Oxford University has just started recruiting for her important work with black mothers experiencing “difficult, abusive or violent behaviour” from their child or adolescent. If you can help by passing on the information in these requests, I am sure the researchers would be immensely grateful.

If you are engaged in research in this field and would like your work to be included on the Research page of this website, you are welcome to contact me.

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Opening up the issue of abuse from children over the age 16

Following on from my last post, and in one of those pleasingly serendipitous moments, it was great to hear the announcement this week from Professor Nicola Graham-Kevan and team at UCLancs, who have been researching child to parent domestic abuse from children over the age of 16, in conjunction with the Lancashire Constabulary and Lancashire Violence Reduction Unit, in a Home Office funded project: Understanding Child to Parent Domestic Abuse in Lancashire.

Aiming to form distinct typologies of child to parent domestic abuse, the team used a systematic literature review and examined recorded domestic abuse cases over the 26 month period from November 2018 to February 2021. They found that over 10% involved abuse from a child towards a parent, a figure which is thought probably to be underestimate because of reluctance to contact the police in such circumstances, and issues around the way such abuse is interpreted. Indeed there is a suggestion that incidence may be on the increase because of changing demographics. Also significant was the range of issues identified, including neuro-diversity, mental health diagnoses and substance use, which led to the suggestion that this is far from straightforward in terms of our understanding of such abuse.

Recommendations include the development of a more nuanced form of assessment tools recognising the specific issues around abuse from child to parent, followed by a set of interventions that take this relationship into account.

This is the first part of the research project and the second phase, which takes a longitudinal approach and examines the profile of those using abusive behaviours, is expected later in the year. You can download the first report here, and listen to a discussion about the research on Woman’s Hour here. (41.35- 52.20).

It is tremendously encouraging to see this new aspect of CPA being investigated, opening up further our understanding of the complexities of family relationships; and to see how this is very much a topic for discussion within the media, promoting greater awareness and understanding.

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Mothering challenging adult children

Happy Publication Day to Judith Smith, author of Difficult: mothering challenging adult children through conflict and change, which is published today!

Reading this very welcome book, I was faced with a barrage of emotions:  

  • Terrible sadness at the sacrifices made by so many women to keep their child as safe as they know how.
  • Anger at the expectations and prejudices in the attitudes of others towards mothers giving a home or a helping hand to their adult children.
  • Weary resignation in the knowledge that the public services needed to take over the care still do not exist in sufficient numbers.
  • A smile at the similarities in so much of the book with my own field of child to parent violence and abuse.
  • And a shout of joy that the book exists – an answer to so many emails and calls for help that I and others receive each week!

Dr Judith Smith is a senior clinical social worker, psychotherapist, professor and researcher in the field of gerontology. This book is based on 8 years of work in which she interviewed more than 50 women, over the age of 60, about their experiences of mothering children who returned home in later life, and whose behaviour was described as challenging – sometimes dangerous. She coined the expression “Difficult” to give a name to the experiences of women in this position, offering a phrase that encapsulated the ambivalence in their feelings as well as the day-to-day practicalities of life, without attaching blame. 

From the start we hear from a range of women about their lives, their hopes and fears. Learning that you are not alone, starting to speak openly about the issues, reflecting on the reality of choices available can begin a process of change in thinking. And the focus is very much on the mothers here – this is not a book about how you can make your child change what they do. Judith explores the ambivalence felt by the women she met, holding in mind both negative and positive feelings about children; and offering new ways to handle uncertainty. The truth is that the options available in terms of alternative care may be few and far between, through a combination of societal expectation and underfunding of public services. There is tremendous empathy for all these women throughout the pages. 

In the final chapters, Judith explores how the Stages of Change model can help to provide a framework for understanding what level of intervention might be possible; and then also looks at the different levels of support that are needed. Building social networks, devising self-care strategies, staying safe, and exploring avenues of help for the child – all sadly familiar for those working with younger children too. While the resources listed are generally for a North American audience, there will likely be enough similar in other countries to make this section useful too. 

There are different legal positions here, than with children and young people under 18, different recourse to law, remedies or responsibilities; but the bond that ties mother and child remains, with its complex emotional and societal meanings. So much resonates with my own work, not least the lack of understanding from both the general public and many in positions of authority. 

It will be good to have something to offer that growing number of people seeking help with their difficult adult children. Their numbers may be expanding for the reasons outlined by Judith, but I hope that that there is also a developing sense that others are in the same boat as more and more people speak openly about their lives. There are no easy answers, and it requires hard work, some practical, but also a lot of emotional work – but if you are ready for change then Judith offers this book for you. 

Judith R. Smith, Difficult. Mothering challenging adult children through conflict and change, Rowman and Littlefield, 2022

Judith welcomes feedback, questions and conversation with parents and can be contacted via her website, Facebook page and Twitter. 

https://www.difficultmothering.com

https://www.facebook.com/difficultmothering/

@JudithRSmithPhD

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How can I be sure? Developing a standard for work with families experiencing child to parent violence and abuse

  • How do I choose between different training and trainers?
  • Can I be sure this service will really help my family?
  • What would make me choose to commission one programme rather than another?

All questions I have been asked over the years – some more recently than others – and all very valid!

How do you decide between different providers, now that the number of agencies offering training and provision around child to parent violence and abuse is growing at pace, and with so many programmes being designed from scratch? With so much offered online now, there is no longer the easy decision about travel time, though budget-size might still feature as a legitimate concern. And there remains limited research citing clear evidence of the long term effectiveness of different approaches.

Parents will be offering each other tips and guidance of course, but that relies on being part of an existing network, which is certainly not the case for all families. Up to now my website has offered listings of providers, and some notes on the philosophy behind different approaches, but I still give a disclaimer that I cannot guarantee the services offered. Is it time to resurrect the work on standards and accreditation which a group of us began back in 2015 and which I reported on at the time? Reading back, I see that the concerns have remained remarkably similar over that period!

The working group was chaired by members of Respect, who are well known for their work developing a Standard for work with adult perpetrators (and more recently with male victims). “The Respect Standard is a quality assurance framework for safe, effective, and survivor- focused work with perpetrators of domestic abuse.” This Standard has been reviewed by Nicole Westmarland and Zuzana Zilkova of CriVA at Durham University, and you can read the full report, published last week, here. Comments pointed to the importance of being assured that work was safe and effective, whether from the user or provider point of view, with stand-out words such as confidence, consistency and rigorous underlining the value of such a measure .

Work with families living with violence and abuse from children and young people surely deserves the same oversight and guarantees. It is important that all involved, whether as family members, as practitioners or in funding the provision of services, can be sure that what is on offer will go some way to mending relationships and not to causing further risk and harm.

If you are interested in developing such a standard, you are welcome to contact me to discuss it further.

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A consideration of violence

I’d like to start the new year off with a hope that we will see a continuing growth in understanding around child to parent violence and abuse – at all stages of life – and that that understanding will be matched by resourcing and provision. I wish all of you reading this good health in 2022, a kinder year hopefully for all!

In the meantime I have a guest blog from Jason Mitchell of Semblance Theatre, considering our understanding of violence and the meaning we make of it. I came across the work of Semblance Theatre through a Google alert. Jason is the Developmental Lead for Semblance, an organisation that combines extensive experience in the field of childhood trauma, particularly around adoption, with therapeutic approaches and performance arts. Over to you Jason ….

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Some seasonal thoughts

We* are all feeling a little emotional at the moment (covid, Strictly Come Dancing final, new grand daughter, Christmas songs on the radio), so I might be forgiven for maybe shedding a tear when I read the letter from Nikki Rutter to her co-researchers, published in entanglements. Please read it yourself – I won’t try to comment on it.

The last year has seen incredible advances in many ways in people talking about child to parent violence and abuse, in media coverage, in government funding for the development of support, and in the publication of new research. But the months of covid have, we know, also been difficult beyond our imagination for those living with this as part of their daily lives. This knowledge MUST temper our celebrations. And it should also sharpen our determination to listen to your voices, to learn from you and to hear what works, what makes things worse, what brings hope and what makes you angry or despairing. That should be our new year resolution if we make them, and that will be my hope for the next year of writing.

In the meantime, I was going to write something fairly bland and dry about opening hours over the holiday. I’ll just leave you with these links to organisations offering support at this time. Wishing you peace, and hope for 2022.

Capa First Response

PEGS

Family Lives

Young Minds

Samaritans

* Royal we, meaning me, obviously!

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