There is a large body of evidence which illustrates how children living with domestic abuse can be harmed by this experience. Children who have lived with domestic abuse are more likely than other children to have both internalising behaviours, such as anxiety, and externalising behaviours, such as aggression (e.g. Kenrick et al., 2003, Fantuzzo, 1999) and poor psychosocial functioning (Berry et al. 2019), as well as experiencing disruption to their schooling (Lloyd, 2018). Other forms of child abuse are more likely to occur in the context of domestic abuse (e.g. Radford, 2011; Lloyd, 2018), and Callaghan et al. (2015) argued that children should not be referred to as ‘witnesses’ of domestic abuse, as this does not reflect their direct experience and the harm caused to them.
DART is designed to support mothers and their children (aged 7 to 14) to overcome the adverse effects of domestic abuse, together. DART aims to help children to share their experiences of the abuse with their mother and to help mothers to understand and address related difficulties their child may have. There are activities designed to help children have a greater understanding of their mother’s perspective; for instance, why they may have found it hard to leave the abuser. The programme’s theory of change is that increasing mothers’ understanding of how their child is affected, whilst helping to improve the mother-child relationship (in line with Recommendation 11 from PH50) and mothers’ self-esteem. This will better equip mothers to support their children and lead to better outcomes for both mother and child.
Example
Aims and objectives
Domestic Abuse, Recovering Together (DART) aims to help children aged 7 to 14 years recover from the adverse effects of domestic abuse, by working with the mother and child together to strengthen their relationship, and help both talk about and recover from the impact of domestic abuse. The programme aims to address the immediate and long-term negative effects that children are likely to experience if they have been exposed to domestic abuse and, thus, improve educational attainment and reduce related presentations to health services by:
- Reducing the difficulties experienced by the child, such as conduct problems, emotional distress and issues with their peer relationships
- Increasing the self-esteem of the mothers and children
- Increasing the mothers’ confidence in their parenting abilities.
This relates to recommendation 11 in PH50: Domestic violence and abuse: multi-agency working in regards interventions to:
- “strengthen the relationship between the child or young person and their non-abusive parent/carer
- deliver group sessions, or both. The sessions should include advocacy, therapy and other support that addresses the impact of domestic violence and abuse on parenting. Sessions should be delivered to children and their non-abusive parent or carer in parallel, or together.”
Reasons for implementing your project
Domestic abuse is considered “highly prevalent” in the UK (Chandan et al, 2019) and the negative effects of this have been well-documented and include a range of poor outcomes for both mothers and children (e.g. Callaghan et al, 2015). Whilst children are harmed by domestic abuse (e.g. Berry, 2019), this is often underestimated by their mothers (Edleson, 1999). A core part of the DART theory of change is that having a supportive parent (usually the mother) can help to improve children’s outcomes after the abuse (e.g. Holt et al., 2008). However, mothers are often struggling with their own trauma and related difficulties, therefore they may not always recognise the effects on the children and/or be in the right emotional place to provide support (e.g. Humphreys et al., 2008). Additionally, domestic abuse can damage the mother-child relationship, which can also make it harder for mothers to help their child (Humphreys et al., 2008).
DART was designed, implemented and tested by the NSPCC, and later rolled out by local authorities and other voluntary organisations to support mothers and children in their area. The programme aims to help mothers understand how their children have been affected by the abuse and how they can support them, in addition to supporting both mothers’ and children’s recovery. An internal scoping review conducted by the DART development team suggested that much domestic abuse recovery work was being undertaken in ‘parallel’: i.e. maternal and child recovery work was delivered to mothers and children separately. In contrast, DART was designed to have half of the programme with ‘joint’ sessions, involving both mothers and children working together, in order that more work can be done to strengthen their relationship and help mothers understand how their child has been affected by domestic abuse.
Eight NSPCC service centres in England, Wales and Northern Ireland ran the original service and were part of the original evaluation of DART. Families could be referred to the service in a range of ways, including a self-referral or a referral from an agency such as social services. Following positive evaluation findings, the tool was rolled out to a further 30 external[1] local authorities/voluntary organisations. An impact evaluation (Smith et al., 2020) also showed the programme led to positive and statistically significant improvements in outcomes for mothers and children.
Stakeholders including mothers, children, referrers and practitioners were involved in the original evaluation of the service (Smith et al 2020) and the implementation of the service (Stokes, 2017). These evaluations led to a small alteration in the programme manual to allow practitioners a little more flexibility with the activities they used in DART, and some changes to the NSPCC implementation approach. The key findings section provides more detail about these evaluation findings.
[1] Non-NSPCC
How did you implement the project
DART was originally designed on the basis of research which showed how domestic abuse could damage the mother-child relationship (e.g. Humphreys et al. 2006) and that strengthening this could help mothers to better support their children, leading to better outcomes for the children (e.g. Holt et al, 2008). The joint group work sessions were also part of the original programme design. Therefore, the NICE recommendations of delivering activities designed to strengthen the non-abusive parent/carer- child relationship, and having mother and child group work sessions were built in from the very start.
Some issues with the original delivery and roll out of DART were highlighted by our process evaluations (Smith et al, 2016; Stokes, 2017). These difficulties included some sites struggling to establish referral pathways and not getting enough referrals to run the programme. However, practitioners and service leads worked hard to address these problems, for example, by building relationships with professionals from other domestic abuse services and holding DART open days to strengthen these networks.
One of the Local Authorities (LAs) who adopted DART in 2018 ran the service in two local schools, in contrast to the NSPCC who ran DART from their service centre. Service leads and practitioners from this LA told us that schools were chosen as delivery sites due to anticipated problems with the logistics of the programme, if it were delivered elsewhere. For instance, delivering in individual schools meant that children were able to attend the programme during the school day and could get quickly to and from the group without having too much time out of class. Additionally, there were a lot of staff at the site who could provide support if a child was struggling during a group, and schools helped with recruiting suitable families. DART was also delivered at this LA as part of a multi-agency team, including police, social care and local domestic abuse agencies, with a balanced mix of male and female facilitators. There were many benefits perceived with this approach, for instance this facilitated positive relationships between staff from different agencies. Additionally, mothers and children, who had previously lived with violent abusive men, were able to develop positive relationships with empathetic and supportive male facilitators. Where police were also involved with programme delivery, this also was felt to have helped families to develop more positive perceptions of the police, where previously families may have had negative views and/or experiences.
Additional problems faced by this LA included having families who did not fit the referral criteria, for example where some children were too young to attend the programme even though the family was otherwise suitable. Additionally, some mothers did not consider the programme necessary due to the abuse they experienced being more emotional than physical. DART facilitators addressed these issues by having support staff run individual work and activities with families who had school aged- children aged under 7 and by persuading families that the programme was suitable for families who had experienced a range of domestic abuse. The COVID-19 pandemic has posed additional challenges for programme delivery, as DART is not considered a suitable programme to deliver virtually, for safety reasons, therefore the current DART programme has been paused during lockdown.
Key findings
The original evaluation of DART provided positive results indicating that mothers’ self-esteem, confidence in her parenting and relationship with her child significantly improved after attending DART, based on pre and post programme standardised measures scores. Additionally, children’s emotional and behavioural difficulties reduced significantly after DART, and significantly more than a comparison group of children from a women’s refuge (Smith, 2015). Qualitative interviews identified programme facilitators, such as creative activities which helped children to share their perspective of the abuse, giving mothers a fuller understanding of how they had been affected. Some mothers said realising the extent to which their child had been affected by the abuse had reinforced their decision not to resume a relationship with their former abusive partner. Having supportive peers in the group who had also experienced domestic abuse was also described by mothers and children as something that made them feel less alone. Some maintained friendships after the group, providing them with more informal support networks after the group had ended (McManus et al., 2013).
This evaluation provides further evidence that DART is an effective intervention which helps to support mothers and children achieve better outcomes following domestic abuse. Similar to the findings from the original DART evaluation (Smith et al 2016), there was evidence that mothers’ self-esteem, aspects of the mother child-relationship and difficulties experienced by the child significantly improved after the programme, and improved more than a ‘no intervention’ comparison group. DART appears to be equally effective whether or not it is delivered by the NSPCC or a service supported by the NSPCC (Smith et al, 2020). This supports the charity’s continued efforts to scale up the programme, as it means that more families can benefit.
Key learning points
Some of the key learning from the programme, obtained via process and implementation evaluations, has led to some small adaptions to the original programme and our approach to implementation. For instance, early interviews revealed that practitioners had considered the original programme too rigid and inflexible. This led to a small change in the programme manual which specified that practitioners could adapt activities according to the needs of the group as long as each session’s aims and outcomes were unchanged.
Additionally, an implementation evaluation of the scale up of DART (Stokes, 2017), where services were trained and supported to deliver the programme, revealed that whilst DART and the training was well-rated, few organisations were adopting it. Interviews with service and implementation leads revealed barriers including difficulties with finding funding streams for prevention work, struggling to meet costs to deliver some aspects of DART, staffing capacity and finding appropriate venues to deliver DART.
Part of the key learning, in relation to the programme implementation, was to understand how NSPCC could address some of these barriers. To help organisations overcome these challenges, the following adaptations and supports were developed, drawing from NIRN Active Implementation Frameworks. The mechanisms developed included:
- Implementation Guide: A resource for potential adopting agencies that outlines the key stages of implementation; staffing resources; and modes of delivery.
- Readiness Assessment: a tool to identify whether the conditions for successful implementation are in place and if not, what must be addressed to achieve this. This included a review from strategic engagement; through referral pathways; to granular detail such as venue size.
- Modes of delivery: it was recognised that when delivered in a variety of contexts, the model must have enough adaptability to embed and thrive. This led to different modes of delivery being developed to decrease the impact of financial and staff resource demands. These modes included: the use of trained volunteers (up to two) in addition to qualified staff; widening the range of qualifications facilitators required to hold; facilitating up to three agencies implementing the approach in partnership.
Agencies that have successfully implemented DART have built upon the findings of the implementation evaluation, and made use of the licence support and communities of practice. Licence support includes:
- NSPCC Implementation Manager (IM) horizon scans for funding opportunities and shares amongst licence holders. The IM in addition supports funding bids as appropriate.
- Full lists of resources are provided to licence holders and discussions around funding for ongoing resources form part of the readiness assessment.
- The implementation guide details the number of staff hours required to facilitate the group.
- Communities of practice are run quarterly to allow the sharing of best practice and problem solving amongst the group of organisations delivering DART.