Case Study: Foundation Domestic Abuse Children’s Service
Foundation’s Child Therapeutic Service offers play therapy, art therapy and integrative psychotherapy to children and young people who have suffered or witnessed domestic abuse.

This powerful case study details work with a family who were referred to the service through Children’s Social Care. The service worked with the family for seven months.

The Background

The family consists of a mother and her three children (girls aged 4 & 9 and a boy aged 11). The mother and children had all suffered long-term physical and emotional abuse and the children had witnessed their mother being raped by their birth father, who eventually received a lengthy prison sentence. At the time of the referral, family functioning was chaotic with no structure or boundaries in place. The children were “running wild” and their mother was depressed and worn down by domestic abuse, poor housing and forgotten parenting skills. All the children slept with mum in one room because they were frightened. The father’s friends had tried to break into the house and were harassing the mother.

Presenting difficulties of 9 year old girl:

  • School refusal (due to separation difficulties) and had not attended school for several weeks.
  • Withdrawn and low self-esteem.
  • Inability to accept cuddles or affection from mother or praise and compliments at school.
  • The girl had a tic and had become the focus of teasing from peers at school.
  • The girl was regularly fighting with his older brother. Frequent displays of anger and swearing directed at mother (oppositional behaviour).
  • Sleep difficulties (inability to sleep in own bedroom).

Presenting difficulties of 11 year old boy:

  • The boy was starting to adopt the perpetrator role towards his mother (checking her texts and demanding to know what she had been doing, hitting her, controlling the household through intimidation and being verbally abusive towards her).
  • Aggression towards his younger siblings.
  • Aggression towards peers at school with several exclusions from school in one term for fighting.
  • Sleep difficulties (inability to sleep in own bedroom).

Presenting difficulties of 4 year old girl:

  • Had delayed development and sleep difficulties (afraid to sleep in own beds and waking in the night with night terrors).

Other agencies working with the family included:

the school Parent/Staff Association, North Yorkshire County Council Family Intervention Programme, police, health visitor, and Domestic Abuse Services adult support worker using a multi-agency approach.

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The treatment and action plan

All three children participated in their assessments and with their consent it was decided that the 11 year old boy would benefit from non-directive play therapy. Play therapy is a non-verbal form of counselling that enables children and young people to explore their feelings and act out past difficult experiences in order to understand and master their feelings and build resilience and modify behaviours. He received ten 1-1 sessions and a further ten peer group sessions. These sessions were agreed to enable him to see his experiences of domestic violence are not isolated or different from others, and to explore non-violent conflict resolutions and build self-protective behaviours.

It was felt that because the 9 year old girl was unable to accept nurture a dyadic Theraplay intervention was more suitable. Theraplay is a short-term, structured, playful intervention that is designed to strengthen the attachment between a child and his caregiver. She and her mother received twelve sessions. This intervention suited the mother as well as it models appropriate parenting and nurtures the parent, enabling her to employ her new skills with all her children. Because this intervention was used it was felt that the younger child didn’t need an intervention at that time as it was hoped the benefits would filter down to them.

All the children completed safety plans with their mother involved in the whole process.

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The outcomes after seven months of intervention:

  • The family were found to be functioning as a cohesive unit and enjoying playing together. Mum was able to put in place boundaries that are respected by all the children, including the 11 year old boy.
  • Improved relations between all family members, with each other, and with their mother. The 9 year old was now able to accept cuddles and nurture from her mum.
  • The 9 year old was now attending school regularly, making friends and enjoying it.
  • All the children’s sleep difficulties were found to be absent. All were able to retire to and sleep in their own beds at appropriate bedtimes and the girls night terrors had stopped.
  • The 11 year old boy able to self-calm and achieve positive behaviour targets at school.
  • The 9 year old’s soiling had stopped.
  • It was agreed by all that targeted services intervention was no longer needed.

 

This case study is presented by Di Wicks , a Foundation Play Therapist/Specialist Children’s Worker.