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Program Profile: Kids Club

Evidence Rating: Promising - One study Promising - One study

Date: This profile was posted on June 15, 2011

Program Summary

A multicomponent approach designed to improve behavioral and mental health in children exposed to intimate partner violence while providing empowerment and parenting training to mothers. The program is rated Promising. Children in the “child plus mother” group showed the greatest improvement over time in externalizing problems, both the child plus mother and child only groups became less excepting of violence.

Program Description

Program Goals

The program focuses on promoting resilience and improving behavior for children who have witnessed intimate partner violence in their homes. The goal of the child-training component is to help the children cope with their exposure to violence and change their attitudes and beliefs about violence, particularly family violence.

 

The program also aims to improve emotional adjustment and social behavior among children. Since being exposed to violence affects children’s ability to have positive social interactions, this program seeks to help them adjust in a social environment. It works to reduce both behavioral (externalizing) problems and emotional (internalizing) problems in these at-risk children.

 

An additional component of the program is designed to enhance the mother’s social and emotional adjustment. The parenting component allows the mother to obtain support, manage issues related to domestic violence, and feel empowered. This component seeks to improve the mother’s emotional state and her parenting skills, with the goal of improving her child’s behavior.

 

Target Population/Eligibility

The program is targeted at children who have been exposed to intimate partner violence and their mothers, who have been abused. Children do not have to be diagnosed with clinical levels of behavioral or mental issues to be eligible. They can be identified as having subclinical levels of behavioral issues or merely be at risk for these problems.

 

Program Components

In the child-training portion of the program, a supportive group environment is provided for children to share their experiences, including group activities and group therapy. By participating in group activities, children are able to learn that they are not alone in their exposure to violence and learn social skills. Many of the group activities address family violence through displacement by using drawings, puppets, and movies.

 

Early therapy sessions focus on providing the children with a sense of safety and to help them make sense of emotions related to violence exposure, while later sessions focus on managing emotions, conflict resolution, and strengthening family relationships.

 

In the parenting-training component of the program, called the Mom’s Empowerment Program, mothers meet together to share their experiences and gain support from each other. Through group therapy, they discuss past experiences, share worries and concerns, and build connections. During therapy, they are encouraged to discuss the impact the violence has had on their child, and how they can improve their parenting competence. They are also taught parenting and disciplinary skills to help their children adjust better.

 

Key Personnel

Specially trained therapists implement this program.

 

Program Theory

This program is based on the theory that exposure to intimate partner violence causes distress and anxiety in children. As a result of observing violence, they learn destructive patterns of behavior, attitudes, and beliefs. Children are then more likely to engage in violence and believe that it is acceptable, and are also placed at a high risk for future delinquent behavior. This program combats these negative attitudes by promoting the idea that violence is not acceptable.

 

Another aspect that underlies this program is that the mother’s parenting and overall emotional state has a strong impact on children’s beliefs toward violence and their behavior. When the mother is stressed from being involved in violence, it is harder to be a competent parent to her child. Therefore, if the mother’s emotional state is improved and she is able to feel empowered, she will be a better parent and role model for her child.

Evaluation Outcomes

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Study 1

Externalizing Problems

Graham–Bermann and colleagues (2007) found that children in the “child plus mother” group (CM) showed the greatest improvement over time in externalizing problems. The percentage of CM children who showed clinical levels of externalizing behavior began at 34 percent at baseline, declined to 21 percent following the treatment, and declined substantially to 7 percent at follow up. Of those children who were in the “child only” category (CO), 47 percent showed clinical levels of externalizing behavior at baseline; this declined to 34 percent following the treatment, then increased to 37 percent at follow up. The percentage of control group children (CG) who showed clinical levels of externalizing behavior was 33 percent at baseline and declined to 28 percent following the treatment.

 

Internalizing Problems

All groups saw decreases in internalizing problems over the course of the study. The baseline percentage of CM children who showed clinical levels of internalizing behavior was 31 percent; this declined to 11 percent following the treatment, and declined further to 7 percent at follow up. Of CO children, 52 percent showed clinical levels of internalizing behavior at baseline. This percentage declined to 34 percent following the treatment and decreased to 26 percent at follow up. For the CG group, 41 percent of the children showed clinical levels of internalizing behavior at baseline; this declined to 31 percent following the treatment.

 

Attitudes Toward Violence

The CM and CO groups saw a decrease in mean Attitudes About Family Violence (AAFV) scores over the course of the study, meaning that the children in these groups became less accepting of violence. The CM group’s mean score on the AAFV score was 30.60 at baseline, declined to 27.71 after the program ended, and remained stable at 27.91 at follow up. In the CO group, the mean score was 30.52 at baseline, decreased to 27.61 at the end of the program, and increased slightly to 28.58 at follow up. The CG group’s mean score increased slightly from a baseline score of 29.14 to 30.06 after the program ended.

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Evaluation Methodology

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Study 1

Graham–Bermann and colleagues (2007) conducted a study to evaluate the impact of the Kids Club program on children and their mothers in Michigan. Mothers were recruited from local social service agencies and battered women shelters, as well as through flyers and newspaper advertisements. To be eligible for the study, they had to have experienced physical conflict in their relationship over the past year, and have a child between the ages of 6 to 12 of either gender.

 

The study sample consisted of 110 boys and 111 girls, a total of 221 children. Children were divided into two groups by age (6 to 8, and 9 to 12) and gender mixed. A small-group format was used, with five to seven children and two therapists assigned to a group. Group therapists were graduate students in clinical psychology and social work; they were paired with therapists from mental health clinics in the community. The program lasted for 10 weeks.

 

The children were randomly assigned to three conditions: child only (CO), child plus mother (CM), and a control group (CG). First, seven children were assigned to the CO group, the next seven to the CM group, and the next seven to the control group, with this pattern repeated until they were all assigned to groups. In the CO group, only the children participated in the program, and in the CM group, both the child and the mother participated in the program. In the control group, neither the child nor the mother participated: These families were told that they were being placed on a waiting list for the program. CM and CO groups did not differ from CG participants in ethnicity, income, maternal age or marital status, education, child age or gender, or exposure to intimate partner violence.

 

There were 62 CO, 61 CM, and 58 CG children who participated in the study, with 123 children total who received treatment from the program. All three groups were interviewed at baseline right before the program began and interviewed a second time at the end of the program. The CO and CG groups were interviewed a third time, 8 months after the program ended. At the end of the 10 weeks, those in the control group were offered a chance to participate in the program and were not interviewed a third time. Seven children who received the treatment were not interviewed a third time; two refused the interview, and five dropped out after the program ended. This left 56 in the CO group and 60 in the CM group who participated in all three interviews.

 

Externalizing and internalizing behaviors were assessed, using the Child Behavioral Checklist. Mothers completed this 113-item questionnaire, rating statements about behaviors in their child from a score of 0 to 2,with 0 meaning “not true,” 1 meaning “somewhat or sometimes true,” and 2 meaning “very true or often true.” The Externalizing scale has statements about aggression and delinquency, while the Internalizing scale has statements about anxiety, depression, withdrawal, and somatic complaints.

 

Attitudes toward violence were also assessed, using the Attitudes About Family Violence scale, an instrument that was created for use in this study. The child was asked to rate 10 statements about violence on a five-point scale about how much they agreed with the statement. Positive statements were reverse scored, so the higher the overall score, the more negative their attitude toward violence.

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Cost

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There is no cost information available for this program.
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Implementation Information

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Training manuals are available to outline how to properly implement this program. Training information can be obtained from Sandra Graham–Bermann (please see Contact Information).

 

Therapists are trained in clinical and social work, as well as in ethical issues dealing with people exposed to violence and at-risk populations. Training is recommended in order to implement the program. A six-hour training program is available on DVD.
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Evidence-Base (Studies Reviewed)

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These sources were used in the development of the program profile:

Study 1

Graham–Bermann, Sandra, Shannon Lynch, Victoria Banyard, Ellen DeVoe, Hilda Halabu. 2007. “Community-Based Intervention for Children Exposed to Intimate Partner Violence: An Efficacy Trial.” Journal of Counseling and Clinical Psychology 75(2):199–209.


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Additional References

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These sources were used in the development of the program profile:

Graham–Bermann, Sandra A., Kathryn H. Howell, Michelle Lilly, and Ellen Devoe. 2011. “Mediators and Moderators of Change in Adjustment Following Intervention for Children Exposed to Intimate Partner Violence (IPV).” Journal of Interpersonal Violence 26(9):1815–1833.

Graham–Bermann, Sandra A, Madhur R. Kulkarni, and Shanta Kanukollu. 2011. “Is Disclosure Therapeutic for Children Following Exposure to Traumatic Violence?” Journal of Interpersonal Violence 26(5):1056–1076.

Graham–Bermann, Sandra A and Alytia A. Levendosky (eds.). 2011. How Intimate Partner Violence Affects Children: Developmental Research, Case Studies, and Evidence-Based Treatment. Washington, DC: American Psychological Association Books.
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Program Snapshot

Age: 6 - 12

Gender: Both

Race/Ethnicity: Black, White, Other

Geography: Urban

Setting (Delivery): Other Community Setting

Program Type: Conflict Resolution/Interpersonal Skills, Group Therapy, Parent Training, Victim Programs, Children Exposed to Violence, Violence Prevention

Targeted Population: Victims of Crime, Children Exposed to Violence, Families

Current Program Status: Active

Listed by Other Directories: Child Exposure to Violence Evidence Based Guide

Program Developer:
Sandra Graham–Bermann
Professor of Psychology and Psychiatry
University of Michigan
530 Church Street
Ann Arbor MI 48109
Phone: 734.763.3159
Email

Training and TA Provider:
Sandra Graham–Bermann
Professor of Psychology and Psychiatry
University of Michigan
530 Church Street
Ann Arbor MI 48109
Phone: 734.763.3159
Email