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Part 1
Therapeutic approaches
Given the complexity of adolescent violence and abuse towards parents, in terms of pathways, conceptual dilemmas and challenges in practice, it is not surprising that a range of therapeutic approaches have been proposed as vehicles for change. Each of the contributors to this section has considerable experience of working with this issue, and over time they have developed methods and techniques that work for their particular clients. Each contributor also has a unique professional background, and their training and past experience of working in related fields is also evident in the approaches they advocate. The contributors to this section have been selected because of their international standing in this field and because they each highlight different ways of thinking about and working with abuse and violence towards parents. This section comprises five chapters which outline particular theoretical approaches to this work. In Chapter 1, Gregory Routt and Lily Anderson discuss their dual parent–child group programme ‘Step-Up’. Developed in Washington, DC, it is based on ideas from cognitive-behavioural skill-learning and restorative practice, and also draws conceptually from the influential Duluth Model used in adult IPV programs. In Chapter 2, Eddie Gallagher discusses his ‘Who’s in Charge?’ approach to empowering parents. Developed in Melbourne, Australia, the programme draws on solution-focused brief therapeutic principles alongside ideas from narrative therapy, positive psychology and strengths-based approaches. In Chapter 3, Haim Omer discusses his development of non-violent resistance (NVR) training in Tel Aviv, Israel, to work with abused parents. NVR has its roots in the socio-political arena and draws on the principles and practices of resistance used by disadvantaged groups to fight exploitation and oppression. In Chapter 4, Jane Evans discusses her use of trauma-based approaches when working with young people and their families in Bristol, UK. Influenced by theory and research from neuroscience, neurobiology, attachment and trauma, Jane describes how working with past traumas can enable family members to find new ways of responding to stress and conflict. Finally, in Chapter 5, Roberto Pereira discusses his work based in his clinic for adolescent violence in Bilbao, Spain. Roberto describes how adopting a systemic-relational model can yield insights into seemingly irrational violent behaviours that can be used to help family members interact more peacefully.
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1
Building Respectful Family Relationships
Partnering restorative practice with cognitive-behavioral skill learning
Gregory Routt and Lily Anderson
Introduction
When parents of adolescents who are violent in the home are asked what changes they would like to see their teen make, we hear different responses. Some parents immediately reply, “I want him to stop hitting me.” For others the emotional abuse is more intolerable than the physical violence: “I don’t want to repeat the foul names she calls me. I’m ashamed to even think she says them to anyone.” Still other parents long for an end to the harassment from threats, verbal attacks, incessant demands and interminable arguing: “I try to get away from him by locking myself in my bedroom, but he yells and pounds the door for hours.” Beyond the physical violence and emotional abuse, parents also have hopes of restoring a healthy relationship with their child: “I want to sit down with her to calmly talk about her grades. I want to spend time doing something fun with her, like we used to do. I want my daughter back.” Parents have seemingly tried everything and feel locked in a cycle of violence with no way out. They find temporary relief when they make fewer demands on their teen, but aggression and violence return when parents reinstate clear limits. More severe consequences only lead to more abuse while parents helplessly watch their leadership slip away. When teens see their parents fail to hold boundaries, they may begin to use high-risk behaviors such as skipping school, using drugs and alcohol or violating curfews. Parents and teens also become locked in a cycle of shame. Teens feel shame when they hurt family members and fail to meet developmental milestones. Parents feel shame as they perceive themselves as inept and through stigmatization by others who see them as lax and incompetent (Edenborough et al., 2008; Holt, 2011; Nixon, 2012). The cycle of shame is fed by seemingly endless rounds of anger, criticism, and blame.
We have worked exclusively with adolescent violence towards parents since 1997. Our work has included over 1,000 interviews with parents and teens and hundreds of weekly group sessions with them. These families represent a wide diversity of ethnic, religious, and socio-economic backgrounds. Teens are sometimes challenged by trauma, mental health issues, and drug and alcohol problems. Through our many years of trial and error, and learning from youth and parents, we have found certain practices especially helpful in guiding youth through a transformative process toward personal responsibility and behavioral change: parents regain leadership in their family and feel more confident parenting their youth. Restorative practice is one such approach. It provides a framework for intervention and a process for rebuilding healthy family relationships damaged by hurtful behavior. It emphasizes family safety and accountability for harmful behavior, and it provides a safe psychological space for everyone, providing that clearly defined boundaries are set. When used carefully, restorative practice teaches youth and parents how to talk about the violence and abuse in a meaningful and productive way. It leads youth out of cycles of violence and shame and moves them toward mutual understanding, empathy, and making amends. A second approach, cognitive-behavioral learning and skill development, supports the restorative process and we have found that partnership between the two is particularly effective for these families. When teens learn how to change their internal cognitive-emotional process that leads to abuse and when parents and teens practice communication and problem-solving skills together, mutual understanding and respect between them can be restored. In addition, group sessions offer a community of support that breaks feelings of isolation and shame and provides an opportunity to learn by observing others practice skills. Groups also provide a source of peer feedback and offer a community to whom participants are accountable for making behavioral changes. In this chapter, we provide an overview of Step-Up, an intervention model we developed for working with adolescent violence in the home, which partners restorative practice with cognitive-behavioral skill development. We describe its theoretical underpinnings, key components, and strategies for practice, including how we assess families to ensure they are an appropriate fit for this model. An in-depth discussion of restorative practice sheds light on how restorative principles help young people engage in accountability, develop empathy, and restore family relationships. We highlight the benefits of coupling restorative practice with cognitive-behavioral skills-based learning and how these practices mutually support each other. Finally we share some examples of group exercises that we facilitate in our group sessions.
The history of Step-Up
Our professional experience in working with adult domestic violence offenders and survivors and in parent education laid the foundation for our work with adolescent violence in the home. Lily worked with survivors of domestic violence, facilitated a parents’ anger management program, authored an anger management and parenting skills curriculum for parents who were abusive with their children, and co-authored a curriculum for parents whose children witnessed domestic violence. Greg facilitated treatment groups for men who were arrested for domestic violence. We were well acquainted with the dynamics and behaviors of family and intimate partner violence, but children abusing parents was new territory. When we began our program, Step-Up, in 1997 the number of juvenile domestic violence cases in King County, Washington (USA) was staggering. Approximately 800–900 juvenile domestic violence cases were referred to the court every year; 85 percent of cases constituted violence against a family member, with 65 percent of these victims being parents. These were most often situations where a parent called the police during a violent incident by their teen. The need to address this critical issue resulted in the development of a specialized program for these young people and their parents. We knew we had a lot to learn and were faced with many unanswered questions. What dynamics are operating when a teen abuses his or her parent? When a parent is afraid of his or her teen, how is it different from intimate partner violence? Most importantly, what helps an adolescent change abusive and violent behavior? What helps a parent cope with the violence in the home? What helps a parent continue to parent a child she/he fears? How can we help teens and parents work together to learn respectful family relationship skills and restore their relationships? The search for answers to these questions led to some unique ways of working with these families.
Theoretical foundations
We adopted methods used by practitioners in a variety of fields which have been evaluated and shown to be effective. Within a broad framework of restorative practice, we weaved together strategies from domestic violence treatment, cognitive-behavioral therapy, anger management, solution-focused brief therapy, and family relationship skill-building – all practiced in a group setting with parents and teens. Some of the best practice and evidence-based approaches that inform our work includes:
- Cognitive-behavioral learning and skills-based approaches that have become the mainstay of programs that teach non-violence to children and adults (Crick & Dodge, 1994; Bandura, 1973; Lochman, Powell, Boxmeyer, Deming, & Young, 2007; Kazdin & Weisz, 1998)
- Motivational interviewing techniques that foster engagement of young people in the change process (Miller & Rollnick, 2002)
- Strengths-based, solution-focused practices that promote change by accentuating young people and their family’s existing strengths and positive qualities (Clark, 1998)
- Anger management, relaxation and self-calming techniques that are effective in promoting the regulation of emotions (Kassinove & Tafrate, 2002)
- Modeling positive behaviors and giving feedback on performance (Cullen, 2002)
- The Duluth Model tool for accountability: specifically, the Power and Control Wheel and the Equality Wheel (Mederos, 2002; Pence & Paymar, , which we have adapted for adolescent behaviors within the family and renamed as the Abuse/Disrespect and Mutual Respect Wheels.
The primary intervention goals are respect between family members and a respectful home where every person feels valued. Respect has universal appeal as a moral virtue valued by all religions, cultures, and classes and it operates as a moral compass for decision-making among family members – offering a standard by which all family interactions are evaluated. Respect has a synergistic effect, as Lawrence-Lightfoot (2000) contends: “Respectful relationships have a way of sustaining and replicating themselves. Respect generates respect; a modest loaf becomes many” (p. 10). When children and parents show respect for each other, as well as receive respect from each other, their mutuality strengthens and their personal confidence and self-esteem are bolstered. A culture of respect inoculates a family against hostility and aggression (Mayseless & Scharf, 2011). Helping families learn and integrate a respect template for relating to each other gives them new options for expressing themselves and responding to others in safe and respectful ways.
Our Abuse/Disrespect and Mutual Respect Wheels (Figure 1.1), adapted from the Duluth Model (Pence & Paymar, 1993), define respect in terms of actual lived behaviors. The wheels illustrate and define abuse and respect in a family and provide weekly guidance for young people with examples of specific respectful behaviors to replace the abuse and violence. Parents use the wheels to re-establish healthy boundaries with their children and to renew family relationships. The two wheels are vital to the restorative process since they join parents and young people in a mutually engaging venture to rebuild their relationship. We will describe how the wheels are also used at the beginning of each group session later in this chapter.
The structure of the program
The program utilizes a 21-session curriculum in weekly 90-minute groups where young people and their parents learn and practice skills for respectful, non-violent family relationships and safety in the home. It includes a youth group, a parent group, and a joint parent–youth group. Separate sessions for parents offer support and teach skills that enable parents to re-establish leadership. Separate sessions for teens provide them with the opportunity to learn personal skills away from their parents. Joint sessions provide opportunities for parents and young people to learn respectful communication, problem-solving and restorative skills. Young people and parents each have their own program manuals. Our sessions begin with parents and teens together for “check-in,” followed by skill learning – either in separate parent and teen groups or in joint sessions, depending on the topic.
Prerequisites for the intervention
In order for a young person to be a candidate for this intervention, the assessment must demonstrate that the following criteria are fulfilled:
Figure 1.1 Abuse/Disrespect and Mutual Respect Wheels
- The young person is the primary perpetrator of violence in the family
- The young person’s violence is not a response to abuse
- The young person is not currently being abused
- The young person has not been abused by the targeted parent(s).
If either the young person or their parents are experiencing mental health probl...
