One man loads a machine gun in front of his wife and children. Another tells his wife, “I don’t have to kill you, I can get someone else to do it.” In one of the most heinous cases, a husband scalps his wife in front of their five children.

Psychology researchers Ernest Jouriles and Renee McDonald have seen families suffer the most extreme cases of domestic violence.

The women and children who retreat to shelters generally have endured horrifying violence, says Paige Flink, executive director of The Family Place in Dallas. “If these women are willing to leave [home], they’re generally at a high stage of chaos.”

Each year more than one million children in the United States are brought to shelters such as The Family Place, says Jouriles, professor and chair of the Psychology Department in Dedman College. “The average family that goes into shelter reports over 60 acts of aggression, such as pushes, shoves, hits, or kicks, during the past year. More than half of the families report an incident in which a knife or gun was used.”

They are driven by the vulnerability of children in these circumstances and the lack of scientific knowledge about how to reduce the risk for poor outcomes among them. Jouriles and McDonald have devoted their careers to understanding how severe levels of domestic violence affect children and, more importantly, what can be done to help them.

A married couple with a 12-year-old daughter, the mild-mannered scholars reveal their fierce advocacy for a vulnerable segment of society when talking about their research. “It would be very disappointing if our research died on the bookshelf in some library,” Jouriles says. “We’re doing work that we hope will better serve children in very high-risk environments.”

Help For The Helpless

To help these victims start anew, the researchers have developed and evaluated Project SUPPORT, a home-based intervention. Project SUPPORT’s intensive, targeted services, offered to families after they leave the shelter, help mothers start new lives apart from their abusers and learn parenting skills critical in guiding children with serious behavior problems. After receiving Project SUPPORT, the children have shown significant decreases in clinical levels of behavior problems for up to two years – the length of time tracked by Jouriles and McDonald.

In fact, only 15 percent of children who received the intervention exhibited clinical levels of conduct problems two years after the services ended, according to McDonald and Jouriles’ recent paper following up on the effects of the intervention. This compares with 53 percent of children in the comparison group, whose families received monthly follow-up calls, referrals to community services, and donated goods, but did not receive the home-based intervention program.

In addition, children who received Project SUPPORT were “viewed by their mothers as being happier, having better social relationships, and exhibiting lower levels of internalizing problems than children in the comparison condition,” states the paper, in press with the Journal of Family Psychology.

The Office of Juvenile Justice and Delinquency Prevention (OJJDP), part of the Department of Justice, has recognized Jouriles and McDonald’s work as one of 15 “most promising practices” nationally in helping children exposed to violence. The researchers received a four-year grant from the OJJDP to implement their interventions in Dallas in conjunction with The Family Place. Funding for the first two years is nearly $420,000, and the final two years, awaiting approval, will be close to the same amount.

“The federal government recognizes that children growing up in these violent families are the kids at risk for later delinquency and criminal activity,” Jouriles says. “They see that we need to do something to prevent these risks from being realized.”

The Consequences Of Violence

As expected, children often suffer serious consequences from exposure to domestic violence. Even children exposed to less extreme forms of violence between parents are at higher risk for problems, Jouriles says. “Common couple violence,” which he defines as marital conflicts that escalate into a few pushes and shoves two to five times a year, occurs in 10 to 15 percent of couples each year in the United States.

“So the prevalence of serious clinical problems among kids who get brought to shelters is very high,” Jouriles says. Problems range from aggressive behavior and other types of delinquency, such as cheating and stealing, to drug abuse, relationship problems, and poor grades.

Although exposure to domestic violence as a child is not always linked to violent adult behavior, it increases a child’s risk for myriad problems in adolescence and adulthood, Jouriles and McDonald say. “One of the things we do know is children who are acting aggressively and engaging in other forms of antisocial behavior are more likely to grow up and engage in various criminal acts, including domestic violence,” Jouriles says. “Also, we’re finding that these children are very prevalent among families that go to shelters.”
Jouriles and McDonald often are asked what they consider a fair question: “Why don’t these women leave their abusers?”

“If you spend any time in a shelter, you clearly understand the lack of options these women feel,” says McDonald, associate professor of psychology. “The average income among shelter women that we have worked with is $8,000 a year, and they usually have multiple children. Many are young, poorly educated, and have few, if any, job skills. Oftentimes they feel like their choices are to leave and be on the streets or stay and at least be able to feed their kids through whatever income their husband is providing.”

Also, if women try to leave, they often receive from abusive partners threats of bodily harm, of taking the children away, or of personal ruin through deportation or harassment at work. For many, personal safety is a major issue. “There is some empirical evidence indicating that the time homicides are most likely to occur is when women are trying to break off these relationships,” Jouriles says.

A Life Independent

Jouriles and McDonald target for their interventions women who leave shelters and whose children are showing clinical levels of behavior problems. As they start out on their own, the women continue to face new and pressing issues of survival. For this reason, the first component of Project SUPPORT focuses on helping mothers meet basic needs.

“Often they don’t have diapers or formula. They have no furniture. They need utilities,” McDonald says. “We help them access community resources to get things they need.”
Jouriles and McDonald have counseled families in sweltering Houston apartments. They’ve driven mothers to the food bank or to court for protective orders and provided them with beds and other donated furniture.

Jouriles laughs in recalling a home visit when he stood up from the couch and the cushion, freshly stained with peanut butter, stuck to his leg. “Going into homes gives service providers a better understanding of the family’s circumstances,” he says.

For an hour a week for six months, the family receives joint visits from a service provider and a mentor. The service provider works one-on-one with the mother while the mentor interacts with the children.

The intervention depends on the family, Jouriles says. “Some of it, for example, is getting on the phone [with social services] and showing the mother how we get the runaround, too. Service providers go shopping with mothers to help them learn how to make cost-effective decisions. A lot of the first part of the intervention is helping these families get back on their feet.”

McDonald adds, “It’s also about helping the mom get to the point where she can think beyond the next meal and about, ‘OK, how can I help the kids?’”

Creating New Behaviors

Once the family has gained some stability, the intervention moves on to the second component – teaching the mother child management skills based on the strengths and weaknesses of mother and child. The service provider and mentor model these skills in their interactions with the children. Mothers practice through role play and homework and receive feedback from service providers.

Service providers begin with positive behaviors, showing mothers how to play with their kids, how to listen, and how to give praise and positive reinforcement. “For many of these women, they’re so stressed and so bogged down with the day-to-day that they’ve either never learned or have forgotten that, for kids, it’s important to have fun,” McDonald says.

By strengthening positive aspects of the relationship, the child often begins to improve in behavior even before mothers have learned more punitive skills, which are exclusively nonphysical. “Physical punishment does not seem to help these kids, and it maintains the cycle of behavior,” McDonald says.

The 24-month research follow-up shows that mothers who received the interventions were less likely to use aggressive forms of punishment than mothers in the comparison group.
Working with the mothers is the key to change, the researchers say. “When the mom’s the one trying to change the child’s behavior, she realizes she can have a positive impact,” Jouriles says.

Circle Of Influence

Abeer Monem was an undergraduate psychology major when she began assisting Jouriles and McDonald at the University of Houston. As part of their research, Monem worked with children at the Fort Bend County Women’s Center in Richmond, Texas. She also worked as a mentor for Project SUPPORT.

Today Monem is director of programs at the women’s center in Richmond. “Seeing how many children came through and the positive impact on them made a big impression on me,” Monem says. “When the time came for the children to exit the shelter, they didn’t want to go. They would hug you and hold onto you, and it warmed my heart.”

Because Jouriles and McDonald moved to Dallas and SMU in 2003, the Fort Bend County Women’s Center no longer offers home-based interventions. Most agencies receive funding based on the number of client contacts, so even if they see the benefits of home-based care, phone contacts and office visits are more realistic, McDonald says.

However, the center has incorporated into its programs some of the Jouriles-McDonald principles. Staff members have been added to follow up with clients after they leave the shelter and to assess children for behavior problems. When clinical levels of problems are found, children can receive nonresidential counseling after they leave the shelter. In addition, play-care staff members have been added and trained in positive reinforcement skills to work with the children in the shelter.

“This is not just a research project for [Jouriles and McDonald],” Monem says. “They really want to help these children. Their passion drew me in.”

Beginning this spring, Jouriles and McDonald will work with The Family Place to identify 160 families for the research project funded by the OJJDP. Eighty families will receive Project SUPPORT and 80 will compose the comparison group.

SMU students will be among those assisting the project as mentors and service providers. Laura Minze worked at The Family Place for nine years before coming to SMU to pursue a Ph.D. in psychology. “This will be a new experience for me as a therapist. I’ve never worked in home-based services,” says Minze, a licensed professional counselor. “It can be difficult for women in major transitions to come to an office, so this provides an opportunity to meet them where they are.”

Home-based care also is new for Paige Flink of The Family Place. “I’m curious to see if home-based intervention is a good mode of treatment,” she says. “In 28 years, The Family Place has never been able to do home-based programming.”

Jouriles and McDonald hope their research could help change the way agencies are funded to make home-based intervention a viable option for shelters. Working with the OJJDP is a “big step” toward that goal, McDonald says. “In terms of society bearing the cost, this is much more effective in the long run because we’re reducing behavior problems down the road. These kids won’t be in jail or dropping out of school or into drugs.”

Jouriles and McDonald taught and conducted research at the University of Houston for more than 15 years before coming to SMU. Jouriles earned his Ph.D. in psychology from SUNY at Stony Brook and McDonald earned her Ph.D. from the University of Houston.

For more information:
www.smu.edu/psychology/faculty/ejouriles.html www.smu.edu/psychology/faculty/rmcdonald.html