MISC Intervention for Children Traumatized by Domestic Violence

(MISC-IPV Trial)

Overseen By Madeleine Allman, MA

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Houston

Disqualifiers: Active suicidality, Intellectual disability, Active psychosis, Severe autism, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

132 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a program called Mediational Intervention for Sensitizing Caregivers (MISC) to assist mothers and children who have experienced domestic violence. The goal is to determine if this program can enhance maternal caregiving and, consequently, improve children's well-being and life outcomes. Participants will either engage in the MISC program or continue with their usual support from a rehousing program, known as Treatment as Usual (TAU). The trial seeks mothers who are part of a domestic violence rehousing program and can speak English, along with their children aged 7 to 11 who have experienced domestic violence. As an unphased trial, this study provides a unique opportunity to contribute to significant research that could lead to better support for families affected by domestic violence.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that the MISC program has been adapted for challenging situations where children may struggle to form bonds with caregivers. Studies have found that programs like MISC can significantly reduce trauma symptoms in children who have witnessed domestic violence. This suggests the program is generally well-received in similar contexts. However, detailed information on any negative effects in these settings is lacking, so direct safety evidence remains limited. As this trial is marked "Not Applicable" for phase, it likely focuses on the program's effectiveness rather than testing a new drug, which usually means fewer safety concerns compared to drug trials. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the MISC intervention because it focuses on enhancing the caregiver-child relationship, unlike traditional treatments that primarily offer logistical support like housing and employment assistance. Most standard care options for children traumatized by domestic violence don't directly address the emotional and behavioral impact a caregiver's actions can have on a child. The MISC intervention aims to sensitize mothers to these impacts, potentially leading to better caregiving and improved outcomes for children. By targeting the emotional dynamics within families, this approach offers a unique pathway to healing that could complement existing support systems.

What evidence suggests that the MISC intervention could be effective for children traumatized by domestic violence?

Research has shown that the Mediational Intervention for Sensitizing Caregivers (MISC), which participants in this trial may receive, can help children who have experienced trauma, such as domestic violence. MISC aims to enhance how caregivers, like mothers, interact with their children. This method has succeeded in other situations where children face challenges. Studies indicate that these interventions can reduce trauma symptoms and improve children's behavior. Early findings suggest that MISC can be a valuable tool for helping these families heal. ^{1 2 4 5 6}

Who Is on the Research Team?

Carla Sharp

Principal Investigator

[e-mail]

Are You a Good Fit for This Trial?

This trial is for English-speaking mothers and their children who have experienced domestic violence and are enrolled in the Harris County Domestic Violence rehousing program.

Inclusion Criteria

Mother enrolled in Harris County Domestic Violence rehousing program

I am fluent in English.

Child must have exposure to domestic violence

Exclusion Criteria

Mother with active suicidality

My mother has an intellectual disability.

My child is not between 7 and 11 years old.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Adaptation

Adaptation of the Mediational Intervention for Sensitizing Caregivers (MISC) for the IPV context

6 months

Process Evaluation

Evaluation of the process to assess acceptability and feasibility of MISC-IPV

6 months

Outcome/Mediator Evaluation

Evaluation of the outcomes and mediators to assess the impact of MISC-IPV on maternal caregiving and child mental health

6 months

Follow-up

Participants are monitored for changes in mental health and sensitive caregiving

18 months

Assessments at baseline, 6, 12, and 18 months

What Are the Treatments Tested in This Trial?

Interventions

• MISC intervention
• Treatment as Usual (TAU)

Trial Overview The study is testing a caregiving intervention called MISC (Mediational Intervention for Sensitizing Caregivers) against the standard treatment to see if it helps women of color and their children recover from trauma caused by intimate partner violence.

How Is the Trial Designed?

Group I: MISC Experimental Treatment 1 Intervention

Mediational Intervention for Sensitizing Caregivers (MISC): a program for mother and children where mothers become sensitized to the impact of their behavior on their children with the aim of improving quality caregiving and child outcomes.

Group II: Treatment as Usual Active Control 1 Intervention

Treatment as Usual in the rehousing program. Mothers receive support in a domestic violence rehousing program to find work and housing.

Who Is Running the Clinical Trial?

University of Houston

Lead Sponsor

Trials

155

Recruited

48,600+

Texas Women's University

Collaborator

Trials

1

Recruited

130+

Published Research Related to This Trial

The Child Witness to Domestic Violence (CWDV) program, a 12-week intervention for children aged 2-17 and their mothers, significantly improved child functioning by reducing hyperactivity, negative emotional symptoms, and total behavioral difficulties in a group of 69 children compared to a control group of 80 children.

Participation in the CWDV program also increased maternal hope, indicating that the program not only benefits children but also supports the well-being of their mothers, highlighting its potential as an effective intervention for families affected by domestic violence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supporting Children Who Experience Domestic Violence: Evaluating the Child Witness to Domestic Violence Program. Schubert, EC.[2022]

Children exposed to domestic violence (DV) are significantly more likely to face long-term negative outcomes, including a 3.8 times higher risk of becoming perpetrators or victims of violence in adulthood, as well as increased health problems and social functioning issues.

To effectively support children affected by DV, physicians should implement training and screening protocols, collaborate with local agencies, and ensure follow-up care, highlighting the importance of a coordinated approach to intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intimate partner violence: childhood exposure to domestic violence. Chen, PH., Jacobs, A., Rovi, SL.[2013]

Children exposed to intimate partner violence (IPV) face significant mental health challenges, including traumatic stress, which can start early in life and continue as they grow up.

The paper emphasizes the need for tailored assessment and treatment strategies for children affected by IPV, as their experiences often lead to complex needs that require comprehensive intervention approaches.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Trauma-Informed Approach to Assessment, Case Conceptualization, and Treatment Planning for Youth Exposed to Intimate Partner Violence. Grasso, DJ.[2022]

Child-parent psychotherapy (CPP) significantly reduced posttraumatic stress symptoms (PTSS) in both parents and children, with improvements of over 0.5 standard deviations observed in a study of 199 parent-child dyads.

The effectiveness of CPP was influenced by factors such as the number of parental lifetime stressors and clinician expertise, indicating that treatment outcomes can vary based on individual and treatment characteristics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parent and Child Trauma Symptoms During Child-Parent Psychotherapy: A Prospective Cohort Study of Dyadic Change. Hagan, MJ., Browne, DT., Sulik, M., et al.[2018]

The Moms' Empowerment Program (MEP), a 10-week intervention for mothers and children exposed to intimate partner violence, significantly reduced traumatic stress, especially in the mother-plus-child (M+C) group, where 85% of women with PTSD were no longer diagnosed after the program.

Among the 181 participants, the M+C condition showed the greatest improvement in reducing traumatic stress compared to the child-only and waitlist groups, highlighting the effectiveness of involving both mothers and children in therapeutic interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intervention to reduce traumatic stress following intimate partner violence: an efficacy trial of the Moms' Empowerment Program (MEP). Graham-Bermann, SA., Miller, LE.[2022]

Recent evaluations of interventions for children exposed to interparental violence (IPV) show that three comprehensive programs have demonstrated effectiveness in addressing various symptoms and distress levels.

Despite these positive findings, there is still a significant need for further research to determine which specific interventions are most beneficial for children with diverse needs and varying intensities of problems.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Intervention for children exposed tointerparental violence (IPV): assessment of needs and restearch priorities. Graham-Bermann, SA., Hughes, HM.[2021]

Children exposed to intimate partner violence (IPV) face significant emotional impairment and harmful effects, similar to those experienced by victims of other forms of abuse and neglect.

The review highlights the importance of identifying risk and protective factors, as well as implementing effective prevention strategies and interventions to ensure the safety and mental health of children affected by IPV.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Children's exposure to intimate partner violence: an overview. McTavish, JR., MacGregor, JC., Wathen, CN., et al.[2018]

Interventions for children exposed to intimate partner violence (IPV) showed a significant decrease in psychological and behavioral problems at the group level, but individual assessments revealed that few children experienced meaningful improvement or recovery.

Improvements in children's behavioral issues were linked to the mental health of their mothers, suggesting that addressing maternal mental health may enhance treatment outcomes for children affected by IPV.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Children exposed to intimate partner violence and the reported effects of psychosocial interventions. Grip, KK., Almqvist, K., Axberg, U., et al.[2019]

The Pediatric Symptom Checklist (PSC) effectively identifies psychosocial problems in children, particularly among low-income, urban mothers who have experienced intimate partner violence (IPV), as evidenced by a study comparing 23 mothers who suffered IPV to a matched group of 23 mothers.

Mothers who experienced IPV rated their children as having significantly more issues in areas such as total problems, externalizing, and internalizing behaviors, highlighting the need for further research on the PSC's performance in diverse populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pediatric symptom checklist ratings by mothers with a recent history of intimate partner violence: a primary care study. Klassen, BJ., Porcerelli, JH., Sklar, ER., et al.[2021]

A unique intervention program for children witnessing intimate partner violence (IPV) showed significant improvements in their understanding that the violence is not their fault, with awareness increasing from 59% to 84% after treatment.

The program also effectively taught children about safety planning, with knowledge of safety plans rising dramatically from 32% to 93%, indicating the program's efficacy in addressing critical psychological and safety concerns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Positive outcomes from an immediate and ongoing intervention for child witnesses of intimate partner violence. Ernst, AA., Weiss, SJ., Enright-Smith, S., et al.[2014]

A meta-analysis of 21 studies found that interventions for children exposed to intimate partner violence (IPV) resulted in a medium overall effect size (d = 0.49), indicating significant improvements in emotional and behavioral outcomes after treatment.

Interventions that included a mix of trauma-specific and non-trauma-specific content were more effective, suggesting that tailoring treatments to children's specific needs could enhance their emotional and behavioral well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Meta-Analysis on Interventions for Children Exposed to Intimate Partner Violence. Romano, E., Weegar, K., Gallitto, E., et al.[2021]

Citations

1. uh.edu uh.edu/class/psychology/clinical-psych/research/dpl/misc/index.php

Mediational Intervention for Sensitizing Caregivers MISC was originally developed by Dr. Pnina Klein (1996) for low-resource and high-risk environments in which attachment disruption has occurred. “MISC” is a ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8418628/

Mediational Intervention for Sensitizing Caregivers to ... There is an urgent need to equip community-based careworkers with the skills to address the mental health needs of orphans and vulnerable children (OVC) as ...

3. taggs.hhs.gov taggs.hhs.gov/Detail/AwardDetail?arg_AwardNum=R01HD102436&arg_ProgOfficeCode=50

Award Information | HHS TAGGS MISC-IPV: A Community Based Intervention for Children Traumatized By Intimate Partner Violence. Award Number: R01HD102436. ORGANIZATION: NATIONAL INSTITUTE ...

4. ctv.veeva.com ctv.veeva.com/study/misc-ipv-a-community-based-intervention-for-children-traumatized-by-intimate-partner-violence

MISC-IPV: a Community-Based Intervention for Children ... This study adapts and evaluates preliminary outcomes of the Mediational Intervention for Sensitizing Caregivers (MISC) for women and ...

5. withpower.com withpower.com/trial/phase-2-misc-intervention-1-2023-ad32c

MISC Intervention for Children Traumatized by Domestic ... Research shows that interventions for children exposed to intimate partner violence can lead to significant reductions in trauma symptoms and behavioral ...

6. reporter.nih.gov reporter.nih.gov/search/FGxAjxRLm0-7iItpqV1wDA/project-details/10928737

Project Details PROJECT SUMMARY Exposure to intimate partner violence (IPV) constitutes a traumatic ... The Mediational Intervention for Sensitizing Caregivers (MISC) has ...