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

Trial Summary

What is the purpose of this trial?

This study adapts and evaluates preliminary outcomes of the Mediational Intervention for Sensitizing Caregivers (MISC) for women and children of color who have survived 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.

What data supports the effectiveness of the MISC intervention for children traumatized by domestic violence?

Research shows that interventions for children exposed to intimate partner violence can lead to significant reductions in trauma symptoms and behavioral problems. For example, the Moms' Empowerment Program, which includes both mothers and children, resulted in a significant reduction in traumatic stress for participants. Additionally, child-parent psychotherapy has been shown to improve trauma symptoms in children, suggesting that similar interventions may be effective. ^{1 2 3 4 5}

Is the MISC intervention safe for children exposed to domestic violence?

The research does not provide specific safety data for the MISC intervention, but interventions for children exposed to intimate partner violence generally focus on improving emotional and behavioral well-being, suggesting they are designed with safety in mind. ^{2 3 6 7 8}

How is the MISC intervention treatment different from other treatments for children traumatized by domestic violence?

The MISC intervention (Mediational Intervention for Sensitizing Caregivers) is unique because it focuses on enhancing the caregiver's ability to respond sensitively to the child's needs, which can help improve the child's emotional and social development. Unlike other treatments that may focus solely on the child or the parent, MISC-IPV involves both, aiming to strengthen the caregiver-child relationship as a pathway to healing. ^{2 3 9 10 11}

Research Team

Carla Sharp

Principal Investigator

[e-mail]

Eligibility Criteria

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

My mother has an intellectual disability.

Mother with active suicidality

My child is not between 7 and 11 years old.

Timeline

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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 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]

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 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]

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]

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]

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]

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]

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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Children exposed to intimate partner violence and the reported effects of psychosocial interventions. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Intervention to reduce traumatic stress following intimate partner violence: an efficacy trial of the Moms' Empowerment Program (MEP). [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Intervention for children exposed tointerparental violence (IPV): assessment of needs and restearch priorities. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Parent and Child Trauma Symptoms During Child-Parent Psychotherapy: A Prospective Cohort Study of Dyadic Change. [2018]

5. United States pubmed.ncbi.nlm.nih.gov

Pediatric symptom checklist ratings by mothers with a recent history of intimate partner violence: a primary care study. [2021]

6. England pubmed.ncbi.nlm.nih.gov

Children's exposure to intimate partner violence: an overview. [2018]

7. United States pubmed.ncbi.nlm.nih.gov

Meta-Analysis on Interventions for Children Exposed to Intimate Partner Violence. [2021]

8. Switzerland pubmed.ncbi.nlm.nih.gov

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

9. United States pubmed.ncbi.nlm.nih.gov

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

10. United States pubmed.ncbi.nlm.nih.gov

Positive outcomes from an immediate and ongoing intervention for child witnesses of intimate partner violence. [2014]

11. United States pubmed.ncbi.nlm.nih.gov

Intimate partner violence: childhood exposure to domestic violence. [2013]