Safety and Resiliency At Home: Voices of Children from a Primary Care Population
Author: Morris, Anita M, email@example.com
Department: School of Social Work and General Practice and Primary Health Care Academic Cent
University: University of Melbourne, Australia
Supervisor: Professor Cathy Humphreys & Professor Kelsey Hegarty
Year of completion: In progress
Language of dissertation: English
, Domestic Violence
, Primary Care
Areas of Research:
, Family Research
One quarter of Australian children experience family violence committed by their father or step father against their mother. Family violence has significant health outcomes for children across the lifespan. The negative effects of family violence are well known, however children who experience family violence are also understood to experience resilience. Children living with family violence lack opportunities to have their voices heard. As a point of early intervention primary care is well placed to respond to these children. The aim of the research was to hear children’s voices about their safety and resilience in the context of family violence, and to determine a framework for an appropriate primary care response.
The thesis conveys an ethical and safe qualitative approach to researching with children and mothers who had all experienced family violence perpetrated by the child’s father or step-father. I conducted in-depth interviews and focus groups with 23 children and 18 mothers from a primary care sample. From a feminist stance and with reference to children’s participation rights, I drew on a theoretical framework of ethics of care and dialogical ethics.
Through hermeneutic phenomenological analysis, I found that children and mothers understood children’s safety in the context of awareness of family violence; whether the violence was named and by whom; who provided care and protection; and children’s sense of trust in relationships. Childlren understood their resilience independently of adversity they had experienced and instead aligned with the concept of relational self-worth. Mothers however, could only understand their children’s resilience with reference to the adversity the child had experienced. This was underpinned by the mother’s sense of responsibility for the adversity and the child’s apparent resilience despite this adversity.
Mothers’ and children’s understandings of safety was further analysed to reveal that children must negotiate their safety in relationships, in the context of family violence and post-separation. Key to the finding was that children required agency to negotiate their safety, hence I identified four factors required for children's agency namely: physical and emotional distance from the perpetrator; awareness of disharmony or danger in the parental relationship; modelling of safety in relationships by non-violent adults; and the child’s sense of family resiliency in which they actively contributed to family continuity. Reflecting these factors I developed a ‘model of children’s agency'.
To develop a fraemwork for an appropriate primary care response, I sought children and mother’s understandings of primary care. Their insights focused on determining a role for primary care to respond to children experiencing family violence; knowing and modelling within the child-mother-health practitioner relationship; and the expectation that the health practitioner would facilitate communication about family violence. Using these insights, I proposed an ‘informed trialogue’ within the child-mother-health practitioner relationship, to foster children’s agency in the primary care consultation. The trialogue enables the health practitioner to encourage and impart the ‘model of children’s agency’ by advocating physical and emotional distance from the perpetrator; building child awareness of family violence; supporting the modelling of safety in trusted relationships and demystifying family resiliency.