The Future of Children, Princeton - Brookings: Providing research and analysis to promote effective policies and programs for children.

The first challenge to providing services to children who witness domestic violence is identifying this population. Once these children are identified, professionals must then assess the needs of each individual to determine whether mental health intervention is necessary, and if so, which services are appropriate.

Children who live in battered women's shelters and children whose mothers seek legal or community-based assistance in coping with family violence constitute obvious sub-groups of the larger population of children affected by domestic violence. Yet, these sources account for a small fraction of the more than three million children annually estimated to witness acts of domestic violence.³ Other sectors of this population are "hidden" in families that are similarly affected, but do not self-identify.⁴ Complicating the identification process is the veil of secrecy that surrounds violence in families. Children may experience feelings of shame, guilt, and divided loyalties to parents, as well as fear of repercussions, making it unlikely that they will disclose the violence to others. Battered mothers may also maintain secrecy, realistically fearing that disclosure may further jeopardize their safety and that of their children.

It is often difficult for professionals to identify children who witness domestic violence. School personnel, who spend significant periods of time with children, may be unsure how to interpret problematic symptoms that children display. In addition, they may be unable to elicit or respond to disclosures about the child's home situation. Pediatricians may not be trained to screen for domestic violence, and rarely inquire about it.⁵ Even when children are brought to mental health professionals because of problem behavior, screening for the presence of family violence is not routine.⁶ Therefore, professionals often fail to detect that exposure to domestic violence is a contributing factor to the child's difficulties. Children who exhibit problematic behavior may receive inappropriate treatment because professionals are unaware of the cause of their symptoms. To respond properly to these children, personnel in schools, health and mental health care settings must develop and implement guidelines for screening and responses if a child discloses domestic violence. (For more information about the roles of health care professionals in identifying children exposed to domestic violence, see the article by Culross in this journal issue.)

Once children who have witnessed domestic violence are identified, professionals must assess the child, the family, the living situation, and the nature of the events the child witnessed. Different recommendations may be appropriate depending upon the child's age and stage of development, the nature and duration of the child's symptoms and the impact on the child's functioning, the child's perceptions of and experiences with the violence, the child's ability to speak about the violence, the safety of the child's current environment, the presence of adults in the child's life who can be emotional resources, and the influence of the child's ethnicity and culture on defining the domestic violence and seeking help. The most commonly used assessment technique with children who have witnessed domestic violence is a focused clinical interview that explores the children's experiences with the violence,⁷ supplemented by data collection from various other sources, such as parents and teachers.

Not every child will need individual therapeutic intervention. Some children are resilient, possessing a wide range of coping skills.⁸ Children who can acknowledge their traumatic experiences by talking about them may require different forms of intervention from those who cannot.⁹ In addition, the presence of adult figures in children's lives who can cushion the child's experience of trauma and promote effective coping may reduce the need for formal mental health intervention.¹⁰