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Outcomes and interventions for children and families

There is increasing government recognition of the importance of early family experiences on individuals in the long term and of how inter-parental conflict influences children’s development. Recognition of the role of such factors early in life is key to helping both policy makers and practitioners promote positive outcomes for children. This accessible book reviews recent research showing how children who experience high levels of inter-parental conflict are at serious risk not only in terms of their own wellbeing, but also in relation to the perpetuation of these behaviours later in life.

It examines the differences between ‘destructive’ and ‘constructive’ conflict and how they affect children, explores why some children are more adversely affected than others, and features the latest evidence on how conflict affects child physiology. Of particular note is the book’s focus on the growing evidence-based literature on conflict interventions within the last decade. A primer for practitioners working with families, policy makers, students and academics, it will show how to improve the tomorrows for children who experience challenging family experiences today.

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The previous chapter sets out how the distress children experience when exposed to conflict between parents can translate into long-term difficulties, including emotional and behavioural problems, troubled relationships and failure to settle and achieve at school (e.g. see Rhoades, 2008; Cummings and Davies, 2010). As the body of research documenting an association between a high conflict home and poor outcomes for children has grown, over the last decade research attention has turned to examining the mechanisms that explain these poor outcomes, the focus of this current chapter. Explanations fall broadly into two categories. First, inter-parental conflict affects parenting and the quality of the relationship between parent and child (i.e. conflict between parents ‘spills over’ to the parent–child relationship). Secondly, children’s negative cognitive and emotional responses to conflict, including how they represent or perceive family relationships, make them vulnerable to adjustment difficulties.

One of the ways that inter-parental conflict influences children’s adjustment is through its impact on parenting and the parent–child relationship (Schoppe-Sullivan et al., 2007; Cox et al., 2001; Erel and Burman, 1995). Distress in the couple relationship can be expressed through a range of unhelpful parenting behaviours, from highly intrusive and harsh parenting through to lax, inconsistent and emotionally unavailable parenting.

In keeping with a ‘spillover’ hypothesis, suggesting that negative emotions in the couple relationship spill over to the parent–child relationship(s), parenting in high conflict homes can be characterised by aggression, criticism, verbal and physical threat, yelling, hitting and shoving (Holden and Ritchie, 1991; Jenkins and Smith, 1991).

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Conflict between parents can have a long-lasting impact on children’s wellbeing and development. However, as noted in Chapter 1, some children may be exposed to similar levels of hostility and aggression between parents and remain relatively unscathed by it. A comprehensive understanding of the impact of parental conflict therefore requires consideration as to why some children are more vulnerable to its impact than others. Moreover, identifying the mechanisms that explain why some children experience serious difficulties in the context of inter-parental conflict, while other children seem relatively unaffected (i.e. resilient) enables us to develop more effective support targeted at children and families most vulnerable and at risk. This is vividly demonstrated by research into the processes occurring within the family when families experience economic pressure; a recognised risk factor for children (Conger et al., 1999). According to one well-supported theoretical model, under the strain of economic pressure parents are vulnerable to developing depression. Parental depression increases the likelihood of increased conflict and violence between parents, which in turn undermines parenting, thereby increasing the risk of children developing mental health difficulties (Conger et al., 1994).The theoretical model highlights the role of inter-parental conflict as a mediator, or vehicle through to harsh parenting practices, which in turn influence children’s psychological outcomes as a result of the emotional strain of coping with difficult financial circumstances. This model focuses on economic pressure, but similar processes can apply in the case of other risk factors (e.g. parental divorce). These carefully researched explanatory models are helpful in isolating and understanding, not only the factors that may trigger increased inter-parental conflict, but also in understanding how inter-parental conflict as a factor in and of itself helps to explain poor developmental outcomes for children.

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The previous chapters have examined the links between inter-parental conflict and children’s adjustment. This evidence suggests that conflict between parents can have a negative impact on children’s social, emotional and behavioural development. Understanding more about what elements of conflict are important and the factors which put children at risk of experiencing harmful effects are useful in considering how best to minimise the impact of destructive conflict behaviours on children, as well as exploring ways to prevent these patterns of behaviour from developing in the first place (Cummings and Davies, 2010). This chapter explores the growing evidence base from various couple or family interventions which have covered areas relating to conflict. It outlines the impact these have on parental, child, and relationship wellbeing.

Evidence suggests that it is not the presence of conflict per se which relates to child outcomes; it is the type of conflict behaviour demonstrated and the duration and intensity of the conflict which are important (Cummings and Davies, 2010).This indicates that focus in intervention programmes should be placed on raising parents’ awareness of the effect of conflict on children and helping parents to develop the skills required to reduce destructive conflict.

Chapter 4 showed that inter-parental conflict can have an indirect effect on child wellbeing by affecting parenting and the parent–child relationship (Schoppe-Sullivan et al., 2007). Therefore, interventions may limit this potential ‘spillover’ effect, by promoting effective parenting skills. A more direct way in which children are influenced by inter-parental conflict is through their own interpretations and understanding of the conflict (Harold et al. 2007).

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This chapter explores the implications of the findings presented in the last chapter on couple interventions. It aims to highlight what this means for those working with families in trying to help parents manage their conflict and avoid its potentially harmful influence on children. The limitations of current intervention research and new innovative ideas for dealing with inter-parental conflict are also highlighted in this chapter.

Early intervention is believed to offer benefits in long- term outcomes and is considered to be more effective than treatment-based interventions, which are provided once problems arise (Rutter, 2010). Many of the programmes presented in the last chapter focus on a prevention-based approach by identifying couples and families who may be at risk of experiencing higher stress and couple disagreement, rather than those who are already characterised by entrenched levels of conflict. Even the programmes aimed at separated and divorced parents predominately target those with a more normative and less extreme conflict style (McIntosh and Deacon-Wood, 2003). It is widely recognised that behaviour change is greater and more sustainable with earlier intervention, rather than trying to change ingrained and longstanding patterns of interaction (Dolan et al., 2010).

The evidence from relationship education or preparation programmes indicates that couple interventions have traditionally been applied to couples entering marriage. Entry to marriage represents a key time for intervention as some couples may face significant challenges as they adapt to the changes and new commitment in their relationship. However, for many couples, marriage may not represent the beginning of a relationship in the same way as it did in the past.

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Although conflict is a normal and necessary part of family life, this review has shown that how parents argue with one another can affect the happiness and adjustment of their children. Conflict, whether parents are together or apart, is particularly detrimental to children when it is frequent, unresolved, intense, and about the child. Meanwhile, couples who continue to positively relate to one another even in the midst of heated conflicts, and who can find ways to resolve an argument, are less vulnerable to relationship breakdown and their children are less at risk of developing emotional or behavioural difficulties. There is also initial evidence that children can learn from observing more constructive conflict behaviours modelled by their parents, which can in turn help them in their own social relationships.

Research over the past decade has provided deeper insight into, not only the outcomes for children of exposure to destructive conflict, but also how children are affected and why some children appear more vulnerable than others. This knowledge is useful in terms of developing interventions to help couples and parents manage their conflict more effectively and avoid the potentially negative influence on their children. This chapter will briefly identify the headline findings from this review before addressing ways that practitioners, policy makers and researchers can help to support families experiencing conflict.

Children exposed to conflict between parents are at risk of a range of negative outcomes including: emotional and behavioural difficulties (such as depression or aggression); trouble getting on with others; such as peers or family members; problems settling and achieving at school; sleep difficulties; and poorer physical health.

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There is growing interest and recognition regarding the importance of couple relationships and how they can influence child wellbeing. A large body of evidence exists which documents the significance of parental relationships on children’s social, emotional, cognitive, behavioural and physical development. Inter-parental conflict (conflict between a child’s parents) is one area which appears to have considerable impact on child outcomes.

It is not simply the presence of conflict per se which affects outcomes for children, but rather the characteristics of this conflict and how parents deal with it that seems to matter most. Conflict is particularly destructive to children when it is frequent, unresolved, intense, or about the child (Cummings and Davies, 2010).This book reviews the latest evidence showing how children who experience high levels of destructive conflict between their parents are at serious risk not only in terms of their own wellbeing, but also in relation to the perpetuation of these behaviours later in life. This book focuses on recent research, over the last 10 years and provides an insight into the outcomes for children of exposure to destructive conflict as well as how children are affected, and why some children appear more vulnerable than others. In other words, there is more of an understanding of ‘why, when, and how’ parental conflict affects some but not all children. Specifically, reviewed research into the physiological and neurobiological impacts, in addition to the intergenerational transmission of conflict, are particularly innovative additions.

Another key area of emerging evidence is in relation to conflict interventions delivered to couples and parents.

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For many children conflict between parents is a natural and normal part of family life and does not signify the demise of the parents’ relationship or any serious threat to wellbeing. For other children, however, conflict between parents is a serious source of stress with debilitating implications for their emotional and behavioural development (Harold and Leve, 2012).What constitutes differences in children’s adaptation to inter-parental conflict?

How this conflict is handled is of primary importance when explaining child outcomes. Important aspects are the intensity of the conflict, the negativity expressed, or emotional tone, the behaviours parents adopt towards one another, the topic of conflict, and if and how things are resolved. Indeed, Lavner and Bradbury (2012) note the importance of negative communication having the capacity to erode relationships and lead to divorce, even among ‘satisfied newly-weds’. This recent study emphasises the point that conflict and negative communication is a matter of great influence on the stability and quality of couple relationships, and one worthy of investment through intervention programmes, such as those reviewed in Chapter 6.The paper concludes:

‘Thus it may only be several years into marriage – when additional stress emerges, or when fundamental disagreements about life values boil over – that negative communication exerts its impact…the present findings reaffirm the value of targeting negative communication in preventive interventions.’ (from Lavner and Bradbury, 2012, p 8).

One important aspect of conflict is how often parents argue. Rather than getting used to conflict, children become more sensitive or reactive to it as they experience more of it (Erath and Bierman, 2006).

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There exists a long standing and wide ranging body of evidence, going back over 30 years, documenting children’s reactions to parental conflict (for reviews see Cummings and Davies, 1994; Grych and Fincham, 2001). This includes evidence collected using experimental, longitudinal, and naturalistic approaches to data collection, as children watch recordings of adults arguing or give their reactions to different scenarios) under carefully controlled experimental conditions (e.g. Davies et al., 2006). It also includes data from interviews with, or questionnaires completed by, parents, children and teachers (Cummings et al., 2002; Cummings et al., 2003).This involves children, parents and families being followed for long periods of time (longitudinal studies; see Harold and Conger, 1997), or other innovative means of obtaining children’s views, such as using puppets (Ablow and Measelle, 2009), as well as diary accounts and observational studies (Crockenberg et al., 2007).

Together the data demonstrate that, in general, children are highly sensitive to parental conflict and their distress is apparent from an early age; as early as six months old according to some studies (Cummings and Davies, 1994; Harold et al., 2004; Crockenberg et al., 2007; Moore, 2010). Children’s distress is apparent in facial expressions, gestures and actions indicating fear and anxiety, in biological regulatory processes i.e. how the body and brain respond to stressful situations (Van Goozen et al., 2007; Davies et al., 2008; El-Sheikh and Erath, 2011), and in their own accounts where children talk about being angry, sad, frightened or responsible (Smart et al., 2000; Dunn and Deater-Deckard, 2001). Children may also have different emotional responses to conflict depending on the nature of the dispute.

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