Research insights from the UK

An update from our CEO Chelsea Tobin, who is on a Churchill Fellowship. To stay up to date with her learnings, sign up to an occasional newsletter.

After a few day’s leave, last week I kicked off a series of meetings in the UK. One of the first was with the Clinical Content lead at the UK Trauma Council (UKTC), which is a project of Anna Freud – a world-leading mental health charity for children and families. Their vision is a world where all children and young people are able to achieve their full potential.

Interestingly, here in the UK in 2021, the landmark Domestic Abuse Act vitally recognised children as victims of domestic abuse in their own right, something the sector had long campaigned for. It recognised that children and young people don’t just witness abuse, they live with it and it can affect every part of their development, especially their wellbeing and mental health.

The UKTC brings together experts in research, practice, policy and lived experience in the field of childhood trauma. It produces free, evidence-based resources for frontline professionals and carers supporting children and young people impacted by trauma. Some of the interesting research insights they shared with me include:

• Internalising and externalising difficulties occur at similar rates for children exposed to domestic abuse as those who are directly abused (Moylan et al 2010).
• Domestic abuse can affect children in different ways at different developmental stages (Carter et al 2022).
• Mothers report feeling suicidal when they realise the impact that domestic abuse has had on their child (Sawston, 2014).
• Exposure of violence towards the protective parent is a strong indicator of child to parent aggression (Calvete et al. 2015).
• Whilst social support for children can increase resilience and functioning, it doesn’t necessarily reduce impact on mental health.

They also shared some qualitative research on domestic abuse and refuge experiences, highlighting teenagers’ feelings of uncertainty and lack of psychological safety. This confirms the need for education and understanding of trauma in refuge settings, with a focus on long-term safeguarding.

In terms of insights to inform how best to support young people, the research points to the importance of a strengths-based approach (Carter et al. 2022) where we:

• Include emotion awareness and emotion regulation (Carter et al. 2022).
• Focus on quality of parent and child dialogue (Overbeek et al. 2022).
• Include support for protective parents – positive reinforcement and “calm limit setting” (Yoo & Huang, 2013).
• Support family cohesion and supportive sibling relationships.
• Don’t need to use mental health clinicians to deliver interventions (Schubert et al. (2022).

An exciting initiative they shared with me is a new partnership between UKTC and Refuge, the largest specialist domestic abuse organisation in the UK. They are working together to develop, pilot and roll out an intervention that aims to address the impact of trauma on children and young people affected by domestic abuse, as well as provide support to their protective parent/carer. This is an opportunity to ensure that children and their protective parents who have experienced domestic abuse receive the very best, evidence-based intervention as early as possible to enhance their recovery and healing. I look forward to following this pilot to see what else we can learn.

I was pleased to hear that the project will draw on the lived experience of young people, which is a theme that is emerging strongly in many of my meetings. Others include the importance of:

• Young people being supported by individuals who have similar experiences.
• Trauma-informed approaches, including improving attachment, reducing PTSD and enhancing psychological functioning for children and their protective parents.
• Training on healthy relationships, early intervention and case management to help young people avoid homelessness in the first place.
• Community-based settings and accessible research.

I’m truly grateful to all the people that I’m meeting and look forward to sharing more soon.

Chelsea.