The term domestic violence is commonly defined as a behavior, or pattern of behaviors, that occurs between intimate partners with the aim of one partner exerting control over the other. Domestic violence may include psychological threats, emotional abuse, sexual abuse, and/or physical violence. This clinical definition is broader than the legal definition, which may be restricted to acts of physical harm. In the past twenty-five years, public awareness of the issue of domestic violence has grown tremendously. As the scope of the problem  has become understood, domestic violence is now acknowledged as a significant legal and public health issue, not only a private family problem. There are laws in every state that make domestic violence illegal. There is also federal funding available in all states to provide shelter and services for victims of domestic violence.
Between 25 and 31 percent of US women report being a victim of domestic violence at some point in their lives (Collins, 1999; Tjaden & Thoennes, 2000). Domestic violence occurs across the spectrum of relationships, from dating teens to elderly couples, in both heterosexual and same-sex relationships. Although the majority of victims of domestic violence are women, it is important to acknowledge that men are also victims of domestic violence, and that in some situations both partners may engage in violent behavior.
Children are exposed to or experience domestic violence in many ways. They may hear one parent/caregiver threaten the other, observe a parent who is out of control or reckless with anger, see one parent assault the other, or live with the aftermath of a violent assault. Many children are affected by hearing threats to the safety of their caregiver, regardless of whether it results in physical injury. Children who live with domestic violence are also at increased risk to become direct victims of child abuse. In short, domestic violence poses a serious threat to children's emotional, psychological, and physical well-being, particularly if the violence is chronic.
Not all children exposed to violence are affected equally or in the same ways. For many children, exposure to domestic violence may be traumatic, and their reactions are similar to children's reactions to other traumatic stressors.
Short-Term Effects of Domestic Violence on Children
Children’s immediate reactions to domestic violence may include:
Long-Term Effects of Domestic Violence on Children
Long-term effects, especially from chronic exposure to domestic violence, may include:
Exposure to domestic violence has also been linked to poor school performance. Children who grow up with domestic violence may have impaired ability to concentrate; difficulty in completing school work; and lower scores on measures of verbal, motor, and social skills.
In addition to these physical, behavioral, psychological, and cognitive effects, children who have been exposed to domestic violence often learn destructive lessons about the use of violence and power in relationships. Children may learn that it is acceptable to exert control or relieve stress by using violence, or that violence is in some way linked to expressions of intimacy and affection. These lessons can have a powerful negative effect on children in social situations and relationships throughout childhood and in later life.
As with other trauma types, children's responses to domestic violence vary with age and developmental stage. In addition, children's responses depend on the severity of the violence, their proximity to the violent events, and the responses of their caregivers.
The table below shows a brief list of possible reactions/symptoms by age: young children (birth to age 5), school-age children (aged 6 to 11) and adolescents (aged 12 to 18).
Age Birth to 5
Age 6 to 11
Age 12 to 18
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It is important to remember that these symptoms can also be associated with other stressors, traumas, or developmental disturbances, and that they should be considered in the context of the child and family's functioning.
Adolescents are involved in domestic violence not only as witnesses to abuse between their parents/caregivers but also as individuals who may themselves be involved in abusive relationships. Data suggests that adolescents are at higher risk of being involved in an abusive relationship than are adults (American Bar Association, 2006). Females 16 to 24 are more vulnerable to intimate partner violence than are females in any other age group. Gay, lesbian, and bisexual adolescents are just as likely to experience dating violence as are their heterosexual peers (Halpern, Young, Waller, Martin, & Kupper).
Surveys conducted with adolescents demonstrate that they hold attitudes that normalize abusive or controlling relationships. For example, many teenagers think that jealousy, possessiveness, and violence are signs that their partner loves them; and about half of high school girls and three-quarters of high school boys believe that forced sex is acceptable in some circumstances (Michigan State University, n.d.; Jackson, Cram, & Seymour, 2000). Nearly 1 in 5 teenage girls who have been in a relationship said a boyfriend had threatened violence or self-harm if presented with a breakup (Liz Claiborne Inc., 2005).
Teen dating violence is associated with higher levels of substance abuse, violence, and victimization, as well as with lower achievement in school. Victims of dating violence display a strong, consistent pattern of exposure to and participation in a broad range of high-risk behaviors including unhealthy weight control, sexual risk behavior, and suicidal ideation (Silverman, Raj, Mucci, & Hathaway, 2001).
Generally, parents are uninformed about the risk of dating violence for their adolescent children, and most parents have not talked to their teenage or young adult children about dating violence (American Bar Association, 2006). Teens rarely report dating violence, possibly because they think it is a normal part of a relationship.
Resources for Teens
For information on dating violence:
Children who live with domestic violence have been called the "silent" or "hidden" victims of violence because their presence is often overlooked by the parents/caregivers or unknown by observers and professionals. Adult victims may be hesitant to disclose to police, hospital staff, or child welfare workers that their children have seen the violence. This may be due to embarrassment, fear of retaliation or harm, or fear that their children might be removed from their care by Child Protective Services. Professionals who come in contact with these children and families may not ask about children's exposure to domestic violence because they are wary of offending caregivers or because they do not know what to do to help the children they do identify. In these cases, children are not linked with services.
In recent years, however, many service systems have increased their efforts to identify children and provide services to their families. For example:
Child and Family Therapies
There are a wide variety of counseling and mental health interventions available to families affected by domestic violence. Usually, families need more than therapy; they need case management and advocacy to assist the victim of violence in navigating the legal system, and in obtaining the resources and support the adult victim needs to maintain safety and security for herself/himself and the children. It is important that mental health treatment be provided in a context of comprehensive support for the children and their nonoffending parent.
For children, interventions include groups, individual therapy, and dyadic treatment with their nonoffending parent. An essential component of intervention with all children is the priority of supporting and strengthening the relationship between the nonoffending parent and the child. For most children, a strong relationship with a parent is a key factor in helping a child heal from the effects of domestic violence. The choice of treatment depends on the child's age, the nature and severity of the traumatic reaction, the circumstances of the family, and the availability of other supports. In either a group or an individual format, treatment can provide children and their caregivers with important information about domestic violence and common childhood reactions, which can help normalize their experience and decrease their sense of isolation.
Many shelters and domestic violence service agencies offer psychoeducational and/or support groups for children. These groups are important tools in helping children to stabilize and to recognize that they are not alone with their worries and fears. Mental health treatment can give children/adolescents a chance talk about and make sense of their experiences in the presence of a caring and neutral counselor. Children may have cognitive distortions or misunderstandings about what has happened or why it happened such as blaming themselves, blaming the victim, and blaming police or other authorities who attempt to intervene. Children often feel torn between their parents or confused by conflicted feelings of love for and fear of their violent parent. A therapist works with the child to correct these misconceptions and to lessen the child's conflicts. For many children, it is very helpful to create a "trauma narrative," in which he/she makes a complete account of what has happened. This allows the child and therapist to understand in more detail what exactly the child experienced as well as which elements of the experience are most disturbing, and why, and to address specific misunderstandings as they are identified.
For victims, interventions include support groups and individual counseling offered through domestic violence service agencies and shelters (Sullivan & Gillum, 2001). A variety of intervention programs for batterers are available, some of which serve voluntary clients and others that are mandated through the criminal justice system (Saunders & Hamill, 2003).
Generally, it is not considered appropriate to engage victims and abusers in couples or family treatment because it may not be safe for the victim or children to participate honestly in the treatment. There is an evolving interest among child-focused therapists to involve the offending parent in the treatment of children when it is safe and clinically appropriate to do so. Because children may maintain strong psychological ties (and, in many cases, direct access) to their offending parents, involving them in the therapeutic treatment provides an opportunity to directly address the impact of the violence on the child and family. An important component of this work is the offender's acknowledgment of the abuse, commitment to abstain from abuse, and willingness to address this issue honestly and openly within the family (Groves, Van Horn, & Lieberman, 2006).
Some members of the NCTSN are involved in developing, testing, and disseminating evidence-based treatments for children who experience posttraumatic reactions following their exposure to domestic violence. These interventions are described briefly below, with links to resources that offer more complete information about each. Multimedia presentations on many of these interventions are available in the NCTSN Training Archives .
Child Parent Psychotherapy (CPP)
A dyadic attachment-based treatment for young children exposed to domestic violence and other interpersonal violence developed by the Child Trauma Research Project, University of California, San Francisco. Year-long treatment focuses on safety, affect regulation, understanding of trauma reactions, improving the parent-child relationship, and joint creation of trauma narrative.
Group Treatment for Children Affected by Domestic Violence
A manualized group treatment model developed by Children's Institute, Inc. (CII) for children aged 5 and over and their nonoffending parent. Children and adult victims of domestic violence attend parallel weekly groups. Topics include psychoeducation on safety, the cycle of violence, and parenting, as well as coping skills such as relaxation, mindfulness, yoga, and movement therapy. Additional interventions focus on feelings identification, trauma cues, anger management, cognitive processing, creating a trauma narrative, making meaning, and setting goals for the future. For more information on this intervention or training, contact CII's Child Trauma Treatment Center senior director, Dr. Leslie Anne Ross: firstname.lastname@example.org 
Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS) A group treatment for adolescents with chronic trauma exposure who may still be experiencing chronic stress and who have difficulties in many areas of functioning. Groups address such topics as affect regulation, impulsivity, relationships, numbing and avoidance, and making meaning of experiences. SPARCS was developed by the Adolescent Trauma Treatment Development Center, North Shore University Hospital.
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
A brief treatment (ideally, 12 to 16 weeks) for children aged 3 to 18 affected by traumatic life experiences and their parents. TF-CBT helps children develop skills for processing the trauma; managing distressing thoughts, feelings, and behaviors; enhancing safety; and improving communication with parents; and helps parents increase parenting skills. TF-CBT was developed by Allegheny General Hospital Center for Traumatic Stress in Children and Adolescents and New Jersey CARES Institute Center for Children's Support.
To work effectively with children and families affected by domestic violence, child clinicians must have a thorough working knowledge of the judicial, law enforcement, and child protection systems, as well as a strong relationship with the local domestic violence service agencies. Clinicians must recognize and appreciate the important role these agencies play in identifying domestic violence, stopping the violence, and promoting safety. Many of these systems have developed strong local collaborations.
The response of the child protection system to children and families affected by domestic violence has been the focus of controversy. At issue is whether child exposure to domestic violence constitutes child maltreatment and mandated reporting to Child Protective Services (CPS). State laws and policies governing mandatory reporting of children's exposure to domestic violence to CPS vary widely. The Child Welfare Information Gateway lists state-by-state CPS reporting requirements  and a summary of each state's laws 
Examples of integrated programs affiliated with the NCTSN that work with families affected by domestic violence include:
For information about comprehensive collaborative approaches, see:
American Bar Association. (2006). Teen dating violence facts. Chicago: American Bar Association. Retrieved from http://www.clotheslineproject.org/teendatingviolencefacts.pdf 
Child Development-Community Policing Program & Domestic Violence Home Visit Intervention Project (DVHVI). (2004-2005). DVHVI case records. New Haven, CT: Yale Child Study Center.
Cochran, D. (1995). The tragedies of domestic violence: A qualitative analysis of civil restraining orders in Massachusetts. Boston: Office of the Commissioner of Probation, Massachusetts Trial Court.
Collins, K. S. (1999). Health concerns across a woman's lifespan: The Commonwealth Fund 1998 survey of women's health. New York: Commonwealth Fund. Retrieved from http://www.commonwealthfund.org/Content/Publications/Fund-Reports/1999/May/Health-Concerns-Across-a-Womans-Lifespan--The-Commonwealth-Fund-1998-Survey-of-Womens-Health.aspx 
Groves, B., Van Horn, P., & Lieberman, A. (2006). Deciding on fathers' involvement in their children's treatment after domestic violence. In J. L. Edleson & O. J. Williams (Eds.), Parenting by men who batter: New directions for assessment and intervention (pp. 65-84). New York: Oxford University Press.
Halpern, C. T., Young M. L., Waller, M. W., Martin, S. L., & Kupper, L. L. (2004). Prevalence of partner violence in same-sex romantic and sexual relationships in a national sample of adolescents. Journal of Adolescent Health, 35(2), 24-31.
Jackson, M., Cram, F., & Seymour, F. W. (2000). Violence and sexual coercion in high school students' dating relationships. Journal of Family Violence, 15(1), 23-36.
Liz Claiborne Inc. (2005). Study on teen dating abuse conducted by Teenage Research Unlimited. New York: Liz Clairborne Inc. Retrieved February 11, 2010, from http://loveisnotabuse.com/c/document_library/get_file?p_l_id=45693&folderId=72612&name=DLFE-207.pdf 
Liz Claiborne Inc. (2006). Study on teen dating abuse conducted by Teenage Research Unlimited. New York: Liz Clairborne Inc. Retrieved July 12, 2011, from http://loveisnotabuse.com/c/document_library/get_file?p_l_id=45693&folderId=72612&name=DLFE-205.pdf
McDonald, R., Jouriles, E. N., Ramisetty-Mikler, S., Caetano, R., & Green, C. E. (2006). Estimating the number of American children living with partner-violent families. Journal of Family Psychology, 20(1),137-142.
Michigan State University. (n.d.). Myths and facts about dating violence. Lansing, MI: Michigan State University. Retrieved from https://www.msu.edu/user/cdaprogs/myths2.htm 
National Child Traumatic Stress Network. (2009). [Core Data Set.] Unpublished data.
Saunders, D., & Hamill, R. M. (2003). Violence against women: Synthesis of research on offender interventions. Washington, DC: U.S. Department of Justice, National Institute of Justice. NCJRS No. 201222. Retrieved from http://www.ncjrs.gov/pdffiles1/nij/grants/201222.pdf 
Silverman, J., Raj, A., Mucci, L., & Hathaway, J. E. (2001). Dating violence against adolescent girls and associated substance use, unhealthy weight control, sexual risk behavior, pregnancy and suicidality. Journal of the American Medical Association, 286(5), 572-579.
Sullivan, C., & Gillum, T. (2001). Shelters and community based services for battered women and their children. In C. Renzetti, J. L. Edleson, & R. Bergen (Eds.), Sourcebook on violence against women (pp. 247-260). Thousand Oaks, CA: SAGE.
Tjaden, P. G., & Thoennes, N. (2000). Extent, nature, and consequences of intimate partner violence. Washington, DC: U.S. Dept. of Justice, Office of Justice Programs, National Institute of Justice. Retrieved from http://www.ncjrs.gov/pdffiles1/nij/181867.pdf