Intervention for children exposed to interparental violence: A randomized controlled trial of effectiveness of specific factors, moderators and mediators in community-based intervention

The main aim of this thesis was to evaluate the added benefit of applying specific factors in community-based intervention for child witnesses of interparental violence (IPV) and their parents, by means of a randomized controlled trial (RCT). The results of this RCT showed no additional benefits of a program with (trauma)specific factors compared to a structural equivalent control program with only non-specific factors. Children in both community-based interventions improved in their level of adjustment problems, assessed by different reporters. Passage of time since violence exposure allowing self-adaptation did not explain this decrease in problems, because problem levels at the start of the intervention were not associated with length of time since violence exposure had stopped. This suggests that most children do not improve over time without intervention. Our results suggest that the use of non-specific factors in community-based interventions for IPV-exposed children is of particular importance for decreasing children’s adjustment problems (Chapter 3). Next, we examined characteristics that could distinguish children who would benefit most from participation in either intervention. These moderator analyses showed that also children exposed to multiple family risk factors improved during participation in either intervention, although children with symptoms of disordered attachment improved less than children without symptoms of disordered attachment (Chapter 4). Finally, we explored mechanisms of change through which treatment factors induced changes in children’s post-traumatic stress symptoms. These mediator analyses showed the importance of including parents in intervention, and improving their psychological functioning through non-specific treatment factors in parent sessions of intervention, in order to allow children’s post-traumatic stress symptoms to improve (Chapter 5)