Examining Therapeutic Change Mechanisms in an Affect Regulation, Father-Focused Intervention for Reducing Family Violence and Associated Symptoms in Children

摘要 儿童接触亲密伴侣暴力(IPV)，通常是由父亲犯下的，被描述为一种 通向其他逆境的门户，50%以上的直接形式虐待儿童(CM)并存。 接触IPV可对儿童造成严重破坏，并有造成心理社会障碍的风险，包括创伤后 应激障碍(PTSD)，可在早期出现，并在发育过程中级联。缺少干预措施 这充分解决了家庭中IPV的复杂性质，包括为人父和为人父母。这一差距 反映出一种倾向，即不让有过错的父亲从事以儿童为中心的工作，以及过度依赖施暴者 干预计划(BIP)，在荟萃分析中显示出的影响可以忽略不计，并且未能解决 父亲冒犯行为的根源。因此，感染了IPV的儿童仍处于危险之中，父亲的 个人和人际功能，包括父子关系，没有改善。实际上，在那里 迫切需要对父亲及其家庭进行有效的干预。《父亲为改变》(F4C)是一部小说 以父亲为中心的干预，双重关注IPV和CM，重点是识别、理解、 以及管理情绪，以减少攻击性，改善伴侣和亲子互动。F4C有一个 越来越多的证据表明家庭暴力显著减少，父子关系得到改善 互动，在一项公开试验中，改善了儿童的心理健康。F4C的治疗机制研究进展 包括反射功能(RF)，即父母理解自己和孩子行为的能力 潜在状态和动机的功能，以及情绪调节(ER)，施加控制的能力 情绪状态和对威胁的反应。较差的射频和急诊室与家庭暴力增加有关 以及与压力相关的精神病理学，提出了干预的关键焦点。到目前为止，还没有 ER和RF作为减少家庭暴力和家庭暴力治疗变化机制的实证检验 改善父子互动和儿童心理健康。建议在两个地点进行多模式的考试 父亲(4-7岁儿童)的ER和RF随机到F4C(N=180)或Duluth模型(N=180)，BIP 作为主动控制。会话中观察性编码将评估自适应和非自适应ER和RF 交叉治疗。每周的自我评估将评估在家的ER和RF。AIMS将(1)评估F4C的疗效 在减少家庭暴力和儿童精神健康损害方面与标准的BIP相比，(2)确定和 比较不同干预措施的治疗变化目标的轨迹，以及(3)检查 父亲的急诊室和射频对儿童相关结局的影响。这项提议将扩大F4C和Advance的证据基础 我们对F4C发挥作用的治疗机制的理解。

ABSTRACT Children’s exposure to intimate partner violence (IPV), often perpetrated by fathers, has been described as a gateway to other adversity, with more than a 50% co-occurrence of direct forms of child maltreatment (CM). IPV exposure can wreak havoc on children, with risk for psychosocial impairments, including posttraumatic stress disorder (PTSD), that can emerge early and cascade across development. Lacking are interventions that adequately address the complex nature of IPV in families, including fatherhood and coparenting. This gap reflects a bias towards excluding offending fathers from child-focused work and an overreliance on batterer intervention programs (BIPs), which have shown negligible effects in meta-analyses and fail to address the roots of offending behaviors in fathers. Consequently, IPV exposed children remain at risk and fathers’ personal and interpersonal functioning, including the father-child relationship, does not improve. In effect, there is an urgent need for effective interventions for fathers and their families. Fathers for Change (F4C) is a novel fatherhood-focused intervention with a dual focus on IPV and CM that focuses on identifying, understanding, and managing emotions to reduce aggression and improve partner and parent-child interactions. F4C has a growing evidence-base demonstrating significant reductions in family violence, improved father-child interactions, and in one open trial, improved child mental health. Proposed therapeutic mechanisms of F4C include reflective functioning (RF), the capacity for parents to understand their own and children’s actions as a function of underlying states and motivations, and emotion regulation (ER), the capacity to exert control over emotional states and reactions to threat. Poor RF and ER have been associated with increased family violence and stress-related psychopathology, suggesting key focal points for intervention. To date, there have been no empirical examinations of ER and RF as therapeutic change mechanisms for reducing family violence and improving father-child interactions and child mental health. Proposed is a dual-site, multi-modal examination of ER and RF in fathers (of children 4-7 y.o.) randomized to F4C (N=180) or the Duluth Model (N=180), a BIP serving as active control. In-session observational coding will assess adaptive and maladaptive ER and RF across treatment. Weekly self-ratings will assess at-home ER and RF. Aims will (1) assess efficacy of F4C compared to a standard BIP in reducing family violence and child mental health impairment, (2) identify and compare trajectories of therapeutic change targets across interventions, and (3) examine the mediating role of father’s ER and RF on child-related outcomes. This proposal will grow the evidence-base for F4C and advance our understanding of therapeutic mechanisms through which F4C exerts its effects.