Background

Children who experience traumatic events early in life which involve ongoing incidents of abuse and violence often develop severe social, emotional, health and behavioural problems (Goddard & Bedi, Reference Goddard and Bedi2010; Levensdosky & Graham-Bermann, Reference Levensdosky and Graham-Bermann2001; Thompson & Tabone, Reference Thompson and Tabone2010). Children who become homeless as a result of fleeing family violence fall into this category and display ‘significant problems’ in many areas of their development (Kirkman, Keys, Turner, & Bodzak, Reference Kirkman, Keys, Turner and Bodzak2009, p. 11).

Mothers who escape family violence are assisted by Australia's Supported Accommodation and Assistance Program (SAAP) which is the major service provider for homelessness (Kirkman et al., Reference Kirkman, Keys, Turner and Bodzak2009). Thousands of children accompany their mothers. The effects on these children of having lived with family violence and the consequent homelessness from escaping such violence are extreme. Frequently, these children present with serious emotional and behavioural issues as a direct result of the violence perpetrated on them, their mothers and their pets (Kitzmann, Reference Kitzmann2012; Mudaly, Reference Mudaly2010). These children require sensitive therapeutic interventions as their emotional and behavioural problems preclude them from accessing and engaging with healing interventions. Effective therapeutic interventions are based on the key elements of emotional and physical security and stability of care which are lacking for these children (Mudaly, Reference Mudaly2010). Their persisting fear and anxiety, coupled with uncertainty about their future, also impairs their ability to engage with traditional therapeutic interventions (Perry & Hambrick, Reference Perry and Hambrick2008). Unfortunately, specialised services that target the specific needs of these children are not available as SAAP services are not designed to meet these needs (Kirkman et al., Reference Kirkman, Keys, Turner and Bodzak2009).

An innovative animal-assisted therapy group was implemented by a homelessness and family violence agency in Melbourne, Australia, in response to the particular needs of the children who accessed their services.

Animal-assisted programmes are becoming recognised as a relevant and valuable therapeutic intervention for humans, and have been used successfully in a range of adult and child mental health programmes (Chandler, Reference Chandler2005; Chandler, Portie-Bethke, Barrio Minton, Fernando, & O’Callaghan, Reference Chandler, Portie-Bethke, Barrio Minton, Fernando and O’Callaghan2010; Friesen, Reference Friesen2010). Animals are particularly helpful for children who demonstrate challenging behaviours due to experiences of abuse and violence (Ascione, Reference Ascione2005; Parish-Plass, Reference Parish-Plass2008). Melson and Fine (Reference Melson, Fine and Fine2006) cite studies which state that children sought emotional support, comfort and reassurance from their pets during times of stress.

Animal-assisted therapy (AAT) is a therapeutic approach that is considered an adjunct to therapy. It encourages and facilitates client motivation and participation, enhances the client–therapist relationship and reinforces positive client change (Chandler, Reference Chandler2005). AAT is differentiated from animal-assisted activities or education as it incorporates ‘emotional connection and relationship’ between therapist, child and animal (Parish-Plass, Reference Parish-Plass2008, p. 12). The delivery of AAT programmes depend on the animal that is involved (e.g. a dog or horse), the setting in which it is delivered (e.g. inpatient or outpatient setting, medical clinic), the duration of the intervention (short or long term), and whether the intervention is delivered in a group or individual format (Nimer & Lundahl, Reference Nimer and Lundahl2007).

For the programme under discussion, the agency partnered with an animal therapy consultancy specialising in the design and delivery of animal assisted programmes for children experiencing violence and abuse, neglect and homelessness (Empathy Education & Training, 2007). A joint therapeutic model using small animals in a group setting, and supported by the family violence agency's internal case management process, was established in 2005.

From anecdotal evidence of children attending this group, dramatic improvements were noted in many areas of their lives. A formal pilot evaluation of this programme on its effectiveness as a therapeutic response for this population of children was therefore commissioned. The aim was to seek the views of children about the benefits of this group.

Details of the Pilot Evaluation

Child Abuse Prevention Research Australia is a university-based research centre, which was commissioned by the family violence agency to undertake the pilot evaluation. Ethically sound research that promotes children's voices is a fundamental aim of this research centre (see http:www.capra.monash.org).

Evaluation is a critical element for sustaining child abuse prevention programmes and is essential for ongoing quality assurance efforts, accountability and obtaining evidence of effectiveness of interventions (Gelles, Reference Gelles2000; Taylor-Powell, Steele, & Douglah, Reference Taylor-Powell, Steele and Douglah1996). As the animal therapy group had been operating for several years, the agency felt it important to evaluate its effectiveness in meeting the children's needs. The chief aim was to obtain children's views on the group in order to plan expansion of the programme.

A qualitative methodology was chosen for the evaluation as it allowed the children to give their own views, in their own voices, in an interactive dialogue with the researcher (Berg, Reference Berg1998; Denzin & Lincoln, Reference Denzin and Lincoln2000; Mudaly, Reference Mudaly2002). The research process used a child-centred approach for obtaining consent, providing information on the research, addressing confidentiality issues, and engaging and supporting the children during and after the research (Archard & Skivenes, Reference Archard and Skivenes2009; Bray & Pugh, Reference Bray, Pugh, Bates, Pugh and Thompson1997; Mudaly, Reference Mudaly2002; Mudaly & Goddard, Reference Mudaly and Goddard2006, Reference Mudaly and Goddard2009). Ethics approval to conduct the pilot evaluation was obtained through Monash University's Human Research Ethics Committee, with criteria set to minimise any possible risks to children who consented to participate (Alderson & Morrow, Reference Alderson and Morrow2004; Mudaly, Reference Mudaly2002, Reference Mudaly2010; Mudaly & Goddard, Reference Mudaly and Goddard2006, Reference Mudaly and Goddard2009). The Animal Ethics Committee of the local animal welfare agency oversaw the welfare of the animals involved in the programme.

Children's Experiences of Family Violence and Homelessness

Every year, thousands of children in the company of their mothers become homeless, often as a result of family violence. The 2006–2007 SAAP data revealed that 69,100 children accompanied mothers who were part of SAAP-funded services in Australia. Of this number, 21,400 children were from Victoria (Australian Institute of Health and Welfare, 2009). For these children, living with and then fleeing family violence, and enduring the loss of their homes, possessions, pets, neighbourhood resources, schools and friends, has an extremely damaging impact on their development. ‘Homelessness is the extreme point of poverty and instability’ as it aggravates the adverse effects of pre-existing circumstances on children's development including behaviour and academic performance (Kirkman et al., Reference Kirkman, Keys, Turner and Bodzak2009, p. 11). Current literature maintains that pets are also often included in the violence as they ‘are an important part of many families’ (Hounslow, Johnson, Kathan, & Pond, Reference Hounslow, Johnson, Kathan and Pond2010, p. 11). Children may be forced to observe or participate in violence to pets to procure their compliance. Such experiences, coupled with the consequent homelessness, exacerbate the impact on children's development.

The Need for a Specialised Therapeutic Programme

The need for a specific focus on the needs of these children was identified and stated in the Government's white paper on reducing homelessness (Kirkman et al., Reference Kirkman, Keys, Turner and Bodzak2009). It was in this context that the animal therapy programme was developed by the family violence agency for the children accessing its services.

As part of the agency's intervention, parents and children are placed in short-term, supported accommodation, with children from this target group selected to participate in the group. The aim is to assist them to achieve a measure of emotional security and prepare them for engaging with counselling services. Children's entry into the group is carefully assessed and planned according to their individual needs (for example, if they require additional support prior to entry), as well as matching them with the age range and dynamics of children already in the group.

Assessment of the children for the group is undertaken by the agency through the children's caseworkers, who also provide ongoing case-management support to the children. Where there is a known history of a child's cruelty to or fear of animals, he or she is not precluded from the group, but carefully prepared for, and more closely supported, in the group. This may include a graduated process of contact with the animals. The comprehensive assessment also identifies and responds to each child's educational, health, cultural, social and emotional needs.

The Animal-Assisted Education and Therapy (AAET) Group

The animal therapy consultancy provides the participating animals and ensures that the animals’ health and welfare are given priority at all times. The animals chosen for the programme include guinea-pigs, rabbits and rats (Empathy Education & Training, 2007). These small animals are specifically chosen for the group for several reasons. Many children who have lived with family violence may be afraid of larger animals or may perceive some animals as fierce, for example, larger dogs. Small animals are also not able to inflict any great damage on anyone. In addition, the parallels between small, vulnerable animals and children's vulnerability within violent families are also profound. The perception that guinea-pigs are small, vulnerable, fragile and needy, and therefore require care and protection (Gurney, Reference Gurney1999), encourages children to connect with their own empathic qualities.

The welfare of the animals is a priority (Fredrickson-MacNamara & Butler, Reference Fredrickson-MacNamara, Butler and Fine2006). This is not restricted to medical care, training and health certification. Empathy Education & Training (EE&T) stipulate that healing interactions between the children and animals can only occur when the animals are stress-free, healthy and relaxed within the therapeutic environment (Melson & Fine, Reference Melson, Fine and Fine2006). Priority is therefore given to protecting the animals from any stress and they are removed if a situation becomes overly stressful. The animals are also constantly monitored for their responses in the group and are ‘retired’ when assessed as not being comfortable any longer in the group (Fredrickson-MacNamara & Butler, Reference Fredrickson-MacNamara, Butler and Fine2006, p. 140). Significant effort is spent on caring for, and preparing, the animals for the group. Group sessions are held on the grounds of an animal shelter and run by staff of the animal therapy consultancy. The children's caseworker transports the children to and from the group, and also facilitates the group, which is held during school terms.

Eight to ten children attend weekly group sessions of 1.5 hours’ duration. There is a repeated framework of activities, which provides routine and safety, but allows considerable flexibility for responding to individual children and their needs. Activities are designed to engage with children and settle them in preparation for contact with the animals. Individual and group activities include art and photography, and shared refreshments. Animal activities include education about animal health, diet, husbandry and welfare, animal handling (grooming, comforting) and animal care (feeding and observation). The adult facilitators provide supervision, knowledge and companionship for the children (Empathy Education & Training, 2007). The group provides opportunities for children to experience positive interactions with animals and adults to counter the damage from experiences of violence, displacement and uncertainty (Ascione, Reference Ascione2005).

Details of the Research Sample

Eleven children (six boys and five girls) from seven families eventually consented to participate in the evaluation. Recruiting children from this population for a research sample is fraught with difficulties. The lives of most of these families are unpredictable, unsafe and filled with crises and ongoing fear. These issues impact on their availability and accessibility, creating difficulties in securing a definitive research sample (Kirkman et al., Reference Kirkman, Keys, Turner and Bodzak2009; Mudaly, Reference Mudaly2010). The children's ages ranged from 7 to 15 years, and attendance at the group ranged from 8 to 24 group sessions, with the average being 15. Three children attended group sessions for over 3 years in a fragmented manner. For eight children, the biological father had been the violent offender and for three children, it had been the mother's partner.

The violence and homelessness experienced by these children had been extensive. It included physical and, for some, sexual abuse, threats of physical abuse to them, being terrorized with threats to kill their mothers and their pets, being stalked and held hostage with their mothers, and destruction of their belongings. All the children had left their known family home and none of them had returned to live in the same property. Some children had stayed in more than one women's refuge and all had spent several nights in a motel at some point in their homelessness experience.

At entry to the group, the children were described by their mothers (and observed by the caseworkers) as displaying a variety of traumatised behaviours. Eight children were described as displaying aggressive behaviours, which included being physically violent with siblings and at school, fighting, bullying, being angry all the time and argumentative. Three children were described as displaying withdrawn behaviours. This included high levels of anxiety, distress, acute sensitivity, running away, hiding and not talking (one child became mute until she attended the group). Being bullied, over-talking, tantrums and constant attention-seeking were other behaviours exhibited by the children.

Children's Voices

There is growing acceptance of the importance and value of hearing directly from children about matters that affect them (Christensen, Reference Christensen2004; Clavering & McLaughlin, Reference Clavering and McLaughlin2010; Mudaly & Goddard, Reference Mudaly and Goddard2006). The quotes and extracts presented here have been taken directly from the pilot research interviews, during which children chose to speak on these topics (Mudaly, Reference Mudaly2010). Therefore, they do not represent the experiences of all the children who participated in the evaluation. The children's voices are presented without theoretical or author interpretation. The quotes, although random, were selected for relevance to the topics under discussion.