Strengthening Bonds & Healing Families Impacted by Gender-Based Violence
By Brandon Martinez, Research Associate
A holistic, innovative program in Manhattan is providing coordinated support to families affected by gender-based violence. The FamilySafe Project addressed healing and mental health needs and goals by using clinically informed assessments and evidence-based interventions.
Using a unique approach that focused on families as a whole, the FamilySafe Project (FSP) developed a trauma-informed approach to provide counseling services to families who have experienced gender-based violence. The FSP — a partnership between Sanctuary for Families (SFF) and STEPS to End Family Violence (STEPS) — used a unique approach that emphasized the connection between family members and focused on serving entire family units by addressing the needs of the adults and children.
Funded by the Criminal Justice Investment Initiative (CJII) - a partnership between the CUNY ISLG and the Manhattan District Attorney’s Office - the FSP created a comprehensive and coordinated screening model to better determine family members’ trauma symptomology and needs as well as help clinicians direct families to appropriate counseling, programs, and services. Using the FamilySafe Project Assessment Tool (FSPAT), which combined three existing assessments, clinicians were able to track participants’ progress towards their mental health goals and measure changes in family functioning and symptoms of post-traumatic stress disorder (PTSD).
Recent findings from an evaluation of the FSP, conducted by the Urban Institute, found that the program was successful in developing a trauma-informed model that served all family members, and that families’ PTSD symptoms improved as a result over time.
Developing a Trauma-Informed, Evidence-Based Program for Families
Sanctuary for Families and STEPS partnered in 2017 to develop the FSP with the intention of creating a model that would treat families as a complete unit, emphasize communication and collaboration between staff, and be rooted in evidence-based assessments (i.e., the FSPAT). Prior to their partnership, STEPS had already developed a service model that emphasized family units and used some assessment tools that were later built upon with the FSPAT. The partnership not only allowed both organizations to further develop this approach, but also allowed Sanctuary to more directly interact with families in East Harlem, where STEPS is located. Staff reported that the FSPAT was well integrated in the participant onboarding process and supported both the needs of participants and the goals of the organization and staff.
[The FSP is] a model that would treat families as a complete unit, emphasize communication and collaboration between staff, and be rooted in evidence-based assessments.
The FSP was designed for people who had experienced gender-based violence and were living with children. Participants were referred to the program from other clients and social service justice systems, including the Manhattan Family Justice Center and New York City’s Family Justice Centers. Once they were in the program, staff administered the FSPAT to adults that included: the PTSD Checklist for DSM-5 (PCL-5) for adults, the Protective Factors Instrument (PFI) for families, and the Parent Report of Post-Traumatic Symptoms (PROPS) for children. This allowed clinicians to understand the needs of participating families and helped them direct participants to appropriate services, such as counseling, family therapy, and workshops. Adults and children then participated in various counseling and therapy services, and received in-house case management to assist them with obtaining housing, scheduling medical appointments, and completing grant applications. The FSPAT would then be re-administered on a regular basis to help clinicians determine if service changes were needed and understand how participants were healing.
Providing Trauma-Informed Services to Gender-Based Violence Survivors and Families
The FSP served a diverse group of families who had experienced gender-based violence and trauma that was reflective of the communities in which the organizations are located and survivors of gender-based violence at large. All participants were parents and about half were participating in the FSP alongside their children. Most adult participants were women — 86 percent and 84 percent at STEPS and SFF, respectively. At STEPS, most adult participants were Latine (61 percent), while at SFF, one-third were Latine and one-fifth were Black (Figure 1).
Figure 1. race-ethnicity of adult fsp participants at steps and sff
Source: Urban Institute analysis of program data.
When starting programming, FSP participants had many needs stemming from their previous or current experiences with gender-based violence. Staff reported that participants dealt with fear and anxiety, often needing help to regulate their emotions, care for their children, and obtain psychological support. Based on a participants’ needs, clinicians would refer them to appropriate services, such as counseling, family therapy, and workshops. Most adults participated in individual counseling sessions (Figure 2). Forty-four percent of STEPS participants and 85 percent of SFF participants received individual counseling. The FSP specifically worked with three evidence-based models for providing therapy:
Parenting Journey (including Parenting in America), which consists of 12 counseling sessions where adults understand how their childhood impacts their parenting.
Child-Parent Psychotherapy for Family Violence (CCP-FV), designed to strengthen parent-child relationships while improving the cognitive, behavioral, and social functioning of children.
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), which addresses trauma symptoms in children and adolescents through psychoeducation and parenting skills, conducting parent-child sessions, and enhancing safety and social skills.
Participants reported that the FSP’s non-judgemental and family-centered approach was a major facilitator of their healing journeys. They also felt that their successes were possible because of the effective communication skills of the staff and their ability to fully express themselves in their native language (Spanish).
“I would say [what was most helpful about the counseling was] making me feel comfortable and understanding that domestic violence is a lot more common than we’d like to think. I think I felt safe. I felt like I could be vulnerable because I think, just for myself, it was very hard for me to admit that I had been abused and that I was in this type of relationship. When I finally opened up to that, I felt that I had really surrendered and was able to heal. I would say I felt safe and understood.”
—FSP client
Figure 2. Percentage of Adult Participants Engaged in Types of Therapy
Source: Urban Institute analysis of program data.
Using Evidence-Based Assessments to Understand How Families Heal
Adult FSP participants reported improvements in their confidence and self-esteem, as well as an improved understanding of trauma and its symptoms. These improvements occurred as PTSD symptoms decreased, which were measured as part of the assessments used as part of the program. On average, PTSD symptoms among adults decreased from high to moderate - as seen in their PCL-5 scores, which dropped 10 points, from 41.7 at intake to 30.1 at follow-up (Figure 3). Given the negative consequences of PTSD symptoms, the improvement of PCL-5 scores represents a major achievement in participants’ healing journeys and shows the positive impact of the program. For additional information on the use and impact of the FSPAT, including how children’s moods, behaviors, and educational performance improved, see here.
Figure 3. Average PCL-5 Score at Intake and Reassessment
Source: Urban Institute analysis of program data.
About the Program and Evaluation
The FamilySafe Project program evaluation helped families address the impacts of trauma and gender-based violence by providing adults and children with much needed counseling that reduced their trauma symptoms. As a result, the FSP improved communication within family relationships and supported educational achievement among children.
The final evaluation report, including process, outcome, and validation findings, is available here. For additional information, an earlier mid-evaluation report describing process evaluation findings in greater depth is available here.
About the Criminal Justice Investment Initiative
The Manhattan District Attorney’s Criminal Justice Investment Initiative (CJII) focuses on three investment areas—crime prevention, reentry and diversion, and supports for survivors of crime. The FamilySafe Project program is part of the CJII’s crime prevention-focused investments in Youth, Families, and Communities.
The CUNY Institute for State and Local Governance manages and provides technical assistance to CJII contractors, and conducts oversight and performance measurement throughout the lifetime of the initiative.
Photo by Cavan for Adobe.