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You are here: Homepage » About Non Violent Resistance (NVR) » Info for Professionals in CAMHS, Social Care & Education
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| A new approach to aggressive, violent and dangerous behaviour in young people. For families, with looked after children, in residential contexts, and in education. Possibilities Non Violent Resistance (NVR) can be used to overcome violent, aggressive, and controlling behaviour by raising parental presence, and helping parents or carers to reduce their helplessness, become more confident and develop a sense of agency in dealing with young people. In social care contexts, NVR can support family preservation, and prevent children from going into care by averting family breakdown. It can further help prevent foster placement breakdown and the need for costly residential or even secure accommodation. In CAMHS, NVR can be used as a therapeutic intervention which effectively ameliorates conduct problems, and a variety of difficulties associated with anxiety and control in the family. In Education, NVR can be utilised to improve student behaviour and reduce aggressive and disruptive behaviour towards staff or peers. In this Information for Professionals, the term ‘parents’ will be used for either parents or anyone in loco parentis, such as foster carers or carers in residential services. The intervention Non Violent Resistance is an intensive, but brief intervention, which lasts up to around three months. In addition to weekly therapy sessions, parents receive one to two supportive phone calls or home visits per week. The telephone supporters are in regular contact with therapists, in order to maintain continuity. When families are supported by social workers or social work assistants, it is useful for these to be trained in NVR and to provide the telephone support described above. The approach A Team around Haim Omer at the University of Tel Aviv has developed this systemic approach over the past 12 years, to help families with children, young people or young adults, who consistently act in aggressive and controlling ways. Therapy does not require the young person’s participation – this already removes the parents’ dependence on their violent child in addressing the difficulties they face. Rather than taking on the almost impossible task of motivating their child to attend therapy sessions, and experiencing the sense of dread that often goes along with it, parents can focus on building their own ability to resist the young person’s control. In the process, they gradually overcome their sense of helplessness and develop greater self efficacy. NVR addresses family interaction in specific ways:
Parents and siblings accommodate violent young people by acquiescing to their demands. Examples of this are: giving their child treats or money on demand, not inviting other adults into the house, accepting that they do not attend school, allowing them unlimited computer time at the expense of their siblings, giving in to the young person’s demand about what to watch on television, etc. Parents and siblings have generally become unaware of the degree to which they show this kind ‘automatic obedience’. They recognise their own responses, when asked to explain the metaphors they use, such as ‘walking on eggshells’ around their violent child. Automatic obedience on the part of the parents reinforces their offspring’s violent behaviour, by yielding greater power to their child. What momentarily appears to calm down a volatile situation, actually increases overall violence, and compromises parents’ and siblings’ safety far more, than refusing to give in to aggressive and threatening behaviour. In NVR sessions, parents decide on which ‘taboos’ to break at a given time; e.g., they may decide not to give their daughter money on demand in the next week, especially as they are aware it is likely to be used for drugs. In this way, they gradually develop their own ability to resist the control their son or daughter has developed over the family. In the immediate situation, breaking a taboo is likely to trigger an aggressive response. However, NVR reduces overall levels of aggression in the family, including the aggressive behaviour shown by the violent young person. This is due to the fact that parents learn to escape from the frequent cycles of escalation they have been engaged in. De-escalation Two kinds of escalation have been observed in families: symmetrical and complementary. In complementary escalation, one person becomes more and more threatening and powerful, while the other withdraws from any confrontation, grows increasingly anxious and helpless. When there is symmetrical escalation, each side attempts to gain power over the other, by answering threatening acts with retaliatory actions of one’s own. In families with violent young people, symmetrical escalation is very frequent, as parents attempt to regain their authority by attempting to assert control, while the young person frustrates any such attempt by raising their own level of aggression. Parents cannot ‘win’ these battles, as they are far more likely to back off, when the confrontation reaches a very high level of intensity, and revert back to being the controlled side of a complementary escalation. They then believe they have ‘lost’, feel helpless, and often engage in endless conversations or rumination about what may have caused their offspring’s aggression. In this way, parents constantly oscillate between symmetrical escalation and helplessness. Parents are generally unaware of the fact, that by reacting in kind to the young person’s provocation, they are actually being controlled: they have shown very strong emotions and have lost their self control at a time, in a situation and in a place of their child’s choosing. What’s more, violent young people can draw a sense of justification for their angry aggression from the parent’s aggressive behaviour when there has been a symmetrical escalation. In this way, symmetrical escalation leaves parents feeling ever more helpless. By developing de-escalatory strategies, NVR helps parents bring down overall levels of anger and aggression in the family, helps them resist being controlled by a young person’s provocation, and prevents them from sliding into the helplessness that follows from ‘losing’ destructive battles. Instead of remaining trapped in the logic of control and believing they must break their child’s volatility during a confrontational situation, parents learn to avoid any attempt at controlling their violent offspring, as this has been futile and counterproductive. Instead, they learn to focus on raising parental presence, which goes far beyond mere physical presence. One way of raising parental presence is to take deferred, direct, non violent action. As a parent, it becomes much easier to de-escalate, when you know that you will be able to act in a decisive and planned manner at a later point in time, and that you do not need to react immediately. Direct, non violent action As with breaking taboos and de-escalating, direct non violent action in the family has been modelled upon Mahatma Ghandi’s and Martin Luther King’s strategies of non violent political action. Parents raise the young person’s awareness of their resistance, and of their presence as parents in their child’s life, by using a variety of strategies. All such actions are deferred, i.e. they take place hours, or even days after a violent incident. In this way, parents can strategically plan their response, acquire outside support, and find themselves acting at a time, in a place, in a situation and in a manner of their own choosing. Rather than reacting in a controlling fashion just after an incident, the deferred response takes place, when the general level of psycho-physiological arousal is much lower throughout the family. Some examples of direct, non violent action in the family are:
These acts of non violent resistance are very complex, and require many hours of careful preparation, analysis, and therapeutic reflection. By showing deferred, carefully planned and strategic responses to violent acts, parents no longer react ‘on the hoof’, are calmer, can create optimal conditions under which to act, and gain maximum support from outside helpers. Behavioural approaches require parents to act consistently and to put consequences in place. Unlike behavioural approaches, NVR does not aim to control the young person, but instead supports the parents in overcoming their sense of helplessness by strategically resisting control. These strategies take the parents’ ability to act decisively at a given moment in time into consideration, as well as the supportive network around the family. Families often become socially isolated due to a young person’s violent behaviour, and the need to develop a support network counterbalances this isolation. In this way, NVR is a community based therapeutic approach, which helps families connect or reconnect with supportive others and develop their interpersonal resources. Helpers NVR supports parents in developing a support network. Helpers can take on a variety of different roles, ranging from taking part in message campaigns, witnessing a sit-in, providing logistical support such as looking after the family’s younger children during direct action, to acting as mediators between parents and their violent children. One cannot expect a support network to be present at the outset of the intervention; it grows throughout the resistance. Parents are supported in overcoming their sense of shame or failure, in order to feel more comfortable about requesting support. A support network is especially important for families, who are socially isolated due to additional factors, such as mental health problems or a high level of neighbourhood aggression. Reconciliation gestures When there is violence, positive aspects of the parent-child relationship become overshadowed by mutual distrust, anger, disappointment and hurt. In their previous attempts to ‘root out’ the aggression, parents have often lost sight of their loving and caring feelings, and the young person feels maligned and rejected. In Non Violent Resistance, parents make carefully planned reconciliation gestures after taking direct action. Such gestures express unconditional positive regard. Parents can show their love and respect for the child verbally, or in other ways, e.g. with a symbolic gift. Reconciliation gestures range from providing a treat or undertaking a joint activity, to such important messages as an apology for the parent’s own past abuse or neglect of the child. Causes and effects of violence NVR does not consider any specific ‘underlying disorders’ to cause aggression. Many difficulties, such as an autistic spectrum disorder, or the experience of trauma, may very well be antecedents of violence in a young person, but no such difficulty per se is either a necessary or a sufficient condition for the ongoing violence and destructive behaviour. We have found that e.g. young people with Asperger’s Syndrome become more amenable to other forms of psychological intervention, such as the use of social stories to support their social communication, once they no longer act in controlling ways. Violent behaviour does affect a young person’s psycho-social development. Again and again, parents, relatives and friends of a family will describe the young person as someone who ‘has no self confidence’. By acting in controlling ways, young people avoid facing normal developmental challenges. When much time is spent fighting with parents, running away or using drugs, and conflicts are resolved by intimidation rather than by negotiation, young people miss out on a multitude of opportunities to develop their social skills, rise to academic or vocational challenges, or learn to feel good about their achievements. Of course, normal developmental challenges trigger anxiety in young people, as do problems such as social communication difficulties or posttraumatic stress. Getting angry becomes a habit, and the shift from anxiety to anger can be so automatic, that aggressive young people may have little awareness of any precipitating anxiety. Much of a child’s or adolescent’s psycho-social development appears to become arrested as their violence increases. By overcoming their acquiescence, parents remove rewards for controlling behaviour from the social environment. When habitual anger no longer achieves the desired results, young people become more able to deal constructively with whatever developmental or psychological challenges they now need to face. Often, parents or carers using NVR see young people ‘blossom’, as they turn to more productive activities. Research links reduced parental presence with conduct problems. Raising parental presence in NVR through direct non violent action, and with reconciliation gestures, brings parents or carers to the young person’s mind and enables more secure attachment, which in turn helps them feel more contained and less anxious. Siblings Siblings are often subject to physical or sexual abuse by their highly aggressive older brother or sister. They may believe their parents do not care about their victimisation, feel the parents are powerless to protect them, or be so habituated, that they see it as normal to be abused. They may also wish to protect their parents from distress, and therefore not tell them about abusive acts, and the effects this behaviour has on them. In this way, the violence isolates siblings, and creates divisions between them and their parents. NVR engages siblings in the process of resistance, by facilitating their communication with parents or adult helpers, so they no longer remain isolated in an abusive situation, and can be protected from further harm. This helps overcome divisions within the family and prevents schisms between non-abusive family members. NVR in education NVR is being used successfully in a variety of educational contexts. Often, relationships between parents and school staff become very antagonistic, when young people show controlling and aggressive behaviour in school. By closing the communication gap between educational staff and parents or foster carers, joint strategizing, and carrying out direct action together, the positive impact of the intervention can be maximised in both home and school contexts. The actual non violent techniques can be adapted to the school environment, whilst NVR also changes the educational context itself. It does this by developing support networks among teachers, who have often felt isolated within the staff group in regard to the challenging behaviour of some of their students. Looked after children In the UK, first at Thanet Multi Agency Service, and more recently at PartnershipProjects, we have been developing the use of Non Violent Resistance to help prevent foster placement breakdown, and/or to enable a young person’s rehabilitation back to their family of origin, where this is appropriate. When there is repeated placement breakdown in the wake of aggressive behaviour, young people become more and more difficult to care for, and often require other forms of residential care or secure accommodation. These environments are highly unsatisfactory for the young person’s emotional well-being, and for their behavioural and mental health. They also are an enormous drain on financial resources, presenting social care managers with great budgetary problems. It has been useful to develop the intervention within a multi-agency context, in which fostering social workers can utilise their supportive role towards foster carers as part of the intervention. In this way, the vicious cycle of repetitive foster placement changes can be broken. By developing care plans which incorporate NVR when a child or young person becomes accommodated – whenever this may be appropriate – rehabilitation back to the birth family can be facilitated within a short time frame, by involving foster carers, parents, social workers and fostering social workers in the intervention. Multi-stressed families Families which struggle with multiple difficulties, such as socio-economic deprivation, social isolation on deprived housing estates with often high levels of aggression, parents’ history of having experienced various forms of abuse since their childhood, domestic violence, parental mental health or drug and alcohol misuse problems, etc. are often involved with Social Services. There is a high risk of family breakdown, and we have been developing ways of using NVR to preserve these often very traumatised families. NVR is very helpful, when parents are being re-traumatised by their violent children. However, work in this area requires sound knowledge and a good skill base in working with trauma. We find that along with a growing sense of agency and confidence, parents’ symptoms of post-traumatic stress become reduced, and parental difficulties such as self-harm, depression, or risk of alcohol misuse relapse decrease, which further increases family stability and prevents children from becoming looked after. A publication on NVR in a UK social care environment is in preparation by the author. Further applications Non Violent Resistance is presently being used for a variety of difficulties, which are linked to either openly aggressive or more subtle forms of controlling interaction. The approach is being used successfully for anxiety and OCD type behaviour, when family members control others, in order to maintain their avoidance of anxiety-provoking triggers, or to be able to continue carrying out ritualistic and compulsive behaviour. A more subtle form of control is exerted when young people withdraw into the family home, and finally into their room (self-immurement), and parents give in to this kind of behaviour because they fear harm could be done to their child, if they were to resist this tendency. A ‘gentle’ form of NVR has been used in such situations. A modified form of Non Violent Resistance is increasingly being used in overcoming domestic violence. Evidence Research on different aspects of NVR has been carried out in conjunction with NVR projects at the University of Tel Aviv, ranging from studies on parental helplessness to siblings’ perception of the intervention. A recent controlled outcome study of five session NVR shows high efficacy in reducing externalising behaviours on Achenbach’s CBCL, which is maintained at a one month follow-up. There are also statistically significant effects on a variety of parental parameters, such as reduction in parental helplessness, increase in social support, increase in parental authority, improvement in parents’ mental health, and improvement of parents’ self efficacy. With the exception of social support, these treatment effects also remained stable at follow-up. Whilst it will be helpful to have more evidence from controlled outcome studies in the future, with longer follow-up periods, the improvement in parental variables would appear to make long term retention of treatment effects very likely, and this is indeed the clinical impression. Very important is the very low drop-out rate for NVR in this study, which lies below 10 %. When dealing with violent behaviour, drop-out rates for behavioural programmes lie at about 50%. Whilst the waiting list control group would allow for the outcomes to be non specific treatment effects, the low drop out rate does certainly appear to be treatment specific given the comparison to other forms of treatment. This low drop-out rate is of great importance in respect to effectiveness and efficiency in the real world of the NHS, social care and education, where funding should yield good outcomes in a high percentage of cases. In this way, NVR can be very useful to Social Services and CAMHS in achieving PSA targets. Training in NVR At PartnershipProjects, we provide comprehensive training in Non Violent Resistance. You can attend our London courses, or access in-house training. (hyperlink to 2007 Training Programme) In-house training can be commissioned by employers in Health, Social Services, Education or the independent sector, anywhere in the UK, Northern Ireland or Republic of Ireland. We will customize the course to match the local needs and level of experience of your team or service. Clinical supervision, or case consultation is available on an individual or team basis. The PartnershipProjects Consultancy Service develops new service models with commissioners and providers to meet local needs. We can deliver in-house training packages in NVR to match these service models, both on a single agency and on a multi-agency basis.
Each training unit lasts two days, and can be provided in-service, or attended as part of the London based PartnershipProjects central training programme (from 2007). For more information on training and supervision please call 01227-768676, or email us.
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