When Abuse Strikes Twice, with Miranda Kaye, Ph.D.
What causes revictimization? How can we prevent it? There are common factors that contribute to child abuse and neglect that may affect any family: job stress, food insecurity, and intimate partner violence, to name just a few. But military families face additional stressors. Miranda Kaye, Ph.D., associate research professor at Penn State’s Clearinghouse for Military Family Readiness, and her colleagues set out to examine what, at the individual, family, and community levels, contributed to revictimization. And the findings about community were perhaps some of the most surprising.
Topics in this episode:
- Stressors on military families (2:13)
- Individual risk factors (7:13)
- Intimate partner violence and child maltreatment (11:28)
- Community risk factors (12:33)
- Families with high levels of support (19:56)
- Advice for child abuse professionals (24:04)
- Public policy (26:37)
- More research needed (28:04)
- Social isolation; making friends (31:11)
- More resources (35:11)
“Factors Predicting Family Violence Revictimization Among Army Families With Child Maltreatment,” Miranda P. Kaye, Keith R. Aronson, and Daniel F. Perkins, Child Maltreatment, 2022, Vol. 27(3) 423-433. DOI: 10.1177/10775595211008997
A previous One in Ten episode about community risk factors: “Is Abuse Contagious?” with Dr. Dyann Daley (October 8, 2020)
For more information about National Children’s Alliance and the work of Children’s Advocacy Centers, and for information about supporting military families, visit our website at NationalChildrensAlliance.org. And join us on Facebook at One in Ten podcast.
Season 5, Episode 1
“When Abuse Strikes Twice,” with Miranda P. Kaye
[Intro music starts]
Hi, I’m Teresa Huizar, your host of One in Ten. In today’s episode, “When Abuse Strikes Twice,” I speak with Dr. Miranda Kaye, associate research professor at Penn State’s Clearinghouse for Military Family Readiness about child maltreatment revictimization among Army families.
Now we know that there are common factors that contribute to child abuse and neglect that may affect any family: job stress, food insecurity, and intimate partner violence, to name just a few. But what Miranda and her colleagues examined was both about revictimization and also the unique vulnerabilities that may exist in military life. The uniquely vulnerable periods at deployment and post-deployment and despite the many military supports, just as one example.
The questions that haunt all child abuse professionals—civilian and military alike—are: What about revictimization? What causes it? And how can we prevent it? As you will hear, these researchers set out to examine what, at the individual, family, and community levels, contributed to revictimization. And the findings about community were perhaps some of the most surprising.
Talking to Miranda took me back to my days early in the war on terror as the director of the Colorado Springs [Children’s Advocacy Center (CAC)], where many of the employees were military spouses, and many of our clients were military children and families. I wish I had known then what we are all learning now about the critical role of community in reducing the risk of revictimization and protecting children.
Whether in a military hub like [Washington,] D.C., a community with military posts like Colorado Springs, or a bedroom community to one, we all have a responsibility to help these military families thrive. To learn more about you can help reduce the likelihood of revictimization, please take a listen.
[Intro music begins to fade out]
[2:10] Teresa Huizar:
Welcome to One in Ten.
Thanks so much for having me.
[2:13] Teresa Huizar:
How did you come to this work? Really looking at the intersection between family violence or interpersonal violence and child maltreatment and the military?
Yeah, that’s a great question. So, the military does a lot to support their soldiers, and part of that is family readiness. And so ensuring that families have the resources that they need, as they’re serving or as a member of the family is serving, is a really important part of their model. And one piece of that is families and parenting.
And so the military offers a number of different programs for families, to help support them through the different cycles of military life. And one piece of that is, you know, a consideration of family violence and ensuring that families are safe and that they have the resources that they need to support them through challenging times.
[3:12] Teresa Huizar:
For our listeners’ sake, not all of whom may be very familiar with the military, can you talk a little bit about stressors on family life, community life, individuals that might be somewhat unique to serving in the military and being a military family?
There are a number of different stressors that military families might experience. And, you know, they’re going to experience all the same stressors that we all do in life, within relationships, in their own lives, within their lives in their family. And in addition to that, you know, and it’ll differ a little bit, service per service by service, but one of the things that we see particularly with Army is these are people that are enlisting young. And they’re getting married younger than what we might see in the civilian population. And they’re having children younger as well.
And one of the reasons people enlist is because they don’t have other options. They might not have the money to go to college, and so this is their way to get an education and advance themselves. So that could be one reason for enlisting.
Another reason could be because, you know, they don’t really see another option because of the family circumstances that they came from. And so one of the things that we see sometimes is this prevalence of family violence, of people that are enlisting and joining the military as well. You know, so there’s a risk sort of from their prior family.
And some other individual risks that they might face are really related to some mental health challenges. And a lot of that we can see sort of within the deployment cycle. And those sort of get into some of these relationship characteristics.
So you have a young couple, maybe with a young child, and one of the parents then is sort of leaving the family and coming back and those transitions can be really challenging for families. And then, you know, if one of the parents is deployed, they may experience different physical and mental injuries from that deployment, which can also have an impact. And then sort of when you’re solo parenting during that time, there are other stressors that you’re experiencing while your spouse is gone as well.
[5:34] Teresa Huizar:
I mean, it seems to me that part of what you’re saying is that of course they have the kind of stressors that are included in many families who might experience child maltreatment. So things like carryover from your family of origin in terms of your own parenting practices or other things, mental health challenges, etc. But the thing that might be a little bit different is that there are periods that we know are particularly stressful to military families around deployment and coming back and that cycle—which, one of the things in your study that I was so interested in is, it was covering a period in—Army families in particular had been repeatedly deployed. And I think, you know, that’s just something for all of us to be thinking about, that we’re still learning what the effect of that long period of foreign involvement at war was, where Army families especially, you know, experienced these repeated deployments as a part of that.
Yeah, absolutely. I mean, there’s a whole cycle, right?, of deployment and the different things that those families may go through. You know, the other challenges that that brings up are really related to the relationship itself between the parents as well as between the parents and the, um, children in the family.
And then, you know, really considering some of these risk factors that maybe we don’t think of in military families so much, like isolation and relocation, because that’s sort of part of the lifestyle, but how does that impact family violence as well?
[7:13] Teresa Huizar:
One of the things that I really liked about the study that you published in 2022—and, you know, knowing that the fact that something’s published in 2022 means the research was done earlier than that.
So, but one of the things I really liked about it was it broke down risk factors, I think, for revictimization, which was what the study was about in Army families in terms of child maltreatment, and it really looked at these different layers: at individual risk factors around this, at family level risk factors, and then looked at community.
So I want to unpack this a little bit because I think that they’re all really important to be thinking about. And so I appreciated the fact that in the study you all were looking at that. So sort of starting with individual risk factors, you started talking about that a little bit in terms of, you know, family of origin, kind of, what did that look like?
Were there other individual risk factors that you were wanting to pay special attention to as you were crafting the study itself?
Yeah, so that’s a great question. So this study, sort of looking at the recidivism piece of it, was really based on data that was coded in a previous study to look at what some of these risk factors were.
So, you know, one of the limitations of this is that those are the risk factors that were coded, that we had available. So, you know, had we been starting from scratch, we may have thought of a few other things that we would like to include as well. And so kind of with that in mind, you know, we still had a pretty comprehensive look at these factors.
Mental health issues is a big one with every family. And then, you know, particularly as we think about military families, anger, job stress, right? All of these pieces. I probably would’ve liked to look a little bit more about parenting stress.
Just cause, you know, I—as a parent, too—
it can get stressful.
You know, we also looked at physical health and, like we had mentioned before, their family history from their family of origin of what that might have looked like. And then the other one that I think we also think about less potentially in a military population is alcohol or drug misuse.
Because that can be used a lot sort of as self-treatment for some of these other issues.
[9:38] Teresa Huizar:
Yes. It’s, you know, it’s interesting because you were in a bit of a unique position in that you probably had more data available to you than some researchers might in this, because, if I’m remembering the study correctly, the data came from sort of family advocacy program, substantiated cases. Is that right?
There were a number of different levels.
So some of it was sort of once this incident occurred during the intake, process, whether it was substantiated or not, sort of—
—from that case file, what happened?
So some of that is self-reported, some of that is reported what happened at the time of the incident, and then that was matched to some other data files. So like the drug and alcohol piece of it, that wasn’t self-reported, that was from Army records.
[10:29] Teresa Huizar:
Yes. So it’s an interesting thing because you did have this sort of depth of information that I think other researchers might be jealous about [laughter] in terms of not having access to it.
But it also had some limitations in that it wasn’t as though you could go and just sort of make up your own domains to look into. You were sort of bound by the information that you had there.
Let’s kind of turn to family risk factors. What were some of the family risk factors for revictimization or recurrence?
Yeah, so, you know, the ones we looked at were some of these marital problems and, you know, again, sort of taken from these different pieces. That we have there, as well as home safety. So, you know, feeling safe in the home, financial difficulty. And then again, looking at sort of this co-occurrence of intimate partner violence as well as the child maltreatment.
[11:28] Teresa Huizar:
You know, one of the things that struck me, because I was struck by the level of IPV [intimate partner violence] that was found in these cases, but also in the military in general. You know, that, probably because these people are very young and have lots of stressors as young families, maybe that’s what’s driving the increased levels. I don’t know. But I just—it was interesting. We have lots of co-occurrence, and we’re aware of the literature around co-occurrence between child abuse and what used to be called domestic violence, interpersonal violence. But I think here it really stood out in your study, to me.
Yeah. I mean, they definitely co-occur. And I think, you know, the piece that stands out to me here is that that really is a risk factor for repeated child maltreatment. And I think, you know, in the way that programs are offered, programs that are available don’t necessarily address both.
And so having a consideration that when these are both happening, right?, it’s just a higher risk. You know, it’s sort of that idea of cumulative risk. This is just really increasing the risk.
[12:33] Teresa Huizar:
Well, in a minute I’m going to talk a little bit about the implications of your findings after we kind of unpack that a little bit.
But one of the things that made me think of in this is that often intake around child abuse, at least in Children’s Advocacy Centers, there may be some questions about interpersonal violence. But you know what I don’t think always happens is that that raises the—a red flag that we need to pay particular attention, because otherwise we could wind up with a case of recurrence or revictimization.
I mean, we see it as an initial problem and we’re like, “Oh gosh, you know, let’s make sure that we get services around that.” But I don’t know that we make the next step sort of thinking, “OK, how do we make sure that we don’t wind up having a repeat victimization because of it?” So I think this is a way in which your study really added to the literature.
Can you talk a little bit about community risk factors? You talked about the sort of instability of the living situations of these families, which I think is both a sort of a feature of military life but also certainly has to add stress to it. Were there other things that might have tied to that that also sort of elevated risk for revictimization or recurrence?
Yeah, that’s a great question because I think normally when we think about community level factors, it’s more about the neighborhood and some of the safety and issues there. And when we’re thinking about it for military families, that’s not necessarily the case. And, and housing instability in itself is less of the issue, because the military provides support for that, and it’s related more to sort of that they’ve just had a recent move, that they have a pending move coming. And that happens frequently for these families that they are isolated, or that there, you know, that there are some housing or neighborhood problems sort of like we would expect from civilian families at the time of the incident.
And so it takes it into a little different aspect of a perspective with that, and I think that it’s easy to feel like, “Well, this is happening for all the military families, and this is part of the military life” as opposed to “This in and of itself may be an important factor for these families.”
[14:15] Teresa Huizar:
It reminds me of a researcher that I had on the podcast who wasn’t really looking at the issue of revictimization but was looking at sort of the overall prevalence rate in a community. And social isolation among families was sort of a predictor of that at a population level. And I think, you know, you’re sort of bringing that to mind again to me, that in looking at the paper itself that you wrote, there was an interesting connection. It’s not just the fact of the moving around. It’s when there’s this, this isolation of the family and this disconnection from the community that—like in other child abuse related matters—is a risk factor period. Whether initially or for recurrence or anything else, that that’s just very problematic when people feel that they’re not tied to social norms and social supports.
[15:52] Teresa Huizar:
So let’s turn a little bit to the study. You know, the study itself gave a great overview of the existing literature at the time it was written and those sorts of things.
What were you hoping to add to the literature through the study? Sort of, what were your hypotheses? What were you thinking you were going to find? We’re going to talk about what you actually did find in a minute, but what did you go into this thinking that you were going to be looking at and thinking you might find?
Yeah, so I think there were a couple pieces. And you know, the first piece is a little bit simplistic and just sort of does this ecological model really fit these military families—
—from the way that we’re conceptualizing it?
So the, you know, the first piece was sort of are: these aspects—you know, are these individual risks that we examined and these specific family risks and community risks—are they really fitting this model? And so I think, because I’m you know, a methodologist [laughter], I like those aspects. And so did that model really fit?
And then within that, what’s really important in looking at revictimization? Because I think we think a lot about the risk factors and making sure that, you know, we can identify families that are at risk and help provide the services that they need.
You know, and then the next step that I feel like is sort of exciting about this is that, should we have those initial risk factors, how does that carry forward within this framework when these families are also receiving some sort of services and intervention in that time period?
[17:32] Teresa Huizar:
Well, and unpacking a little bit, to your point, we’ve sometimes assumed that all risk factors are equal. But are they? [Laughter] You know, or are they—there’s some that are more risky, one might say, for victim revictimization than others. Also, I just so appreciate you contributing to the literature overall around this topic, around revictimization, because there’s so little of it. I mean, there’s so little that we really understand about this topic. Setting aside military families, just, period. There’s so little that we really understand about why this crops up again and again in some families.
Yeah, absolutely. I think in terms of what we found, right, it’s not surprising that families had reported a number of these different risk factors within each of these levels.
And what I think is maybe then a little bit more interesting is when we’re considering each of these levels. It’s really—even though we’re seeing, you know, relatively high levels of individual risk factors and then family risk factors, it’s really the community risk factors that are standing out.
[18:42] Teresa Huizar:
Well, you know, I was about to ask you this question and maybe you’ve answered it, so if you have, you don’t have to feel like you have to answer it again. But I, you know, I’m always curious, about any piece of research, what finding or what conclusion do you draw from a fi finding that’s most surprising to you?
That you went into it not expecting necessarily to find, but did.
That’s a great question. So, you know, I think just sort of to recap some of this: So the model that we used looked at each of these ecological levels as well as the types of, you know, characteristics of the service that were provided. And so really it’s letting us look at this altogether, but it’s also letting us say where are these pieces that are sort of the most important.
And so that mental health issues came out as a significant predictor wasn’t really that surprising. That community aspects did was maybe a little bit surprising at first that it was so strong and sort of makes sense because there’s less that you can do in terms of the treatment that’s currently available to combat something like that in a military family.
[19:56] Teresa Huizar:
Can I tell you what surprised me?
Kind of did and kind of didn’t. So let me preface that and I’ll tell you why I say that it also didn’t in a minute. But one of the things that the study noted toward the end is, how much contact these families had had with the Family Advocacy Program. It wasn’t as though they had had no treatment, no help, no support, no contact.
In fact, you know, in in some of this it was fairly intensive, I would say, the sort of services that they had received. And why I think that this kind of runs counter to what the general public has as a narrative around why someone might revictimize kids, that it’s because they didn’t get any help or there was a complete absence of help available to them or that they even accessed—which in this case, many of them, it’s not just that they had received a referral, they actually did attend certain things.
It’s interesting. Several years ago we partnered with Duke University to take some baby steps into looking at recurrence and revictimization in our world. And interestingly enough, we found something somewhat similar. Which is that the families where there were revictimization and recurrence issues were often ones that had had some of the highest levels of intervention and support.
And I think what this told me—and I’m not saying it applies to your findings, but I will tell you what my takeaway from it is on our own, is that we might be providing a lot of support, but it might not be the right support if we’re still seeing the recurrence and the revictimization. So I’m wondering, and I’m putting you on the spot a little bit here, but what do you draw—what, it doesn’t have to be a conclusion, but what do you mull over and think about as you look at that same issue that these were sort of not families lacking for support necessarily?
Yeah, I think there are sort of two pieces that I take away. Maybe three.
[Laughter] Go ahead. You can have all three.
So one is, you know, when we look at the level of support that’s provided, what that tells me is that, the providers themselves were able to differentiate between families that needed more services and those that didn’t and really worked to give the families that needed more, more.
So part of it is an identification of that, which is a positive thing.
I think that part of it then is the treatment itself, too. And sort of this connects to our other work at the Clearinghouse for Military Family Readiness. So part of the mission of the clearinghouse is to provide this continuum of evidence for programs that are available for practitioners. So there’s a database that they keep of these evidence-based programs that address family issues well beyond child maltreatment or intimate partner violence.
But I think it speaks to the need for evidence-based programs for understanding, you know, for researching programs to look at their impact. Because if we are using something because, anecdotally, we think that this will help a family, that doesn’t necessarily mean that it will. And then even if we say, “Well, this program addresses the risk factors that this family has,” is there evidence to suggest that that’s going to make a difference?
As we’re thinking about military families, another piece would be: Can that be implemented with fidelity in that military family?
So for example, if it’s a program where both parents need to be present for each of the classes, well, how is that going to work if a parent is deployed? And what’s the workaround with that? So I think being really thoughtful too about what is it that we’re providing these families and why would we expect it to help is an important consideration.
[24:04] Teresa Huizar:
Oh, dear. You’re asking us to think analytically.
Yes. I think all of that.
So let me ask you this: When you take a look at your findings as a whole—first I want to start with child abuse professionals, because that’s really who your audience is on One in Ten. What do you think the implications are for child abuse professionals that work with the military and have a good relationship with Family Advocacy Programs and these kids and families are coming through our doors at whether it’s Children’s Advocacy Centers or other programs that may exist in the community?
Well, I think one thing is understanding sort of the additional military stressors that these families face. And you know, I think that some of the things that we sort of maybe took for granted that military families don’t have issues with so much.
You know, food insecurity is one that stands out to me that I think has been sort of overlooked in the past. And this isn’t a big problem, right? Because military families are provided for. And more recent work suggests that actually it is a bigger issue than we had previously thought. So sort of these same considerations and these additional stressors.
And I think some of it is, you know, trying to understand the military lifestyle and what the stressors are related to that.
So, you know, most programs are developed for the civilian population, and they don’t have that type of consideration. And so as a practitioner, if you don’t necessarily have experience with that either directly or indirectly through your work, it’s hard to know. So that, you know, the two programs that stand out to me that have education for people that might—you know, I’m thinking more from a home visitor perspective—that might work more directly with families are the Thrive program and in particular, because a lot of, you know, what I think about is sort of that 0 to 3 range.
It’s called Take Root Home Visitation. That’s been developed by the clearinghouse and the DOD [Department of Defense], has been developed specifically for secondary prevention for military families. And then Parents as Teachers has their Heroes at Home piece as well, which does a great job also of capturing what that looks like and sort of how you can support.
[26:37] Teresa Huizar:
One of the things I’m also wondering is, you know, I think it’s wonderful to think about—and important to think about—what those of us who are working in the field can do to help support military families and to be good partners with the Family Advocacy Program. And doing that and understanding military culture being, I think, a key part of that.
But this also seemed to me to have—especially this community piece—seem to have some implications potentially for policy makers, whether in the military or elsewhere. And I’m wondering, what do you see as sort of the larger implications of this, you know, beyond what any individual who’s working in the field could do, but that we all need to be thinking about?
That’s a great question. And I think sort of from my more research and data piece, I would go back to, you know, we want to ensure that the treatments that we’re offering have evidence behind them, so that we’re making sure that the solutions that we’re offering have evidence to support it. And that we’re learning from that, right? So that we’re continuing to evaluate and assess “Is this impactful?” so that we’re able to provide that level of support.
Sorry, you asked two pieces about the policy, and I’m getting stuck on the research one.
[28:04] Teresa Huizar:
OK, well, I will ask you the second piece in just a second, but this got me thinking—what you just said got me thinking about the fact that you’ve made a really excellent point. Which is that the fact that something is an evidence-based intervention more generally, does not necessarily mean it’s an evidence-based intervention for every single population. And so I think the fact that more research needs to be done so that we better understand these interventions that have to be mapped onto kind of a military setting and the particular unique features of that where one parent may not always be present or those kinds of things. That’s a very good point for us to be thinking about moving forward and supporting research into that specifically, I think.
One of the things that I’m wondering about is, you know, is there something more that can be done around this sort of social support in the community piece?
I think that in the civilian world, we even think about that. There’s been a lot of talk more recently about, you know, the value of family resource centers and other things—which are not in and of themselves evidence-based interventions and shouldn’t substitute for them. But a lot of evidence-based interventions don’t really touch on this community level support either.
And so, you know, what needs to be done around that?
I think the community piece is a big thing, right? Because that also is getting into sort of that isolation, that loneliness, you know, and some of those other issues there.
So for military families in particular, they have a lot of resources that they offer, just like family resource centers would have for the civilian population. But if you’re not seeking them out, if there’s not a way to do that, if you know it’s just, “Hey, here’s something in your briefing about this” at the new place you’re at, you’re not really going to think about that maybe until you, until you need it.
And so really figuring out how to catch those families before they’re in that time of need, I think, is really important. And really hard, whether it’s a military family or a civilian family, because there has to be some interest potentially. So how do you get that interest? How do you get a parent who may be stressed, may be isolated, may be distressed, may just be starting out and not knowing what they’re doing like most parents when they start out, to engage in, you know, some early prevention or education.
So to me that’s sort of the starting place, is around education. And I think that’s true in military families as well. You know, especially when we look in the Army, most of the cases are neglect and a lot of times that’s a lack of understanding about parenting, about child development, about those pieces. And so how can we communicate? How can we get people engaged so that they’re getting that information? Especially if they didn’t experience it as a child themselves.
[31:11] Teresa Huizar:
I think the other thing is even at a really basic level, I think we assume that adults know how to make friends. You know that they’re just supposed to automatically be dropped into any place in the world and quickly be able to create their own social support networks. And I don’t know that that’s true.
And when I think about military kids I’ve known who are now adults, some of them really picked up along the way from all those moves a wonderful skillset around that. And others hated it because they never did. And so I think, you know, the military certainly has lots of supports and lots of training and other things to prepare people for moves.
But I think on the part of providers, not assuming that every adult that walks through your doors has plugged into something when they just landed in a new community, because that is a challenge. And as a person who’s moved multiple times myself and was never in the military, you know, maybe I have a little bit of a special appreciation for the the difficulties, at least initially, as you’re trying to build out those supports and relationships and friendships, you know, from scratch all over again.
Yeah, absolutely. And to build on that, I think it’s, it’s often the families that need that the most that maybe are the least aware of it or that want to engage the least.
[32:31] Teresa Huizar:
Well, I think for listeners, you have your marching orders [laughter] to make sure that as we’re engaging these families we’re really inquiring beyond just the incident of maltreatment itself and really looking at how we can provide a comprehensive array of supports and ensure that folks have that, not just assume that somebody else is doing that along the way.
Well, let me ask you this, Miranda, what else should I have asked you and didn’t? And was there anything else that you wanted to make sure we talked about today?
Those are hard questions.
I think … not necessarily anything else that you should have asked, but I think the one thing that maybe came out a little bit less in the paper with the way we looked at the model but that I can say from the data that I think is a really positive thing. And that even though we’ve said, like, we need to make sure that what we provide families is what they need and there’s evidence. I think the other piece of that, um, is that when we look at this data, families who engaged even in as little as 20% of the prescribed treatment, were nearly three times less likely to engage in recidivism. And so figuring out—I mean to me that is, is just so impactful that such a low dose can have such an impact.
And so, how do we entice families to engage in these treatment plans? How do we reduce barriers that keep them from engagement? You know, it looks a little bit different in Army life than in civilian life.
I think the other piece to consider there is really looking at a pretty varied level of treatment, what is the treatment that’s being recommended? And that’s going to vary, obviously, depending on the issue as well. But what can we do to help?
And then I think the positive piece is taking in that even a little bit can help a lot.
[34:27] Teresa Huizar:
I love that. And I think that gives a lot of hope for—you know, I think sometimes when child abuse professionals deal with cases of revictimization, it can feel a little bit hopeless.
But I think the very point you’re making says there’s a lot of hope that if we can engage families, we can make a world of difference. And even if someone drops out of treatment early or something else, there’s clear evidence that, you know, even a low dose is really lessening the likelihood of revictimization and recurrence, which is exciting.
[Outro music starts]
Well, you saved the most exciting finding to the end. I love it, Miranda. Well, thank you so much for coming on One in Ten. We truly appreciate it.
Thanks so much for having me. It was great talking to you.
Good talking to you.
[35:11] Teresa Huizar:
Thank you for listening to One in Ten. If you like this episode, please share it with a friend or colleague. And for more information and resources on supporting military families, please visit our website, www.nationalchildrensalliance.org.