Woman in cozy sweater meets with a home visitor virtually using a tablet

For home visitors, identifying and supporting caregivers who face intimate partner violence (IPV)* is tough under “normal” circumstances. Factor in the COVID-19 pandemic and resulting shift to virtual visits, and new challenges emerge. We interviewed the home visiting team at Family and Children’s Services of East Alabama Mental Health Center (EAMHC) to learn about their experiences.

NHVRC: Tell us a little about your program and the families you work with.

EAMHC Team: We host one clinical in-home therapy and parent education program for moms with young children ages 0–5 in Lee County. We use Child-Parent Psychotherapy and Mothers and Babies for this program, and then our model . . . is Parents as Teachers funded by MIECHV [Maternal, Infant, and Early Childhood Home Visiting Program] and our governor’s infant mortality fund and Medicaid match funds. We typically serve around 80–90 families across all programs. Some of the challenges our families face are lack of resources, whether that’s financial or social support. Our catchment areas are mostly rural, with little public transportation.

Many of the families that find their way to us are coming from referrals from our child welfare agency, so it takes us some time to assure them we’re not caseworkers with child welfare or reporting their every move to them. Families experiencing domestic violence sometimes are afraid to say anything due to history of involvement with child welfare, even when they’re being victimized.

Another hurdle for our home visitors is helping families understand the present consequences of children witnessing domestic violence in the past because [they think] kids “don’t remember because they were babies” and educating them on child development. Typically, what we find is when parents start to learn what healthy parenting and child development look like, they begin to recognize they didn’t have that [experience], which is painful and feels like a legacy they’re doomed to repeat.

NHVRC: How did the pandemic affect your ability to screen for and address IPV?

EAMHC Team: We had very few new families enrolling during the pandemic. The families we were serving either weren’t in a relationship in which IPV had been documented, or IPV was historical and no referral was needed. Our fears were really about domestic violence going unnoticed or unreported due to us not being physically in the home and our services being limited to phone calls and virtual visits.

Conversations are more difficult over the phone or via virtual visits. Being in the home brought out conversations more easily, just because the relationship was more natural, families were more relaxed and at ease to communicate about more difficult topics. In the home, we can serve as an extra set of hands while we’re with our families. The rush for parents to get off the phone or computer has been palpable.

NHVRC: What were the greatest challenges?

EAMHC Team: We were in crisis mode with our families. We discussed more difficult topics—not regarding IPV—but about frustration with virtual school, being out of work, loneliness, depression, feeling disconnected. We weren’t in a physical place to provide comfort during the pandemic. For our home visitors, we’re just now beginning to notice the consequences of [them] feeling powerless to use their strengths and be helpful in their typical ways.

NHVRC: What are some of your takeaways from this experience? What advice would you give to other home visitors?

EAMHC Team: Prepare practical and tangible resources and what we call “little happies,” with specific things for families to let them know you’re thinking of them after they’ve disclosed hard things or when you know they could use some support.

Know the process in your area about what happens when families call domestic violence intervention services so you can confidently let families know what to expect when they reach out to use a resource. This goes for all resources you use when referring families. It builds confidence when they practice and feel successful.

If we believe in the parallel process, then us asking hard questions to make sure that our families are safe is modeling for them how to ask hard questions to ensure their children are safe. Relationships are key. If the family understands your heart and intention for them are good, then they are more willing to see your questions as wanting to help rather than pry into their business.

Read “Addressing Intimate Partner Violence in Virtual Home Visits.”

*See the brief for the distinction between IPV and domestic violence.