J Fam Viol (2013) 28:5–15
DOI 10.1007/s10896-012-9490-9
POLY-VICTIMIZATION IN THE HOME
A Feasibility Pilot Intervention Program to Teach Parenting
Skills to Mothers of Poly-Victimized Children
Paulo C. Pereira & Sabrina M. D’Affonseca &
Lúcia C. A. Williams
Published online: 29 November 2012
# Springer Science+Business Media New York 2012
Abstract The Parceria (Partnership) Project is a Brazilian
intervention program designed for mothers with an intimate
partner violence (IPV) history. Its short term goal is to teach
parenting skills to abused women, and in the long term, to
prevent behavioral problems in their children. The objective
of this pilot study was to evaluate the feasibility of the Parceria
Project with mothers of children who had experienced multi-
ple forms of maltreatment (poly-victimization), as it was
expected that most of the mothers would also have a history
of IPV. Seventeen Brazilian mothers took part in this inter-
vention. They completed several types of evaluation. The
intervention program using a cognitive-behavioral model took
place in each family’s home. All mothers completed the
intervention and evaluated the project positively. The study
showed that it is feasible to conduct interventions with fami-
lies who face severe psychosocial risk such as family violence.
Keywords Parenting program evaluation . Intervention with
abused mothers . Prevention of child abuse . Poly-victimized
children
Family violence is an international phenomenon that consti-
tutes a serious risk factor at any stage of human development
and is also a violation of human rights. Children and women
P. C. Pereira
Centro Universitário FAFIBE, LAPREV (The Laboratory for
Violence Analysis & Prevention), Federal University of São
Carlos, São Carlos, Brazil
S. M. D’Affonseca (*) : L. C. A. Williams
Laprev—Laboratory for Violence Analysis & Prevention,
Departamento de Psicologia, Universidade Federal de São Carlos,
Rodovia Washington Luis km 235,
São Carlos, SP 13565-905, Brazil
e-mail: samazo@hotmail.com
are the most frequent targets of this phenomenon. Studies
conducted in Brazil have shown that the prevalence of phys-
ical violence against women varies from 26.4 % to 44.8 % in
different regions of the country (D’Oliveira et al. 2009; Moura
et al. 2009). The perpetrator is usually the woman’s partner or
someone close from her family, and often male (i.e., father,
brother, uncle, etc.). Violence against women may have sev-
eral negative consequences for victims, such as high levels of
depression, suicidal ideation, alcohol and/or drug addiction,
posttraumatic stress disorder, chronic anxiety, frequent somat-
ic complaints, irritation, sleep and/or eating disturbances, low
self-esteem, passivity, and extreme dependency (Whitaker and
Lutzker 2009).
Studies have shown a high correlation between the exis-
tence of violence against women and the occurrence of vio-
lence against children (Appel and Holden 1998; Capaldi et al.
2009; O’Leary and Woodin 2006). According to O’Leary et
al. (2000), the correlation between intimate partner violence
(IPV) and child abuse is higher than 50 % in clinical samples.
Stith and McMonigle (2009) mentioned that father-to-child
physical abuse is often associated with the occurrence of
husband-to-wife physical abuse. Brazilian studies on child
physical abuse have suggested that mothers perpetrate this
type of violence more than fathers (Azevedo and Guerra
2001; Pinheiro and Williams 2009), but the literature is still
unclear about this issue, indicating that perhaps the violence
intensity is higher when perpetrated by the father.
Studies on IPV victims’ parental practices have stressed
the difficulties of many mothers in raising their children
(Damant et al. 2010; Doyle and Markiewicz 2005; Finger
et al. 2009; Holt et al. 2008; Hughes and Huth-Bocks 2007;
Kelleher et al. 2008; Levendosky et al. 2006; Renner 2009;
Rossman and Rea 2005; Taylor et al. 2009; Zerk et al.
2009). Mothers who experience IPV may present an inade-
quate parenting style that includes insufficient surveillance,
lack of control over their children’s behavior, lack of
6 J Fam Viol (2013) 28:5–15
warmth and support, inconsistency, and displays of aggres-
sion or hostility (Sleek and Staff 1998). In addition, children
of IPV mothers often have behavioral problems, anxiety,
and poor academic achievement (Capaldi et al. 2009;
Dahlberg and Simon 2006; Doyle and Markiewicz 2005;
O’Leary and Woodin 2006; Rossman and Rea 2005).
A mother may not be able to protect her children at times,
because she herself is a victim of family violence. She may
also face other adversities, such as living in poverty or being
a single parent, factors which can contribute to becoming
abusive toward children (Holt et al. 2008; Williams 2010).
According to the literature, IPV mothers present an inade-
quate parental style (Damant et al. 2010; Doyle and
Markiewicz 2005; Kelleher et al. 2008; Rossman and Rea
2005), as such was the model received from their family of
origin. Therefore, it is important to have protection mecha-
nisms to help these women, such as special laws and inter-
vention programs. Since the 1980s, authors have argued that
preventing violence against women also prevents child
abuse, because a mother’s own safety reflects in the protec-
tion of her child, even if indirectly (Sinclair 1985).
Given these facts, the high correlation between families’
characteristics and antisocial and inappropriate behavior in
children is not surprising. Finally, attention should also be
given to the fact that some children have suffered multiple
forms of abuse, known as poly-victimization. According to
Finkelhor (2008), although there has not been a great deal of
research yet on this matter, there may be several pathways
by which children arrive at additional victimization. Thus, it
is important to target parents of such children through flex-
ible, culturally sensitive interventions.
Intervention programs for parents have been recognized
as the most effective strategy in preventing and minimizing
behavior problems (Patterson et al. 2002; Webster-Stratton
and Hammond 1997). Several studies in the literature have
described and evaluated parenting programs with solid the-
oretical and practical results, namely the Oregon Model of
Parent Management Training (Patterson et al. 1992, 2002),
Incredible Years (Webster-Stratton et al. 2004), and the
Triple P – Positive Parenting Program (Sanders et al. 2003).
A recent review indicated that most Brazilian parenting
programs assessed interventions targeted to parents of chil-
dren with behavioral problems (Rios and Williams 2008). In
contrast, the Parceria Project, to be described subsequently,
initially targets IPV mothers rather than the children. The
Parceria Project was developed because there are still no
standard, evidence-based parenting interventions in Brazil,
and there are limited published studies about parent inter-
vention evaluations. In addition, when the Parceria Project
was developed, there were no published studies in North
America teaching mothering skills to IPV victims.
A recent review conducted by D’Affonseca and Williams
(2011) identified one study, the Support Project, conducted
by Jouriles et al. (2009). This project targeted mothers and
children who had recently sought refuge at domestic vio-
lence shelters, with children ages 4 to 9 exhibiting clinical
levels of elevated externalizing problems (e.g., disruptive,
defiant behaviors). Sixty-six families (mothers and children)
with at least one child exhibiting clinical levels of conduct
problems took part in the study, and they were randomly
assigned to either the Project Support intervention or the
existing intervention in the shelter. The Project Support
intervention involved: (a) teaching mothers child manage-
ment skills, and (b) providing instrumental and emotional
support to mothers. The families were assessed on six occa-
sions over 20 months following their departure from the
shelter. Results showed that children in families in the
Project Support condition, compared with those who did
not have this condition, exhibited greater reductions in con-
duct problems. Mothers in the Project Support condition
compared with those in the comparison condition displayed
greater reductions in inconsistent and harsh parenting
behaviors and psychiatric symptoms. Changes in mothers’
parenting and psychiatric symptoms accounted for a sizable
proportion of Project Support effects on child conduct prob-
lems at the end of treatment. Some limitations of the study
were noted, such as the small number of participants, the
need for additional replication, considerations about the
feasibility and utility of this particular intervention in com-
munity settings without university involvement, and gener-
alization of the gains to other settings.
The Laboratory of Violence Analyses and Prevention
(LAPREV) at the Federal University of São Carlos, Brazil
has evaluated intervention programs designed for parents of
children with behavior problems and physically abusive
parents, in addition to training teachers and institutional staff
within a cognitive-behavioral perspective (Williams et al.
2009). Among such projects, the Parceria (Partnership)
Project is a research-based intervention program aimed at
teaching mothering skills to women with an IPV history,
with the goal of preventing behavioral problems in children
exposed to domestic violence (Williams et al. 2012). The
Parceria Project involves two units with corresponding man-
uals: the first focused on the mothers examining their own
violence history and learning coping strategies to prevent
violence; and the second unit geared towards parenting
skills.
The Parceria Project adopts a cognitive-behavioral model
employing techniques such as discussions based on written
manuals, relaxation training, social problem-solving, and
homework. It was developed with a grant from CNPq
(Brazil’s National Research Council) and tested initially in
a pilot study (Williams and Araújo 2009). Twelve mothers
with IPV experience and their children ages 4–12 years were
recruited from a shelter, from the judicial system, and from
other agencies; however, only seven women remained until
J Fam Viol (2013) 28:5–15
the end of the intervention. A pre- and post-test design with
a 3-month follow-up was employed using multiple instru-
ments to measure the mother’s depression (Beck Depression
Inventory [BDI]; Beck et al. 1979); the mother’s abuse
potential (Child Abuse Potential Inventory [CAP]; Milner
1994); the mother’s parenting style, assessed by the mother
and the child (Inventário de Estilos Parentais [IEP]; Gomide
2006), and the target child’s behaviors (Strengths and
Difficulties Questionnaire [SDQ]; Goodman 1997).
Besides the self-evaluation measures, observational data of
mother-child interaction was also collected in three sessions
at a university house-replica laboratory equipped with dig-
ital recording cameras and one-way mirrors, using a proto-
col adapted from the Triple-P Program (Sanders et al. 2003).
Observational data gathered before the intervention
(Williams and Araújo 2009) showed the same pattern of
difficulties for all seven mothers in praising their children.
In addition, two of the mothers reacted to their child’s
misbehavior by yelling, complaining, and being verbally
abusive. Although post-intervention observational changes
were unremarkable, participants showed marked improve-
ment in all instruments, lowering abuse potential and de-
pression, as well as improving target children’s behaviors.
After the encouraging initial results of the Parceria
Project, Santini (2011) tested the assumption that the order
of presentation of the units would affect the results of the
intervention, comparing the efficacy in three groups: (a)
Unit 1 followed by Unit 2, (b) Unit 2 followed by Unit 1,
and (c) Units 1 and 2 conducted simultaneously. Nine moth-
ers and their children with IPV experience completed the
BDI, CAP, and IEP (mother’s version only), as in the pilot
study. In order to account for the small number of partic-
ipants (three mothers per group), a nonrandomized clinical
trial with intragroup comparisons over time was employed,
using daily self-report measures by mothers (Williams
2010) of sense of well-being and sense of parental compe-
tence. All mothers showed general improvement, but com-
parison of score results indicated that both units
(psychotherapeutic and educational) applied simultaneously
had better results than when applied sequentially.
Participants showed more progress when they had a session
covering IPV topics interspersed with a parenting session.
One possible explanation is that mothers are eager to discuss
their children’s difficulties and do not want to wait 2 months
to start learning about behavior management. However, they
also have personal issues to address, and thus, when units
were used sequentially, they were not as effective as when
applied together.
Although the Parceria Project was designed to help moth-
ers with an IPV history, the authors found that it would be
feasible to implement the Parceria Project with vulnerable
mothers of poly-victimized children via home visitation.
Thus, the objective of the present study was to evaluate
7
Project Parceria with mothers of children who had multiple
forms of maltreatment (poly-victimization), as it was
expected that most of the mothers would also have a history
of IPV.
Method
Participants
17 Brazilian mothers and their respective 17 children living
in extreme poverty took part in the intervention. The moth-
ers’ ages ranged from 29 to 54, they had an average of
2.8 years of schooling, most lived in common-law relation-
ships, and only seven were employed. The 17 families were
involved with the judicial system in Brazil, as their children
had previously experienced different types of maltreatment:
one had suffered sexual violence by an uncle; another had
suffered sexual violence by a family’s friend as well as
physical violence from both parents; eight experienced
physical violence from both parents; six suffered physical
violence from fathers exclusively, and one experienced
physical violence from the mother only. In addition, 15
adolescents were also exposed to marital violence, as moth-
ers had been victimized by current or past partners. The
adolescents were mostly male (n09), with ages ranging
from 12 to 16, and with an average of 7.1 years of
schooling.
Measures
Initial Interview with Victims of Domestic Violence The
Initial Interview with Victims of Domestic Violence
(Williams 2010) is a semi-structured interview guide that,
in addition to violence history, identifies socioeconomic
data and problems faced in child-rearing.
Daily Rating Forms of Sense of Parental Competence and
Sense of Well-Being The Daily Rating Forms of Sense of
Parental Competence and Sense of Well-Being (Williams
2009) is a record sheet that mothers completed daily and
returned on a weekly basis to assess the two variables on a
1–10 scale. For example, mothers were told to rate as a 10 a
day in which they felt extremely competent in their mothering
skills, 5 when feeling average as a parent, and 1 when they felt
like “the worst mother ever.” Likewise, a 10 was given for
feeling extremely happy, 5 for an average feeling of well-
being, and 1 for feeling extremely down. This instrument
was given to mothers for the first time 1 week prior to the
intervention beginning (baseline measure). As six mothers
were illiterate, five of these women asked one of their children
to help fill in the daily records. These children were trained by
the first author to complete the forms, with the
8 J Fam Viol (2013) 28:5–15
recommendation to make reliable daily scoring of sheets. The
sixth mother who could not read was able to discriminate
numbers, and so she filled out the rating form by herself.
The analysis of Daily Rating Forms was based partially on
methodological suggestions by Borckardt et al. (2008).
Parental Style Inventory The Parental Style Inventory (IEP;
Gomide 2006) is an instrument developed and widely used
in Brazil, containing 42 items related to seven parenting
practices: two positive items (positive monitoring and moral
behavior), and five negative items (inconsistent punishment,
negligence, overindulgence, relaxed discipline, negative su-
pervision, and physical abuse). Each parenting practice do-
main has six questions. In addition to mothers, children also
assessed their own mothers’ parenting style with the IEP
Child’s Version form.
Child Abuse Potential Inventory The Child Abuse Potential
Inventory – Form VI (CAP; Milner 1986) is a 160-item,
paper and pencil questionnaire that was originally designed
to provide an estimate of parental risk in suspected cases of
child physical abuse. The CAP Inventory has a 3rd grade
reading level and is used internationally as a risk screening
tool in a variety of assessment situations. Individuals are
instructed to respond to each item by indicating whether
they agree or disagree with the item statement. The 160-item
CAP contains a 77-item child physical abuse scale and six
factor scales: (a) distress, (b) rigidity, (c) unhappiness, (d)
problems with child and self, (e) problems with family, and
(f) problems from others. In addition, subsets of the 160
questionnaire items have been used to develop two ‘special’
scales: (a) the ego-strength scale, and (b) the loneliness
scale. To detect response distortions, the CAP contains three
validity scales: (a) a lie scale, (b) a random response scale,
and (c) an inconsistency scale. The validity scales are used
in different paired combinations to form three validity in-
dexes: (a) the faking-good index, (b) the faking-bad index,
and (c) a random response index. If any validity index is
elevated, the abuse score may not be an accurate represen-
tation of the respondent’s ‘true’ abuse score. The Brazilian
version (Rios et al. 2012) of the CAP was used.
Strengths and Difficulties Questionnaire The Strengths and
Difficulties Questionnaire (SDQ; Goodman 1997) is a brief
behavioral screening questionnaire for children ages 4–
16 years. All versions of the SDQ ask about 25 attributes,
some positive and others negative. These 25 items are
divided between five scales: (a) emotional symptoms (five
items); (b) conduct problems (five items); (c) hyperactivity/
inattention (five items); (d) peer relationship problems (five
items); and (e) prosocial behavior (five items). The ques-
tionnaire was adapted for use in Brazil by Fleitilich-Bilyk
and Goodman (2001).
Considering that the average educational level of the moth-
ers was 2.8 years and the fact that six mothers were illiterate, it
was decided that all of the standardized instruments would be
read to them. Thus, the first author read the instructions for
completing the instruments (IEP, CAP, and SDQ) and wrote
the answers given orally by the participants.
With the exception of the Daily Rating Form, which was
completed daily, the other instruments were completed on
three occasions: (a) before the intervention, (b) immediately
afterwards, and (c) in a follow-up after 4 months.
Ethical Issues
The study was approved by the University Ethics Research
Committee. All participants signed informed consent forms
prior to the intervention. The first author read and explained
the consent form in detail, answering whichever questions
mothers raised. A fingerprint of the right thumb was used as
a signature for mothers who could not sign their names.
They also received a copy of the consent form and were
encouraged to ask additional people to read them the form
and confirm the information given by researchers.
Recruitment
The only inclusion criteria used was taking part in a study
by Pereira et al. (2009), which characterized the school
performance of maltreated children, whose families where
involved for that reason in the Brazilian judicial system.
From 20 original families of the previous study, three did
not take part in the present study; one mother was not found,
one mother had died, and one declined participation.
Procedure
Project Parceria took place in families’ homes rather than at
the university. The program involved two components: (a) a
Psychotherapeutic Unit to analyze and treat the effect vio-
lence may have had on the mothers’ lives, teach protective
strategies, assess the impact of violence on parenting, and
promote self-knowledge; and (b) an Educational Unit to
teach positive parenting skills. Two manuals were specifi-
cally developed: (a) A Life Free of Violence (Unit 1), with
topics such as the cycle of violence, human rights, violence
against women, and fighting depression; and (b) Positive
Parenting (Unit 2)1, including materials related to the im-
portance of praising children’s behavior, setting limits and
rules, teaching moral behavior, and teaching social skills. It
encompassed 16 weekly, 1-hour sessions, employing
1
The manuals may be downloaded from LAPREV’s website,
www.ufscar.br/laprev
J Fam Viol (2013) 28:5–15
techniques such as discussions based on the manuals, relax-
ation training, social problem-solving, and homework. The
manuals were read to participants during the weekly visits.
Results
All of the 17 mothers completed the intervention, which was
an encouraging result given the families’ vulnerabilities. All
mothers took part in post-intervention and follow-up meas-
ures except one, Mother 10 (M10). This mother was sup-
posedly arrested for drug involvement according to her ex-
partner, who then cared for the children.
Daily Rating Forms
Daily records were examined from two perspectives: (a)
analysis of individual records for Sense of Well-Being and
Sense of Parental Competence, and (b) comparative statis-
tical analysis of the group’s average before the intervention
(baseline), mid-way (after session 8), and at the end of the
intervention program (at the completion of session 16).
Table 1 presents the group’s average performance in the
daily forms according to Tuckey test comparisons in three
moments. Results for the mothers’ Sense of Well-Being
showed a significant positive difference from baseline to
mid- and post-intervention (p<.01). In contrast, mothers’
Sense of Parental Competence showed no significant effects
of the intervention program, according to the average of the
daily records by mothers (p00.258). Individual analysis on the
data showed that the mother’s ratings of Sense of Well-Being
were associated with Sense of Parental Competence, suggest-
ing that one influenced the other in a mutual way. As in the
study by Maia (2010), which used the same type of recording
with adolescent parents, analysis of satisfaction of participants
in daily marital and parental roles indicated in several cases a
mutual influence (self-correlation) between both systems.
Table 1 Group average perfor-
mance on rating forms (n017) Variable Phase
Maternal competence Baseline
8th week
16th week
Well-being Baseline
8th week
16th week
* p<0.01
9
Parental Style Inventory
The results of the self-assessment by mothers about their
own parenting style in three stages (pre-intervention, post-
intervention, and follow-up), as evaluated by IEP (Gomide
2006), are shown in Table 2. With the exception of M10,
who was not assessed at post-intervention and follow-up,
participants showed a significant positive difference in per-
centile scores, comparing pre- and post-intervention. Nine
mothers improved their parental style classification (moth-
ers 6, 8, 9, 11, 12, 13, 14, 16, and 17). When comparing
post-intervention with follow-up, 12 mothers maintained the
post-intervention data (mothers 1, 2, 3, 5, 7, 9, 12, 13, 14,
15, 16, and 17); three mothers showed further improvements
(mothers 4, 6, and 8); and only M11 returned to her baseline
level, probably due to severe stress faced by this mother –
she was a working-mother while her partner cared for their
five children. However, he developed some health compli-
cations that required surgery. He stayed at his mother’s
house during surgery recovery, and M11 had to take care
of the children alone. During the father’s absence, her older
child (a female) presented defiant behaviors towards M11,
spending long periods away from home (including over-
night periods). Child Protection Services suspected that her
older child was using drugs and that M11 was neglecting her
children, especially the two younger ones, who were then
temporarily sheltered.
Statistical analysis revealed a significant effect of the
intervention program for the IEP (Gomide 2006), with p0
0.001, according to the Friedman test. Figure 1 illustrates
IEP results graphically.
IEP scores regarding the children’s evaluation of moth-
ers’ parental style, both before and after the intervention
program, are shown in Table 3 (follow-up data were not
obtained). Statistical analysis of scores obtained by adoles-
cents in both phases revealed a significant difference (p0
0.018) according to the Friedman test, suggesting that
Average ± Standard Range CI1 (95 %) Value P
deviation
6.14±1.46 3–8.1
(−0.427; 1.322)
6.59±1.67 4.6–10 0.258
(−0.633; 1.386)
6.97±1.80 3.8–10
4.93±2.12a 1.3–8.4
(0.67; 3. 63)
7.08±1.88b 3.6–10 0.001*
(0.59; 1.00)
7.29+1.65b 4.6–10
10 J Fam Viol (2013) 28:5–15

Table 2 Results of mothers’

self-evaluation of parental style Parental style inventory – IEP

Mother Pre-intervention Post-intervention Follow-up

Classification Percentile Classification Percentile Classification Percentile

1 At Risk 10 At Risk 20 At Risk 25

2 At Risk 1 At Risk 5 At Risk 5
3 Low Average 35 Low average 35 Low average 40
4 At Risk 35 At Risk 20 Low average 45
5 Excellent 85 Excellent 80 Excellent 85
6 At Risk 20 Low average 50 High average 60
7 At Risk 5 At Risk 20 At Risk 25
8 At Risk 15 Low average 45 Excellent 85
9 At Risk 20 High average 60 High average 75
10 At Risk 5 x x x x
11 At Risk 5 Low average 35 At Risk 20
12 Low average 50 High average 55 High average 65
13 Low average 45 High average 55 High average 65
14 High average 55 Excellent 85 Excellent 80
15 High average 70 High average 75 High average 65
16 At Risk 20 Excellent 85 Excellent 80
17 At Risk 15 High average 75 High average 70
Average 65 52.5 20
Range 5–85 5–85 5–85
*p<0.05. x0mother was not Value p 0.001*
assessed

according to the children, mothers had improved their pa-
rental style after the intervention.
Comparing scores regarding the classification of moth-
ers’ parenting style assessed by children after the interven-
tion, there were nine positive improvements (mothers 1, 6,
7, 8, 12, and 17); five mothers remained with the same
classification (mothers 2, 3, 4, 5, and 9), and one child felt
that the mother had deteriorated (M10, the mother arrested
for drug involvement).
100%
64,70%
Strengths and Difficulties Questionnaire
The mean scores obtained by mothers in the SDQ
(Fleitilich-Bilyk and Goodman 2001; Goodman 1997), as
shown in Table 4, illustrate a favorable decrease in pre-
intervention to post-intervention. This suggests that after
the intervention, participants assessed their children’s men-
tal health in more positive ways, as measured in terms of
increased prosocial behavior, as well as decreases in behav-
ior problems, hyperactivity, emotional problems, and prob-
lems in peer relationships. This decrease in scores changed
Excellent Low-Average
the classification from Abnormal to Normal for four partic-
High Average Risk
ipants (mothers 1, 6, 7, and 9). At follow-up, the same

80%
classification was maintained for all but three participants
(mothers 6, 7, and 9).
The change in SDQ scores indicated that the intervention
37,50%

60%
had a positive effect (p00.001), as evidenced by a marked
reduction in scores.
18,70%

25%
17,60%

25%

25%
25%

40%
12,50%
11,80%

Child Abuse Potential

5,90%
5,90%

20%

Statistical analysis of the results obtained with the CAP

0% Inventory (Milner 1986) revealed no significant differences
Pre Post Follow-up
comparing the three data collection times (pre-, post-
Fig. 1 Percentage of IEP scores throughout the study intervention, and follow-up), suggesting that the intervention
J Fam Viol (2013) 28:5–15 11

Table 3 Results of children’s evaluation of IEP

Parental style inventory (IEP)

Adolescents Type of violence Pre-intervention Post-intervention

Classification Percentile Classification Percentile

1 Physical and psychological At Risk 15 High average 75

2 Physical, psychological and neglect At Risk 25 At Risk 25
3 Sexual, psychological and neglect At Risk 15 At Risk 15
4 Phyical Low average 30 Low average 30
5 Sexual At Risk 10 At Risk 15
6 Neglect Low average 50 High average 75
7 Physical and psychological At Risk 10 Low average 50
8 Physical, psychological and neglect At Risk 15 Excellent 80
9 Psychological High average 65 High average 55
10 Physical, psychological and neglect Low average 35 At Risk 25
11 Neglect At Risk 10 At Risk 10
12 Neglect Low average 40 High average 70
13 Physical and psychological At Risk 1 Low average 50
14 Neglect Low average 30 Excellent 80
15 Physical Low average 30 High average 55
16 Physical and psychological Low average 30 High average 55
17 Sexual At Risk 25 Low average 50
Average 25 50
Range 1–65 10–80
Value p 0.001*

* p<0.05

program did not produce positive effects on the index of
potential abuse of the participants.
The scores of the three validity scales (Faking Good
index, Faking Bad index, and Random Response index)
are shown in Table 5. Based on the cutoff scores presented
by Rios et al. (2010), the average scores at the three meas-
urements are above the original cutoff scores for scales of
the Faking Good index and Inconsistency.
Discussion
The purpose of this study was to evaluate the feasibility of
Project Parceria with mothers of poly-victimized children, a
group of children who are a recent topic of concern in the
literature, as proposed by Finkelhor (2008). Fifteen out of
17 mothers were also victims of IPV, as only mothers 5 and
11 did not have this type of victimization in the past. This
aspect is consistent with studies that show a high correlation
between IPV and child abuse (Appel and Holden 1998;
Capaldi et al. 2009; O’Leary and Woodin 2006).
The pre-intervention assessment showing that almost all
mothers (except M5) had poor parenting skills according to
the mothers as well as their children, is consistent with the
literature that highlights that women with an IPV history
often present an inadequate parental style (Damant et al.
2010; Doyle and Markiewicz 2005; Finger et al. 2009; Holt
et al. 2008; Hughes and Huth-Bocks 2007; Kelleher et al.
2008; Levendosky et al. 2006; Renner 2009; Rossman and
Rea 2005; Taylor et al. 2009; Zerk et al. 2009). Almost half
of the children had some type of behavior problem before
the intervention, as measured by SDQ, a finding that is also
consistent with the literature (Capaldi et al. 2009; Dahlberg
and Simon 2006; Doyle and Markiewicz 2005; O’Leary and
Woodin 2006; Rossman and Rea 2005). The mothers’ initial
difficulties in positive parenting reflect the challenges of
living with other adversities besides IPV, such as living in
extreme poverty (Holt et al. 2008; Williams 2010).
Overall data showed that mothers’ parental behaviors and
children’s behavior problems were positively affected by the
intervention, as in the previous studies using the same
procedure (Santini 2011; Williams 2010). Mothers’ daily
evaluations indicated that there was a significant increase
in the records of mothers’ Sense of Well-Being after the
intervention, which was maintained during the follow-up
and was associated with Sense of Parental Competence. In
12 J Fam Viol (2013) 28:5–15

Table 4 Results of strengths

and difficulties questionnaire Strengths and difficulties questionnaire (SDQ)
scores
iMother Pre-intervention Post-intervention Follow-up

Classification Pontuation Classification Pontuation Classification Pontuation

1 Abnormal 17 Normal 11 Normal 11

t2 Abnormal 31 Abnormal 22 Abnormal 27
3 Normal 13 Normal 7 Normal 10
4 Normal 8 Normal 5 Normal 4
5 Normal 7 Normal 4 Normal 6
6 Abnormal 18 Normal 13 Borderline 14
7 Abnormal 21 Normal 13 Borderline 16
8 Normal 12 Normal 12 Normal 9
9 Borderline 16 Normal 13 Borderline 14
10 Abnormal 19 x x x x
11 Abnormal 19 Abnormal 17 Abnormal 17
12 Normal 12 Normal 3 Normal 6
13 Borderline 16 Borderline 14 Borderline 16
14 Normal 8 Normal 4 Normal 5
15 Normal 12 Normal 11 Normal 12
16 Abnormal 26 Abnormal 19 Abnormal 21
17 Normal 10 Normal 5 Normal 7
Median 16 11.5 11.5
Range 7–31 3–22 4–27
CI (95 %) (−6; −3) (0.5; 2.5)
Value p 0.001*
* p<0.05. x0mother unavailable

addition, a significant improvement in parenting style was
indicated by the mothers’ assessments, as well as (and most
importantly) according to their children’s evaluation.
Finally, a significant decrease in mothers’ perception of
problems related to their children’s mental health was also
found. These results seem to suggest that when mothers feel
good about themselves, they are able to use positive parent-
ing and deal with their children’s misbehaviors in a more
productive way.
It is worth noting that despite participants’ improvement
in the assessments of parental style and child behavior
problems, the mothers did not improve their child abuse
potential, as measured by CAP. In other words, the inter-
vention seemed to be effective in improving parental behav-
iors and child behavior problems, but it did not seem to
affect abuse potential. Caution regarding this data must be
taken, because CAP’s Brazilian version is still in its valida-
tion phase (Rios et al. 2012). Thus, in the absence of
Brazilian norms, the U.S. original norms were used, which
implies that some cultural considerations may have affected
the results.
Another point that should be mentioned is that given the
mothers’ low educational level, the CAP was presented in
an oral interview mode. Since researchers read the items for

Table 5 CAP validity scores

Child abuse potential inventory (CAP)

Validity scales

Pre-intervention Post-intervention Follow-up

Median SD Median SD Median SD

Faking good 12.4 3.93 10.6 3.33 10.7 3.47

Faking bad 4.1 1.65 3 1.26 2.6 1.2
Inconsistency 6.8 1.97 6.8 2.45 5.8 1.86
J Fam Viol (2013) 28:5–15
the participants, this may have affected the validity scores
(appearance of high scores for the Faking Good scale), as
participants may have been more inclined to give socially
acceptable answers in order to avoid censorship from the
applicator. According to Milner (1986), there are no empir-
ical data on the effects of the application inventory as an
interview, but in doing so, the researcher should read the
items aloud, without offering explanations, advice, or com-
ments, and the application must occur in privacy – proce-
dures that were followed in this study. Similar results with
CAP validity scales were found in studies by Bergamo
(2007) and Patrian (2009), which were also conducted with
the same interview format in Brazil. A final consideration is
that the mothers complained about the length of the instru-
ment and its repetitive questions, expressing some discom-
fort when completing it – a variable that may be associated
with their low educational level.
One result that should be highlighted is the mothers’
adherence to the intervention program. All of the mothers
had 100 % attendance, which is an important aspect given
that studies designed for high-risk families often show low
participant adherence to intervention programs. In the pres-
ent study, in addition to exposure to IPV (in 15 cases), the
17 poly-victimized children had other risk factors for child
abuse, such as severe poverty, large families, low maternal
education, and alcohol and/or drug use by some of the
parents. In spite of such stressors, all mothers completed a
fairly long (4-month) intervention program.
A strong alliance with the researcher, measured by qual-
itative appraisals from the mothers, may have contributed to
program adherence, as mentioned by Lambert and Barley
(2002). Other strategies employed that may have contribut-
ed to intervention adherence included: (a) flexibility to set
up alternative meeting dates for sessions when the partici-
pant could not attend (which rarely happened); (b) familiar-
ity with the researcher who knew the families from his
judiciary practice as a forensic psychologist as well as a
previous study (Pereira et al. 2009); (c) phone calls between
sessions to monitor difficulties and progress; (d) additional
home visits for crisis intervention as needed; and (e) access
to the researcher’s mobile phone for emergency calls.
Finally, the fact that the intervention took place in the home
environment is an important variable, as the literature has
indicated that this strategy is useful in facilitating program
adherence (Wasilk and Bryant 2001). The manuals used in
the intervention program were also found to be visually
attractive and helpful by the mothers.
Thus, the mothers’ participation and the improvement
demonstrated by scores in the assessment tools revealed that
despite adversities in the family, notably family violence
and poverty, it is possible to develop effective intervention
programs with vulnerable families covering IPV topics,
child abuse, and positive parenting practices. Other
13
intervention studies conducted with this population have
shown similar results in Brazil (Rios et al. 2010; Santini
2011; Williams 2010)
As these initial results suggest, the Parceria Project
(Williams et al. 2008a, b) may be an efficient and effective
program for tertiary prevention of IPV and child abuse, since
it addresses two problems experienced by women victims of
violence: (a) the effects of violence victimization by moth-
ers, and (b) the difficulties experienced in managing child-
ren’s behavior. It is worth noting that the project may be
applied in different contexts (clinical environment and par-
ticipants’ home). Santini’s (2011) data showed that when the
two units were applied simultaneously, mothers had better
results than when the units were applied sequentially. Future
studies should try this strategy while expanding the sample
of participants and using randomized control groups.
Despite the encouraging results, there are several meth-
odological limitations in this study: (a) a fairly small number
of participants, (b) the absence of a randomized control
group that could have functioned as comparison, and (c)
the absence of mental health measures from the child’s point
of view. Future studies should evaluate the program in larger
samples, comparing the intervention context (clinic vs.
home), and the maintenance of positive results considering
the stressors these families are exposed to, which can make
them more vulnerable to violence.
Acknowledgments This paper is part of the first author’s Ph.D.
dissertation conducted at Universidade Federal de São Carlos. A sim-
ilar version of the study was presented at the 2nd International Con-
ference on Child Abuse and Neglect, Porto, Portugal, May, 13–14,
2011.
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