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“Like an Equal, Somehow” – What Young People Exposed to Family Violence Value in Counseling

  • Åsa KällströmEmail author
  • Sara Thunberg
Open Access
Original Article

Abstract

One way for young people to reduce the risk of problems associated with having experienced family violence is to talk about their experiences with a counselor. However, little is known about how young people judge the quality of such relationships. The aim of this study was to analyze what young people describe as valuable in their relationship with the counselor with whom they talked about experiences of family violence. Fourteen semi-structured interviews with nine young people between the ages 12 and 19 years were analyzed using a thematic method. The participants were recruited within an evaluation of a treatment program in Sweden. The thematic analysis revealed four distinct themes about what the young people described as particularly valuable aspects of the counseling relationship: the opportunity to talk, a model for other relationships, and going “in and out of” the topic of violence, which was valued by the younger teenagers; and being listened to “almost like an adult,” which was valued by the older teenagers. The abstracted common thread was the importance for the young people of feeling equal to others somehow. The quality of the relationship between helper and helped is of central importance for young people and what specifically, from young people’s point of view, constitutes such quality for younger and older teenagers respectively. The results indicate the benefit of counselors being especially flexible with young people exposed to violence and being able to establish trustful relationships with them.

Keywords

Young people Children witnessing intimate partner violence Domestic violence Qualitative research Children’s accounts 

Introduction and Literature Review

Children and young people can experience violence by one parent against the other for shorter or longer periods in their lives. Although both mothers and fathers may be perpetrators of such violence, most research indicates that fathers’ violence against mothers constitutes a more severe risk to young people than the reverse (e.g. Miller et al. 2014). It is well known that experiencing such violence during childhood increases the risk of developing emotional or psychological problems such as depression or post-traumatic stress, as well as behavioral and relationship problems (Holt et al. 2008; Kitzmann et al. 2003). Many children and young people hide their “secret” from everyone, because if others found out, the shame would be devastating, and one possible result of living with the shame that family violence entails for many children, is that their self-esteem is damaged (ibid.).

Violence against their mother seems to affect teenagers’ psychosocial health less than younger children’s, perhaps because teenagers are better able to avoid the violence, or have more emotional distance to their parents (Levendosky et al. 2002). However, there are indications that experiencing violence in one’s parents’ relationship during early childhood can have consequences also in one’s teenage years and even in early adulthood (Cater et al. 2015; Moylan et al. 2010).

If, how, and how much a young person reacts to being exposed to violence in the parents’ relationship varies. Some seem able to muster the resilience to deal with violent experiences and thereby overcome their experiences without long-term damage to their mental development (Howell et al. 2010; Levendosky et al. 2002). The risk that the young people’s mental and psychosocial health and development will be adversely affected increases with the seriousness of the violence they have experienced and the length of time that it has persisted (Kitzmann et al. 2003). Family violence often includes violence against the children, which also increases the risk of negative consequences for them (Annerbäck et al. 2012). Also, a full understanding of children’s experiences of family violence needs to include not only physically violent incidents, but also forms of coercive control woven into daily life (Katz 2016).

However, young people are not mere passive victims of family violence, but their understanding of what has happened also influences the impact of the violence in their lives (Graham-Bermann et al. 2017). How young people interpret and understand their experiences of violence in their parents’ relationship can be influenced by their talking to other people. One way to reduce some of the problems mentioned above is therefore to give young people the opportunity to talk about their experiences (Cohen et al. 2011; Graham-Bermann et al. 2011). For example, social workers can offer counselling. However, not all children and young people are helped by such interventions (Broberg et al. 2011).

Howe (2008) emphasizes that good relationships between social workers and clients are in fact a central part of such changes in people’s lives life that social work is aimed at. Trevithick (2003) believes that just for this reason, social workers need a theoretical understanding of the importance of building and maintaining good relationships with clients as well as an ability to translate this knowledge into practice. The importance of the quality of the relationship between helper and helped for the outcome of interventions for young people seems robust and consistent (Shirk and Karver 2003). However, what actually constitutes “quality” depends on subjective conceptions, and little is known about how young people judge the quality of such relationships. Particularly, as most of the studies cited above are quantitative in nature, research based on qualitative accounts of young people is needed to better understand their experiences of family violence and post-violence growth.

Against this background, the aim of this study is to use young people’s narratives to analyze what they express as valuable in their relationship with the counselor with whom they talked about their experiences of family violence.

The Significance of the Teenage Life Phase in Counseling after Experiences of Violence

During their teenage years, people progress towards adulthood by developing more autonomy and responsibility, and shape their identity by consolidating their cognitive abilities and achieving social privileges (Geldard et al. 2016; Herman 2012). An important factor influencing this development is the emotional responses of others (Geldard et al. 2016; Herman 2012). However, the relationship between an adult counselor and a young victim of abuse can be quite unequal (Cater 2014). What young people themselves deem important in talk-based interventions offered to them is therefore particularly important.

The teenage years are increasingly being divided into and described in terms of narrower age ranges, with differing expectations from society in relation to maturity and proximity to adulthood (Steinberg 2008; Geldard et al. 2016). For example, older teenagers are attributed more responsibility for their well-being than younger teenagers, for whom that same responsibility is primarily attributed to their parents (Geldard et al. 2016; Steinberg 2008). Therefore, analyses of what young people value in counseling relationships must take age into consideration.

The teenage years are also the time for developing a gender identity. Some literature claims that men, in contrast to women, are prone to ignore, deny or suppress their emotions (Burcar 2005). In line with this, some research has found that women often use emotion-focused strategies to seek support or express their feelings in the context of social relationships, while men tend to handle their experiences through avoidance, distancing or distraction (e.g. Copeland and Hess 1995). Nolen-Hoeksema and Aldao (2011), however, found no such gender differences. In line with the latter, Burcar (2005) shows that young men want support, albeit not necessarily the kind of support that the service providers offer. For example, they want more practical help. Thus, gender also needs to be taken into consideration in analysis of what young people value in counseling relationships.

Based on the research presented above, we argue that young people’s descriptions of what they deem valuable in their relationship with a counselor need to be understood in relation to the vulnerability that exposure to violence entails, but also what it means to be on the verge of changing from a child, dependent on the parents who exposed them to violence (and on other adults), into an adult (Uprichard 2008; Geldard et al. 2016). Such understanding also requires recognizing the possible importance of age and/or gender, both of which are included in the present study.

Method

This article is based on qualitative interviews conducted within an evaluation of the Staircase Model (Trappan-modellen), a counseling model for children and young people who have experienced violence in their parents’ relationship, but who have not necessarily reached a specific risk level or developed any specific symptoms (Arnell and Ekbom 2010; Cater 2009). The Staircase Model was developed by Save the Children, and is described in a handbook by Arnell and Ekbom (2010). The model consists of individual crisis counseling with the goal to give young people an opportunity to deal with their traumatic experiences, preferably after the threat has ended. It can be offered at a shelter, by an NGO or by public social services. The model consists of 3–8 individual sessions of 30–60 min each, during which the manual allows flexible use of the suggested themes.

During the course of a year, all children and young people aged 4–19, voluntarily enrolled in Staircase Model counseling at a public social work unit that offers support and help to children and young people, were included in the study, resulting in a total of 36 participating children and young people. On two occasions, directly after having participated in the counseling, and one year after the counseling ended, all the children and young people were invited to take part in semi-structured interviews using open questions about the counseling. These interviews aimed to identify the children’s perceptions and elicit their descriptions of the counseling. In this article, focusing on understanding the specific experiences and views of teenagers, the interviews with all nine young people over 12 years of age are used to analyze what they express to be valuable in their relationship with an adult counselor, most of whom trained social workers.

Participants

This study includes four boys and five girls, who were 12–19 years old at the time of the first interview, and who were interviewed on one or both occasions. The boys were 14 years old on average and the girls 17 years. The analysis is based on 14 interviews; one of the boys and three of the girls only participated in the first interview, while three boys and two girls also participated in the second interview. (Thus, in total, nine interviews were made immediately after completion of the counseling, and five a year later.) This article does not aim to compare what the young people said directly after the counseling with what they expressed a year later. However, as both interviews include questions about the counselling relationship, the interviews from both occasions are used together (for those young people who were interviewed twice) to form a more comprehensive basis for the analyses.

Procedure

The study procedure was approved by the regional Board of Research Ethics (dnr removed for blinded review) and followed the ethical principles recommended for projects within the social sciences. However, including children in vulnerable situations such as having experienced violence in research requires special attention to research ethics (Cater and Överlien 2014). The criteria for including children and young people in the intervention were that they: (1) had experienced violence against their mother by her partner, and (2) were 4–19 years of age.

Cater and Överlien (2014) argue that some circumstances may make the issue of consent particularly complicated in research involving children exposed to domestic violence. On the one hand, initial contact may need to be made with the children’s legal guardians to help the child feel at ease in talking about the issues in an interview situation. On the other hand, if the perpetrator and/or victim is the child’s legal guardian(s), the child’s participation may be obstructed either by a perpetrator not acknowledging the violence as such, or by a victim or other adult wanting to protect the child from such issues. Therefore, demanding consent from only the victimized parent may put the child at risk when/if the perpetrator finds out about his/her child’s participation in a research project focusing on what he/she has done. On the other hand, a child could also be put at risk by a researcher asking for consent from the perpetrator. This is a difficult dilemma. In this study, before beginning counseling, all the children (if 15 years of age or older) or their mothers (if the child was under 15 years) were briefly informed about the study by staff at the unit, and asked if they would like more information. If so, the researcher informed them about the study in more detail.

After considering the advisability of participation, children 15 years or above declined or consented, while mothers of children under 15 years declined or consented on their child’s behalf. The place and time for an interview was then decided upon based on their preference. The children under 15 years of age were informed about the study and invited to participate with their mother present and gave their consent orally. Before the interview a written consent form was signed by the young person (15 years of age or above, as this is the age for legal consent according to Swedish law) or mother. All the children and young people were informed of their right to terminate their participation in the study at any time. Although all of those who were asked agreed to participate at that stage, it was not always possible to implement interviews after the counseling, for practical reasons or because the young person (or mother) preferred to discontinue participation in the study.

In the one-to-one interviews, a semi-structured interview guide with open questions was used. The interviews included questions such as: Can you tell me what the counseling has meant for you? Is there anything that has become harder or easier for you since you went through counseling? Was there anything in particular that [the counselor] said or that you did together that made a difference for you? The young people’s descriptions were clarified and deepened through openly formulated follow-up questions based on what the young people had said and how they had expressed themselves earlier in the interview (cf. Greig and Taylor 1999; Korkman et al. 2008). The interviews were conducted by the first author, who is a trained social worker and an experienced child interviewer for research purposes. The interviews took place in a quiet and separate room at the unit or in the child’s home, depending on the child’s (or mother’s, if the child was under 15 years) wish. Mothers of children under 15 years of age were invited to stay in an adjacent room during the interviews, but none did so in the sample used in this study. The interviews were not audio-recorded, but written down by the interviewer during the interview. Although key formulations were read out loud to the informant to ensure that transcription was accurate, the citations in the results section should be read with this in mind.

Analysis

The interviews were analyzed using thematic analysis focusing on the content of the interviews (cf. Braun and Clarke 2006). The thematic analysis was used to develop a better understanding of what young people with experiences of family violence value as important in a counselling relationship and aimed at strengthening the trustworthiness of results by including a kind of inter-coder reliability process. Therefore, the authors conducted the analysis both separately and together, using the following steps: First, both authors familiarized themselves with the data and noted initial ideas. Second, the first author generated initial codes by identified data that in some way provided answer to the study aim and collated these codes into themes. Third, the co-author used these themes and coded the interviews again. Fourth, both authors reviewed and discussed the themes, and a new theme emerged, leading to a new coding by the co-author. Fifth, the first author checked the analysis and agreed with the results. Sixth, the results were then controlled for gender and age of the participants to investigate similarities and differences between the participants. Then, the results were discussed a further time by the authors. The analysis resulted in four overall themes concerning both general aspects of talking about violence with a counselor and specific aspects of talking (and listening) in a counseling situation. The final phase of analysis included looking for what the themes have in common to identify an abstracted common content.

Results

All of the young people expressed positive experiences of talking about the violence with a counselor. However, talking about the violence was not easy, and several described it as painful. This is understandable, as one of the most common symptoms of post-traumatic stress is attempting to avoid anything that reminds one of the traumatic event (Connor et al. 2014). Therefore, assistance with overcoming the impulse to avoid talking about the event may be necessary in order to enable someone to put it behind them.

Within the positive, yet painful, experiences, four distinct themes could be identified in the interviews, based on what the young people described as particularly valuable about the counseling relationship they had participated in. Two concerned more general aspects of talking, and two concerned specific aspects of the nature of talking (and listening) within the counseling relationship. The opportunity to talk and a model for other relationships were valued by all age-groups, while going “in and out of” the topic of violence was valued by the younger teenagers, and being listened to “almost like an adult” was valued by the older teenagers.

The Opportunity to Talk

The first theme is constituted by descriptions of the general value of having someone to talk to about the violence. These descriptions thus provided an understanding of what talking within the counseling relationship meant for the young people. Many described that talking about the violence had helped them not to think about it so much:

You become a bit empty when you’ve told someone [about the violence], and it feels a lot better, I think. […] Because if [the thoughts] are in here you think about them all the time, but if you tell someone, you forget after a while, you don’t think about it. (Boy 15 years)

The young people described it as a relief and a pleasure that now, after the counseling, they no longer have to think about the violence all the time.
The value of talking within the counseling relationship was explicitly described by some young people in relation to the lack of other such sources of support:

The talks were good because I haven’t talked about it with so many other people. Being able to talk made it less painful. The more you talk, the less it hurts. (Girl 19 years).

The young people thus expressed gratitude for not having to go around thinking about the violence and feeling sadness and pain.

Some also described how, previously, things could happen that would make them start thinking about the violence and feel bad, but that after the counseling they are relieved to discover they can handle such events without thinking about the violence for the rest of the day. Now that they can talk about it, the experiences no longer feel so heavy:

Something might happen during the day and then I’d immediately start thinking about it [the violence] and feel miserable, but this doesn’t happen these days and that’s a real relief. (Girl 19 years)

The way the young people stressed the importance of having an opportunity to talk about their experiences of violence supports findings in the literature that young people need adults to talk to about family violence (cf. Graham-Bermann et al. 2011). Constantly thinking about the violence would be particularly difficult during one’s teenage years, when other things (such as biological changes, identity development and social relationship building) are in focus and when it also becomes increasingly important how others see and respond to you (cf. Geldard et al. 2016; Burcar 2005). According to the young people’s descriptions, the counseling – at least applied in the context of flexible and empathic counseling relationship – could help them stop thinking about the violence in a depressing manner and instead start feeling more like other people. This was expressed by both girls and boys, and thus does not support the notion that teenage boys avoid expressing their feelings within relationships (cf. Copeland and Hess 1995).

A Model for Other Relationships

A second theme is constituted by the counseling relationship being described as a model for learning how to act, position oneself, and talk in other relationships or in other ways having taught them so. The interviews with the young people included several descriptions of how the counseling relationship helped them break the social isolation that the violent experiences had generated. For some, it was about relationships within the family:

I got a new way of thinking about how I could help improve the relationship between my mother and I, through acitivities, walks and thinking about other things. […] I’d hardly interacted with my mother before, just lived there and went out most of the time: “okay, bye!” (Girl 17 years)

This quotation shows how the girl previously had virtually no relationship with her mother at all, but only lived under the same roof as her. It is not clear whether it is the young person who withdrew from the relationship, but she described how she was able to use experiences from the counseling to improve her relationship with her mother.
In other examples, the experiences from the counseling were used to establish more equal relationships with others:

[After the talks], you don’t allow people to walk all over you or talk behind your back or things like that. What’s become harder is that I don’t tolerate being ill-treated. (Girl 19 years)

The girl in the above example seems to have experienced being ill-treatedby others, while others described previously having taken a subordinate position themselves:

I hadn’t thought about it, before, that I shouldn’t follow along with everyone else. […] I’ve learned that I shouldn’t put myself down so much, as I otherwise do, and that I’m not to blame when things happen. […] Not to be so insecure about what I do. I used to hesitate, and didn’t do things because I thought I wasn’t good enough. […] Because I blamed myself for everything that happened. (Girl 17 years)

This quotation illustrates how the girl had previously adapted to what she thought others wanted, perhaps in order not to offend anyone, or as an attempt to prevent new situations from developing into violence. In both quotations, it is also clear that it is the violence that is the reason for the young people’s withdrawal, as the withdrawal involves dwelling on concerns in a way that can be seen as an expression of trauma (to be pulled inside oneself by all the memories of violent events) and/or in ways that are part of their self-image (cf. Connor et al. 2014).
In all the examples, some form of positive change in the participants’ social relationships is depicted, and some participants explicitly connected this with their relationship with the counselor:

I didn’t think I was worth much before, but now I can assert myself more because I think I’m worth it, and much of it comes from the conversations, and that I got to talk, and that there was someone who listened and understood. (Girl 19 years).

This example clearly illustrates the experienced relationship between having been listened to by the counselor, feeling “worth it” and now being more assertive in relation to others.
It is clear that it is mainly the girls in the study who express that they withdrew from socializing and relationships, and refrained from asking for help, as a result of their own feelings or of how they have been treated or excluded by others within or outside the family, or a combination of both. But it was not a simple matter of girls having one set of counseling needs (in relation to what the violence had meant for their living situation and emotions) and boys having completely different needs, as one of the boys also expressed pain about feeling ostracized from his family, and anger towards those he perceived as responsible for it, while also describing how the counseling had helped:

It was the two of us: Me and my sister, who had certain wishes, and the two of them: mom and the man, who had parties, and the children had to adjust. If I hadn’t [been through this counseling] I wouldn’t have told you anything personal, haha! […] [Since the counseling] I don’t use my feelings as a defense, but let them step aside for a while, because it’s easy for the feelings to get confused and take over. And then it’s easy to hate your parents for something, and you may want to go there and beat them up or something. (Boy 17 years old)

In the young people’s descriptions, violence lead to difficulties with social relationships, both in the sense that shame about the violence makes them withdraw and because it became difficult for them to manage their own aggressive feelings. The conversations with an adult counselor about violence had helped the young people to deal in a better way with these relationships and their experiences of them. For this reason, the counseling relationship can be seen as a model for future relationships, by developing experience of positive relationships that they can use to handle future ones. In some of the interviews, it was clear that it was the experience of the relationship that had served as a model for the young person’s insights, in others, they might have developed from what they talked about.

Using the counseling relationship as a model for developing other relationships may be particularly important for young people who have experienced family violence, because it helps counteract risks often associated with it. First, the interviews indicated that counseling had helped many young people break the isolation often associated with family violence (cf. Levendosky and Graham-Bermann 2001). Second, the self-esteem that some young people in this study seem to have developed through the counseling focusing on their self-worth and helping them understand that they do not have to do everything that others ask or expect them to do. This may help counteract the associated risk of being subjected to violence in the future (cf. Murray et al. 2016). Third, developing skills for talking about emotions may counteract the increased risk of using violence to solve conflicts that experiencing family violence is connected with (Moylan et al. 2010). It is noteworthy, however, that although both girls and boys in this study described having used the counseling relationship as a model for other relationships in some way or another, this was not done by any boy under 14 years of age.

Going “in and out of” the Topic of Violence Is Valued by the Younger Teenagers

The third theme is the first of the themes concerning the nature of the talk within the counseling relationship, and it is represented by all the young people below 14 years of age in the study. When the young people described that counseling had helped, or that it was beneficial to talk, they were not always referring only to speech. Instead, they expressed in various ways that it had been particularly positive to be able to delve into the topic of violence and then move away from it during the course of the conversation. Some expressed this in terms of examples of being able to draw or write:

We’ve talked about feelings, and what it’s like, and drawn and talked about it. Feelings like being angry, afraid, scared, almost everything. We’ve written and talked a lot. Written about what happened and so on. Drawn what happened. […] It was better to draw than to talk. You draw a kind of comic strip. Six pictures. From beginning to end. And then you talk about it. Almost all of it was fun. (Boy 13 years)

It seemed as if drawing was a particularly valued aspect of counseling among the younger teenagers. Drawing also seemed directly linked to the violence, in that the quotations indicate that they associated violent memories with the images. Although they appear to have drawn situations that had to do with violence, a plausible interpretation of these descriptions by the young people is that drawing could be a kind of break from the painful conversation about violence, despite the images also being about it.
However, others described activities that did not seem related to talking about the violence at all, and talked about the effects these activities had had on them:

[The best thing about talking is] when we have fun together, play […] Play games with [the counselor]. Dice games […]. The games were fun and you started to laugh and then you thought about [the violence] less. (Boy 12 years)

Some interviews, however, indicated that the value of activities not related to the violence had to do with the signal it sent to the young person, namely that the counselor was willing to adjust to their emotional state and acute needs:

I: What was the best thing about talking?

I don’t know, but it was probably one time when we sat and played a game, and it helped a bit that someone can be considerate of the fact that you’re feeling a bit depressed. (Girl 13 years)

Thus, two different ways for adult counselors to offer the young people a grace period from the violence-focused counseling can be identified. One was to engage them in an activity that was linked to their experience of violence, but that could divert focus from the actual conversation, if only for a while. The other was to take a break from the theme of violence altogether by doing something completely different, and only later to return to the young person’s experience of violence. These techniques enabled the young people to deal with their experiences at their own pace.
Among the older teenagers, there was also an example similar to going in and out of the topic of violence:

The violence didn’t affect me, but everyone needs to talk about themselves, personal stuff that has happened. But a lot of it has been related to the incident and to my relationship with the man my mother was together with. (Boy 17 years)

In this quote, the boy also seemed to be approaching and backing away from the violence, but in a different way. Here it is not a question of other activities, but instead of positioning the violence in relation to his own mood. We interpreted this not as a case of going in and out of the topic of violence, but rather of this boy focusing on the violence all the time with the goal of understanding how the experiences of violence against his mother were related to how he was feeling.

This example clarifies through contrast what we mean by going in and out of the topic of violence, namely taking a temporary break from the conversation about the violence and doing something completely different for a while, before beginning to talk about the violence again. It does not matter whether this “completely different thing” consists of talking about trips, playing games or drawing, even if the young person draws a situation linked to violence. The important thing is that all these types of “interruptions” give the young people a moment’s respite from actively processing the violence.

When an adult counselor talks to a young person who has experienced violence, there are many factors that increase the risk of the adult unintentionally making the conversation overwhelming for the young person. These include their different roles within the counseling relationship, their different levels of maturity, and how much talk about violence that they can handle (Cater 2014). Although it can obviously be painful for a counselor to talk about violence, it could be even more so for those who were actually involved in it. Providing opportunities for the young person to temporarily “rest” from painful topics of conversation can thus be a way for the adult to reduce the effect of the power inequality built into the relationship (Geldard et al. 2016; cf. Hydén and Överlien 2013). As a result, the young person can have more control over the conversation. While drawing can also provide a temporary period away from the counseling relationship, playing games together, for example, could rather be a way to directly strengthen it.

Being Listened to “almost like an adult” Is Valued by the Older Teenagers

The last theme, and the second concerning the nature of the talk within the counseling relationship, emerges in relation to the older teenagers and concerns the “listening aspect of talking.” This aspect was mentioned only by girls and boys over 16 years of age. Specific ways that the counselor had handled the relationship were highlighted by them as particularly positive. In some interviews, the young people described the value of being listened to:

The first time I talked, he listened in a way that I think most people want to be listened to […]. It seemed to me like he wanted to listen to what was said. (Boy 17 years)

In others, they expressed the value of meeting with understanding and acknowledgment of the feelings that the violence experiences had generated:

[The best thing about talking was], I could say, the encouragement. Someone who really listens to what you’re saying and doesn’t just sit there nodding their head, but who gives – maybe not advice and tips – but maybe answers “That must have been horrible for you.” Of course, too much of that can trivialize it… Perhaps it’s that you get to hear that you were right. That “you didn’t do anything wrong. It must have made you very sad,” that “he’s the one who did something wrong.” (Girl 19 years)

In one interview, the implications of such a relationship with an adult in a helping role was contrasted with a previous experience:

You know, there is a counselor at my school. It was her I contacted first, and it was about the way she handled it… She talked to my teacher without talking to me first. […] A teacher came up to me in the hallway and was really serious and asked “Is everything alright at home?” and I was like “Huh!?” and then I got a similar reaction from another teacher, and I thought she should have asked me first. […] I think it was wrong of her to tell other people before asking me about it. (Girl 19 years)

As it is hardly possible to combine having an empathic understanding of the situation of a young person who has experienced violence in the family with violating her trust in the way that is described in the quotation, our interpretation is that having confidence in the counselor because she/he behaves in a trustworthy manner is an expression of having perceived such empathy.
In another interview, a young person described how the adult counselor offered a selection of options for how to talk, which was valued and enabled them to have a conversation:

The first time she asked me if I should talk or if she should ask questions, and what made it so much easier for me was that I said she should ask questions. It really made a difference. […] I’ve always found it hard to explain things. I’ve always had problems getting started talking. It’s easier if someone asks, so I can think about what I want to say. (Girl 17 years)

Such concrete examples of what the adult counselors did during the counseling may perhaps be what constitutes the feeling of having been treated as an equal, as another girl clearly expressed:

She [the counselor] was not like everyone else. She was very… She talked with me as if I was a… When I was here, I never felt that she treated me like… but as a friend, equal to her in a way. I never felt inferior, always worth as much as her. I mattered. I think it was her way. She wasn’t like: here’s our agenda. We took it as it came. If I came and felt like I couldn’t cope with talking about something. It wasn’t only on my terms, but both of ours. I really felt like I’m the one who matters. (Girl 19 years)

This example also describes a type of adjustment by the counselor (If the girl did not feel up to talking as much as the “agenda” required, she did not have to.). What is clear is that such an adjustment, perhaps in combination with other factors not mentioned, made her feel a sense of self-worth and of being important.

Our interpretation of this is that young people’s expressions of empathy, trust and equality interrelate with, or rather are comprehensible in relation to, each other, as well as in relation to what it feels like to be a young person in a counseling relationship with an adult, focusing on painful personal memories: namely very vulnerable. If one is in a life stage (as a teenager) that is characterized by being about to enter another life stage (adulthood) (Geldard et al. 2016; Steinberg 2008; Uprichard 2008), and one finds oneself treated like an adult and feels equal to an adult in a counseling role, this can be perceived as an important symbol that one is viewed as ready to be welcomed into the new group. This further stresses the importance of reducing the power inequality built into the counselor-client-relationship, to enhance young people with experiences of violences’ abilities to handle their experiences and improve their well-being (cf. Hydén and Överlien 2013).

Age, Violence and Perceived Equality

In the interview material, a pattern was identified whereby the younger participants in the study more often valued having been given the opportunity to rest from talking about the violence, while the older ones more commonly described valuing being treated almost like an adult. However, our analysis revealed no gender-related patterns. From a theoretical standpoint, age is a complex category, and previous research has often focused on life phases instead of ages (e.g. Steinberg 2008). The findings in this study thus suggest that, at least when it comes to what is valued in counseling, it is relevant to differentiate between teenagers below and above the age of 15. These different attitudes to counseling, in turn, may point to a leap of maturity on the path toward becoming adults. However, one might also ask whether these findings actually reflect the younger teenagers’ greater need (than the older ones’) to “play” and do other things during counseling, and the older teenagers’ greater need (than younger ones’) to be given more say about the contents of counseling sessions and the nature of the relationships, or whether they rather reflect counselors’ ideas about what younger and older teenagers need (cf. Uprichard 2008).

Another reflection concerns the significance of age – or life phase – in relation to the topic of the counseling. While being allowed to go in and out of the discussion is likely to be particularly important in counseling about experiences of violence, one can imagine that perceiving oneself as being treated with empathy and as an equal may have more to do with the life stage that one is in during the teenage years than with the fact that the counseling concerns violence or the gender of the young person.

Taken together, these results also seem to have something in common, namely the descriptions by the young people of the value of being equal to others. First, within the theme of the value of talking, it is clear that the conversations had resulted in the young people feeling more normal, and thus more equal to other people. Second, within the theme of using the counseling as a model for other relationships, breaking one’s isolation and developing a “normal” sense of self-worth can also be seen as aspects of becoming more equal to other people. Third, within the theme “going in and out,” being given such opportunities could be understood as a result of the relationship being equal in the sense that the counselor is adapting to the teenager’s needs. The fourth and final theme included explicit examples of viewing equal treatment as a central value in the counseling relationship. Therefore, our overall and general conclusion is that the most valuable aspect of a counseling relationship for young people exposed to family violence is to feel equal to other people in some way. Given that subjection to violence can be said to be an extreme form of an unequal power balance and subordination, especially for young people who already tend to be subordinated to adults, the value that the young people ascribed to a form of counseling that signals that they have the same rights as other people to influence the sessions, to have healthy relationships, and to feel a sense of normality and pride, is particularly understandable.

Discussion

The analysis of the 14 interviews with nine young people between 12 and 19 years of age, all of whom had experienced family violence and received counseling as a result, thus revealed four distinct themes about what they described as particularly valuable aspects of the counseling relationship: the opportunity to talk, a model for other relationships, and going “in and out of” the topic of violence, which was valued by the younger teenagers; and being listened to “almost like an adult,” which was valued by the older teenagers. From these themes, the general conclusion is that young people with experiences of family violence want to be treated as equals in their counselling relationship. Being treated as an equal could be seen as a direct contrast to what it is like living with pervasive and ongoing control (involving tactics intended to intimidate, humiliate or degrade) which narrows children’s and young people’s space for action (Katz 2016). Thus, experiencing being treated as an equal can be seen as an important prerequisite for young people’s agency.

First and foremost, these results support previous research findings that the quality of the relationship between helper and helped is of central importance for young people (e.g. Shirk and Karver 2003). A good counseling relationship – that is, one that is flexible in the ways described above – seems able, according to the young people’s own descriptions, to reduce the painful recurrent thoughts that violence generates, and also to help them achieve better social relationships. Specifically, while for instance Cater (2014) gives insight into ways to enhance child participation in the different phases of accessing support, this study provides insight into what young people value after counselling has taken place. In addition, the results of this study provide insight into what specifically, from young people’s point of view, constitutes such quality in counseling relationships for younger and older teenagers respectively. From this interview material it seems that the young people do not withdraw from social relations to avoid being reminded of the trauma, but rather because they do not feel deserving of relationships or because the constant thoughts of violence do not allow them time to focus on social relations (cf. Connor et al. 2014). Both avoidance of, and aggression in, social relations would be serious barriers for developing independence from one’s parents and intimate relationships with peers during the teenage years (Herman 2012). It is in the light of such descriptions that we believe the participants’ descriptions of how important it was to them that the adult counselor listened to them and accommodated their wishes and needs must be understood. When someone feels ostracized or stepped on, and not important or valuable, a flexible and empathic counseling relationship is likely to convey such value in ways that mere words perhaps can not. And if the person has difficulties with social relationships in particular, a counseling relationship may perhaps be liberating/cathartic.

Implications for Counseling Practice

Analyses of interviews with young people about what they value in counseling can contribute to our understanding of counseling processes and hence be valuable for improving interventions. The results of this study clearly indicate the benefit of counselors being especially flexible with young people exposed to violence and being able to establish trustful relationships with them, to enable the young people to exercise their autonomy (cf. Geldard et al. 2016). Good relationships between counselors and young clients who have experienced family violence seem to demand understanding from the counselor’s part about the roles of shame and isolation in the dynamics and experiences of violence in families and an ability to translate this knowledge into practice (Trevithick 2003). By sharing their power in such ways as are described by the young people in this study, signaling to the young people that they are important, and giving them a sense of self-worth, the counselors can enable the young people to experience equality in the counseling relationship. Therefore, handbooks, in addition to techniques and session content, should perhaps focus on how counselors in practice can signal equality and self-worth, as well as on how they can practice the method flexibly to adequately adapt to the young person receiving the counseling. In the long term, focusing on young people’s autonomy in relation to counseling might reduce the problem of young people not seeking psychosocial support (Wilson and Deane 2012). In addition, counselors and social workers in other roles may want to consider ways to encourage people in the young person’s network (e.g. family members and close friends) to signal such importance, equality and self-worth to him or her.

The results further indicate that younger and older teenagers might benefit from being treated somewhat differently in counseling. Future handbooks and manuals on counseling young people exposed to abuse could take into consideration specifying how counselors can give younger teenagers space for going in and out of the topic of violence, for example by play, and how they can listen to older adults in ways that make them feel like an almost adult. Finally, our results suggest that if counselors want young teenage boys to also be able to use the counselling relationship as a model for future ofter relationships, they may need to approach them in new ways and specific ways to do so may need to be developed.

Limitations and Future Research

A limitation of the present study is that the sample is small, and that the voices of the young people were unequally heard because some were interviewed once and others twice. A bigger sample might, for example, have enabled analysis about whether what the young people valued in the counselling relationship changed over time. Including younger children might have enabled analyses of differences between what younger children valued and older respectively, but might also have hidden some of the variance found in this study. Adding to this, the present study only gives one perspective on talking about violence, and the counselors may have different views on what took place within the counseling relationship and what was valuable about it. Also, information about how long the young people had experienced family violence and the nature of it would have been interesting. The interviews were not audio-recorded, which increases the risk of transcriptions being misinterpreted. However, when unsure, the interviewer asked the informant if the transcription was accurate. This is particularly important to bear in mind because research has found that researchers’ notes can differ significantly from what young people actually said during interviews (Iversen 2012).

Lastly, we note that the results do not exclusively reflect the counselling relationship, but occasionally tap into general aspects of counselling processes. As counselling can be said to be relationshop-based, these two cannot be fully separated, but are rather closely interrelated. However, as our aim was to primarily understanding the counselling relationship, we ask readers to keep this in mind then reading about and interpreting our results. We suggest that future research should seek to further nuance our understanding of how girls and boys in different stages of their teenage years handle experiences of physical and control-based family violence. In addition, we suggest that future research investigates whether such flexibility in counselling and such ways to make young people who have experienced family violence feel like equals may enhance their well-being and self-esteem when tested by standardized measures.

Notes

Acknowledgements

This study was enabled by financial support from the Uppsala Regional Council in Sweden and Stiftelsen Allmänna Barnhuset [The Children’s Welfare Foundation] in Sweden. The findings and conclusions in this manuscript are those of the authors only.

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Copyright information

© The Author(s) 2019

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Authors and Affiliations

  1. 1.School of Law, Psychology and Social workÖrebro UniversityÖrebroSweden

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