What is TEVI Program?
In 2003, we observed that more than half of the children and adolescents at our outpatient mental health clinic (Centre de Salut Mental infant Juvenil de Cornellà de l’Hospital Sant Joan de Déu de Barcelona) were sons and daughters of battered women.
Based on this finding, we began to offer specialized treatment to this type of problem, and in 2005 we created the Domestic Violence Witness Attention Program at our centre. A program that we call TEVÍ (“I saw you”), to emphasize the fact that children are aware of domestic violence, although they do not talk spontaneously and their environment does not detect it as a problem. In 2010 the TEVÍ Program was implemented in the rest of the outpatient mental health clinics of the Psychiatry Service of the Hospital Sant Joan de Déu of Barcelona.
Since the implementation of the TEVÍ program in 2005, we have verified that the detection of exposure to situations of domestic violence in patients improves the diagnosis of their symptoms and allows a more effective treatment. This effectiveness implies a more rational use of resources.
In 2013, the TEVI Program was recognized as a “Good Practices Program” by the Ministry of Health, Social Services and Equality, Women’s Health Observatory, to strengthen the gender focus on care, prevention, Health research and training on sexist violence.
Objectives of the TEVI Program
- Specific, specialized detection, assistance and rehabilitation for children and adolescents who have been exposed to domestic violence and have mental health symptoms.
- Secondary prevention of the consequences of these experiences on health, schooling, social relationships.
- Decrease the risk of intergenerational transmission of violence.
- Build a useful healthcare model that generates tools, knowledge and practices that can be generalized to other mental health devices.
- Network working with the local community services that work with battered women (the Institutional Commission on gender violence).
- Generate research to improve care processes and to give more visibility to the sufferings of girls, boys and adolescents witnesses of domestic violence.
The international guidelines for the treatment of patients witnessing domestic violence recommend that once family safety is established, it is time to offer different psychotherapeutic interventions. For minors, recommended interventions include individual and group therapy. Our program provides a specific group therapy of Emotion Regulation and Interpersonal group Therapy (ERIT).
An essential component of the intervention with minor witnesses of domestic violence is the priority to support and strengthen the relationship between the minor and the non-abusive parent. For most minors, a strong relationship with one of the parents is a critical factor in the first evolution of the traumatic effects of domestic violence (National Child Traumatic Stress Network, 2015).
The program offers specific Animal-assisted therapy (https://www.ctac.cat/ctac/ctac) to support and strengthen the relationship between the minor and the mother (https://www.tevican.com/ ). The proposal of the inclusion of a dog in treatment is supported by literature; on the one hand, it is known that the presence of animals with children produces a decrease in basal anxiety since minors see the animal as a neutral element that does not judge them. On the other hand, the capacity of confidence of these children who have grown in violent environments is frequently affected, so they do not easily trust a therapist.
The violent scenarios in the families in many cases diminish the parental abilities of the mother, and the personality and roles of the children, so dysfunctional interactions between them are frequent. These interactions remain after the father is no longer mistreating. So the mother’s parental ability is a decisive factor in the recovery of children.
In this reality, we offer a Seal Program in the summer for these families. Through various sailing trips, it is intended to provide satisfactory experiences of the relationship between mother and child, empowerment, joy and proper treatment. Teamwork that requires this sport puts in play the relational styles of mothers and children. This experience helps a mother to discover they carry the ‘rudder’ of their lives; they gained the trust and shared a joyful experience with their children.
Institutional Commission on gender violence our community
Since 2005, our centre is part of the Institutional Commission on Gender Violence, formed by representatives of the city council of Cornellà (Deputy Mayor of citizen policies, mental health services, primary care doctors, social services, associations women victims of gender violence, educational facilities, security forces). In practice, the institutions that are represented in the commission form a coordinated network of detection, care and assistance to women victims of gender violence and their children.
The program has served more than 1000 children and families.