Family violence is a serious and widespread issue in our community. Violence between adults within the same family is a risk factor encountered by child protection workers at all points of child protection intervention. Accurately measuring the extent of family violence within the general community and within families notified to child protection is difficult, but we do know that it is an increasing aspect of the workload of Child Protection workers. The Department of Human Services Child Protection program tracks the number and types of characteristics for parents involved with Child Protection according to six categories. These categories are: psychiatric disability, intellectual disability, physical disability, family violence, alcohol abuse and substance abuse. For substantiated cases of child abuse and neglect the percentage of families with family violence noted as a parental characteristic increased from 38 per cent in 1996-97 to 52 per cent in 2000-01 (Department of Human Services 2002). The same data also indicates that for parents for whom family violence was the major parental characteristic recorded over the past five-year period, the co-occurrence of psychiatric disability increased by more than 50 per cent, alcohol abuse increased by 20 per cent, and substance abuse increased by 52 per cent.

Domestic violence has been a highlighted concern for some years. This has resulted in governments now providing recurrent funding for a range of domestic violence service provisions. The funding of services has given rise to a significant shift in service delivery, moving from volunteers staffing services to the development of specialised professional expertise in a range of domestic violence service provisions.

A number of years practice experience in the field, together with a review of the literature, leads to the conclusion that pregnancy may be a vulnerable time for some women whose partners choose to use violence. This has grave implications for the short, medium and long term health and welfare of these women and children.

The case that was presented to the symposium highlighted the impact of witnessing domestic violence on the health and development of an infant. For privacy reasons the full paper cannot be published. An outline of the presentation is summarised and some of the literature relevant to the particular case presented.

Where family violence is a significant feature of an infant/child's world, a healthy emotional developmental path may not be fully realised. The need to survive becomes the key organising principal through which all relationship dynamics are then filtered. An environment of violence can impede the important ingredients of consistency, stability, nurturing and security necessary for the healthy emotional development of the individual and their relationship with their immediate external world. When working with children and families where there is, or has been, ongoing violence, second only to addressing immediate as well as ongoing concerns about safety, is the importance of creating therapeutic opportunities to begin to develop or rebuild strong and healthy attachments.

This paper looks at some of the difficulties that practitioners face when developing intervention programs for children who have experienced abuse or family violence. It argues that different intervention strategies have developed in Australia, the USA and Britain for children who have been physically abused and for children who have been sexually abused or who have experienced family violence, and that these strategies reflect the different ways in which these problems were identified rather than being based on rigorous evaluative methodologies that identify what is actually effective in intervening in children's lives.

In this paper, I will discuss the importance of early intervention with vulnerable families where children and babies may be at risk of neglect and disadvantaged by their social circumstances in accessing appropriate, preventative support services. I will describe the Strengthening Families Program located in the Social Work Department of the Royal Children's Hospital, which provides a model for interdisciplinary and intersectoral (welfare and health) collaboration. The Program offers care management to individual families and is working towards systemic changes in the hospital's response to these families. Finally, I will illustrate aspects of the work of the Royal Children's Hospital Strengthening Families Program with a case study wherein a recent history of domestic violence impacted on the family's capacity to access health and welfare services for both mother and children.