Development and description of an empirically based ecobehavioral treatment program for child maltreatment

Victims of child maltreatment and their families evince a myriad of behavioral problems, including deficits in parenting skills, social skills, safety skills, anger, stress, and financial management, mood disorders, and abusive behavior. Controlled treatment outcome studies in child maltreated samples have indicated that many of these problems are responsive to clinical intervention strategies. However, empirically based practitioners who treat child maltreatment are faced with the inevitable task of effectively integrating these treatments into their clinical programs. Therefore, this paper describes the development of an ecobehavioral treatment program for child maltreatment that is founded on a comprehensive integration of previously validated procedures. The program's development, and methods of assessment and intervention, will be underscored, including therapist training strategies, and solutions to problems that sometimes occur. Data in support of the program is examined, but primarily as a means to demonstrate how evaluative components may be utilized in practice settings to guide intervention. Copyright © 1999 John Wiley & Sons, Ltd.     

儿童虐待与问题行为：基因与环境的作用

当前预防虐待之所以成为儿童保护的重要内容,不仅是法理上的儿童权益保护,也因虐待关联的基因与环境作用对人发展的长期影响。儿童虐待与问题行为关系复杂,已有研究显示,虐待特征、受害者特点是其关联因素,但其内在机制并不清楚。。随着分子遗传学的兴起,MAOA、COMT、5-HTT等基因为解释儿童虐待与问题行为的机制提供新视角,重要候选基因可能调节这一关系。未来研究可从动物模型和纵向追踪角度去探究儿童虐待与问题行为关系的易感期、保护因子,完善儿童虐待与个体发展关系的研究图谱。     

Psychologists' involvement in cases of child maltreatment. Limits of role and expertise

As psychologists have become increasingly involved in the investigatory and adjudicative phases of child maltreatment cases and as criminal prosecutions have become increasingly common in such cases, the ethical problems facing psychologists have become more acute. Psychologists involved in cases of child maltreatment should remember their primary duty to promote human dignity. In that regard, care must be taken to protect the rights of the various parties, assist the parties to make use of the legal process, and keep implicit or express promises, including those emanating from professional roles. Psychologists must be careful to avoid intruding into the province of legitimate decision-making authorities.     

Commonsense about Psychoanalysis by Rudolph Wittenberg

Obstacles are described that constrain or block the full implementation of Yalom's model of inpatient group psychotherapy. These obstacles include situational constraints that are imposed by the temporal, spatial, and organizational structures of many treatment settings, and attitudinal constraints that consist of therapist and patient resistances to the implications and demands of the model. Recommendations are provided that have proven useful for overcoming these obstacles. They address such issues as: (1) patient confusion with here-and-now focus, (2) tendencies toward therapist-centered interaction, (3) the apparent irrelevance of interactional groups for many patient presenting problems, (4) insufficient time to accomplish interactional goals, and (5) the inability of patients to engage in group processing.     

The distressed family and wounded children

This article addresses the issue of the need for clergy to be better informed regarding the assessment of child abuse and neglect. It provides a quick reference guide to assist clergy in assessing the risk factors in the abusive family with guidelines for the recognition of child maltreatment. In a society that is marked by unprecedented levels of child maltreatment reporting and an ever increasing shortage of mental health services, clergy are increasingly being confronted by situations involving potential child maltreatment that require expert crisis intervention skills. This article provides specific, concrete guidelines for clergy confronted with situations that call for the recognition of child maltreatment.Andrew J. Weaver, Ph.D., United Methodist minister and a licensed marriage, family, and child therapist. He holds a doctorate in clinical psychology and serves as the director of the Pacific Center, Community Counseling Service, sponsored by 11 churches in Central Los Angeles.This article is dedicated to the staff of Alameda County Child Protective Services in Oakland, California, with appreciation for their courage and devotion to the grievous and demanding task of caring for distressed parents and their wounded children.     

Is elevated risk of child maltreatment in immigrant families associated with socioeconomic status? Evidence from three sources

In this study we tested whether children from Dutch‐immigrant families are at increased risk for maltreatment, and if so, what factors could explain this risk. Three data sources from the second Netherlands Prevalence Study of Maltreatment of Youth (NPM‐2010) were used to answer these questions. First, 1127 professionals from various occupational branches (sentinels) were asked to report each child (including some background information on the child and family) for whom they suspected child maltreatment during a period of three months. Second, we included the 2010 data from the Dutch Child Protective Services and third, 1759 high school students aged 11–17 years filled out a questionnaire on their experiences of maltreatment in the past year. We found that children from traditional immigrant families with a relatively long migration history in the Netherlands (Turkish, Moroccan, Surinamese, and Antillean) and from nontraditional immigrant families (African [except Morocco], Eastern European, Central Asian, and South and Central American; often refugees) were at increased risk for child maltreatment compared to native Dutch families. However, in the professionals’ and CPS data this risk disappeared for the traditional immigrant families after correction for educational level of the parents and for step‐parenthood. Within the group of families with low education or step‐parents, the risk for child maltreatment was similar for traditional immigrant families as for native Dutch families. Nontraditional families remained at increased risk after correction for sociodemographic and family factors. In conclusion, we found that children from both traditional and nontraditional immigrant families are at increased risk for maltreatment as compared to children from native Dutch families. For the traditional immigrants this risk could partially be explained by socioeconomic status. This implies that socioeconomic factors should be taken into account when outlining policies to fight child maltreatment.     

Examination of the Extent to which Employment Factors are Associated with Reduced Child Maltreatment Potential and Drug Use

Job assistance programs are commonly recommended for parents of children who have been victimized by child maltreatment, particularly when illicit drugs are indicated. However, the relationship between employment factors, substance abuse, and risk of child maltreatment has received limited empirical attention. Therefore, the current study examines employment factors in a sample of 72 mothers, who were referred by child protective services for treatment of substance abuse and child neglect. Child maltreatment potential was found to be negatively associated with number of hours employed and self-reported happiness with employment. The association between child abuse potential and personal income of participants approached significance (p?=?.057), and the results were not influenced by social desirability. Employment satisfaction significantly contributed to the prediction of child maltreatment potential over and above other employment factors and control variables. These findings suggest that when mothers are involved in child protective services their risk of perpetrating child maltreatment may be reduced when they are assisted in gainful employment that is personally satisfying. Happiness with employment was the only employment factor correlated (inversely) with substance use (biological testing, self-report of participants). Future directions are discussed in light of the results, including the importance of considering employment satisfaction when conducting vocational assistance programs in this population.     

Cumulative Risk and Protection Models of Child Maltreatment

Abstract

The often misused concepts of risk, vulnerability, protective factors, and resilience are clearly defined and existing models of child risk are presented. Research of risk and protective factors for child maltreatment is then discussed as it reflects on these models. A major conclusion is that child maltreatment exists within a complex context of cumulative risk and protection which needs to be considered in designing research of intervention programs. This article provides one of the clearest presentations and integrations in the literature of the conceptual bases and research findings relevant for considering child risk and resilience.     

Controversies in Family Preservation Programs

Summary

This paper examines the controversies over the use of family preservation policies to prevent and treat child abuse and neglect. Policies that aim to preserve families in which child maltreatment has occurred are at least a century old. However, there is renewed interest in such policies, given the dramatic rise in child abuse and neglect reports and a large number of children who spend time in out-of-home placements. New intensive family preservation services were advanced as able to assure the safety of children while working toward a lasting preservation of the family unit. The paper summarizes the research on intensive family preservation services and reports that such programs do not reduce placements nor do they appear to enhance child safety. The paper concludes by proposing that risk assessments and assessments of readiness to change could improve decision-making regarding which families might be aided by family preservation and which children should be protected by terminating their parents' rights.     

Child maltreatment as a global phenomenon: From trauma to prevention

Past studies have clearly showed the negative impact of neglect and abuse on child development at both the psychological and neurobiological levels. To date, many studies have focused on identifying risk and protective factors occurring at all levels of the ecology. However, more distal‐level variables, such as culture and ethnicity, have not been studied as much as those of more proximal levels; yet studies in Western countries have consistently found an overrepresentation of child maltreatment reports among ethnic minority groups. In this commentary, we reflect on a series of articles examining maltreatment from a crosscultural perspective and using samples of diverse countries. Taken together, studies in this special section document the terrible fact that maltreatment is a global phenomenon. Through a summary of these studies’ main findings and concerns, we highlight four key points that we believe are important to consider for future research and intervention efforts.     

The limits of child effects: evidence for genetically mediated child effects on corporal punishment but not on physical maltreatment

Research on child effects has demonstrated that children's difficult and coercive behavior provokes harsh discipline from adults. Using a genetically sensitive design, the authors tested the limits of child effects on adult behavior that ranged from the normative (corporal punishment) to the nonnormative (physical maltreatment). The sample was a 1994-1995 nationally representative birth cohort of 1,116 twins and their families who participated in the Environmental Risk Longitudinal Study. Results showed that environmental factors accounted for most of the variation in corporal punishment and physical maltreatment. However, corporal punishment was genetically mediated in part, and the genetic factors that influenced corporal punishment were largely the same as those that influenced children's antisocial behavior, suggesting a child effect. The authors conclude that risk factors for maltreatment are less likely to reside within the child and more likely to reside in characteristics that differ between families.     

Where do we go from here? Moving toward an integrated approach to family violence

This article discusses patterns across reviews of the risk and protective factors for each of seven forms of family violence: partner physical, psychological, and sexual abuse; child physical, psychological, and sexual abuse and child neglect. We note that both child and partner literatures have large research bases on risk factors for physical abuse, but relatively few articles on psychological or sexual abuse (or child neglect). In addition, co-occurrence of forms of maltreatment within families is high, but little integrative work has been conducted. We argue that the overlap of both occurrence and risk factors across forms of maltreatment suggests that both etiological and intervention models would be improved by considering all forms of maltreatment more explicitly in a family (rather than dyadic) context.     

What sources contribute to variance in observer ratings? Using generalizability theory to assess construct validity of psychological measures

Cronbach and Meehl (Psychol. Bull. 1955; 52:281–302) stated that the key question to be addressed when assessing construct validity is ‘What sources contribute to variance in test performance?’ We illustrate the utility of generalizability theory (GT) as a conceptual framework that encourages psychological researchers to address this question and as a flexible set of analytic tools that can provide answers to inform both substantive theory and measurement practice. To illustrate these capabilities, we analyze observer ratings of 27 caregiver–child dyads, focusing on the importance of situational (contextual) factors as sources of variance in observer ratings of caregiver–child behaviors. Cross‐situational consistency was relatively low for the categories of behavior analyzed, indicating that dyads vary greatly in their interactional patterns from one situation to the next, so that it is difficult to predict behavioral frequencies in one context from behaviors observed in a different context. Our findings suggest that single‐situation behavioral measures may have limited generalizability, either to behavior in other contexts or as measures of global interaction tendencies. We discuss the implications of these findings for research and measurement design in developmental psychology. Copyright © 2008 John Wiley & Sons, Ltd.     

To be in touch

This study examined the constellation of interaction structures – repetitive patterns of interactions between patient and therapist over the course of treatment – that emerged in the psychodynamic therapy (PDT) of a child diagnosed with borderline personality disorder and treated by two doctoral student therapists. Identification of these interaction structures can inform therapists of what might be expected from patients with particular symptom or behaviour patterns and how interactions change over time. This study also examined each session’s adherence to three session prototypes: PDT, cognitive-behavioural therapy (CBT) and reflective functioning (RF) process. The Child Psychotherapy Q-Set (CPQ) is a 100-item instrument that assesses the processes within a single psychotherapy session. Items reflect a wide range of therapist attitudes and behaviours, patient attitudes and behaviours and interactions between therapist and patient. Experts used the CPQ to define PDT, CBT and RF process session prototypes. The results suggested that four distinct interaction structures could be identified and that their constellations differed between the two therapists and also differed over time within each treatment. Therapists were more structured and accommodating early on in their treatments and more interpretive later. Prototypical PDT process was more prominent in the sessions than RF process, which in turn was more prominent than CBT process. Unique therapeutic processes are at work in every dyad, despite holding the patient and theoretical orientation constant. An effective treatment in one dyad might not work in another due to therapist-specific and dyad-specific effects.     

The Role of Parenting Programmes in the Prevention of Child Maltreatment

Child maltreatment is a major worldwide concern and continuing high rates of abuse demand action. This article examines the role of parenting programmes as a strategy to prevent child maltreatment in the population as a whole and also as a targeted intervention for parents who have abused, or are at risk of abusing, their children. We argue that a blend of universal and targeted interventions is needed to reduce the prevalence of child maltreatment. Parenting interventions that concurrently target positive parenting and effective child management skills, dysfunctional parental attributions, and increasing parents' capacity to regulate their emotions are particularly useful. A variant of the Triple P—Positive Parenting Program, known as Pathways Triple P, is discussed to illustrate the value of this approach. Contextual factors that need to be addressed in working with child protection cases are also discussed. The role of training and supervision is discussed in the context of disseminating evidence‐based parenting programmes, and future directions for research are presented.     

Ethnic Disparities and the Psychological Trauma of Maltreated Children: Evidence from Three Multi-ethnic Counties in China

This study aims to discuss the effect of ethnicity on child maltreatment trauma in China and to contribute to international knowledge on the quality of life of children. The data come from a survey of 1763 rural children (M_age = 12.34, 50.0% boys) in three multi-ethnic counties in western China that was conducted from November 2019 to January 2020 with the modified versions of the “Juvenile Victimization Questionnaire” Scale. There are three important findings of this study. First, child maltreatment is significantly related to child depression in China. The depression score and rate of severe depression symptoms (SDS) are 2.09 times and 3.82 times higher, respectively, for maltreated children than children without maltreatment. Second, the effects of maltreatment on child depression differ significantly among the ethnic groups. The negative effect of maltreatment is most influential among the Han population and least influential among the Zhuang population. Third, ethnic disparities are also found in the effects of the influencing factors on child depression. The effect of intergenerational relationships on child depression is significant only in the Han and Tibetan populations, while the negative effect of peer support is found only among Han, Tibetan, and Miao children. Based on the confirmation of ethnic disparities in trauma due to maltreatment, this study suggests that it is necessary to establish a high-quality psychological intervention system in China’s multi-ethnic counties.