Child abuse: is there a mandate for researchers to report?

During the past 20 years, states have increasingly expanded the lists of individuals who are obligated to report their suspicions of child abuse and neglect. These legal requirements are juxtaposed with ethical considerations in research and professional practice. The ethical issues include the obligation to maintain both confidentiality of information provided by human participants and the safety and protection of these participants. This article reviews the types of state child abuse reporting statutes and outlines the categories of mandated reporters. I develop a model of how individual researchers should approach deciding whether they are mandated reporters of child abuse and neglect.     

Resisting Abuse at What Cost? The Impact of Mandated Reporting Laws on the Process and Content of Therapy

Child abuse reporting is mandatory for family therapists. Little is written regarding the impact of mandated reporting and its impact on the family therapy systemic processes. This paper reviews literature on the impact on therapy of mandated reporting, and shares the results of a study designed to assess the impact of mandated reporting on family therapist's attention to systemic issues. The study demonstrates that MFTs shift their focus when the question of a mandated report arises to the detriment of systemic considerations. The institutional split between investigation and treatment of child abuse is discussed.     

儿童虐待与戒毒动机：自我概念的中介效应

本文旨在探讨戒毒人群儿童虐待情况,以及儿童虐待、自我概念和戒毒动机之间的关系。采用儿童虐待问卷、田纳西自我概念量表和戒毒动机问卷对771名（男520,女251）正在戒毒的人员进行调查。结果发现：（1）强制戒毒人群的儿童虐待现象比较普遍（56.7%）,特别是躯体忽视和情感忽视;（2）儿童虐待与自我概念、戒毒动机呈显著负相关,自我概念与戒毒动机呈显著正相关;（3）自我概念在儿童虐待与戒毒动机间起部分中介作用。结论：治疗戒毒人群的心理成瘾,应评估其儿童虐待情况,针对有儿童虐待经历者,可通过构建积极自我概念的方式改善戒毒动机,进而提高戒毒成功率。     

“I Love You, and I Cheated”: Investigating Disclosures of Infidelity to Primary Romantic Partners

The research presented in this article used a quantitative–qualitative mixed design to investigate components of infidelity. Two studies were completed. The first study compared responses from persons (n = 22, 16 women, 6 men) who, in the context of a romantic relationship, disclosed infidelity to their primary partner, with a matched control sample of persons (n = 22, 16 women, 6 men) who did not report infidelity. Study 2 involved in-depth, bibliographic interviews with those persons disclosing infidelity to primary partners. Study 2 explored how persons defined infidelity and the nature of their disclosure. As predicted, results from Study 1 demonstrated clear differences between persons who did and did not report infidelity on measures of sexual permissiveness and intentions to engage in extradyadic activity, but not on other sexological measures. In Study 2, disclosures of infidelity to primary partners were interrogated using principles of interpretive biography. Qualitative analyses revealed that disclosures of infidelity were embedded with multiple meanings, including transformative moments of self-understanding. Results from the current research add depth to researchers’ and clinicians’ understanding of how infidelity is defined and disclosed to partners.     

Preventing Maltreatment with a Community-Based Implementation of Parent–Child Interaction Therapy

The purpose of this study was to examine rates of child abuse and neglect reports following a community implementation of Parent–Child Interaction Therapy (PCIT), an evidence-supported intervention for the prevention of maltreatment. Among a group of families receiving PCIT, predictors of reports were examined including family demographics, course of treatment, changes in clinical measures, and caregiver report for prior maltreatment victimization and perpetration. Participants (n = 120) included families at-risk for future maltreatment with and without prior maltreatment history. Agency case records were linked with state administrative records of child welfare reports. Time to follow-up ranged from 13 to 40 months. Bivariate and multivariate survival analyses were used to model risk for a later report. During the follow-up period, 12.5 % of families had a report for physical abuse or neglect. Reports of prior victimization as a child and prior perpetration as an adult were strong predictors of a report of perpetration after PCIT. Dosage of PCIT and change in clinical measures did not increase risk for a later report. PCIT can be an effective intervention for preventing maltreatment. Family history of child welfare involvement is a prominent factor in assessing risk for future involvement.     

Prevention of Child Abuse: Possibilities for Educational Systems

The traditional role of school personnel in the handling of child abuse and neglect cases has been expanded dramatically from identification and reporting to more prevention and safety efforts. Many educational systems are now requested, if not required, to provide prevention programs for children and their parents. Additionally, educators are faced with the increasing responsibility of assuring that children will not be abused or neglected within the school environment. The author examines: this expanding role for educators; programs currently being implemented; and, the impact of both on stopping the problem of child abuse and neglect.     

Professional Disclosure Statements and Formal Plans for Supervision: Two Strategies for Minimizing the Risk of Ethical Conflicts in Post‐Master's Supervision

Ethical conflicts related to the issues of informed consent, due process, competence, confidentiality, and dual relationships in supervision are discussed. Two strategies are proposed as ways to minimize the potential for ethical conflict in post‐master's supervision: the use of professional disclosure statements by supervisors and the development of formal plans for supervision.     

儿童心理虐待与忽视和自杀意念的关系：有调节的中介模型

采用问卷法对988名初中生进行调查,探究儿童心理虐待与忽视和自杀意念的关系,应对方式的中介作用以及友谊质量的调节作用。结果表明：（1）儿童心理虐待与忽视正向预测自杀意念;（2）应对方式是儿童心理虐待与忽视和自杀意念之间的中介变量;（3）儿童心理虐待与忽视对自杀意念的直接效应受到友谊质量的调节,直接效应对于友谊质量低的青少年更显著;（4）儿童心理虐待与忽视通过应对方式对自杀意念的间接效应的后半段受到友谊质量的调节,友谊质量高的青少年的自杀意念水平相对更低。因此,儿童心理虐待与忽视和自杀意念之间是有调节的中介关系,儿童心理虐待与忽视通过应对方式影响自杀意念,友谊质量在直接路径和间接路径中起调节作用。     

The emotional impact of treating child abuse

The author agrees with the need for pastoral intervention in child abuse and neglect, but warns that pastors need to be prepared to handle the intense emotional effects that result. The emotional impact of treating child abuse and neglect is examined under the rubric countertransference. Three sources of countertransference are outlined: identification with the child, identification with the parent, and encountering resistance. Finally, ways to cope with countertransference engendered by treating child abuse and neglect are explored. The need for quality supervision is especially stressed.     

Educational needs of school personnel regarding child abuse and/or neglect

From a review of literature a questionnaire was developed to identify problems related to child abuse/neglect in a rural school district. School administrators, regular and special education teachers, and counselors completed the survey to help establish more effective training programs. Analysis indicated that (1) school personnel need further assistance in dealing with problems pertaining to the maltreatment of students. (2) Formal, coordinated, workshop training for child abuse/neglect is needed. (3) Colleges and universities should offer instruction on abuse/neglect for persons preparing to work in schools. (4) School personnel need to be aware of and abide by the laws regarding reporting cases of abuse/neglect. (5) Improved communication among school, community, courts, and social service agencies is required for dealing wtih abuse cases. (6) School personnel should become more aware of what happens after abuse/neglect has been reported. Information from such analysis even for one school district can increase insight into problems.     

Video Intervention for Child and Caregiver Distress Related to the Child Sexual Abuse Medical Examination: A Randomized Controlled Pilot Study

Children who disclose child sexual abuse are often referred for a comprehensive medical exam to ensure physical well-being and gather evidence. This study examined a brief, developmentally appropriate, psychoeducational video designed to instruct children and caregivers about the exam procedures and coping strategies to be used during the exam. Sixty-nine children ages 4–15 and their caregivers were randomly assigned to view the psychoeducational video (n = 35) or to receive standard practice (n = 34). Distress before, during, and after the exam was assessed in both children and caregiver, as were measures of satisfaction and knowledge about the investigation process and coping strategies. Consistent with hypotheses, results indicated that the video intervention was well-received by families, increased caregiver knowledge, and decreased stress during the examination. Caregiver and child distress decreased from pre to post examination across both conditions, and, unexpectedly, there were no significant differences in these decreases between groups. Overall results from this pilot study are promising in supporting a cost-effective and brief early intervention approach at the time of the medical examination for child sexual abuse for children and their caregivers.     

Child abuse and the limits of confidentiality: forewarning practices

Confidentiality is widely considered to be of great importance in psychotherapy. With few exceptions, the breaching of confidentiality is an ethical violation and grounds for litigation. One such exception is the mandated reporting of known or suspected child abuse, representing a legally sanctioned limitation of confidentiality. Because clients generally expect unlimited confidentiality in therapeutic relationships, many therapists have begun to "forewarn" clients as a matter of informed consent. This research report: (a) briefly reviews issues surrounding mandatory reporting and confidentiality as they relate to forewarning, (b) defines and discusses forewarning as contrasted with "informing," (c) examines state statutes, case law and ethical guidelines relevant to forewarning, and (d) presents a survey of 428 mental health providers (MHPs) on their forewarning practices in which 36.9% forewarned all clients, 36.4% informed clients only upon suspicion of abuse, and 20.6% informed only after receiving a disclosure of abuse. The implications of these findings are discussed.     

Relationships between Parental Maltreatment and Adolescents’ School Adjustment: Mediating Roles of Self-Esteem and Peer Attachment

Parental maltreatment of children has been steadily increasing in Korea despite national efforts to curb it. Children and adolescents who experience maltreatment develop psychological and social maladjustment. Therefore, mediating variables alleviating the negative effects of parental maltreatment on child development should be investigated to develop effective intervention programs. We identified the direct effects of parental abuse and neglect on adolescents’ school adjustment and the mediating effects of adolescents’ self-esteem and peer attachment on the relationships between parental abuse and neglect and their school adjustment. We used data from 2351 middle school students who participated in the Korean Children and Youth Panel Survey. Structural equation modeling revealed the following: child neglect directly and negatively related with adolescents’ school adjustment, whereas child abuse did not. Further, while adolescents’ self-esteem and peer attachment mediated the relationship between child neglect and school adjustment, adolescents’ self-esteem alone mediated the relationship between child abuse and school adjustment. These findings imply that there is a need to develop different intervention programs based on child maltreatment types. Finally, we suggested that the negative effects of parental neglect on adolescents’ school adjustment could be alleviated by adolescents’ self-esteem recovery resulting from peer support. On the other hand, in the case of adolescents experiencing parental abuse, self-esteem recovery through education and counseling provided by teachers or respected adults could be prioritized.     

The Relationship between the Supervision Role and Compassion Fatigue and Burnout in Genetic Counseling

Many genetic counselors provide supervision to students during their career. Previous studies have shown genetic counselors, in general, are at increased risk for developing compassion fatigue. The purpose of this study was to determine if there was a difference in compassion fatigue and burnout levels in genetic counselors who currently supervise compared to genetic counselors who do not. Genetic counselors who currently practice in a clinical setting (N = 391) completed an online survey containing demographic questions, the Professional Quality of Life Scale, the State-Trait Anxiety Inventory, and questions specific to the genetic counselor’s experiences with supervision. Overall, when controlling for trait-anxiety, the supervision role by itself was not independently associated with the risk for compassion fatigue and burnout among genetic counselors. Within supervisors, however, there were several factors which were associated with this risk. Those with less supervision experience reported more secondary traumatic stress. Those supervisors reporting less confidence had decreased compassion satisfaction. Those with less experience or less confidence in their supervision role were most likely to be at increased risk for developing compassion fatigue. Training in supervision and support for dealing with compassion fatigue and burnout may be beneficial to supervisors with less experience.     

The certificate of confidentiality at the National Institute of Mental Health: discretionary considerations in its applicability in research on child and adolescent mental disorders

Child and adolescent researchers must balance increasingly complex sets of ethical, legal, and scientific standards when investigating child and adolescent mental disorders. Few guidelines are available. One mechanism that provides the investigator immunity from legally compelled disclosure of research records is described. However, discretion must be exercised in its use, especially with regard to abuse reporting, voluntary disclosure of abuse, and protection of research data. Examples of discretionary issues in the use of the certificate of confidentiality are provided.     

Family Support and Mental Health Service Use Among Suicidal Adolescents

Despite the fact that multiple evidence-based treatments exist for suicidal adolescents, these youth are unlikely to engage in mental health treatment. While family members can be influential in connecting adolescents to mental health care, suicidal youth are more likely to be exposed to family environments characterized by abuse, neglect, and to have poorer parent–child attachment quality than non-suicidal youth. This study analyzed data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to examine the relationships between perceived levels of parental support, symptom severity, and mental health service use in a nationally representative sample of suicidal adolescents in the U.S. (n = 1804). Higher levels of parental support were associated with a lower likelihood of mental health service use, lower levels of depression, and lower likelihood of an actual suicide attempt. Additionally, the presence of a suicide attempt and higher levels of depression were associated with a higher likelihood of mental health service use. When mediation effects were tested, the presence of a suicide attempt partially mediated the relationship between parental support and mental health service use. Implications discussed include the protective nature of parental support the need for more family-based interventions for this population.     

Child Maltreatment in Vietnam: Prevalence and Cross-Cultural Comparison

This Vietnam prevalence study on child maltreatment (VPM-2014) was designed to examine the prevalence of child maltreatment in Vietnam and to compare it with the child maltreatment prevalence in the Netherlands using the same measures and procedure. Questionnaires were filled out by 1,851 students aged 12 to 17 years (47.3% were boys). Results indicated that half of the students (49.9%) reported at least 1 event of child maltreatment in the past year. Emotional abuse was most frequently reported (31.8%), followed by physical abuse, neglect, and witnessing parental conflict. Sexual abuse was the least prevalent (2.6%). Compared with the Netherlands, the prevalence rates of most types of child maltreatment were higher in Vietnam: The largest difference was with emotional abuse, followed by neglect, physical abuse, and witnessing parental conflict. Only the past-year sexual abuse prevalence in Vietnam was lower. These findings highlight the alarming problem of child maltreatment in Vietnam.     

Parents’ Experiences of Their Child’s Disclosure of Child Sexual Abuse

A child’s disclosure of sexual victimization is a difficult experience for parents and has been associated with traumatization, disbelief, denial, self-blame, and clinical difficulties. To date, most studies on parents’ responses have been quantitative assessments of the psychological impact of disclosure on parents. A paucity of research has qualitatively explored mothers’ experiences of their child’s disclosure of child sexual abuse (CSA) and fathers’ experiences have been even further neglected. The current study seeks to characterize parents’ experiences of their child’s disclosure of CSA and to uncover the process-oriented nature of parental responses. This qualitative study, using a grounded theory approach to analysis, involved interviews with 10 mothers and four fathers whose children (3–18 years) had experienced sexual abuse. Three themes emerged from the analysis. The first theme—making sense of the abuse in retrospect—captured the process through which parents sought to make sense of their child’s disclosure, focusing on why their child had not disclosed the abuse to them earlier, and how they had noticed something was wrong but misattributed their child’s behavior to other factors. The second theme—negotiating parental identity as protector—reflected how parents’ identity as a protector was challenged, their perception of their world had been forever altered, and they now experienced themselves as hypervigilant and overprotective. The final theme—navigating the services—pertained to parents’ struggle in navigating child protection and police services, and feelings of being isolated and alone. These findings highlight the need for empathy and parental support following child disclosure of sexual victimization.     

Elder abuse policy: considerations in research and legislation

Elder abuse has become the most recently "discovered" form of intrafamilial violence. Most states have enacted elder abuse statutes or have amended their adult protection acts to specify the elderly. A majority of jurisdictions have included mandatory reporting requirements within their statutes. Commentary has been fiercely opposed to mandatory reporting for a variety of reasons. Compelled reporting does not appear to increase the number of reports filed, while enforcement of the schemes depletes much of the funds devoted to elder abuse. Definitions of elder abuse are contradictory and vague. Mandatory reporting requirements suggest that legislators believe elders are unable to determine whether reporting is in their own best interests and thus is an ageist response to the problem of elder abuse. Finally, few services are available to families in which elder abuse has been verified and even fewer program evaluations have been performed to assess these services. Mandatory reporting to identify elder abuse is not appropriate in the absence of programs found to be helpful.     

Review of the contemporary literature on how children report sexual abuse to others: findings, methodological issues, and implications for forensic interviewers

Methods used during forensic interviews with children are driven by beliefs about how children recall and report child sexual abuse (CSA) to others. Summit (1983) proposed a theory (Child Sexual Abuse Accommodation Syndrome) contending that, due to the specific traumatic characteristics of CSA, children will often delay disclosing abuse or altogether fail to disclose during childhood, deny abuse when asked, and often recant abuse allegations. His theory has had a tremendous impact on the field of CSA forensic evaluations, despite its dearth of empirical support. In this paper, we review and critique the contemporary literature from two main sources: retrospective accounts from adults reporting CSA experiences and studies of children undergoing forensic evaluation for CSA. We conclude that data support the notion that children often delay abuse disclosure, but that among valid abuse cases undergoing forensic evaluation, denial and recantation are not common. Methodological issues and implications for forensic interviewers are discussed.