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.     

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.     

Multiple forms of child abuse and neglect: adult retrospective reports

There are few research reports of the experience of multiple forms of child abuse and neglect (multi-type maltreatment). A critical review is presented of 29 studies in which adult retrospective reports of more than one form of child maltreatment (sexual abuse, physical abuse, psychological maltreatment, neglect, or witnessing family violence) are assessed. Empirical investigations of the extent and impact of multi-type maltreatment are identified. Data on the relationship between the different forms of maltreatment and the adjustment problems associated with each type of maltreatment are critiqued. As well as using dichotomous measures of maltreatment, an important methodological problem was the failure of researchers to assess all child maltreatment types, the relationship between multi-type maltreatment and adjustment, and the role of variables influencing the occurrence or impact of maltreatment. Considerable overlap was found in the occurrence of maltreatment types. The compounding or interacting effects of experiencing multi-type maltreatment were ignored in many studies. Where an assessment was made of the specific impact of multi-type maltreatment, it was associated with greater impairment than single forms of abuse or neglect. A multi-dimensional approach to prevention and treatment of child abuse and neglect is required in which children's vulnerability to multi-type maltreatment is addressed.     

Externalizing problems and problematic sexual behaviors: same etiology?

The study sought to determine whether maltreatment subtypes, family sexuality, and personal characteristics predicted and distinguished child problematic sexual behaviors (PSB) and externalizing problems (EP). Participants were families of 188 children, 6–11 years old, referred by child welfare services in four Quebec districts. Caregivers completed interviews and questionnaires. Results suggested that family environment and maltreatment subtypes had partially different impacts on PSB and EP. When EP and gender were controlled, younger children in a sexualized family environment and those verbally victimized were more likely to exhibit PSB. When PSB and gender were controlled, verbal abuse and neglect emerged as predictors of EP. Potential implications for child PSB research and interventions are discussed. Aggr. Behav. 36:358–370, 2010. © 2010 Wiley‐Liss, Inc.     

Preface

Abstract

Child victimization is a serious and on-going problem in the United States and throughout the world. In 2000, an estimated 900,000 children were victims of abuse and neglect in the United States. New and different responses to child maltreatment will have to be developed and implemented in response to the increasingly diverse contexts and situations within which maltreatment occurs. Emerging trends in adult-child boundary violations are explored within this volume from a cross-section of disciplines, including law, sociology, criminal justice, psychology, and health services. The selections analyze issues critical to child maltreatment and offer intriguingly different perspectives of present and future issues related to child abuse.     

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.     

Risk Factors for Infant Abuse and Neglect in Group-Living Rhesus Monkeys

This study investigated maternal abuse and neglect of offspring in a large population of rhesus monkeys over a period of 29 years. Abuse and neglect did not occur together and were associated with different risk factors. Infant abuse was concentrated in 8 of 57 families and among closely related females. Abuse was also repeated with successive offspring. In contrast, infant neglect was not affected by genealogical factors, was not repeated with successive offspring, and was displayed mostly by primiparous mothers. These results suggest that abuse and neglect may be different phenomena and that infant abuse in group-living monkeys could represent a good animal model for investigating the mechanisms underlying the intergenerational transmission of child maltreatment.     

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.     

Differentiating between child protection and family support in the Canadian child welfare system's response to intimate partner violence,corporal punishment,and child neglect

Rates of reported child maltreatment nearly doubled in Canada over the period 1998–2003, an increase that reflects growing awareness of the harmful effects of an expanding array of parental behaviors, including corporal punishment, lack of supervision, and exposure to intimate partner violence (IPV). Some of these situations may benefit from voluntary family support programs outside of the child welfare system. Analyzing a sample of 11,807 investigations, this paper compares cases where the sole concern is exposure to IPV, or hitting a child, or neglect, or other forms of investigated maltreatment. Situations where exposure to IPV or potentially abusive hitting were the sole reason for investigation presented with fewer risk factors and were less likely to lead to ongoing child welfare interventions compared to other maltreatment investigations. While situations involving alleged neglect presented a higher risk profile and elicited a more intensive child welfare response than did exposure to IPV or hitting, opportunities for alternative services were nevertheless identified. The study also found that visible minority families were overrepresented in cases involving hitting and that Aboriginal families were overrepresented in cases involving neglect. Overall the findings support the development of alternative response programs in Canada.     

Children with Disabilities

Abstract

Children in out-of-home care due to abuse and neglect are at disproportionately high risk for disabling conditions. The reasons for the over-representation of children with disabilities in the child welfare system are reviewed and discussed in this chapter. Factors discussed include impact of abuse and neglect, the impact risk factors such as exposure to community and domestic violence and poverty, risk of abuse or neglect associated with disability, and child welfare system factors. In addition, the need for greater efficacy in identification of disability, identification of service needs, and linkage with and delivery of services to serve the needs of children with disabilities in out-of-home care is addressed. Recommendations for policy review at State and Federal levels are offered along with direction for future research.     

Physical Abuse in U.S. Children: Risk Factors and Deficiencies in Referrals to Support Services

More than 600,000 U.S. children are reported for physical abuse annually. Risk factors are proposed in the literature, but a comprehensive, national assessment of risk factors and support services has not been conducted. An analysis of national data from the National Child Abuse and Neglect Dataset revealed that domestic violence, parental alcohol and drug use, prior child abuse and neglect, public assistance receipt, and child behavior problems are associated with higher odds of substantiated physical abuse reports, compared to unsubstantiated reports. Most families, however, failed to receive relevant support services for any of these risk factors. Screening by physicians, child protection workers, and others for these risk factors could help identify children at increased risk for physical abuse and inform prevention efforts and support-service provision.     

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.     

Permanent Housing for Child Welfare‐Involved Families: Impact on Child Maltreatment Overview

A longitudinal randomized controlled trial tested whether access to permanent housing reduces child maltreatment among inadequately housed families under investigation for child abuse and neglect. The study followed homeless and child welfare‐involved families randomly assigned to receive a referral for housing subsidies plus housing case management (n = 75, 196 children) or housing case management alone (n = 75, 186 children). Latent growth models examined change in caregiver‐reported frequencies of psychological aggression, physical abuse, and neglect toward children at five time points across 2.5 years. Intent‐to‐treat analyses suggested treatment differences for minor assault and neglect that approached significance; families randomly assigned to permanent housing plus case management exhibited marginally greater declines compared to families referred for housing case management only. Caregiver psychological aggression remained high over time, regardless of treatment condition. No evidence indicated higher risk families benefitted more from permanent housing. Results show some promise of permanent housing and highlight the complex needs of homeless families under investigation for child maltreatment. Findings emphasize the importance of continued involvement from the child welfare system to connect families with important resources.     

The Role of Parental Depressive Symptoms in Predicting Dysfunctional Discipline Among Parents at High-Risk for Child Maltreatment

Parental depressive symptoms are an important public health concern because they have been linked, in numerous previous studies, to negative parenting behaviors including dysfunctional discipline and child abuse and neglect. Taking this into consideration, parental depressive symptoms warrant particular attention among families with child maltreatment allegations—a group at high risk of dysfunctional discipline and future physical abuse. The current study sought to examine relations between parental depressive symptoms and dysfunctional discipline in an ethnically diverse sample of 234 families who were referred for psychological services due to concerns of child maltreatment. Referrals were made by school, medical, or child welfare personnel. 59.8 % of children were male and the average age was 7.05 years. Results indicated that parental depressive symptoms were significantly correlated with dysfunctional discipline including laxness, over-reactivity, and hostility. However, all three relations lost statistical significance after controlling for parental stress. The findings of this study suggest that well-documented relations between parental depression and negative parenting behavior may be driven by elevated parental stress rather than reflecting risks uniquely associated with depressive pathology.     

Parental Cooperation with Social Services and Termination of Parental Rights in Israeli Court Cases of Child Maltreatment

Parental cooperation with social services in child maltreatment cases is fundamental to all forms of family intervention. If rehabilitation efforts fail and the child cannot be safely reunified with his parents, the state is authorized to initiate termination of parental rights (TPR) proceedings. Given the scant literature on parental cooperation and TPR, the present study examined associations between parental cooperation and TPR in Israeli court cases of child maltreatment. Comparisons between uncooperative (n = 106) and cooperative parents (n = 155) revealed that uncooperative parents were more than three times more likely to have their parental rights terminated than cooperative parents, controlling for child and parent characteristics. Parents who did not cooperate with social services had high levels of mental health problems, substance abuse, criminal records, and poverty and their children had more mental health concerns and suffered more from neglect. We discuss the important implications resulting from these findings, which include: the need to view the engagement of parents in the child welfare process as a specific goal in itself and develop research-based models specifically targeting multiple-problem families at high risk of TPR; the need for professionals to build a good working alliance with parents in order to strengthen their participation; the need to take into account different background conditions and stressors related to the parents in order to facilitate greater cooperation; and the need to assess the potential mental health needs of children involved in cases of maltreatment with low parental cooperation.     

Intervention in child neglect: an applied behavioral perspective

Child maltreatment in the forms of abuse and neglect is a serious social problem, affecting over 1.5 million children in the US annually. Abuse has generally received more public and professional attention than other forms of child maltreatment. Given that more than one type of child maltreatment frequently occurs in families, there are few behavioral studies that have specifically addressed techniques for the reduction of child neglect. Only recently have researchers begun to regard child neglect as a phenomenon that may be conceptually different from other forms of child maltreatment, thereby warranting specific attention. Described here are intervention strategies for parents at-risk for or referred for child neglect. We review these strategies, along with commentary on the difficulties of conducting applied research in this field. Suggestions are offered for improved intervention research in child neglect.     

Preface

Summary

Child victimization is a serious and on-going problem in the United States and throughout the world. In 2000, an estimated 900,000 children were victims of abuse and neglect in the United States. New and different responses to child maltreatment will have to be developed and implemented in response to the increasingly diverse contexts and situations within which maltreatment occurs. Emerging trends in adult-child boundary violations are explored within this volume from a cross-section of disciplines, including law, sociology, criminal justice, psychology, and health services. The selections analyze issues critical to child maltreatment and offer intriguingly different perspectives of present and future issues related to child abuse.     

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.     

RECENT TRENDS IN RESPONSE TO CHILD VICTIMIZATION

Abstract

This chapter serves as an introduction to the many roles of health care professionalsin the assessment, care, and treatment of child victimization. It concentrates on those professionals caring for the physical health of victims of child abuse and neglect, although there are many similarities between child maltreatment and other family violence victims. In reviewing the health impact of maltreatment and the historical contributions of health care professionals, it discusses the roles that health care disciplines play in clinical care, training, research, and advocacy and their interaction with the community's child welfare, legal, and criminal justice systems.     

Single versus Multi-Type Maltreatment

Abstract

The purpose of the present study was to identify the long-term impacts of different types of child abuse and to assess differential effects of single versus multi-type maltreatment. Three hundred and eighty-four college students completed measures of child abuse history (neglect, emotional, physical, and sexual abuse), depression, suicidality, self-esteem, sexual behavior, drug and alcohol use, and delinquent behavior. The results demonstrate the high rates of co-occurrence of different types of abuse, with few differential effects identified. Rather, all types of abuse were associated with symptoms. Experiencing multiple types of abuse was associated with greater symptoms than experiencing no abuse or a single type of abuse. The results highlight the importance of considering all types of abuse when studying child maltreatment.