Project 12-ways: Measuring outcome of a large in-home service for treatment and prevention of child abuse and neglect

Described here is Project 12-Ways, a large service project employing an ecobehavioral approach to the treatment and prevention of child abuse and neglect. By ecobehavioral it is meant that multifaceted in-home services are provided to clients, and that in-home data are collected on as many variables related to these services as possible. Four levels of research, data collection, and assessment are used to evaluate these services: Included here is a discussion of these levels of assessment. They are: data collected for clinical purposes; data from single-case experiments; research through the use of single-subject design logic applied to several subjects or groups of subjects, or by group statistical research designs; and program evaluation. The particular focus here is the program evaluation data which compare incidents of abuse and neglect during and after treatment between 50 families served by Project 12-Ways and 47 comparison protective service families. The data showed significantly fewer combined abuse and neglect incidents among the families served by Project 12-Ways. Suggestions for additional program evaluation data are provided along with a discussion of the limitations of the current analysis.     

Denial of reality: A form of emotional child abuse

Parental denial of reality is a form of emotional child abuse. The case history of a 49-year-old patient in psychoanalytic psychotherapy is described in order to illustrate how parental denial, especially parental collusive denial, of reality may impair a child's sense of reality by invalidating his perceptions and memories. The resulting doubts about their truth may result in a feeling of "being crazy."     

Personality characteristics and disciplinary attitudes of child-abusing mothers

The literature indicates that child abusing mothers are characterized by distinctive personality attributes. No studies appear pertaining to the attitudes of abusive mothers on child discipline. To further explore the personality characteristics and examine disciplinary attitudes manifested by abusive mothers (AMs), 20 AMs receiving Aid to Dependent Children (ADC) and 20 nonabusive, ADC mothers were administered the Family Concept Inventory, a measure of self-esteem (California Test of Personality), selected items from the MMPI reflecting depression/apathy and resentment/ agression, measures of reward- and punishment-oriented disciplinary stance, a series of seven Eriksonian developmental conflict scales, and selected stimuli from the TAT. Multivariate analysis of covariance revealed highly significant differences between the groups on the personality measures. Abusive mothers manifested lower self esteem, lower family concept, lower frustrated independence and greater depression and apathy; they scored lower on measures of the first six Eriksonian developmental stages. AMs scored higher on MMPI and TAT measures of aggression. No difference in attitudes towards discipline was found. Discriminant analysis using these data and actuarial data rendered 97.5% correct differentiation between the groups. Implications of the results are discussed.     

The prevention of child abuse and neglect: A review of the literature with recommendations for application

Families at high risk for inadequate parenting can be identified during the perinatal period, or during later health care visits. Effective intervention can be implemented for these special families. During the maternity ward stay, intervention can include early delivery room contact, rooming-in arrangements, and increased teaching sessions on child care. The primary physician can provide frequent office visits, telephone contacts and helpful advice during acute illnesses and developmental phases which might precipitate child abuse. The physician can seek assistance from outreach workers such as public health nurses, lay health visitors, and child welfare caseworkers. Community prevention programs such as parenting classes, Parent's Anonymous groups, crisis nurseries and crisis hotlines should also be integrated into the family's treatment. When provided in concert, these actions can stabilize most dysfunctional families.     

Prenatal prediction of child abuse and neglect: A prospective study

Five hundred eighty-seven women in a combined Maternity-Infant, Children and Youth project were interviewed at between 3 and 6 months of gestation by a skilled masters degree social worker (M.S.W.) using a Family Stress Checklist developed at the University of Colorado Health Sciences Center. Only 7% of the women were scored as “high risk” for serious parenting problems. Neither single status nor teenage status increased the risk significantly. A review of charts of 100 of the children whose mothers had been considered “at risk” was conducted 2 to 2.5 years later, and compared with 100 charts on children whose mothers had been considered at “no risk,” giving the following results: Twenty-five children had experienced failure to thrive, neglect or abuse. Twenty of these were from the original high risk mothers, giving an incidence of neglect/abuse in that group of 52%. The no risk control group of 100 mothers showed a 2% incidence of abuse/neglect; a low risk group showed a 4% incidence of abuse/neglect; and a mid-score group had an abuse/neglect rate of 5%. The scale proved a remarkably accurate predictor, with a sensitivity (percent correct negatives) of 89%. The authors suggest use of such scales prenatally or even before conception as a step toward the development of true preventive measures.     

Exposure to domestic violence as abuse and neglect: Constructions of child maltreatment in daily practice

Research finds that exposure to domestic violence can adversely affect the emotional, behavioral, and physical health of children. These effects have led some child advocates and policymakers in the United States to conclude that child exposure to domestic violence (CEDV) is a type of child maltreatment warranting state intervention. However, few states have defined CEDV as a type of maltreatment in statute and little is known about how child welfare agencies respond to allegations of CEDV in the absence of other safety threats. This study considers that CEDV itself might prompt an initial child welfare referral and may be construed by workers as a type of statutory maltreatment. Using a random sample (n = 295) of case records, this study analyzed one large child welfare agency’s response to referrals alleging CEDV between 2011 and 2012. Findings indicate that CEDV itself did trigger investigation. At time of referral, workers used statutory maltreatment typologies to construe alleged CEDV as a type of maltreatment; however, CEDV was not consistently construed as a safety threat and few allegations were substantiated. Instead most families were referred to community-based domestic violence services. Findings indicate that CEDV was not consistently construed as a type of statutory maltreatment and infrequently resulted in ongoing child welfare services. Findings suggest that training is needed to help workers better assess CEDV-related safety threats. Findings also raise questions about what types of interventions are needed to protect children from domestic violence and which types of agencies are best positioned to deliver those interventions.     

Disentangling life events, stress and social support: Implications for the primary prevention of child abuse and neglect

There is a growing body of literature linking stress and child abuse and neglect, but the relationship is not unambiguously supported by empirical data. Two considerations regarding Garbarino's ecological model of child abuse and neglect may explain this research problem. First, any of the predisposing factors, which are grouped into four levels called individual, familial, social, and cultural, may either positively or negatively affect the potential for child abuse and neglect depending upon the quality of social networks and social supports available to families. Second, these factors operate most importantly, not between the perception of stress and the act of abuse or neglect, but through the interpretation of whether a given life event is stressful or not. This clarification of the ecological model points the way to redefining interventions for the primary prevention of child abuse and neglect. Existing support systems can be strengthened in order to increase a family's ability to cope with untoward events before these become stressful. In addition, advocacy activities which support children and families in general can be major components in the primary prevention of child abuse and neglect.     

Interdisciplinary Training Program (ITP) in child abuse and neglect: Long term effects

BackgroundUniversity of Oklahoma Health Sciences Center has offered Interdisciplinary Training Program (ITP) for Child Abuse and Neglect since 1987. However, there are limited evaluations on multidisciplinary/interprofessional training for early professionals in the field of child abuse and neglect.ObjectiveThis study aimed to examine the effects of the ITP on young professionals in developing their careers and taking leadership roles in the field of child abuse and neglect.MethodsThe anonymous online survey was conducted for students who completed in the ITP from 1989 to 2016 (n = 405, with contact information out of total 508 graduates). One hundred seventy nine alumni (44.2%) responded to the survey.ResultsSatisfaction for the ITP was high (m = 9.3, sd = 0.97 on a 10 point scale with higher numbers being positive). Their current contributions to the field of child abuse and neglect were widely seen in child advocacy (43.0%), clinical treatment (39.1%), primary prevention (29.6%), or research (27.9%). Graduates reported they made 133 presentations to civic or professional groups and published 69 articles since they finished the ITP.ConclusionThe ITP trainees have made significant contributions to the field in clinical treatment, research, and child advocacy. Alumni were highly satisfied with their experience and continue to see the importance of the ITP to their jobs and career.     

Environmental influences on incidents of alleged child abuse and neglect in New York State psychiatric facilities: toward an etiology of institutional child maltreatment

In order to gain a better understanding of the etiology of institutional child maltreatment, 232 allegations of child abuse and neglect in New York State Office of Mental Health operated facilities were investigated with the hypothesis that environmental stresses placed on professional child care workers can precipitate incidents of child maltreatment in institutional settings in the same way that stress and anxiety experienced by a parent can contribute to incidents of abuse in the home. The study focused on administrative policy decisions, patient census and admissions, seasonal influences, staffing levels and identifiable one-time disruptions in daily routines as potential contributors to institutional abuse. A multivariate regression analysis revealed a significant four-variable model for predicting the number of reports of abuse and neglect per month, R2 = .585, F(4,21) = 7.41, p less than .01. Potential preventive measures based on this model were suggested.     

How to avoid burnout: A study of the relationship between burnout and worker,organizational and management characteristics in eleven child abuse and neglect projects

In conclusion this study affirms the hypothesis that burnout occurs when a constellation of factors--relating to worker, organizational and management--interact to create an alienating work environment. It suggests that solutions to the problem of worker burnout and performance require a systematic assessment of each of these areas to determine how and in what ways they contribute to burnout in any one particular agency. Further study and investigation that focuses on the interaction among worker, organizational and management characteristics is needed to affirm what common practices in social agencies lead to burnout and interfere with performance. Thereby, developing a relevant theory of management for social agencies that deals effectively with a high degree of uncertainty In the work task, that meets the needs and expectations of a professional manpower, and that can respond to changing and often hostile environmental conditions.     

Evaluation of parenting,depression and violence profiles in methadone maintained women

Twenty-one patients of the Family Center Program for pregnant drug dependent women were studied employing tools which indicate potential ability to parent or risk of child abuse. The Profile of Mood States and Beck Depression Inventory were administered, and a Violence Questionnaire was self-administered to ascertain the presence of physical or sexual abuse in the mothers' lives. These results were compared to an assessment of parenting ability as well as general demographics and urinalyses which indicate whether the mothers were taking any drugs in addition to their methadone. Results revealed that there were strong relationships between parenting ability and abusive life events, prenatal clinic attendance, use of depressant drugs, number of children, age, and education and/or employment. These variables were also interrelated with depression, abnormal mood states, and general drug abuse. It appears that while polydrug abuse, psychological problems, and stressful life events are strong indicators of poor parenting ability, the successfully methadone maintained woman who does not feel the need to supplement her methadone with other drugs, whose life has stabilized, and who is relatively normal in her affect and mood, has a strong potential for good childrearing ability.