Factors associated with successful and unsuccessful intervention with child abusive families

The authors conducted a treatment outcome study on 79 patients engaged in a program for maltreating parents. Treatment modalities included individual psychotherapy and counseling, group therapy, home visiting, and telephone advocacy with the duration of treatment ranging from 6 sessions to 36 months. On the basis of ratings by the primary therapist consensually validated by other staff, $\text{2}\text{3}$ of the sample demonstrated at least symptomatic improvement, whereas 28% improved significantly. Overall improvement was highly correlated with more subtle indices of childrearing, perception of the child, object relations, insight, and capacity for self-observation. The profiles of those maltreating parents who improved and those who did not emerged with respect to the impact of critical demographic, psychological, and therapeutic variables. Favorable outcomes were unlikely among parents who themselves had a history of maltreatment, who inflicted the more severe injuries, who entered the program involuntarily or who terminated against advice; while positive results were more prevalent in those parents with a less abusive childhood experience and who perceived a need for involvement in the program. Home visiting and advocacy appeared to enhance the potential for improvement.