Toward effective community-based interventions in child abuse.

Abstract

Traditional individual and family-oriented clinical and educational approaches to treating child-abusing parents seem to have limited effectiveness. Within an ecological framework, causal factors bearing on the problem of child abuse are amenable to community intervention through use of such concepts as natural support systems and community development activities. An example of community development intervention is described, and guidelines for community-level interventions are suggested. The consultation and education program of the community mental health center is cited as one such approach to this problem. Child abuse has become an increasingly visible problem in the last two decades, but effective intervention programs have not kept pace with the concern over the problem. Child protective service workers are already overburdened with cases, and even if treatment of abusing families were a defined part of their role, they usually lack the time, training, and experience for such interventions. One alternative in many communities is to refer child abuse cases for psychotherapeutic treatment, often to community mental health centers. However, referring cases for treatment often does not resolve the problem, because most evidence indicates that psychotherapy is not sufficiently effective to justify psychotherapy, or other forms of individual or family treatment, as a prevalent form of intervention-. This article briefly reviews the evidence for this assertion and discusses alternative community support interventions based on contemporary research on child abuse.