Training program in child abuse for community health workers

Abstract

A wide range of health workers in the community provide care for families that abuse or have a potential for abusing their children. Frequently these workers are unable to work effectively because of difficulty dealing with feelings aroused by contact with such families. An experimental child abuse training program for community health workers was designed by a pediatrician, a social worker, a public health nurse and two child psychiatrists. This program included a six-month study group which met weekly to focus on feelings and conflcts aroused during the course of work with abusing or potentially abusing families. Through analysis of the group experience, the leaders identified eleven sets of feelings or conflicts which seemed to interfere consistently with effective delivery of care: 1)anxieties about a) being physically harmed by angry parents and b) about the effects of a decision; 2) denial and inhibition of anger; 3) need for emotional gratification from clients; 4) lack of professional support; 5) feelings of incompetence; 6) denial and projection of responsbility; 7) feeling total responsibility for assigned families; 8) difficulty separating personal from professional responsibility; 9) feelings of being a victim; 10) ambivalent feelings a) toward clients and b) about one's professional role; 11) need to be in control. This type of group experience seems to be an effective method for exploration and resolution of feelings and conflicts.