Nonabusive Parents Research Articles

Repetitive mild traumatic brain injuries in children of abuse

Repetitive mild traumatic brain injuries in children of abuse

Improving professional practice in the investigation and management of intrafamilial child sexual abuse: Qualitative analysis of serious child protection reviews

BackgroundLocal multi-agency case reviews are regularly held in England when children have suffered significant harm from abuse or neglect, including from child sexual abuse (CSA). Most CSA takes place within families, is common but under-reported and can cause long-term harm. ObjectiveThe aim was to analyse English child protection reviews relating to intrafamilial CSA to identify improvements for professional practice. Participants and settingLocal Child Safeguarding Practice Reviews (LCSPRs) and Serious Case Reviews (SCRs) relating to serious incidents of intrafamilial CSA occurring between 01 April 2017 and 31 March 2020. MethodsLCSPRs and SCRs were obtained from the National Case Review Repository and thematically analysed. ResultsThere were 243 reviews, of which 25 featured intrafamilial CSA. The main themes related to perpetrators, vulnerable families, and professional practice. Half of perpetrators were known by services to have previously abused children, but issues with professional practice enabled them to continue. Most children did not disclose CSA verbally showing challenging or sexualised behaviour; but professionals lacked knowledge and confidence on how to intervene without verbal disclosure, which limited safeguarding actions. Non-engagement by families with services was common, with some non-abusing parents complicit in abuse and deception. Significant neglect occurred in half the families, which diverted professional attention away from CSA. ConclusionCSA is deliberate abuse of children involving considerable deception by perpetrators in contrast to some other types of child abuse. This difference in abuser behaviour makes child protection more difficult, particularly when professionals do not recognise and respond to children's non-verbal disclosures.

Gendered Discourses of Responsibility and Domestic Abuse Victim-Blame in the English Children’s Social Care System

PurposeThis paper foregrounds the experiences of mothers involved with England’s children’s social care system when experiencing domestic abuse. It reports on data from a survivor-led study on domestic violence and/or abuse (DVA), involving women victim-survivors and domestic abuse practitioners. It aimed to understand how dominant discourses governing child protection work with families in which there is a perpetrator of DVA, might be revised to shift a tendency to hold mothers (solely) responsible for the protection of children as well as for their partners’ abuse.MethodsThe study advances a discourse analysis of interview and focus group data, substantiating how children’s social care practices produce the routine responsibilisation of the non-abusing parent, usually the mother, with limited focus on the abusing parent, usually the father.ResultsThe paper exposes the gendered discourses of mother-victim-blame and responsibility patterning children’s social care responses to domestic abuse, which together intensify adult and child victim-survivor material harm and hamper child protection work. Also in evidence are the enduring traumatic consequences of the court-ordered removal of children.ConclusionThe paper has implications for policy and practice, asserting that shifting responsibility away from mothers requires the ongoing interrogation of normative understandings of gender relations and gender-role stereotypes as they manifest in families. Fathers’ accountability should be constructed on a structural as well as individual level, which in the case of DVA and the family, incorporates efforts to enable perpetrators of DVA to cultivate an individual sense of responsibility and accountability, as standard practice.

What can go wrong in child arrangement proceedings where there are allegations of domestic abuse?

ABSTRACT Research suggests that there are significant problems with the way that the family courts deal with child arrangement proceedings involving domestic abuse. As allegations of domestic abuse are present in the majority of cases reaching the courts for a decision about who a child should spend time with, it is essential that the process and outcomes are safe for non-abusive parents and children. However, the recent conjoined appeal Re-H-N and others highlights flaws with the fact finding process and the presumption of parental involvement, resulting in minimisation of domestic abuse. These flaws were also identified by the 'Harm Panel' report (2020), which made recommendations for fundamental reforms. The Court of Appeal does not specify the nature of the reforms needed, but does confirm the need for a fresh approach. This case note will consider what went wrong in the four cases considered by the appellate court and how the cases bolster the urgent need for reform.

Reaching everyone in general practice? Feasibility of an integrated domestic violence training and support intervention in primary care

BackgroundPrimary care needs to respond effectively to patients experiencing or perpetrating domestic violence and abuse (DVA) and their children, but there is uncertainty about the value of integrated programmes. The aim of the study was to develop and test the feasibility of an integrated primary care system-level training and support intervention, called IRIS+ (Enhanced Identification and Referral to Improve Safety), for all patients affected by DVA. IRIS+ was an adaptation of the original IRIS (Identification and Referral to Improve Safety) model designed to reach female survivors of DVA.MethodsObservation of training; pre/post intervention questionnaires with clinicians and patients; data extracted from medical records and DVA agency; semi-structured interviews with clinicians, service providers and referred adults and children. Data collection took place between May 2017 and April 2018. Mixed method analysis was undertaken to triangulate data from various sources to assess the feasibility and acceptability of the intervention.ResultsClinicians and service providers believed that the IRIS+ intervention had filled a service gap and was a valuable resource in identifying and referring women, men and children affected by DVA. Despite increased levels of preparedness reported by clinicians after training in managing the complexity of DVA in their practice, the intervention proved to be insufficient to catalyse identification and specialist referral of men and direct identification and referral (without their non-abusive parents) of children and young people. The study also revealed that reports provided to general practice by other agencies are important sources of information about adult and children patients affected by DVA. However, in the absence of guidance about how to use this information in patient care, there are uncertainties and variation in practice.ConclusionsThe study demonstrates that the IRIS+ intervention is not feasible in the form and timeframe we evaluated. Further adaptation is required to achieve identification and referral of men and children in primary care: an enhanced focus on engagement with men, direct engagement with children, and improved guidance and training on responding to reports of DVA received from other agencies.

Parental substance use disorder and child abuse: risk factors for child maltreatment?

Although the literature consistently shows an association between parental substance use disorders (SUDs) and child abuse, it is unknown what factors discern non-abusive and abusive parents with SUDs. This study aims to investigate which specific risk factors are associated with child abuse in clinically treated parents with SUDs in the Netherlands. It examines two groups of parents with SUDs in a clinical setting, with and without known instances of child abuse. These groups were compared on SUD-related factors such as the type and severity of the SUDs, and variables addressing psychological disability such as comorbid diagnoses and quality of life. Other than a marginally significant difference in severity of addiction and a lower mean age of the parents in the child abuse group, no significant differences were found. The small sample size and the inherent difficulty of studying SUDs in a clinical sample is likely to have affected the results.

The Effects of Intimate Partner Violence on Children: Navigating Therapeutic Assessment and Intervention

Over 5 million American children are estimated to be exposed to intimate partner violence (IPV) annually. The past decade has seen a surge in research, assessment, and related interventions regarding children and violence. Contemporary practice guidelines continue to expand relative to the wide range of violence that a child might be exposed to, particularly noting that children who have experienced one type of violence, such as physical abuse, are at great risk for also experiencing other forms of violence. Effects on children exposed to IPV are potentially catastrophic and can be influenced, by not only the number of exposures, but also the protective factors that are available to a child when violence is encountered. Treatment should be individualized and appropriate for the developmental level of the child. It is also essential to identify and include the child’s non-abusive parent into the process to support the child and related treatment

Affective reactivity to cry sounds predicts young women’s reactivity and behavior in a simulated caregiving task

Different populations of adults (experienced vs. inexperienced caregivers, men vs. women, abusive vs. nonabusive parents, etc.) have been reported to differ in their affective reactions to the sounds of infant crying. These differences are thought to impact caregiving behavior and, in some instances, to affect long-term outcomes for infants. There can be great intra-group variation, however, even when group differences are significant; modeling developmental process will require a finer grained approach. We have undertaken a pair of studies intended to validate the Negative Affect Scale (NA) from the PANAS as a measure of individuals’ affective reactivity to cry sounds. In Study 1, 306 young women who were not yet mothers listened either to infant crying or to birdsong. The results supported the NA as a measure of reactivity to crying. In Study 2, a new sample of 301 young women listened to crying in a screening task; a group of “high reactors” (n = 21) and a group of “low reactors” (n = 22) then participated in a simulated caregiving situation. Individuals’ affective reactivity to the caregiving simulation mirrored their affective reactivity in the screening task, and rates and overall organization of caregiving behavior differed between the groups. Changes in negative affect, then, appear to be both a result of infant crying and a determinant of some aspects of caregiving behavior. Further studies will extend these laboratory results to real infants and their caregivers, and further validate the NA as a measure of individual differences in reactivity to cry sounds.

IMPRoving Outcomes for children exposed to domestic ViolencE (IMPROVE): an evidence synthesis

Background: Exposure to domestic violence and abuse (DVA) during childhood and adolescence increases the risk of negative outcomes across the lifespan. Objectives: To synthesise evidence on the clinical effectiveness, cost-effectiveness and acceptability of interventions for children exposed to DVA, with the aim of making recommendations for further research. Design: (1) A systematic review of controlled trials of interventions; (2) a systematic review of qualitative studies of participant and professional experience of interventions; (3) a network meta-analysis (NMA) of controlled trials and cost-effectiveness analysis; (4) an overview of current UK provision of interventions; and (5) consultations with young people, parents, service providers and commissioners. Settings: North America (11), the Netherlands (1) and Israel (1) for the systematic review of controlled trials of interventions; the USA (4) and the UK (1) for the systematic review of qualitative studies of participant and professional experience of interventions; and the UK for the overview of current UK provision of interventions and consultations with young people, parents, service providers and commissioners. Participants: A total of 1345 children for the systematic review of controlled trials of interventions; 00 children, 202 parents and 39 professionals for the systematic review of qualitative studies of participant and professional experience of interventions; and 16 young people, six parents and 20 service providers and commissioners for the consultation with young people, parents, service providers and commissioners.

Child abuse potential inventory in Italy: A comparative study of abusive and nonabusive parents

ABSTRACTThe aim of this study was to explore the reliability and ability of the Child Abuse Potential (CAP) Inventory to discriminate parents in an Italian sample who are physically child abusive and physically nonabusive parents. The CAP Inventory and measures on parenting stress (PSI-SF) and parents’ attributions of child adjustment (CBCL) were administered in a sample of 37 abusive and 102 nonabusive parents in an Italian sample: Both groups of the respondents were similar in age, gender, marital status, and education. The Abuse scale showed adequate internal consistency (α = .86) and 52 items significantly discriminate between abusive and nonabusive parents. Moreover, the mean score of abusive parents (M = 194.5) was significantly higher than the mean score of nonabusive parents (M = 78) and the Abuse scale was correlated with parenting stress and parental perceptions of maladjustment in children (in terms of internalizing and externalizing symptoms). Finally, with the cut-off suggested in the original version of the CAP Inventory (Milner, 1986) when abusive and nonabusive groups are compared (166), the Abuse scale correctly classified 70.3% of the abusive group and 100% of the nonabusive group. These results showed adequate reliability and validity of the Abuse scale for Italy.

In the Best Interests of the Abuser: Coercive Control, Child Custody Proceedings and the “Expert” Assessments That Guide Judicial Determinations

This paper outlines why domestic violence (or more specifically, coercive control) should be crucial to child custody proceedings. What is known about parenting in the context of coercively controlling violence, and what the legislation directs courts to consider, is juxtaposed with the actuality of court decision making. Current knowledge about the recognition of domestic violence in judicial practice is overviewed, drawing particular attention to the role of the “expert” family assessment in determinations of a child’s “best interests”. A comprehensive synopsis of the existing research on these “expert” reports in Australia, the United Kingdom and the United States is provided. It is concluded that, in court proceedings the reality of living with coercively controlling violence and the potential on-going risks it poses to children and non-abusive parents, is typically negated. Instead, “best interests” considerations prioritise the maintenance of perpetrator/child relationships, and thus “abuser’s rights” over victim safety. Judicial officers are not experts in domestic violence and they can only make decisions on the basis of the evidence before them, the assessments made by the “experts” likely play an important role in best interest considerations. Of concern is current research that calls into serious question the expertise of these “experts” when it comes to proceedings involving allegations of coercively controlling violence.

What parental characteristics can predict child maltreatment at the Emergency Department? Considering expansion of the Hague Protocol.

The Hague Protocol considers three parental characteristics of Emergency Department adult patients to identify child abuse: (a) domestic violence, (b) intoxication, and (c) suicide attempt or auto mutilation. This study investigated whether additional parental characteristics could be included to improve the chance of detection. Using a nested case-control design, we compared parents identified as child abusers who were missed by the Protocol with a matched group of nonabusing parents. The parental characteristics used were, among others, all physical injuries possibly resulting from domestic violence, psychological, or mental complaints that might indicate elevated domestic stress levels and the number of Emergency Department visits during the previous year. None of the characteristics were statistically significantly associated with child abuse. The Hague Protocol will not be improved by adding one or more of the characteristics that were investigated.

Validation of the Child Abuse Potential Inventory in Italy

The aim of this study was to provide preliminary findings on the reliability and the validity of the Italian Child Abuse Potential (CAP) Inventory, a screening tool that measures parents’ potential for child physical abuse. The CAP Inventory and measures on parenting stress (Parenting Stress Index–Short Form [PSI-SF]) and parents’ perceptions of child adjustment (Child Behavior Checklist [CBCL]) were administered in a nonclinical sample of Italian parents ( N = 551) with a 2- to 6-year-old child. The Abuse scale showed adequate internal consistency (α = .87), with significantly negative correlations between socioeconomic status and educational level of the parents. Also, the Abuse scale scores were significantly predicted by high levels of parenting stress and by parental negative perceptions of the child’s behavior. Finally, using a cut score for the English version of the Abuse scale (where 95% of parents would be expected to be classified), 93.8% of Italian parents were classified as nonabusive by the Abuse scale. These results supported the cross-cultural generalizability of the Abuse scale. However, complementary studies with abusive samples are needed to verify the ability of the instrument to discriminate between abusive and nonabusive parents also in the Italian population.

Family Dysfunction and Social Isolation as Moderators Between Stress and Child Physical Abuse Risk

Stress is a significant contributor to child physical maltreatment risk. Family and social supports are expected, but less studied, risk factors. Little empirical support clarifies the interactive influence on abuse risk for non-abusive parents. This study examined whether the stress-abuse risk relation was moderated by family dysfunction and social isolation. Subjective appraisals of these factors were administered to 95 community mothers. After creating composite scores using factor loadings from a CFA, multiple regression analyses were conducted to predict abuse risk. As expected, stress predicted abuse risk, with social isolation and, to a lesser extent, family dysfunction serving as moderators. Perceived stress and dysfunctional supports are important, interactive predictors of abuse risk. Future directions consider interactions within other ecological levels.

Child sexual abuse and subsequent relational and personal functioning: The role of parental support

This study examined the role of nonoffending parental support in the relationship between child sexual abuse (CSA) and later romantic attachment, psychiatric symptoms, and couple adjustment. Of 348 adults engaged in stable romantic relationship, 59 (17%) reported sexual abuse. In this subgroup, 14% (n=8) reported parental intervention after the abuse was disclosed (i.e., support), 15% (n=9) reported a lack of parental intervention after abuse disclosure (i.e., nonsupport), and 71% (n=42) reported that their nonabusive parent(s) was(were) unaware of their abuse. Results indicated that, compared to other groups, CSA survivors with nonsupportive parents reported higher levels of anxious attachment, psychological symptoms, and dyadic maladjustment. In contrast, CSA survivors with supportive parent(s) expressed psychological and couple adjustment equivalent to non-abused participants, and lower attachment avoidance, relative to all other groups. Path analysis revealed that insecure attachment completely mediated the relationship between perceived parental support after CSA and later psychosocial outcomes. An actor–partner interdependence model showed different patterns for men and women and highlighted the importance of considering relational dynamics in dyads of CSA survivors. Overall, the results suggest that perceived parental support serves as a protective factor among those exposed to CSA.

A preliminary examination of perceptions of betrayal and its association with memory disturbances among survivors of childhood sexual abuse.

Disturbances in memories of abuse among survivors of childhood abuse have been well documented. However, less is known about who is most likely to suffer such disturbances. This article examines the extent to which Betrayal Trauma Theory (BTT) can account for differences in memory disturbances. Freyd (1996) posited that betrayal by a caregiver, who is also someone with whom the child needs to maintain a relationship, is at the core of forgetting about traumatic childhood abuse experiences. We examined whether abuse perpetrated by a caregiver would be associated with greater feelings of betrayal and more strongly predictive of memory disturbances than abuse perpetrated by noncaregivers. We also applied BTT to the nonabusing parent and assessed perceptions of betrayal by the nonabusing parental figure and its relation to memory disturbances. Participants were 113 treatment-seeking women with histories of childhood sexual abuse. Results suggested that those abused by a caregiver have greater perceptions of betrayal and greater disturbances in memory than those abused by nonparental figures. Perceptions of betrayal by the nonabusing parental figure were also found to be associated with dissociation.

Fostering Healthy Attachment Between Substance Dependent Parents and Their Infant Children

Infants of parents with substance abuse problems enter foster care at a higher rate than infants of nonabusing parents and are at a higher risk for attachment problems and child maltreatment. The current study evaluates the impact of a 10-week infant massage intervention designed to increase attachment between parents in a drug rehabilitation facility and their infants. The program focuses on parental awareness of infant's internal states, the development of skills for self-regulation of affect, the calming of their child, and the development of a capacity for sustained positive parent-child interaction so that parents can become more available in the psychological space and time they spend with their infant children. Parent participants, interviewed before and after the intervention, completed a demographic and program evaluation survey, as well as standardized measures of parent knowledge of child development, parenting stress, and depression. Results indicate trends towards decreased parental stress, increased knowledge of good parenting practices, better relatedness between parent and infant, and improved parenting self-efficacy, suggesting that attachment interventions with substance dependent parents may have substantial benefits for the parent-child relationship as well as the mental health functioning of parent and child.

“If you’re not safe anywhere, you turn it inside yourself”: Narratives about childhood experiences told by 12 individuals diagnosed with psychosis

The aim was to study what patients diagnosed with psychosis related about early relationships with caregivers and about themselves as children. Data consisted of transcripts of 12 interviews, which were analyzed according to a thematic analysis. Through the narratives, a picture emerged of parents who had been unable to put aside their own difficulties and negative emotions. Parents were portrayed as sexually, physically, and/or emotionally abusive, often in tandem with a non-abusive parent described as passive. A family atmosphere marked by silence became visible. Further, a picture appeared of an introverted and “conformable” child, who had handled sadness, as well as fear, alone. Childhood strategies such as daydreaming and ”trying to become invisible” emerged. These strategies resemble what in other frames of reference are often regarded as childhood symptoms of schizophrenia spectrum disorders. Consequently, it could be questioned whether what are commonly viewed as early symptoms of schizophrenia might instead be the child’s attempts to adapt, in order to survive in a disorganized family.

Help for children after child sexual abuse: Using a qualitative approach to design and test therapeutic interventions that may include non-offending parents

This article is about the use of qualitative methods in the design and development of new ways of intervening to help children who have been sexually abused. Specifically, it is about ways of including non-abusing parents and carers constructively in the intervention; about the complex, triangular relationships between social workers, children and parents that result; and about the contribution of qualitative methods to the design and development of such interventions. The difficulties of defining a precise model of intervention are discussed. But despite these difficulties, this article discusses the qualitative research strategies that were used to describe causal processes leading to outcomes and to identify factors that are indicative, or counter-indicative, of constructive parental involvement in children’s therapy. Using these methods it has been possible, first, to describe the dynamics of successful helping processes, second, to identify aspects of professional expertise and, finally, to identify ways in which service users are active in shaping interventions.

A Preliminary Evaluation of a Massage Program for Children Who Have Been Sexually Abused and their Nonabusing Mothers

The aim of this study was to conduct a pilot evaluation of the Mosac Massage Program, a novel program that uses massage to address some of the difficulties faced by children who have been sexually abused and their nonabusing parents. Interviews were conducted with four participating mothers immediately before and after the program. Benefits included improved bonding and communication between mother and child and a relaxing and enjoyable therapy for both mother and child. The program appeared to be a useful complement to talking therapies. Further evaluations are needed to confirm the potential benefits.