Child Abuse Treatment Research Articles

Book Review: Treatment of child abuse: Common ground for mental health, medical and legal practitioners

Book Review: Treatment of child abuse: Common ground for mental health, medical and legal practitioners

Sibling Abuse: A Study of School Counselors’ Shared Attitudes and Beliefs

The impact of sibling abuse on children and adolescents is rarely contemplated. Counselors are in a position to advocate for all children and protect them from harm; yet one source of harm that counseling practitioners and educators might be unaware of stems from violence between siblings, which can become abusive. In this article, findings are presented from a phenomenological study examining eight practicing school counselors' attitudes and beliefs about sibling abuse and the contexts or situations that have influenced them. Seven themes emerged supporting school counselors' perceptions of their role in responding to sibling abuse and their beliefs about factors contributing to sibling abuse. Recommendations for advocacy for children and adolescents are offered for counselor educators, counselors-in-training and counseling practitioners, school counselors in particular.Keywords: sibling abuse, school counselors, advocacy, children, adolescentsAll counselors advocate for their clients (American Counseling Association [ACA], 2014; Ratts & Hutchins, 2009). School counselors, in particular, often perform a fundamental role in advocating for the well-being of children and adolescents (American School Counselor Association [ASCA], 2012; Ratts, DeKruyf, & Chen-Hayes, 2007). A unique aspect of practice for school counselors is that they work with children and adolescents on a daily basis and often over a longer period of time than other counselors in the community. School counselors' close proximity to children and adolescents within the school system also allows them to advocate for students systematically year after year.One important way that school counselors can advocate for students is by protecting them from harm. In accordance with the Child Abuse Prevention and Treatment Act (Children's Bureau, 2010), the ASCA Ethical Standards (2010) and the ACA Code of Ethics (2014), school counselors must report any suspicion of child abuse or neglect to child protective service (CPS) agencies. School counselors often receive training on abuse recognition and reporting (Alvarez, Donohue, Kenny, Cavanagh, & Romero, 2005; Kominkiewicz, 2004; Lambie, 2005; Minard, 1993). However, child abuse training is typically exclusively focused on parent-to-child abuse or abuse by another adult over the age of 18.Abuse of children by adults may not be as prevalent as other forms of abuse against children. A less commonly explored form of family violence is sibling abuse. In the past, sibling abuse was considered a normal rite of passage that most children experience and was misidentified as sibling rivalry (Phillips, Phillips, Grupp, & Trigg, 2009). However, results from National Family Violence Surveys indicated that violence between siblings was extensive and harmful (as cited in Straus, Gelles, & Steinmetz, 1980). Wiehe (2002) summarized that participants in these surveys revealed the rates of sibling abuse make the high rates of other forms of family violence, such as parents abusing children or spouses abusing each other, seem modest by comparison (p. 2). In addition to potentially being the most prevalent form of abuse, it also has been determined that violence between siblings was the least reported and researched form of family abuse (Eriksen & Jensen, 2006, 2009). Stutey (2013) posited that a lack of federal laws and protocol for reporting sibling abuse, as well as the absence of a definition for sibling abuse in the school counseling literature, might contribute to this problem.For this study, the term sibling aggression was utilized to represent a continuum of behaviors beginning with mild aggression (i.e., competition and conflict) and progressing to severe aggression (i.e., violence and abuse; Caspi, 2012). Sibling abuse and sibling violence were both viewed as severe forms of sibling aggression, with sibling abuse being the most severe. Sibling abuse has been defined as the unilateral physical, emotional or sexual harm of one sibling by another (Caspi, 2012). …

The Professional's Influence within the Client System: Exploring Counter-Transference and Adult Attachment within the Therapeutic Relationships with Children Experiencing Abuse and Their Caregivers

A large amount of research has been completed on the impact of abuse and neglect on children's brain development, attachment and behaviour (Malinosky-Rummell & Hansen, 1993, ‘Long-term consequences of childhood physical abuse’, Psychological Bulletin, vol. 114, pp. 68–79; Margolin & Gordis, 2000, ‘The effect of family and community violence on children’, Annual Review of Psychology, vol. 51, pp. 445–479; Perry, 2002, ‘Childhood experiences and the expression of genetic potential: what childhood neglect tells us about nature and nurture’, Brain and Mind, vol. 3, pp. 79–100; van der Kolk, 2005, ‘Developmental trauma disorder’, Psychiatric Annuals, vol. 35, no. 5, pp. 401–408). Research has also begun to address the impact on the professional's and carer's psychological well-being, as a result of working with children who have experienced abuse and neglect (Cunningham, 1999, ‘The impact of sexual abuse treatment on the social work clinician’, Child and Adolescent Social Work Journal, vol. 16, pp. 277–290; Trippany, Kress and Wilcoxon, 2004, ‘Preventing vicarious trauma: what counsellors should know when working with trauma survivors’, Journal of Counselling and Development, vol. 82, pp. 31–37; Conrad & Kellar-Guenther, 2006, ‘Compassion fatigue, burnout and compassion satisfaction among Colorado child protection workers’, Child Abuse and Neglect, vol. 30, pp. 1071–1080). Psycho-dynamic concepts such as projection and splitting have begun to be explored in how children who have experienced abuse communicate their experience to their carers and the professionals involved with them. Some authors (Dale et al., 1986, Dangerous Families: Assessment and Treatment of Child Abuse, Tavistock Publications, London) have also explored the impact of the psycho-dynamics on the treatment team and the ‘splitting’ that can occur among professionals involved with the child. This paper aims to extend this reflection to also consider the impact of the professional's attachment history, early childhood experiences and current personal relationships on the child and caregiver's systems. Therefore, concepts such as counter-transference and adult attachment styles within the therapeutic relationship are explored and examples provided from my own practice.

Personal reflections about the work of the U.S. Advisory Board on Child Abuse and Neglect

Created by amendments in 1988 to the Child Abuse Treatment and Prevention Act of 1974 and first convened in 1989, the U.S. Advisory Board on Child Abuse and Neglect issued a series of passion- and research-laden reports that articulated a new neighborhood-based strategy for child protection in the United States. In so doing, the Board went far beyond the vision of its congressional creators, the most relevant federal agencies, and the field itself. The dedication, daring, collegiality, and public spirit of the drafters and ultimately the moral and intellectual power of the reports themselves were awe-inspiring, as was the level of public attention given to the Board's initial declaration of a national emergency. However, the specific effects on policy were quite limited. Possible reasons for the enormous gap between the strength of the Board's vision and the weakness of its implementation are reviewed. In the end, the history of the Board may be a case study of a single but notable step in a long process toward redemptive cultural change in the status and safety of children.

Introductory Assessment and Characteristics of the Legal System of the Child Abuse and Neglect Treatment in Japan as Seen Empirically

Introductory Assessment and Characteristics of the Legal System of the Child Abuse and Neglect Treatment in Japan as Seen Empirically

Treatment of Child Abuse: Common Ground for Mental Health, Medical, and Legal Practitioners – Second edition Reece Robert M (Eds) et al Treatment of Child Abuse: Common Ground for Mental Health, Medical, and Legal Practitioners – Second edition 392pp $65/£50 Johns Hopkins University Press 978 1 4214 1273 3 142141273X

This American text is a resource packed with useful information for those involved in the care of children and their families.

Prevention of violence against children and psychosocial models of intervention: Network analysis of an inter-institutional service

This study describes an Italian service, the Inter-institutional Groups Operating against child Abuse and Maltreatment (GOIAM), which specializes in the treatment of child abuse. The GOIAM service is composed of 53 professionals divided into four different categories: social workers, psychologists, child neuropsychiatrists, and psychopedagogists. With the aim of detecting strengths and weaknesses of the operative model adopted by GOIAM, the whole service was analyzed through the application of social network analysis (SNA). The analysis revealed a low-density network, while the study of centrality yielded different distributions of power indicators (degree, closeness, and betweenness): prestige and pervasiveness were balanced, while influence, reachability, and betweenness were quite unbalanced. The search for subgroups (N-clans, lambda sets, community structure) suggested the presence of many overlapping triads, leading to the formation of large clusters. The inspection of such groups revealed that professionals belonging to the same district tended to cluster. This condition did not promote the diffusion of opinions and expertise, and could be an important factor of weakness in an interdistrict service. The analysis of inter-groups relationships (brokerage) and the study of social roles (REGular Equivalence) showed that most professionals had “diffuse” roles through which they try to perform every task, exchanging assignments, activities, and positions. The flattening of the roles inside the organization might at first appear as facilitation, although this could represent a limit for a complex organization in the long term because it generates a lack of specialization. Finally, the potential evolution of the GOIAM network (P1 model) seems to be characterized by a further decrease in density, more isolation of peripheral nodes, an increase in centralization, and, consequently, a higher level of hierarchy in the network.

Screening, Testing, and Reporting for Drug and Alcohol Use on Labor and Delivery: A Survey of Maryland Birthing Hospitals

Recent amendments to the Child Abuse Prevention and Treatment Act tie the receipt of federal block grants to mandatory reporting of substance-exposed newborns. To determine rates of screening, testing, and reporting of drug and alcohol use at the time of delivery, we administered a telephone survey of nursing managers and perinatal social workers at Maryland birthing hospitals. Of the 34 hospitals, 31 responded (response rate 91%). Although 97% of hospitals reported universal screening, only 6% used a validated instrument. Testing was reported by 94% with 45% reporting universal maternal testing and 7% universal newborn testing. Only 32% reported obtaining maternal consent prior to testing. There is significant heterogeneity in screening and testing for substance use in birthing hospitals. Given federal reporting mandates, state-level practices need to be standardized.

Implementing Developmental Screening Programs for Infants and Toddlers in the Child Welfare System

In 2003, revisions to the Child Abuse Prevention and Treatment Act required states to develop plans to refer children younger than 3 years of age with a substantiated case of abuse and neglect for developmental screening. A decade after legislation was passed, its implementation varies considerably across states. This article explains how research informs the need for careful developmental monitoring of young children, especially those experiencing trauma or living under stressful conditions. Finally, this article presents how one community used colocation to increase developmental screenings for young abused and neglected children.

Will Your Religion Allow Youuto Live? The Mature Minor Doctrine, Religious Exemptions, and a Look into Louisiana Law

Imagine being fifteen years old and diagnosed with a rare disease that will kill you if you do not undergo certain medical procedures. Further imagine that the treatment the doctors say will save your life is a treatment that is utterly against your religion. Would you follow your religious beliefs, or would you follow the doctor’s highly recommended procedures? Would you weigh your parent’s beliefs, or are you mature enough to make the decision for yourself? Even if you think you are mature enough, will your home state allow your “mature” decisions to be considered in court? The 1974 Child Abuse Prevention and Treatment Act originally required states to adopt religious exemptions to child neglect in order to keep federal funding for child-protection programs. Despite the lifting of this requirement, many states still have the exemptions in force. Due to these exemptions, many children have died because their parents believe that they are not required to give their children proper medical treatment if it is against their religion. The mature-minor doctrine makes these issues even stickier. While some states use this doctrine in a very limited sense, others have adopted a broad interpretation that would allow a mature minor to refuse medical treatment while not holding the parents responsible. Each state has its own unique interpretation of religious exemptions and the mature-minor doctrine. Thus, both should be interpreted with particular caution. This article uses a 2013 Wisconsin Supreme Court case, Dane County v. Sheila W., as a factual backdrop to discuss the issues of religious exemptions and the mature-minor doctrine. These issues have not been heavily discussed in Louisiana, and this article seeks to provide an overview and a guide for when Louisiana is faced with a similar situation.

Predictors of Treatment Engagement in Ethnically Diverse, Urban Children Receiving Treatment for Trauma Exposure

Keeping traditionally underrepresented children and their families engaged in treatment until completion is a major challenge for many community-based mental health clinics. The current study used data collected as part of the National Child Traumatic Stress Network Core Data Set to examine whether racial/ethnic disparities exist in treatment duration and completion in children seeking treatment for trauma exposure. We then explored whether disparities persist after accounting for other variables associated with children's social contexts and the treatment setting. The sample included 562 ethnically diverse children receiving services from a child abuse prevention and treatment agency in Southern California. The results indicated that African American children had significantly shorter trauma-informed treatment duration and higher rates of premature termination than Spanish-speaking Latino children. These disparities persisted even with other variables associated with treatment duration and completion (e.g., child's age, level of functional impairment, and receipt of group and field services) in the model. Implications and future directions for research and practice are discussed.

Caregiver-Fabricated Illness in a Child: A Manifestation of Child Maltreatment

Caregiver-fabricated illness in a child is a form of child maltreatment caused by a caregiver who falsifies and/or induces a child's illness, leading to unnecessary and potentially harmful medical investigations and/or treatment. This condition can result in significant morbidity and mortality. Although caregiver-fabricated illness in a child has been widely known as Munchausen syndrome by proxy, there is ongoing discussion about alternative names, including pediatric condition falsification, factitious disorder (illness) by proxy, child abuse in the medical setting, and medical child abuse. Because it is a relatively uncommon form of maltreatment, pediatricians need to have a high index of suspicion when faced with a persistent or recurrent illness that cannot be explained and that results in multiple medical procedures or when there are discrepancies between the history, physical examination, and health of a child. This report updates the previous clinical report "Beyond Munchausen Syndrome by Proxy: Identification and Treatment of Child Abuse in the Medical Setting" The authors discuss the need to agree on appropriate terminology, provide an update on published reports of new manifestations of fabricated medical conditions, and discuss approaches to assessment, diagnosis, and management, including how best to protect the child from further harm.

Early Childhood Interventionists' Perceptions of the Child Abuse Prevention and Treatment Act: Provider Characteristics and Organizational Climate

Research Findings: A 2003 amendment to the Child Abuse Prevention and Treatment Act (CAPTA) required states to develop plans to ensure that children younger than the age of 3 years who are victims of substantiated abuse or neglect have access to developmental screenings. Programs authorized under Part C of the Individuals with Disabilities Education Act are the designated providers of developmental screening and intervention services. This study explored the relationship of provider characteristics and organizational climate to the attitudes of early childhood interventionists about CAPTA. Findings indicate that publicly employed early childhood interventionists are generally willing to serve children referred from child welfare under CAPTA. Older workers are perhaps a little more skeptical about Part C's responsibilities under CAPTA. Regression analysis found that a positive organizational climate is associated with more positive perceptions of these responsibilities. Practice or Policy: When interventionists are viewed in an organizational context, it becomes easier to see how their attitudes and practices reflect systemic influences. Early childhood intervention program administrators should consider initiatives to foster positive work environments. This is especially important when service providers are required to implement new initiatives.

Future Directions for the Study and Application of Religion, Spirituality, and Trauma Research

A year ago at the international meeting of the Christian Association for Psychological Studies, I (Walker) stood in a symposium being chaired by Aten and asked if the church was really ready to respond to issues of child abuse, domestic violence, and in supporting survivors of wars or disasters. A year later, not much has changed with respect to the current state of research, training, and practice in religion, spirituality, and trauma among Christian practitioners. However, seeing the work that has been done in this special issue gives us cause for hope. In concluding the special issue, we topically review the issues that were raised by authors throughout this volume, and present our reflections on the state of research and practice in each area, with some suggestions for future research, training, and practice. In doing so, we will discuss child abuse prevention and treatment, intimate partner violence, responding to survivors of natural disasters, and integrative approaches to trauma treatment. Child Abuse Prevention and Treatment In presenting their call for more effective prevention and treatment of child abuse in the church, Vieth and his colleagues highlight several important issues for the Christian community to consider. First, Vieth provided a number of practical suggestions for preventing child abuse in churches and Christian organizations. We appreciate the thoughtfulness and practical nature of these policies, but question the degree to which they are currently being implemented in churches around the country. As practitioners who have treated courageous survivors of child abuse, we cannot emphasize enough the urgency with which we undertake the call to help churches prevent the abuse of children in their care. Collaboration with churches in implementing the protection policies that Vieth recommends is sorely needed. Along with that, as Vieth suggested in his article, training for clergy in responding to survivors of abuse is also needed. We are encouraged by Vieth's development of the When Faith Hurts Curriculum, and look forward to seeing its dissemination among clergy. As psychotherapists, we also highlight the need for Christian counseling and psychotherapy training programs to comprehensively consider child abuse treatment in their training, both in the curriculum and in providing opportunities to receive clinical supervision of treatment with survivors. One of us (Walker) directs the Child Trauma Institute in the PsyD program at Regent University. The Child Trauma Institute (CTI) aims to become an exemplar for research, training, and practice in this area. Students in the PsyD program at Regent have an opportunity to take a course entitled the Psychology of Trauma and Crisis, during which they receive training in Trauma-Focused Cognitive Behavior Therapy (TF-CBT; Cohen, Mannarino, & Deblinger, 2006) as well as Spiritually Oriented Trauma Focused Cognitive Behavior Therapy (SO-TF-CBT; Walker, Reese, Hughes, & Troskie, 2010). As part of the course, students are also taught to assess and comprehensively treat complex trauma among children and adults using evidence based, best practice assessment and treatment methods (e.g., Courtois & Ford, 2009). In addition to learning other treatments for adults, students are also taught Eliana Gil's play therapy methods for treating abuse (Gil, 2006). A primary emphasis in the course is on reading, then seeing therapeutic models of the various approaches, followed by opportunities for practice in the form of role-plays. Students participating in the Child Trauma Institute also have the chance to participate in clinical trials of SO-TF-CBT and, as a result, to receive clinical supervision of child abuse cases. To date, no research has been conducted on the comprehensiveness of training for child abuse and other forms of trauma among Christian counseling and psychology programs. However, we suspect that training may he lagging behind our secular counterparts in this area among most programs. …

Child Abuse and the Church: A Call for Prevention, Treatment, and Training

Child abuse is both a sin and a crime. In this article, we present a call to the global Christian church to prevent and treat child abuse, and to train professionals across disciplines to do so. Vieth discusses effective child protection policies in churches. Among other recommendations, he encourages consultation with child protection experts, thorough screening of child workers, and accountable supervision of children in church. Tchvidjian examines cultural aspects of missions organizations that contribute to the abuse of children in the mission field. He suggests that missions organizations who have failed to protect abused children in the past placed their reputation above child protection, failed to treasure children, and believed in God-sanctioned power and control of missions workers. Knodel reviews the efforts of Christian organizations to prevent the trafficking of children worldwide. She finds effective advocacy occurring across the globe but among Christian organizations that are rarely tied to any specific denominational support. Next, Walker reviews evidence-based treatment recommendations for children and adolescents. Trauma-focused CBT is a leading empirically supported treatment for child abuse. Recently, efforts have been made to sensitively integrate faith into TF-CBT. Vieth then discusses effective church responses to allegations of abuse. He suggests suspending the activities of a church worker when allegations are made against him or her in addition to informing the police. Tchivdjian concludes by discussing the mission and vision of the GRACE foundation—a multidisciplinary Christian nonprofit organization dedicated to protecting children from child abuse and treating children who have been abused.

Religion, Spirituality, and Trauma: An Introduction

Current research trends suggest that about half of all people will experience directly, or vicariously, some form of trauma over the course of their lifespan. Recent societal events, such as high profile child abuse cases and scandals, increased rates of post-traumatic stress disorder and suicide rates among returning veterans, and some of the worst natural disasters recorded in history have brought greater attention to issues of trauma. With this have come several advances in our understanding and treatment of trauma. As a result, this area of study has seen an increase in the diversity of topics investigated and sophistication of research methodologies implored. Despite these significant gains, there is still much to be learned about the unique role of religion and spirituality in relation to trauma. Thus, the purpose of this special issue is to contribute to this burgeoning body of literature. Before describing the work contained in the pages that follow, we briefly share some background about where our interest and work on faith and trauma began. This special volume has evolved out of our shared professional and personal experiences. Both of us, at different times in our personal and professional lives have been deeply moved by first-hand accounts of trauma. I (Aten) had just finished graduate school and had moved to South Mississippi to start my first academic appointment. Little did I know that Hurricane Katrina would strike the Gulf Coast just six days later. I saw first hand how devastating and far-reaching trauma can be. Perhaps even more importantly, I saw first hand how the church cared for trauma survivors and how faith helped bring about meaning and recovery to survivors. Within two months my research team had completed our first study on religion and trauma among Hurricane Katrina survivors. It was these early experiences after Hurricane Katrina--and years that followed of living in, studying, and working with communities affected by this disaster--that has led me to continue this work in other regions domestically and internationally, and ultimately to my involvement in this special volume. One of us (Walker) was working on a child abuse treatment team in a secular community mental health center near his hometown in Canton, Ohio for his predoctoral internship. I (Walker) remember working on a Child Abuse Treatment Team that year, and seeing a client who had been beaten to the point that he had broken bones. I was horrified, and shocked to learn that a child, living twenty minutes from where I had grown up, had been treated this way by his family. In attempting to help another child client to process his reactions to his abusive experience, I once asked him if he had talked to God about what had happened. The client responded by saying that he was not sure that God could help. In that moment, I realized that nothing in the course of study in my PhD, my theology degree, or my integrative training had adequately prepared me for how to respond. I have since spent a good deal of my professional life trying to understand the process of healing from child abuse from the perspective of survivors and their therapists. …

Child maltreatment—Clinical PTSD diagnosis not enough?!: Comment on Resick et al. (2012)

Child maltreatment has a high prevalence. It can lead to severe psychological and physical problems from childhood to late adulthood. At present, the recognition and treatment of child abuse and its consequences is inadequate. Diagnostic criteria, such as those defined in the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, are vital for that purpose. Resick and colleagues (2012) conclude that insufficient scientific basis now exists for incorporating complex posttraumatic stress disorder (CPTSD) into DSM-5. Although they are right from a research point of view, what would be the clinical, political, and social consequences of not including it? This comment discusses those consequences from the standpoint that treating children with developmental trauma disorder at an early age will serve to prevent later sequelae.

Implementing Child Abuse Prevention and Treatment Act (CAPTA) Requirements to Serve Substance-Exposed Newborns: Lessons From a Collective Case Study of Four Program Models

The Child Abuse Prevention and Treatment Act (CAPTA) of 2003 requires states to develop procedures to notify child protective services of newborns prenatally exposed to illegal substances and develop plans of safe care. In 2005 the Administration for Children and Families awarded grants to four programs to develop models for implementing these CAPTA requirements. Although the programs were quite varied, they encountered similar challenges collaborating across agencies, developing effective protocols for identifying exposed newborns, and engaging families in services. This article describes the programs, discusses how they implemented CAPTA requirements, and presents recommendations for other communities.

Provider cultural competency, client satisfaction, and engagement in home-based programs to treat child abuse and neglect.

Home-based programs to treat child abuse and neglect suffer from high rates of attrition, limiting their impact. Thus, research is needed to identify factors related to client engagement. Using data (N = 1,305) from a statewide family preservation program, this study investigated the role of program type (i.e., SafeCare(®) [SC] vs. Services as Usual [SAU]) and client perceived provider cultural competence on client satisfaction and engagement with services. Families in SC completed more treatment goals than those in SAU. In addition, provider cultural competence and client satisfaction were higher in SC than in SAU. Higher provider cultural competence was associated with higher goal attainment and satisfaction, and these effects partially mediated the service program differences. The effects of service type and cultural competence on goal attainment and satisfaction varied somewhat by client ethnicity. Findings suggest that clients receiving manualized programs for child maltreatment may be more likely to meet their goals and may perceive such programs to be culturally appropriate and satisfactory.

Early childhood interventionists' perspectives on serving maltreated infants and toddlers

A 2003 amendment to the Child Abuse Prevention and Treatment Act (CAPTA) required states to create developmental screening programs for maltreated infants and toddlers. Programs authorized under Part C of the Individuals with Disabilities Education Act (IDEA) were directed to work with state and local child welfare authorities to develop the screening program. They were also to ensure that additional assessment and intervention was provided when needed. The degree to which this mandate has been implemented varies widely between state and local programs. Some early intervention experts and Part C program administrators have expressed concerns about providers' willingness to serve families referred from child welfare, but there has been no systematic research on this issue. The Professional Interventionist CAPTA Survey (PICS) is a newly developed measure of early childhood intervention providers' perceptions of their responsibilities under CAPTA. The first aim of this study was to conduct analysis of the PICS using a national sample of providers. This study also reports the perceptions of early childhood interventionists about their responsibilities under CAPTA and examines the relationship between worker characteristics and how they perceive these responsibilities. The PICS appears to be useful for examining early childhood intervention providers' responses to CAPTA.