TRUTE, Barry, Elizabeth ADKINS and George MacDONALD, COORDINATING CHILD SEXUAL ABUSE SERVICES IN RURAL COMMUNITIES. Toronto: University of Toronto Press, 1994, 217 pp., $18.95 softcover / $45.00 hardcover. Reviewed by: J. F. CONWAY* The integrated, inter-agency social service delivery model is part of the current official cant of most governments in Canada, particularly when it comes to delivering intervention and support services to children and families at risk. The arguments in favour of such an approach are well-known: a high risk child, or a dysfunctional family, may well come to the tender official attention of a diversity of agencies over time - educators, social workers, police, probation officers, etc. - and indeed any one high risk child or family is often simultaneously involved with a variety of agencies, and their professional staff. It makes good common sense -- economically and from a treatment perspective - to coordinate services and professionals, to develop a team approach based on information sharing and collaborative treatment strategies. Not only would such a team approach be more effective in assisting the child or the family, but such an approach would be more cost effective. This last is what warms government bureaucrats' and politicians' hearts in these dark neo-conservative times - here is a way of doing things by which we can get more for less, a big bang out of the social service buck. But the professionals have a somewhat different perspective - such an approach is just more therapeutically effective and achieves better long-term outcomes for troubled and afflicted clients and their families. This excellent book provides strong evidence in support of this approach, but also offers up a portion of realism. The book reports on a demonstration project involving the coordinated, inter-agency delivery of intervention and treatment in cases of intrafamilial sexual abuse. The seven year project, funded by Health and Welfare Canada, compares the effectiveness of such an approach to the absence of such an approach in two roughly comparable regions of rural southern Manitoba. Following 43 cases from disclosure through investigation to early treatment (29 cases from the test site, 17 from the comparison site), the authors have taken the theory of integrated service delivery and applied it in the real world of child sexual abuse. The results are impressive in a variety of ways. First, the good news. The model works and works well for those affected by intrafamilial child sexual abuse. Those who benefitted from the approach in the test region, when compared to those in the comparison region who were subjected to the usual separate agency approach, enjoyed the more effective mobilization of significantly more treatment resources. Furthermore, the techniques of investigation of complaints developed in the model were less stressful to clients. Finally, the psychological difficulties of those involved, especially non-offending parents, were more readily and successfully addressed. At the end of the study it was clear: those afflicted - victim, non-offending parents, non-vctimised children in the family - who enjoyed the approach were better adjusted, made a more speedy recovery, and exhibited superior psychological functioning in the post-trauma period. As the authors conclude, coordinated investigation and early treatment services do help families recover more quickly from the trauma associated with child sexual abuse (p. 173). Second, the bad news, especially for the simple-minded politician seeking cheap, quick-fixes for complex human distress. …
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Jan 1, 2022
Allison Marsh 
Open Access
