Examination of the relationship between social support and treatment outcomes in mothers referred by Child Protective Services utilizing the Significant Other Support Scale

ABSTRACT

Supportive social networks may play an important role in recovery for mothers within the umbrella of Child Protective Services (CPS). However, investigators have yet to develop methods of measuring how significant others contribute to the treatment and recovery process. In this study, the influence of significant others was examined in the family-based treatment of 38 mothers who were referred for Family Behavior Therapy by CPS. The Significant Other Support Scale (SOSS) was empirically developed and subsequently utilized to assess the extent to which participants’ significant others were perceived by treatment providers to support the participants’ goals during treatment sessions. Results indicated that SOSS scores (but not participant and significant other session attendance) were associated with lower participant child abuse potential and drug use frequency at the conclusion of treatment. There was no relationship found between SOSS scores and participant session attendance. However, there was a positive correlation between SOSS scores and significant other session attendance (r = .489, p < .01). The results of this study suggest the quality of significant other support during treatment sessions in this population of mothers may be more important to improving treatment outcomes than session attendance per se. Future directions are discussed in light of the results, including methods of using SOSS scores to assist family-based treatments.     

Physical abuse after child protective services investigation and adolescent substance use

The longitudinal pathways connecting physical abuse and substance use in child welfare-involved adolescents, a population with multiple risk factors for substance use problems, remain unclear. This study examined the relation between self-reported physical abuse among adolescents investigated by Child Protective Services (CPS) and later substance use, with a particular focus on exposure to physical abuse after CPS investigation as a potential contributing factor to this relation. Using data from the first National Survey of Child and Adolescent Well-being (NSCAW-I), a path analysis was conducted on a sample of 1079 adolescents aged 11–15 years who had recently been investigated by CPS. At baseline and 18-month follow-up, youths self-reported past-year physical abuse using the Parent-Child Conflicts Tactic Scale and past 30-day substance use frequency. At baseline, youths self-reported current internalizing and externalizing problems to the Youth Self Report. Path analysis revealed no significant relation between physical abuse at baseline and substance use at 18 months. Physical abuse at baseline was associated with higher levels of concurrent substance use and externalizing problems, which in turn predicted higher substance use at 18 months. Furthermore, physical abuse and externalizing problems at baseline predicted physical abuse at 18 months, which in turn was related to higher substance use at 18 months. The findings suggest that physical abuse after CPS investigation contributes to the development of adolescent substance use behaviors. Results indicate a need for innovative efforts to prevent physical abuse after CPS investigation, as well as assessment and treatment of substance use and externalizing problems at the point of investigation, to reduce future substance use in child welfare-involved adolescents.     

Motivational interviewing as a pregroup intervention for partner-violent men

This study investigated the effects of a pregroup motivational intervention for domestic abuse perpetrators. Men presenting for treatment at a community domestic violence agency (N = 108) were assigned to receive either a two-session intake using the techniques of motivational interviewing (MI) or a structured intake (SI) control. All participants were then referred to a cognitive behavioral treatment (CBT) program in groups homogeneous with respect to intake condition. The motivational intake led to more constructive in-session behavior during the early phase of group CBT, greater compliance with group CBT homework assignments, higher late session therapist ratings of the working alliance, and more help seeking outside of the domestic violence program. No significant effects of intake condition were found on session attendance, self-reports of readiness to change abusive behavior, or client reports of the working alliance. Partner reports of abusive behavior outcomes during the 6 months after group CBT revealed a marginal effect favoring the MI condition on physical assault. The findings suggest that motivational interviewing can increase receptivity to partner violence interventions.     

Initial findings from Parent Party Patrol: an intervention to reduce adolescent substance use through reduced involvement in unchaperoned parties

This article presents preliminary evaluation findings from Parent Party Patrol (PPP). PPP is a two-hour single-session intervention that provides information to parents about ways to increase monitoring and improve communication and family guidelines regarding substance use, with the goal of reducing adolescent involvement in unsupervised activities and associated substance use. Seventy-three attendees from 15 PPP sessions completed baseline and three- to six-month follow-up information. At follow-up, participants showed significantly increased awareness of adolescent substance use and unchaperoned activities, improved communication and use of family guidelines regarding substance use, and increased monitoring of their children's activities. A significant reduction in adolescent attendance at unchaperoned parties was also reported. Replication of the study with a larger, more representative sample and controlled design is suggested. As adolescent substance use is a multidetermined problem, PPP may be best viewed as one part of a broader comprehensive substance abuse prevention program.     

A Randomized Controlled Trial Assessing the Efficacy of Cognitive Behavioral Therapy for Substance‐Dependent Domestic Violence Offenders: An Integrated Substance Abuse‐Domestic Violence Treatment Approach (SADV)

The current study evaluates a therapy for substance‐dependent perpetrators of partner violence. Sixty‐three males arrested for partner violence within the past year were randomized to a cognitive behavioral substance abuse‐domestic violence (SADV; n = 29) or a drug counseling (DC; n = 34) condition. Seventy percent of offenders completed eight core sessions with no differences between SADV and DC conditions in the amount of substance or aggression at pretreatment. SADV participants had fewer cocaine‐positive toxicology screens and breathalyzer results during treatment, were less likely to engage in aggressive behavior proximal to a drinking episode, and reported fewer episodes of violence than DC participants at posttreatment follow‐up. SADV shows promise in decreasing addiction and partner violence among substance‐dependent male offenders.     

DIFFERENT LENSES: VARIATIONS IN CLIENTS' PERCEPTION OF FAMILY THERAPY BY RACE AND GENDER

Race and gender have been given extensive theoretical and clinical attention in family therapy in the last decade. However, little empirical work has focused on their effect on therapy. The present study examines the effect of clients' race and therapists' race and gender on male and female partners' assessments of an initial and subsequent family/marital therapy session. One hundred twenty-six individuals, comprising 63 heterosexual adult couples, evaluated both the first and the fourth therapy session using the Session Evaluation Questionnaire (Stiles, 1980). Results indicated a strong effect for race, with black females rating initial sessions more negatively than white females when seeing a white therapist. Black men, however, had a more positive response than white men to the initial session, regardless of the race of the therapist. Over time, these differences decreased. The results suggest not only that race and gender may contribute to differences in partners' perceptions of the same session, but also that these differences are not static.     

Extended evaluations in cases of child sexual abuse: how many sessions are sufficient?

This article provides new findings from a national study involving 18 forensic interview sites of 137 children who were randomly assigned to a four or eight session extended evaluation. Cases assigned to the eight session protocol were significantly more likely to be classified "credible disclosure" of sexual abuse (56.6%) than cases assigned to the four session protocol (29.5%) and significantly less likely to be classified "credible nondisclosure" of sexual abuse (9.2%) than cases in the four session protocol (24.6%). When four versus eight sessions, demographic variables, and case characteristics were entered into a regression, variables that predicted likelihood of sexual abuse were eight session protocol, older victim age, and caretaker belief the child had been sexually abused. When new disclosures were examined by session in the eight session protocol, 95% of new disclosures occurred by the sixth session.     

Negative Communication Behaviors During Family Problem Solving: Cohesion as a Moderator in a Growth Curve Analysis

Using archived data a multilevel model examined change in negative communication behaviors of three family members (mother, father and preadolescent) across four sequential family problem solving sessions in the home. The sample included 756 problem-solving sessions, nested within 189 individuals, within 63 families. Basic tenets of family therapy were used to examine the effect of the occasions of measurement, revealing that communication was less negative when the adolescent selected the problem. The individual level analysis was guided by a conflict structure perspective that found adolescents (in general) showed more negative communication behaviors than parents. At the family level, scores on the Family Adaptability and Cohesion Evaluation Scale (FACES III) were significantly related to changes in negative communication behaviors. A significant interaction between FACES III scores and negative communication behaviors showed negativity increased across sessions in families that scored lower on the FACES III, but decreased in families that scored higher.     

How child protective services investigators decide to substantiate mothers for failure-to-protect in sexual abuse cases

The purpose of this study was to determine how Child Protective Services (CPS) investigators decide to substantiate mothers for failure-to-protect from sexual abuse. A case-comparison study was used to compare 31 mothers who were and 62 mothers who were not substantiated for failure-to-protect by CPS. The multivariate analysis showed that mothers who did not consistently believe the sexual abuse occurred and who did not consistently act protectively were more likely to be substantiated. In addition, if they knew about the abuse from more than one source were less supportive of the children; and had a substance abuse problem, a mental health problem or were being battered, then they were more likely to be substantiated. Investigators appear to apply criteria consistently to substantiate mothers. doi:10.1300/J070v15n04_04.     

Caregiver substance abuse among maltreated children placed in out-of-home care.

Child protective services (CPS) case records of 639 children placed in out-of-home care due to maltreatment were reviewed, and substance abuse by the child's caregiver prior to the child's placement was evaluated systematically. Based on several different sources of information, 79% of the caregivers were found to meet the criteria for caregiver substance abuse (CSA). Children with and without evidence of CSA differed on age, ethnicity, family composition, and type of maltreatment. The importance of operational specificity in defining CSA and implications for policy and service delivery are discussed.     

Caregiver drug use and arrest as correlates of child trauma exposure

This study proposed to determine the prevalence of substance use and drug-related arrests among caregivers of children referred to Child Protective Services (CPS), examine the relationship between substance use and arrests among caregivers, and examine the main effects and interaction of substance use and arrests in predicting child trauma exposure. Secondary data was collected from CPS files for a randomly selected group of 1127 children. Findings indicated that rates of caregiver substance misuse and arrests were higher than the general population, which was expected. When controlling for demographic and other variables, there was a main effect of substance use and arrests on child trauma exposure, but no significant interaction. Implications for caregivers engaged in substance use and/or involvement with the criminal justice system are discussed, as well as clinical and research implications for children exposed to trauma related to caregiver behaviors.     

MODES OF EXPRESSION IN FAMILY THERAPY: A PROCESS STUDY OF ROLES AND GENDER*

Twenty-two two-parent families with a referred adolescent were seen by 11 male and 11 female trainees in family therapy. Mothers, fathers, adolescents, and therapists were rated for verbal expression in affective, behavioral, and cognitive! attributional modes during the first session. Results clearly point to role and content difference in modes of expression. Of particular importance are differences by role which occured as a function of therapist gender. These differences suggest that therapist gender has an impact on family therapists' and family members' verbalizations in first sessions of family therapy.     

Motivational signage increases physical activity on a college campus

OBJECTIVE: The authors evaluated whether motivational signage influenced rates of stair use relative to elevator use on a college campus. PARTICIPANTS: In March and April 2004, the authors observed students, faculty, staff, and any visitors accessing a college campus building. METHODS: During Phase I, the authors monitored ascending stair and elevator use at the same time each weekday (Monday-Friday). During Phase II, the authors placed motivational signs encouraging stair use at the bottom of the stairs and outside and inside the elevators. During the third week (Phase III), the authors removed the signs. RESULTS: The authors observed 18,389 ascending trips during the 3 weeks of the study. Motivational signs significantly contributed to an 18.6% increase in stair use in the second week, which was maintained in the following week. CONCLUSIONS: The signage intervention successfully enhanced physical activity on a college campus by providing educational health tips that may have served as motivation to choose the stairs.     

Correlates of male and female juvenile offender abuse experiences

This paper reports the results of developing and evaluating a classification of 315 arrested youth processed at the Hillsborough County Juvenile Assessment Center from September 1, 1994 to January 31, 1998. Youth were characterized as physically or sexually abused if they reported abuse or if they had been referred to juvenile court for abuse. Stepwise logistic regression analysis revealed that family problems, friends' substance use, and delinquency involvement (marginally significantly related) were associated with both physical abuse and sexual victimization. In addition, physical abuse was associated with psychological problems and sexual victimization with being female, being older, and own substance use. The research implications of these results are discussed.     

Gavel-to-Gavel Congressional Television Coverage as Political Advertising: The Impact of C-Span on Legislative Sessions

This article examines the effect of television on the length of legislative sessions at the federal level in the United States. Data from the U.S. Congress during the period 1972–96 are employed, during part of which time each house of Congress received significant television coverage by C-SPAN and C-SPAN2. Evidence from a Parks regression suggests that the presence of C-SPAN has increased House sessions by 88–250 hours and the presence of C-SPAN2 has increased Senate sessions by a striking 252–431 hours, other things constant. Additional estimates suggest that House sessions are about two minutes longer per bill introduced under the eye of C-SPAN, and Senate sessions are about four minutes longer per bill introduced in the presence of C-SPAN2. Longer sessions, which represent low-cost forms of advertising for incumbents, are not without costs to taxpayers. We estimate that these costs lie somewhere between $16 million and $392 million in real terms per session of Congress.     

Emotional Dysregulation: The Key to a Treatment Approach for Violent Mentally Ill Individuals

Prior research has suggested that psychopathy, substance abuse, and the presence of a personality disorder increase an individual's risk for violence toward others. Substantial clinical literature has established emotional dysregulation as a risk marker for violence toward self. It is hypothesized that emotional dysregulation may be an important component in a constellation of risk markers for violence toward others and may interact with psychopathy and substance abuse in individuals with personality disorders to enhance risk for violence. If these hypothesized relationships exist, it suggests that the development of an intervention approach which directly targets these factors may hold promise. A potential intervention approach based on dialectical behavioral therapy, with case illustrations, is provided.     

Substance Abusing Mothers with a History of Childhood Abuse and Their Children's Depressive Symptoms: The Efficacy of Family Therapy

This study examined the associations among maternal history of childhood abuse, substance use, and depressive symptoms and the change in children's depressive symptoms in therapy. Mothers (N = 183) were randomly assigned into either a family or an individual treatment condition. Mothers were assessed for their childhood abuse retrospectively, baseline depressive symptoms, and substance use, whereas their children's depressive symptoms were measured five times during 1.5 years. Maternal childhood abuse was associated with a slower decline in child depressive symptoms through elevated maternal depressive symptoms, only in individual treatment. Maternal substance use further moderated this mediation pathway. This study supports the efficacy of family therapy in protecting children of mothers with a substance use disorder and a history of childhood abuse.