Experiences of child welfare social workers in addressing substance use among maltreated young mothers to prevent child maltreatment

Substance use during the perinatal period and while parenting can pose a significant risk to children's safety and well-being. Mothers who have experienced child maltreatment are more likely to use substances than mothers without a history of maltreatment. This study explores how child welfare social workers experience supporting young, maltreated mothers struggling with substance use to prevent the intergenerational transmission of child maltreatment. Semi-structured in-depth interviews were conducted with four social workers working with young mothers with a history of maltreatment and substance use. Interpretative Phenomenological Analysis revealed two themes: (1) grappling with system challenges and (2) supporting strategies for disrupting intergenerational transmission of child maltreatment. The results highlight the need for systemic changes around support for social workers who work with young mothers who use substances and have a history of maltreatment, and substance use treatment and mental health programs themselves. Mothers need access to prenatal programs that are trauma-informed, non-judgemental and that support participants' basic needs and parenting skills.     

Child maltreatment types and adolescent substance use: The role of deviant peer affiliation

This is the first study to examine the mediating effects of deviant peer affiliation on the association between different types of child maltreatment and adolescent substance use that includes alcohol, tobacco, and marijuana. Peer deviance is a well‐established correlate of adolescent substance use, but most studies exploring the relationship between child maltreatment and adolescent substance use have failed to include peer deviance. Structural equation modelling was conducted to examine the direct effects of each type of child maltreatment (i.e., physical, sexual, and emotional abuse, and neglect) on adolescent substance use, as well as indirect effects via deviant peer affiliation, using Longitudinal Studies of Child Abuse and Neglect. The results indicated that deviant peer affiliation fully mediated the individuals who had been emotionally abused showed increased deviant peer affiliation, which in turn was associated with higher levels of adolescent substance use. None of the four types of child maltreatment was directly associated with adolescent substance use. The study's findings underscore the importance of early assessment and intervention for the peer relationships of youth who have been emotionally abused.     

What parents value from formal support services in the context of identified child abuse

Parents whose children are identified as having experienced or being at risk of experiencing significant harm potentially provide an invaluable dimension to our understanding of the circumstances that result in child abuse or neglect and how best to respond to these invariably complex situations. This paper reports findings from a study of the experiences of six parents.
In-depth interviews were conducted with four mothers and two fathers who had been referred to an intensive family support service by the Queensland statutory child protection authority. Using a critical ecological perspective, the study focused on identifying and understanding the experiences of the parents in using formal family support services, including aspects of service delivery that were helpful or unhelpful. Parents also commented on their experiences of statutory child protection services.
Service components and worker qualities that parents identified as being helpful included being accessible, targeted and integrated and being able to meet a continuum of needs, from a micro to a broader level. Their reports provide invaluable insight into how formal family support services, including child protection services, can better meet the needs of parents in addressing the recurring problem of child maltreatment.     

Awareness of Child Maltreatment among Professionals in Shanghai

This study reports on a series of qualitative interviews with professionals in Shanghai, China who work with children. The interviews explored the awareness of child protection issues amongst a range of people who work with children, how they differentiate corporal punishment from maltreatment and what they would do in response to cases of child abuse. Shanghai has one of the most well developed child welfare systems in China, and compared to similar professionals in other cities, those in Shanghai had higher awareness and more training, but were nevertheless reluctant to intervene and did not feel well prepared to deal with cases of child abuse should they be encountered. However there are some indications that practice is improving, and examples of recent developments are provided.     

Equipping child protection practitioners to intervene to protect children from cumulative harm: legislation and policy in Victoria,Australia

Many children are repeatedly reported to statutory child protection services, but do not receive the protection they need. Many such children are suffering chronic maltreatment, which is likely to result in cumulative harm. Chronic maltreatment encompasses emotional abuse and chronic neglect. As a result, children can experience a range of cognitive, emotional, and behavioural problems that are more serious than those associated with other abuse types. This paper focuses on the Victorian statutory child protection system, and considers why cumulative harm is not receiving the attention the legislation intends. Under the Victorian legislation cumulative harm must be proven on grounds of emotional abuse and/or neglect. However, it is difficult for child protection practitioners to place before the court the necessary evidence to establish these grounds. The paper concludes that the legal definitions of emotional abuse and neglect should not require evidence of a link between the abusive actions of the parent and the poor outcomes for the child. The evidentiary focus should be on the actions of the parent. Furthermore, legislation should focus on abusive parental behaviours that are likely to result in cumulative harm, which are more concrete and measureable than emotional abuse and neglect, such as intimate partner violence and parental illicit drug use.     

Child welfare policy and services in Korea

Over the past 20 years, the Korean government has developed child welfare laws to respond to an increasing number of child maltreatment cases and create a centralized child welfare delivery system. However, the system remains fragmented and under-developed due to a lack of understanding of child maltreatment and limited government support. Further, few studies have comprehensively reviewed the system. This study examines the Korean child welfare system, identifies challenges for child welfare policies and services, and discusses the implications for future policy; the results can be used to improve the safety, permanency, and well-being of children and families in Korea. The analysis shows that the government has prioritized family preservation over removal from families, even in substantiated cases of abuse. However, ensuring the safety of children in Korea will require not only working to preserve families but also developing and implementing better options for in-home services and out-of-home placement.     

Addressing common forms of child maltreatment: evidence‐informed interventions and gaps in current knowledge

This paper reviews interventions for preventing the occurrence and recurrence of major types of child maltreatment. We begin with an overview of the challenges of establishing evidence‐based interventions to prevent child abuse and neglect in many countries, and underscore the importance of this need with child maltreatment incidence rates in the USA, and how much each type and subtype contribute to child out‐of‐home placement. Next, we identify the well‐supported, supported and promising interventions for each child maltreatment type and subtype, according to their level of research evidence using an evidence‐based clearing house. The paper closes with a discussion of the implications for practice, evaluation, policy and agency management, including intervention knowledge gaps that showcase areas that need additional practice research.     

Physical Abuse, Cognitive and Emotional Processes, and Aggressive/Disruptive Behavior Problems

Cognitive and emotional processes were examined in maltreated children with a history of physical abuse (n = 76), children with a history of maltreatment other than physical abuse (i.e., sexual abuse, physical neglect, and emotional maltreatment; n = 91), and a group of non‐maltreated comparison children (N = 100). Physical abuse was associated with errors in cue interpretation, easy access to aggressive responses to conflict, and poor emotion regulation. In turn, maladaptive cognitive and emotional processes made unique contributions to explaining the relationship between physical abuse and peer nominations of aggression and disruptive behavior. Maltreated children who had not been physically abused evidenced a trend toward cognitive and emotional maladaptation, but only poor emotion regulation accounted for aggression and disruptive behavior in these children. The findings emphasize the importance of considering multiple domains of development in efforts to understand how varying forms of child maltreatment contribute to later maladjustment.     

‘I am the face of success’: peer mentors in child welfare

Child welfare systems have struggled to create innovative, culturally sensitive programmes to address the multiple and pervasive barriers that exist in engaging child welfare parent clients in their service plans. Peer mentor programmes—those in which parents who have successfully navigated the child welfare system and reunified with their children, mentor parents newly entering the system—are designed to address some of these barriers, to improve reunification outcomes. Focus groups with parent clients (n = 25) and interviews with peer mentors (n = 6) were conducted to identify the characteristics of peer mentoring programmes that are critically helpful to parent clients, as well as the mechanisms that allow peer mentors to be effective in their work. The qualitative analysis uncovered three general themes to which both parents and peer mentors frequently referred in interviews—the value of shared experiences, communication and support. Additionally, the study found that peer mentorship has positive effects not only on parent clients but also on the mentors themselves. The inclusion of peer mentors in child welfare practice suggests an important paradigm shift within child welfare that could lead to culture change for the field.     

Caregiver involvement in behavioural health services in the context of child welfare service referrals: a qualitative study

Human service agencies serve a growing number of adults with behavioural health needs. Despite these agencies' key role in identifying need and facilitating services, many individuals do not receive care or end services prematurely. Few studies have explored the experiences of families referred to behavioural health services by such agencies or the extent to which families' perceptions of service need align with those of treatment providers and frontline workers. This study presents findings from a qualitative study of caregivers involved with child welfare agencies who were referred to behavioural health services. Researchers reviewed agencies' case records and conducted in‐depth interviews with 16 caregivers, 9 child welfare caseworkers and 12 behavioural health treatment counsellors. Findings suggest that when deciding to engage in services, caregivers weigh not only their individual and family behavioural health needs but also potential agency intervention, including loss of child custody. Many professionals reported that involvement with a child welfare agency hindered the caregiver's disclosure of behavioural healthcare needs. Implications for managers and practitioners are discussed.     

Factors influencing resubstantiation of child neglect in South Korea: A comparison with other maltreatment cases

While a high prevalence of child neglect cases has been reported by Child Protective Services (CPS) in Western countries, child neglect cases reported to South Korea's Child Protection Agency (CPA) present different trends than those in Western countries. Nevertheless, child neglect is an understudied area within child welfare. Thus, a need exists to investigate the unique characteristics of child neglect cases substantiated by the CPA in Korea. This study investigates the unique characteristics of child neglect cases and examines how factors associated with the resubstantiation of these cases differ from those of other maltreatment cases. Using CPA administrative data, we employed a multilevel discrete‐time hazard analysis to analyze the risk and protective factors associated with the resubstantiation of child neglect cases and compared the results with other maltreatment cases. In both cases, younger children, perpetrators with alcohol problems, families receiving welfare, and months of agency operation were associated with resubstantiation. For child neglect cases, the provision of child and parent services, and CPAs located in metropolitan area were protective factors that reduced the risk of resubstantiation. The finding in this study highlights the need to expand the provision of services to child neglect cases to prevent resubstantiation.     

Racial/ethnic and socio‐economic biases in child maltreatment severity assessment in Spanish child protection services caseworkers

Evidence from several countries has shown the over‐representation of racial/ethnic minority groups in child protection services (CPS). The objective of the present study was to explore whether racial/ethnic and socio‐economic biases influence Spanish CPS caseworkers' judgements of the severity of child maltreatment. Moreover, the study attempted to explore the influence on these judgements of the use of structured instruments and professional experience. Two case vignettes of child maltreatment were presented to 405 CPS caseworkers and 169 students of social work and psychology. Family ethnic origin and income were manipulated in the vignettes. The findings showed no statistical evidence of biases related to family ethnic origin or socio‐economic status (SES) in Spanish CPS caseworkers' judgements of maltreatment severity. Biases related to family SES were found for students for the vignettes of physical abuse. CPS caseworkers and students who did not use a structured instrument to assess maltreatment severity tended to underestimate the severity for the vignettes of parental incapacity to control child/adolescent behaviour and to overestimate it for the vignettes of physical abuse. CPS caseworkers who used a structured instrument showed higher percentages of accuracy and inter‐rater agreement, supporting the relevance of structured tools in reducing potential caseworkers' biases.     

Living with an elephant: Growing up with parental substance misuse

Although parental substance misuse is now a focus of concern in child welfare practice, we know little about what it is really like for children who grow up in families where adult drug and/or alcohol use is an issue. Set against a backdrop of research links between parental substance misuse and child maltreatment, this article examines a number of studies that focus on the experiences of children and young people in this context. Emerging themes are identified which provide insight into the world of children for whom a substance is, effectively, a family member –‘the elephant in the living room’– and the implications for practice, particularly in relation to children's visibility, disclosure and confidentiality, are considered. It is argued that a focus on the ‘elephant’ often leads to children remaining ‘invisible’ to those whose role it is to ensure their welfare.     

Child care subsidy and child maltreatment

This study examined the relationship between receipt of child care subsidies and child maltreatment investigations in a sample of low‐income mothers in Illinois. We expected that receiving child care subsidies would have a protective effect on child maltreatment risk and therefore decrease the likelihood of child protective services investigations. Using structural equation modelling, we tested the direct and indirect paths of the receipt of child care subsidies to physical abuse or neglect. We found only direct effects of receiving child care subsidies on both physical abuse and neglect investigations. The findings suggest an important protective role of child care subsidies in the lives of low‐income families.     

Spirituality and child welfare reunification: a narrative analysis of successful outcomes

When children are removed from their families because of maltreatment, the child welfare system seeks reunification whenever possible. Despite the importance of this goal, little is known about families who are able to achieve and maintain successful reunification. This qualitative study conducted in‐depth interviews with 15 families who completed their child welfare case plans, were reunited with their children and remained together for at least 1 year post‐reunification. Narrative analysis using a combination of thematic and structural coding was completed to examine the strengths and process families discussed related to their successful child welfare outcomes. This paper discusses one of those strengths, spirituality, in greater depth. Specifically, 12 participants situated the strength of spirituality within their stories as an important narrative element they perceived as critical, leading to important changes. Findings highlight the benefits some families receive from their spiritual beliefs, practices and faith communities when working towards reunification, suggesting child welfare practitioners be prepared to identify and honour this family strength.     

Child abuse in China: a yet-to-be-acknowledged 'social problem' in the Chinese Mainland

Child abuse or child maltreatment has been a worldwide concern. In China, however, it receives scant attention from both academic communities and government. Chinese society has little awareness of child abuse as it is known in the West and there are apparently different conceptions and treatments of the problem. This paper attempts to delineate how the problem is now understood and treated in Mainland China. The reasons why child abuse has not yet been recognized as a social problem worthy of public concern in China are explored. It is argued that as a signatory of the UN Convention on the Rights of the Child there is a need for the Chinese government, the academic community and professionals to reflect on their conception and treatment of child abuse so as to achieve more effective child protection for all children who are victims of child abuse.     

Patterns and correlates of co‐occurrence among multiple types of child maltreatment

This study examined the patterns and correlates of the types of maltreatment experienced by adolescents aged 9–12, participating in an ongoing longitudinal study on the impact of neglect on children's development. Using case record abstraction, the study compared the child protection classification and findings from the case record abstraction with regard to the rates of four types of maltreatment (i.e. physical, sexual, emotional abuse and neglect) as well as co‐occurrence across multiple types of maltreatment. Next, the study examined the frequently observed patterns of child maltreatment. Finally, the study investigated whether aspects of caretaker functioning and the detailed incident characteristics in the cases of neglect differed by the number of different types of maltreatment the children experienced. Results showed significant discrepancies between the Child Protective Service classification and case record abstraction. Child Protective Service classification considerably underestimated the rate of co‐occurrence across multiple types of maltreatment. Neglect accompanied by physical and emotional abuse was the most common form. Some of the caretaker functioning variables distinguished the number of types of maltreatment. Based on the findings, future‐research directions and practice implication were discussed.     

Substance use and other factors associated with child welfare case duration: Looking beyond out of home care

Little is known about factors associated with child welfare case duration. Understanding factors associated with case duration may help stakeholders make more informed decisions about funding and service allocation and improve compliance with federal law. This study had two research questions: (1) What factors are associated with child welfare case duration? And (2) Do factors differ depending on whether children were placed exclusively with parents or with others (e.g. relatives and foster care) during the case? The study sample consisted of families (N = 874) with co-occurring child maltreatment and substance use in one midwestern state in the United States between 2007 and 2016. Linear regression models were used to identify correlates of case duration while controlling for child placement status. Overall, having a child under 1 year of age, benzodiazepine use, methamphetamine use and injection drug use were all associated with longer case duration, whereas marijuana use with no other substance use was associated with shorter case duration. Additionally, factors associated with case duration differed based on child placement status during the case. These findings suggest important heterogeneity in families involved with child welfare services and may allow for proactive mitigation of cases at greater risk.     

Street children in Russia: steps to prevention

This article examines the historical evolution of the development of social policy toward street children in Russia and makes recommendations for prevention. The historical examination begins with the Soviet period, when statistics on social problems were not publicly known. It continues through the post-Soviet period when there was an emerging awareness about the increasing number of abused, abandoned children and children living on the streets. Etiological factors, such as child maltreatment and parental substance abuse, are then discussed. Based on these etiological factors, the article then proposes a model in which existing institutions and professionals are supported in facilitating an integrated system of primary, secondary and tertiary prevention. This includes improving child protection services and interventions to prevent children leaving their homes, early identification of children who are becoming involved in street life and a continuum of care for children who cannot return home.     

Rising to the Challenge of Treating OEF/OIF Veterans with Co‐occurring PTSD and Substance Abuse

This article reviews data on the relatively high incidence of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans reporting mental health and substance abuse problems, and some perceived barriers that may account for low rates of their engaging in treatment. Treatment outcomes for veterans with co‐occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) are generally poorer than for those with PTSD or substance abuse alone. Several evidence‐based individual therapy approaches offered by VA Medical Centers are described along with how they conceptualize the relationship of substance abuse to PTSD. Problems with sequential treatment for persons with PTSD and substance abuse in specialized programs are discussed, including notably the practice of requiring veterans to be completely drug and alcohol free for a month or longer prior to entering PTSD treatment. Several integrated treatment programs are described along with a brief summary of evidence supporting their effectiveness. Some recent policy changes from the Department of Veterans Affairs that bode well for the future of PTSD/SUD treatment are described. Differences between younger and older veterans were cited along with their implications for treatment. Recommendations regarding how to better engage and retain OEF/OIF veterans with PTSD/SUD in treatment are presented together with examples of their implementation. The author concludes that to rise to the challenge of treating this difficult population it is necessary to adapt treatment to meet their needs rather than requiring them to adapt to therapies that may not be a good fit.