Multidimensional approach to helping emotionally abused and neglected children and abusive parents

Emotional abuse is notoriously difficult to define and, thus, to assess and operationalise for intervention purposes. This paper addresses these issues and emphasises the heterogeneous nature of emotional maltreatment, a fact that demands a multi-level, multidimensional approach to intervention. Some of the available methods for tackling the various facets of a complex social and personal problem will be outlined and discussed. Social work and other professionals involved in child care protection work may find the material provided here helpful when working with these children and families. Copyright © 1999 John Wiley & Sons, Ltd.     

The outcomes of a longitudinal study of non‐organic failure‐to‐thrive

Individuals who had failed‐to‐thrive for non‐organic reasons received psychosocial intervention which was tailor‐made to their particular needs during childhood. Their progress was followed up over 20 years later, including their physical growth and social and cognitive functioning. Not all clients showed the same outcomes. The quality of the parental relationship and the reason for the growth‐faltering were found to be related to the outcomes at 20 years. Unless they experienced a positive and sustained change in their life or circumstances, individuals who had experienced abuse showed poorer outcomes than those whose growth‐faltering had been thought due to neglect, lack of parenting or feeding dif?culties. Abuse tended to be a contributing factor to growth‐faltering more frequently in families where the parents were observed to have a poor relationship with each other. However, a signi?cant change in the quality of care given to the child and the emotional environment experienced by them resulted in positive outcomes 20 years later despite experiencing abuse during childhood. Copyright © 2003 John Wiley & Sons, Ltd.     

Care Proceedings: Exploring the Relationship Between Case Duration and Achieving Permanency for the Child

The 1989 Children Act in England and Wales and the derivative1995 Children (NI) Order in Northern Ireland provide the legislativeframework within which issues pertaining to the care and supervisionof children that come before the Courts are examined. Both piecesof legislation were intended to address a number of problemswith the way that such issues were dealt with by the Court,particularly the tendency for proceedings to become protractedand for children to ‘drift’ in care as a consequence.The imposition of the ‘No Delay’ principle in bothjurisdictions was designed specifically to address these concerns.However, since the introduction of both the 1989 Children Act(implemented in October 1991) and the 1995 Children (NI) Order(implemented in November 1996), there has been a steady increasein the average duration of proceedings and concerns remain aboutthe impact that this may be having upon the children involved.This paper presents the findings of a research study (McSherry et al., 2004)that explored the complex relationship between the durationof care proceedings and costs to children in terms of the likelihoodof achieving permanency.     

Attachment style in adults who failed to thrive as children: outcomes of a 20 year follow-up study of factors influencing maintenance or change in attachment style

Summary A group of children identified as non-organic failure-to-thrivebetween 1977 and 1980 were investigated, assessed and providedwith social work intervention and treatment. Those childrenand their families have been followed up for the last 20 years.The current paper examines the stability of an internal workingmodel in a sample of individuals who had failed to thrive aschildren, by comparing each individual's adult attachment stylewith their childhood attachment to their mother. In this sample,several cases showed changes from insecure to secure attachmentstyles. Possible reasons are discussed for positive and negativechanges, as well as cases when there was no change in attachmentstyle. These include the effectiveness of intervention in additionto changes in life circumstances. The findings suggest thatwhen appropriate support and intervention is provided, or whendifferent circumstances or relationships are experienced, internalworking models can change.     

An Empirical Study into the Psychosocial Reactions of Staff Working as Helpers to those Affected in the Aftermath of two Traumatic Incidents

Correspondence to Professor Dorota Iwaniec, Institute of Child Care Research, Queen's University Belfast, 5a Lennoxvale, Belfast BT9 5BY, Northern Ireland, UK. Summary This paper will address the outcome of the first empirical studyon the psychosocial impact on four groups of professional staffinvolved as helpers in the aftermath of two major incidents.The two incidents selected were the Kegworth Air disaster thatoccurred in the East Midlands area of England in 1989 and aterrorist bombing on the Shankill Road Belfast, Northern Ireland(NI) in 1993. The four groups of staff chosen for the research,both in England and Northern Ireland, were social workers, ambulancepersonnel, accident and emergency nurses and clergy. The policyand practice implications of the study were used to developa training programme for those who have to cope with traumain their workplace. The need for such training was based onthe hypothesis that pre-training will help to ameliorate anynegative reactions that may be experienced by the helpers. Theresults from both incidents were compared to highlight the impactof the work on helpers working with victims from a single incidenttrauma and in a situation where there was multiple incidenttraumatization.     

Maternal mental health and faltering growth in infants

This study reports on the first phase of a large‐scale, longitudinal, multidisciplinary community study examining the growth, learning and development of young children with a particular focus on failure to thrive without organic cause. However, the group identified in this study may be better described as weight faltering. This paper examines the psychological data collected using the Parenting Stress Index, Rosenberg Self‐Esteem and the General Health Questionnaire in relation to child growth. There were no significant differences between the mothers of the weight faltering and control children in terms of parenting stress, maternal depression, maternal perceptions of their parenting competence or maternal self‐esteem. Maternal sensitivity to comments about child size, regardless of direction, had a negative impact on mood. Copyright © 2007 John Wiley & Sons, Ltd.     

Research Review: Risk and resilience in cases of emotional abuse

This paper examines risk and resilience in relation to emotional abuse. Research has identified numerous child and family factors that may increase the risk of emotional abuse occurring and has also identified numerous ways in which an experience of emotional abuse can enhance vulnerability to negative outcomes. However, relatively little is known about the factors that determine the extent to which an experience of emotional abuse predicts later psychosocial functioning. Factors that may determine risk and resilience in children who experience emotional abuse are discussed. These include predisposing factors such as early caregiving experiences; precipitating factors such as the frequency, intensity and duration of the abuse; factors intrinsic to the child such as working models of the self and others, internal or external attributions, behavioural and coping strategies, self‐esteem, and disposition; and external factors such as school and availability of supportive relationships. The need to pay attention to the particular vulnerabilities and protective factors pertaining to each emotionally abused child in order to most effectively enhance resilience is highlighted.     

The Quality of Parenting of Individuals Who had Failed to Thrive as Children

Correspondence to Professor Dorota Iwaniec or Dr Helga Sneddon, Institute of Child Care Research, The Queen's University of Belfast, 5a Lennoxvale, Belfast BT9 5BY, UK. E-mail: d.iwaniec{at}qub.ac.uk, h.sneddon{at}qub.ac.uk Summary Parenting behaviour is determined by a range of factors includingpersonality, psychopathology, values, social support, childcharacteristics and socio-cultural influences. It has also beensuggested that an individual's style of child-rearing is influencedby the style of parenting that they experienced as children.The relationships between children who fail-to-thrive and theirparents are often characterized by interactional difficulties.Previous research using retrospective accounts suggested thatmothers of children who fail-to-thrive for non-organic reasonsthemselves showed high levels of abuse, neglect, and deprivationduring their childhoods. However, to date no one has investigatedprospectively what kinds of parents failure-to-thrive individualsbecome. This paper examines the parenting experiences of individualswho had received psychosocial intervention for their non-organicfailure-to-thrive as children over 20 years ago. Results suggestthat where initial intervention failed to bring about long-termchanges in family interactional patterns, there was a greaterincidence of failure-to-thrive in the next generation. Thesefamilies were characterized by dissatisfaction with the child,high levels of stress associated with the parenting role, andlow levels of social support. However, where the family environmentin the original study had changed substantially, the formerclients' outcomes were more positive with their own children.These parents tended to find interaction with their childrenmore rewarding, had good support networks and low levels ofstress. The characteristics of particular cases are discussedin detail to illustrate differences between these two groupsof individuals.     

Prevalence of childhood abuse in mothers taking part in a study of parenting their own children

This paper describes the incidence of maltreatment histories in a community sample of mothers of one‐year‐old infants in Northern Ireland. The occurrence of five subsets of childhood maltreatment is examined: emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse. Of the 201 women who completed the Childhood Trauma Questionnaire, 70 mothers (35%) reported that they had experienced one or more types of maltreatment during childhood. Forty‐eight mothers (24%) gave a history of being emotionally abused, 43 (21%) of emotional neglect, 27 (13%) of physical abuse, 20 (10%) of sexual abuse and 19 (10%) of physical neglect. Physical abuse was the only type of maltreatment which showed an association with maternal socio‐economic status, with a higher incidence reported amongst Occupational Classes 4 and 5 (lower supervisory and technical occupations and semi‐routine and routine groups). More than half of those with a history of abuse experienced more than one type of maltreatment (42 mothers or 60% of those reporting maltreatment). Differences in rates of incidence to more recent studies on younger adults are discussed, as well as implications for prevention and intervention. Copyright © 2009 John Wiley & Sons, Ltd.