Relationships matter: the problems and prospects for social workers' relationships with young children in care

One of the key lessons learnt in the UK from the Laming Inquiry into the death of Victoria Climbié was the importance of social workers developing consistent and long-term relationships with young children in whose lives they are involved. This issue is now informing policy developments, including the proposed Social Work Practices which, based on a similar model to General Practitioner practices, aim to provide a lead professional to act as a parental figure and an advocate for every child in care. This paper begins by confirming the importance of developing relationships between social workers and young children, but questions the ability of the new policy developments to facilitate these. Drawing upon data from research involving interviews with social workers, the paper outlines the factors which hinder social workers' relationships with young children and argues that while the new proposals address some of the more surface structural and organizational factors, they do not address the deeper factors regarding attitudes, values and emotional competence which are crucial if social workers are to successfully build relationships with young children in care.     

Defining the boundaries: social worker assessment of sexual abuse in a cultural context – multivariate analysis of personal and professional factors influencing social workers' labelling of intimacy behaviour

To explore personal and professional factors influencing social worker assessment of family intimacy behaviour in diverse cultural groups, a 27‐item questionnaire was mailed to a random, stratified sample of MSW‐level social workers. The instrument measured rank‐order responses to 10 questions about attitudes towards public exposure to sexual stimuli and rank‐order responses to questions about three vignettes depicting culturally informed family intimacy behaviour. The instrument also measured sample characteristics such as area of social work practice and per cent of caseload involving sexually abused as well as diverse clients. Completed questionnaires (n = 387) were analysed for association between respondents' definition of intimacy behaviour (dependent variable), attitude towards sexual stimuli, and intervening variables thought to explain variance in the dependent measure. Labelling theory provided a basis for hypotheses testing. When mean attitude scores were correlated with mean definition scores, Pearson's r returned a significant low, positive association between conservative attitudes towards exposure to sexual stimuli and definitions of cross‐cultural scenarios as sexual abuse. Holding attitude scores constant, regression modelling of the sample's definition of scenarios indicated that practice area, minority status, and per cent of caseload with sexual abuse clients were significant predictors of R² change in the dependent variable. Further analysis of data through regression tree modelling showed that a small group of conservative practitioners with ethnically diverse caseloads were more likely to label culturally influenced behaviours as deviant. Among conservative practitioners with less diverse caseloads, number of hours in sexuality training had a moderating influence on deviancy labelling. Tree modelling of the data also indicated that an ethnic minority subgroup within the sample accounted for the lowest ranking of scenarios as sexual abuse. Results support earlier work on social worker assessment of child maltreatment as a function of agency setting. Another implication for social work is the need for practitioners to understand their attitudes towards human sexuality in relation to assessment of diverse patterns of childhood sexual socialization.     

Assessing Child Protection Risk

Correspondence to Lorraine Waterhouse, Lecturer, Edinburgh Centre for Social Welfare Research, 23 Buccleuch Place, Edinburgh EH8 9LN. Summary The article outlines a set of child protection criteria usedby social workers for the evaluation of risk in sexual abusecases. The criteria were distilled from research findings basedon a sample of 51 child sexual abuse cases drawn from ChildProtection Registers in Scotland in 1987/89. Criteria dividebetween two types: primary (child care) criteria which concentrateon assessing circumstances prevailing within the family home;and secondary (disclosure) criteria which serve to either substantiateor refute disclosure. Primary criteria include attitude of non-abusingparent to alleged perpetrator; access between referred childand alleged perpetrator; type of abuse; age of child or youngperson; attitude of alleged perpetrator to allegations; andparental attitude to social work investigation. Secondary criteriainclude belief or disbelief of child; psychological symptomsin child; physical signs of abuse; children's attitudes towardsremaining at home; and criminal or psychiatric history includingalcohol or drug abuse. In practice the criteria tend to be usedlike a set of building blocks: tall towers represent higherrisk; low towers lesser risk. Given the enormous stakes involvedin child protection decisions, front-line practitioners wereunder considerable pressure to ‘play it safe’.     

Psychological distress among women who were sexually abused as children

One of the aims of the study was to investigate how participants in self‐help groups (SHG) for women (n = 87) who had been sexually abused in childhood rated their mental health and to what extent they were at risk of developing posttraumatic stress disorder (PTSD). A further aim was to investigate the relationship between the ratings of mental health, occurrence of PTSD, women's interpersonal relationships, reasons for participating in an SHG and characteristics of the childhood sexual abuse (CSA). The participants completed questionnaires regarding their personal relationships, reasons for joining a group, abuse characteristics, mental health (Symptom Checklist‐90‐Revised) and PTSD (Impact of Event Scale‐Revised). The women showed poor mental health, and more than half of them were at risk of developing PTSD. Lack of social support and feelings of shame correlated with poor mental health, whereas guilt did not. Relationships with female friends had a positive association. Further research is needed to determine whether participating in an SHG could provide adequate social support and reduce feelings of shame, thereby contributing to the healing process in the aftermath of CSA. Key Practitioner Message: ? Child abuse is a significant component of the global burden of disease; ? Both social workers and public health care providers meet sexually abused girls and it is important that they have knowledge about the subject; ? An important clinical implication for adequate treatment would be to assess and recognise childhood sexual abuse and to link diagnosis to trauma.     

Chapter 7 Sexual Abuse of Older Women Living in Nursing Homes

Abstract

Aggregated data from APS case files of sexually abused older women between the agesof70 and 89living in nursing homes were collected over a five-year period, yielding a total of 50 substantiated cases. The most common types of sexual abuse involved instances of sexualized kissing and fondling and unwelcome sexual interest in the women's body. All alleged perpetrators were male; they typically were 70 years of age and older and residents in the nursing home. In only three cases was the alleged offender prosecuted in court and only one of these cases was the offender convicted. Implications of these data for future practice and research are discussed.     

Implementing the Power to Kids programme in home-based (foster) care: Identifying the SAFETY approach

Sexual abuse and dating violence are chronic problems for children and young people in out-of-home care. This study explored the impact of a prevention and response programme Power to Kids, which targets harmful sexual behaviour (HSB), child sexual exploitation (CSE) and dating violence (DV) for children and young people in home-based (foster) care. Twenty-eight case managers, 25 foster carers and 13 children and young people participated in a mixed methods study in Victoria, Australia informed by the research question: How does the Power to Kids programme impact the sexual health and safety of children and young people in home-based (foster) care? The data analysis revealed a SAFETY approach whereby the sexual health and safety knowledge of carers and case managers was enhanced, and carers were given permission to have Brave Conversations with children and young people, who could then apply the new knowledge to their lives. Case managers were upskilled in identifying indicators of sexual abuse and empowered to escalate stalled therapeutic and disruption practice when children and young people were identified as experiencing HSB, CSE or DV.     

Korean Survivors of the Japanese “Comfort Women” System: Understanding the Lifelong Consequences of Early Life Trauma

Prior to and during World War II, thousands of girls and young women were abducted from Korea and forced into sexual slavery by the Japanese government. Termed comfort women, these girls and young women suffered extreme sexual, physical, and emotional abuse and trauma. Research on this group is not well-developed and people know little of the impact of this early life trauma on the lives of these women who are now in later life. Using snowball sampling, 16 older adult survivors of the comfort women system participated in semistructured qualitative interviews. Thematic analysis was conducted to gain an understanding of the trauma that these women suffered and how it impacted their lives. Results revealed the depths of the abuse these women suffered, including repeated rapes, physical beatings, humiliation, forced surgery and sterilization, and social exclusion. These early traumatic experiences appeared to reverberate throughout their lives in their family relations, their inability to marry and to conceive children, and their emotional and physical well-being throughout the life course and into later life. The experiences of these survivors illustrate the lasting impact of early-life trauma and can guide interventions with current survivors of sexual abuse or trafficking.     

A Comparative Study of Child Abuse Risk Assessment in the United States and Korea

The perceptions and judgments of social workers who interview the child and family are especially significant factors in child abuse assessment process. The current study describes and compares child protection workers’ assessment processes in Korea and the USA through the use of case vignettes and in‐depth interview. The responses from social workers in these two countries were compared and discussed in the areas of: risk assessment; perception of the main problems; tolerance of corporal punishment; and judgments about appropriateness of interventions. Most revealing was that Korean social workers determined abuse based on their child abuse definition and the US Army FAP social workers determined abuse based on their definition, which was affected by legal standards and cultural differences. Korean social workers are more likely to remove a child from the home, even in mild cases, but US FAP social workers would recommend child removal from the home as a last option. The social workers that participated in this survey play a vital role in the safety of children in child protective services. Both countries can benefit from sharing information to improve the child protection services delivered. Social workers' professional judgment leads to objective and consistent outcomes and are less likely to compromise child safety in the decision making process.     

Helping families when child sexual abuse is suspected but not proven

This paper reports from a project investigating reactions within families when intra‐familial child sexual abuse was suspected, and family members’ responses to a therapeutic approach. Data were obtained from therapeutic sessions and follow‐up interviews with mothers, children and alleged perpetrators. Before treatment the mothers felt uncertain as to how to interpret the children’s unclear signs. The children had severe symptoms, but had seldom disclosed abuse. The alleged perpetrators were often not informed about the suspicions. The families were in a state of crisis and shock, and communication within the family was characterized by uncertainty about what to talk about and whether the suspicions should be shared. In most cases after treatment the conflicts had been reduced, the children had few symptoms, supervised contact had been established, and the clients were satisfied with the treatment. One conclusion is that therapeutic sessions, where family members share information about concerns and take part in the decisions of how to protect children, seem relevant and helpful to the clients in unclear abuse cases.     

Best practice guidelines for health service professionals who receive initial disclosures of sibling sexual abuse

Sibling sexual abuse is one of the more common forms of child abuse and involves a number of unique complexities. A gap in the literature exists with regards to the appropriate response to an initial disclosure of sibling sexual abuse and the values underlying such a response. This article employs a power and control analysis to consider the definition, prevalence and outcome of such abuse and presents best practice guidelines for health care professionals. The guidelines aim to promote ethical and respectful responses to disclosures of sibling sexual abuse. They reflect an explicit value stance, detailing appropriate responses to disclosure including interagency collaboration, parental notification and consideration of the special status of the abuser as a young person.     

Children's narratives of sexual abuse

Children rarely disclose sexual abuse. Hence, studies of children's abuse experiences are relatively rare. This paper reports on a qualitative analysis of 2986 cases of self‐disclosure of sexual abuse from children, aged 5–18 years, who contacted ChildLine Scotland, a free, confidential telephone counselling service. Children discussed their feelings regarding the abuse, the impact of abuse on their health and well‐being, sources of support, disclosure, coping strategies, the context in which abuse occurs and the various ways in which they were groomed or their compliance in abuse was gained. Children's narratives contained detailed contextual information on their experiences of sexual abuse, perpetrators of sexual abuse and the circumstances in which sexual abuse occurs. The way in which children communicated about sexual abuse was found to differ quite considerably, and the terminology they employed was often markedly different from adult constructs. Nonetheless, children of all ages were able to describe their experiences and their feelings around the abuse in considerable detail. This study provides a rare insight into children's accounts of sexual abuse. The findings illustrate the profound impact that sexual abuse has on the lives of children and their understandings of the circumstances in which abuse occurs.     

Correcting misconceptions about the development of social work in China: a response to Cunfu Jia

In this brief debate article we respond to Cunfu Jia's criticism of our article ‘Defining the Profession?’ (International Journal of Social Work 16: 382–389). We address the issue of ‘evidence’ and the issue of the applicability to China of the global definition of social work. We suggest that although debate articles by their very nature risk generating false dichotomies, they provide an important and welcome opportunity to explore commonality and difference and to develop our knowledge and thinking as a result of an international exchange of views.     

Understanding Adolescent Female Prostitution: A Literature Review

Correspondence to Dr Jill Jesson. Aston Business School, Aston Triangle, Birmingham B47 7ET. Summary Sexual behaviour and sexuality are currently topical issuesof concern for child care social workers. Social workers arespending more and of more of their time with children who comeinto care because of sexual abuse, or who have an involvementin the ‘rent’ scene or Prostitution. In additionmany teenage young women come into care because of social orparental concern over their lsquo;promiscuous’ behaviour.The review of research on adolescent prostitution offers severalexplanations for involvement in prostitution. which vary accordingto the discipline of the author. Explanations vary from pathologicaland personal psychology factors to the wider social aspectsof the family and local environment. This literature reviewwas used as a basis for research which examined the incidenceof female prostitution for a social services department. Thisis a relatively new field of interest and consequently thereis very little British research published on the issue of adolescentprostitution, or on under age (16) prostitution. There is nopublished research on girls in care and prostitution. We needto know much more about the reality of young people's livesbefore social workers can offer a meaningful response.     

Missing years of abuse in children's homes

This paper reflects upon the historic abuse of young people living in children's homes. Beginning with a recognition of ‘individual abuse’, it explores, first of all, the reasons why young people were abused, including: (1) the status of childhood and being in care; (2) the application of ‘approved’ treatment methods; (3) the failure of managerial, organizational and inspection systems; and (4) the institutional critique and the popularity of preventative policies. Second, by identifying common themes arising from this account, it is suggested we need to rethink the way abuse has been conceptualized. Individual direct abuse, sanctioned abuse, organized systematic abuse and system outcome abuse are discussed. Finally, the paper reviews recent changes in law, policy and practice, including the Children Act 2004, designed to prevent abuses happening again. It is argued that challenges still remain in addressing structural inequalities, improving protection, balancing needs and rights, extending protection to different groups of young people and in having a preventative vision for children's homes.     

Developing a Sensitive Practitioner Research Methodology for Studying the Impact of Child Sexual Abuse

Correspondence to Andrew Durham, Warwickshire Social Services Department, The Grange, Coventry Road, Southam CV47 1QB, UK. E-mail: andrewdurham{at}warwickshire.gov.uk Summary This paper outlines the methodology of a research study whichused unstructured life-story interviewing to explore the impactof child sexual abuse on the lives of seven young men aged between15 and 24 (see Durham, 1999). In approaching this research,a theoretical relationship was established between ethnography(particularly a life-story approach), feminist praxis, anti-oppressiveresearch and social work practitioner research. Researchingexperiences of child sexual abuse is stressful for all concerned,and requires a methodology which establishes a safe environment,which facilitates an expression and discussion of painful andfearful feelings and experiences, and provides appropriate on-goingsupport. In setting up this environment and providing support,before, during and after the data collection phase, the valueand importance of social work practitioner research was established.The potential influence of this on the nature of data collectedwas acknowledged, both as a potential cost, in terms of objectivity,but also as a benefit, in creating a climate for the productionof sensitive knowledge. It is concluded that a life-story practitionerresearch approach, incorporating the principles of anti-oppressiveresearch practice, is an appropriate methodology for the studyof the experience and impact of child sexual abuse, producingknowledge of substantial depth.     

Using Photovoice to Identify Service Needs of Older African American Methadone Clients

ABSTRACT

This article presents findings from a photovoice project designed to identify service needs of older-adult African American methadone clients, as well as their current barriers to and supports for abstinence. The project involved 10 participants (aged 53 to 63 years old) recruited from a methadone maintenance program in a large Northeastern U.S. city. Thematic analysis techniques were used to analyze participants’ narratives of their pictures. Transportation emerged as a significant challenge to accessing services, and caregiving was a motivation for remaining abstinent. Future research should use similar participatory methods and engage a broader group of aging people struggling with substance abuse.     

Story-building and narrative in social workers' case-talk: A model of social work sensemaking

Despite the importance of decision-making in child and family social work, how social workers make sense of information in undertaking assessments and making decisions has received limited attention. Drawing on an ethnographic study of four child and family social work teams across two English local authorities, this article demonstrates how social workers make sense of the lives of children and families through a story-building process. Data comprise interviews with social workers and supervisors (n = 22), recordings of one-to-one supervision (n = 17) and observations of everyday case-talk (n = 21). A model of social work sensemaking is offered, consisting of three stages: (1) initial formulations, (2) developing the narrative and (3) adopted account. Across these stages, social workers engage in different forms of sensemaking activity, such as case framing, testing and weighing information, and generating hypotheses. Collegial and supervisory case-talk provide opportunities for social workers to scrutinize their developing narratives; however, some forms of case-talk can limit or shortcut sensemaking. This model has applications for practitioners and organizations as a tool to promote reflection on how social workers make sense of their cases. Further recommendations include social workers having access to formal and informal reflective spaces where sensemaking case-talk can take place.     

Aggressive Behaviors in Social Interaction and Developmental Adaptation: A Narrative Analysis of Interpersonal Conflicts During Early Adolescence

Using conflict narratives reported by adolescents in grade 7 (mean age = 13.4 years), this study investigated the interactional properties and developmental functions of four types of aggressive behaviors: social aggression, direct relational aggression, physical aggression, and verbal aggression. A total of 475 participants from the Carolina Longitudinal Study ( Cairns & Cairns, 1994 ) were included. Results showed that the majority of conflict interactions involved more than a dyad. The use of social aggression (e.g., concealed social attack) was associated with more individuals involved in the conflict. Social aggression was primarily reported as an initiating behavior for interpersonal conflicts, while direct relational aggression was a responding behavior. Medium to high levels of reciprocity were found for physical, verbal, and direct relational aggression, whereas a low level of reciprocity was reported for social aggression. School authorities were most likely to intervene in physical aggression. The use of social aggression was associated with higher network centrality among adolescents. Developmental maladjustment in late adolescence and early adulthood was primarily predicted by physical aggression.     

(Un)‐blaming mothers whose partners sexually abuse children: in view of heteronormative myths,pressures and authorities

Mothers of children who have been sexually abused are often shamed, blamed and held guilty for their male partners' sexual perpetrations. These feelings are constrained by the dominant heteronormative discourses, institutions and systems that devalue women, that silence them and which subsequently blame women for the abuse as well as their silence. Paradoxically, the risks for mothers speaking out are reinforced by social criticism and professional response that draw on heteronormative discourses that accuse women for ‘failing to protect’ their children, for being ‘bad’ mothers or for making poor choices in their lovers. With these issues at the forefront, this paper illuminates how heteronormative discourses may operate to not only shame and blame women unable to leave their adult relationships and protect their children, but they also strengthen the perpetrator's power as strategic actors in concealing child sexual abuse. It is argued that the heteronormative discourses that reinforce women's sense of guilt obstruct professional intervention and make service engagement of these women difficult. In light of the power of discourse, the importance of combining an overlapping systems approach in which individualized client‐centred support is provided to each family member involved in child sexual abuse matters, including for the mothers in their own right, is discussed.