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.     

Giving voice to experiences: parental maltreatment of black children in the context of societal racism

ABSTRACT This paper seeks to explore the ways in which black children who have been maltreated within their families come to voice to tell their stories. A discussion of black children's recovery from maltreatment necessitates understanding how they interpret and name their experiences as abusive. Research indicates that while many factors mediate the effects of abuse on children's development, telling your story about childhood trauma is critical in the healing process for promoting psychological well‐being. However, what does the naming and speaking of trauma entail for black children when the broader context of their lived realities is embedded in racism that confers on them a stigmatized status? Where black children's lived experiences encompass the complexity of societal racism as a mutually reinforcing and contradictory reality in their lives, their capacity to name the maltreatment they experience will be particularly problematic. Essentially, parents’ issues silence children and can encourage them to block out painful emotions, ultimately putting their emotional and psychological well‐being at risk. Taking race and gender as benchmarks for analysis, the complexities involved in giving voice to childhood maltreatment are discussed to consider how these dynamics contribute to black children's resilience and adaptive behaviours in the aftermath of abuse.     

Improving social psychiatric treatment in residential programmes for emerging dependence groups in Europe: cross-border networking, methodological innovations and substantive discoveries

A mini-symposium series of papers presenting the results of the European Commission-supported Biomed II project is introduced. The project accomplished a cross-border scientific networking engaging 31 European residential treatment programmes. The results showed that scientific development is best served by a flexible bureaucratic approach. 'Old' science and the 'new' science ways of working were balanced. 'History' and 'social networks' are the key concepts signalling the project knowledge gains. A treatment sample (N=723) was extracted from a database of 1028 current European cases. Non-drug-specific characteristics are as important as drug-specific characteristics in distinguishing emerging dependence groups. The project networking created a process that increased the level of involvement of science and the service communities. To sustain the gains of the project, a reaching out of existing European treatment services to extended family and friendship networks with a history of dependence-related problems will be required.     

Childhood abuse and neglect in severely dependent female addicts: homogeneity and reliability of a Swedish version of the Childhood Trauma Questionnaire

This study explores the psychometric characteristics of childhood experiences ('Barndomsupplevelser'), using a Swedish translation of the 53–item version of the Childhood Trauma Questionnaire (CTQ). Fifty–five female addicts, treated in a compulsory–care setting, completed the questionnaire. Homogeneity and reliability were studied using principal component analyses (PCA) and Cronbach's alpha. The test was submitted to content analysis. Nearly all (94.5%) had experienced childhood abuse or neglect. The internal consistency is high. The 4–factor solution corresponded to the subscales of emotional and physical abuse (combined), of sexual abuse and of emotional neglect, while the items in the physical neglect subscale were distributed to several factors. In the 5–factor solution, this subscale was divided into two factors. Content analyses of these factors point to other meanings than physical neglect. The CTQ (Swedish translation) was found to have high consistency and homogeneity in four of the five subscales (emotional, physical and sexual abuse, and emotional neglect), while the subscale on physical neglect may need revision. The new 28–item brief version seems to be an improvement, with regard to these problems.     

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.     

The role of research in drug policy in Hong Kong: highlighting life satisfaction from two longitudinal studies of drug abusers

ABSTRACT

This paper examines the role of research in the development of drug policy in Hong Kong. The upsurge of the prevalence of psychoactive drug abuse in young people since the mid-1990s had brought about a great demand for medical and social science research on psychoactive drugs and users. Among a large number of Beat Drugs Fund-funded projects, two longitudinal studies, conducted between 2000 and 2002 and between 2009 and 2011, respectively, were used to illustrate the possible contributions of research findings to treatment and rehabilitation services. The most salient finding present in both studies was the significant and negative relationship between life satisfaction and continuation of drug use. The finding suggested that subjective well-being should be incorporated into treatment programmes, and there is a need to provide post-treatment services to young rehabilitated psychoactive drug abusers in the form of life planning programmes and organisation of sustainable social activities in the community.     

Individual rights and collective obligation. Compulsory intervention towards substance abusers in Norwegian social law

This article focuses on an important duality in the modern welfare state: the will to help our fellow citizens through institutionalized welfare policies, and the danger of violating individual liberty and integrity. Individual rights of self-determination and integrity are important values of the liberal constitutional government (the Rechtstaat). Our collective ethical obligation to help those in need is an important value of the welfare state. With respect to compulsory intervention towards adult and under-age substance abusers, the possible tensions between these values are particularly visible. The legal foundation for such efforts in Norwegian social law is discussed with regard to different ethical and moral principles. The main questions are how compulsory interventions are justified and how different principles are weighted in positive law. The ethical principles of collective obligation and the moral principle of individual rights are differently balanced in the Child Care Service Act and the Social Service Act. Both acts, however, expose the problematic combination of solving social problems by the use of force and securing individual autonomy and integrity.     

Preliminary data on abuse during childhood among female university students

This study investigated the childhood experiences of physical and sexual abuse in relation to the risk of adult depression among female university students. The objectives of the study were to determine the prevalence of abusive experiences in childhood, to examine if childhood physical and sexual abuse, parental antipathy and neglect correlated to depression, and to determine the risk factors of depression in this population. A translated childhood experience of care and abuse questionnaire (CECA-Q) was randomly distributed to the students. The results showed that the reliability of the CECA-Q was good and stable. The prevalent rate of childhood physical abuse in this population was 19% and childhood sexual abuse was 5%. Childhood physical abuse by the mother was a significant risk factor in contributing to depression. The study provides evidence of a correlation between childhood abuse and depression among female university students.     

Substance use disorders and referral to treatment in substantiated cases of child maltreatment

Parents with substance use disorders (SUD) require treatment and support in order to provide children with appropriate care and protection. Using the 2012 National Child Abuse and Neglect Data System (NCANDS), this paper analysed 464 313 substantiated child maltreatment reports to determine (i) the proportion and characteristics of reports involving substance abuse; and (ii) the child and caregiver/perpetrator (C/P) characteristics that predicted referral to treatment as recorded in service plans. Findings indicate that 12% (N = 53 234) of maltreatment reports involved C/P SUD. Yet, of those reports, only (19%) (N = 10 088) were referred to substance abuse treatment as part of their service plan, indicating a large gap between those who need treatment and those who receive it. This finding is important given that parental SUD is consistently linked to poorer child outcomes. Amongst other variables, reports indicate that C/P with co‐occurring emotional disturbance were three times more likely to be referred to treatment for SUD as part of service plans. Additional research is needed regarding the characteristics that distinguish C/P who receive referrals for SUD treatment in substantiated cases of child maltreatment.     

Family treatment of childhood anxiety

Anxiety in childhood and adolescence can cause serious impairment across many settings in a child's life. Childhood anxiety may be impacted by parent‐child attachment and by three specific parenting characteristics: acceptance, control and modelling of anxious behaviours. We review two evidence‐based family interventions for childhood and adolescent anxiety problems. Cognitive behavioural treatment is currently the most commonly used form of psychotherapy to treat specific anxieties. Global or diffuse anxiety, however, may be better suited to experiential interventions such as communications approaches to family treatment. Experiential therapists examine how dysfunctional family roles exacerbate childhood anxiety. These intervention techniques and their implications for social work practice were discussed.     

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.     

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.     

Child maltreatment,maladaptive cognitive schemas,and perceptions of social support among young women care leavers

The purpose of the study was to evaluate the associations between child maltreatment, cognitive schemas of disconnection/rejection reported in emerging adulthood, and social support perceived in emerging adulthood among young women who have exited placements in residential care. The sample is derived from a longitudinal study conducted with 132 young women who had been placed in residential care during adolescence in Montreal (Canada) in 2008–2009. The present study relied solely on the last measurement wave of this study, which was conducted approximately 5 years (2012–2014) after Wave 1. At this time, participants were out of residential care (mean age = 19.4 years). Results showed that the more severe the retrospective accounts of child maltreatment were, the less social support young women perceived as available to them in emerging adulthood. When the tendency to endorse disconnection/rejection schemas is considered, the direct connection between maltreatment and perceived social support disappears, and we instead see an indirect relationship through these schemas. Findings suggest that programs and services must go beyond identifying social‐support networks for young women care leavers. Considerable effort should be devoted to helping these young women develop the skills they need to build and maintain trusting relationships with significant people around them.     

The effectiveness of selected interventions for previous maltreatment: enhancing the well-being of children who live at home

The authors critically assessed reviews of the literature published between 1984 and 2002 to describe the state‐of‐knowledge about the effectiveness of interventions aimed at protecting or improving the welfare of child victims of maltreatment and who remain in the family home. The interventions studied target children, parents or families. They chiefly involve cases of sexual abuse, physical abuse or neglect; very few concern psychological abuse or exposure to violence. For the most part, the intervention effectiveness indicators measure changes in parents’ and children's knowledge (e.g. better knowledge of child development), attitude (e.g. gains in enthusiasm), emotion (e.g. decreased anxiety) and behaviour (e.g. decreased rates of aversive behaviours). Few assessments follow up on participants to determine whether the changes are lasting. The small number of evaluative studies, methodological limitations and disparities in the content and the carrying out of interventions make it difficult to draw sound conclusions about the effectiveness of interventions, even for interventions most often and most favourably assessed, such as behavioural and cognitive‐behavioural interventions with maltreating parents. Implications for practice, research and policy are underlined.     

Women,trauma and substance abuse: Understanding the experiences of female survivors of childhood abuse in alcohol and drug treatment

Despite the available evidence suggesting gender should be considered in the provision of alcohol and/or drug (AOD) treatment, programmes are frequently offered in an apparent ‘gender vacuum’. This article argues that the generalist ‘one size fits all’ approach of many AOD services is not gender neutral but should be understood as implicitly gendered in that it neglects the specificity of women's needs in relation to abuse, mental illness and parenting. The discussion presented in this article is based on a qualitative study of the experiences of adult women with histories of childhood sexual abuse and/or domestic violence in AOD treatment. By examining the ways in which AOD treatments effectively ignore or minimise gender, this article uncovers intervention practices that efface the complexities underpinning AOD use among women and suggests ways in which alternative models of service delivery can create more validating and supportive environments. Key Practitioner Message: ● Some of the common assumptions underpinning alcohol and drug treatment do not adequately acknowledge the specific needs of female clients and so gender‐neutral service provision can be disenabling for women; ● Punitive service cultures or behaviour change strategies have a differential impact on female clients, many of whom have prior and ongoing experiences of abuse and violence; ● Service models that acknowledge the complex responsibilities and relational histories of female clients are more likely to engender a positive response and provide the opportunity to address the multiple and complex needs that can go unmet in non‐specialist services.     

Alcohol and drug abuse: removing structural barriers to treatment for historically disadvantaged communities in Cape Town

The article reports on an exploratory study that examined access to alcohol and other drug treatment for historically disadvantaged communities in the Cape Town metropole. In-depth interviews were conducted with 20 key informants from various sectors of the alcohol and drug treatment system, including treatment service providers, members of local drug action committees and social workers from district social service offices. Findings highlighted three structural barriers to service delivery: (i) difficulties in developing and implementing a strategic plan relating to alcohol and drug problems due to poor capacity and other infrastructural issues, such as a lack of information, poor intersectoral collaboration and limited consultation with service providers; (ii) limited allocation of resources to alcohol and drug treatment which has restricted the availability of affordable services as well as the capacity of established services to meet increased demand for services in this area; and (iii) fragmented service delivery. The study highlighted the need for further transformation of the South African social welfare system responsible for alcohol and drug treatment service delivery through public–private partnership development and the introduction of a management information system.     

Dilemmas when working with substance abusers with multiple and complex problems: the case manager's perspective

Since the 1990s, case management has been implemented in the USA and Canada – and recently also in various European countries – to support substance abusers with multiple and complex needs. Although this intervention is often presented as a set of standardised functions, its application is often a subjective task involving various dilemmas, which may influence case management outcomes significantly. Based on a comparison of case managers' experiences in Denmark and Belgium, we focus on several core dilemmas in case management for substance abusers with complex problems. Case management practices vary from one project to the next and even within the same project. Such differences are apparently related to the way in which case managers approach dilemmas such as those existing between control versus self-determination, or between systematic versus ad-hoc planning. The conclusion is that it is vital to discuss these dilemmas during training courses and supervision meetings in order to ensure that the intended form of intervention is actually delivered on the ground.     

Risk factors for child maltreatment in South Korea: An investigation of a nationally representative sample

This study investigated the risk factors associated with the occurrence of child physical and psychological abuse in South Korea based on the ecological theory of child maltreatment. A subsample of 3‐ to 18‐year‐old children from “A Study on the Current State of Child Abuse and Neglect,” a nationally representative study on child abuse and neglect, was utilized for secondary data analysis. The sample was divided into two age groups (third graders in elementary school and below and fourth graders and above). We utilized hierarchical logistic regression for each age group separately to analyze the data. The variables at each level of the system (i.e., ontogenic development, microsystem, and exosystem) were entered into the model in sequential order. The results showed the common risk factors for both age groups are the caregiver's experience of abuse in childhood, the child's problem behavior, exposure to domestic violence, community size, and informal social control. The child's age was also significant in both groups but in the opposite direction. Social support was a significant predictor for the younger age group only, while the caregiver's level of education was significant for the older age group only. Implications for future research and practice are discussed based on the study results.     

A brief moment of glory: the impact of the therapeutic community movement on the drug treatment systems in the UK

The introduction of concept-based therapeutic communities, based upon the model pioneered by Charles Dederich with the Synanon community in California, was a significant development in the evolution of drug treatment provision in the UK. For a short period in the 1970s, these communities enjoyed unparalleled influence in the development and direction of treatment approaches across the whole spectrum of services. This article considers the developments in psychiatry and social care that prepared the ground for that phenomenon. In addition, the article considers the subsequent demise in the importance of therapeutic communities to the direction of drug policy and the implications that this might have for future development of residential treatment services.