Treatment Approaches for Child Welfare Mothers with Addiction Problems

Abstract

This paper argues that child welfare mothers with addiction problems may require specialized treatment approaches based on their gender. The prevalence of women's problems with addiction and the unique ways addictions manifest themselves in women are discussed. The literature is then used to guide a discussion on the limitations of traditional treatment approaches that have been designed for men and may be of ill service to child welfare mothers. Alternative treatments are reviewed, and suggestions for improving treatment services to child welfare mothers with addiction problems are provided.     

Child Abuse Investigation and Treatment for Deaf and Hard of Hearing Children

Abstract

Deaf children are more susceptible than other children to abuse in home and institutional settings. Many helping professionals are unaware of the unique vulnerabilities and needs of the deaf; this lack of awareness limits the effectiveness of their services to that population. Laws and ethical standards mandate that social workers and others use communication methods that deaf clients can understand; however, many human service agencies rely on less than adequate means of communication in child abuse investigations and other procedures. Such ineffective intervention practices fail to protect a vulnerable population of children who literally cannot speak for themselves.     

Interpersonal Dependency Among Adult Survivors of Childhood Sexual Abuse in Therapy

ABSTRACT

This study investigated dependency in survivors of childhood sexual abuse (CSA). The Interpersonal Dependency Inventory (IDI) was administered at intake to 24 men and 85 women seen in therapy at a university-based community mental health clinic. In contrast to findings from earlier studies, no significant gender differences were obtained for IDI whole-scale or subscale scores. Analyses comparing CSA IDI scores with the IDI scores of previously studied groups indicated that among women, CSA survivors obtained higher dependency scores than non-CSA psychiatric patients, community adults, and college students. Findings for men were less consistent. Follow-up analyses revealed that commonly investigated CSA characteristics were unrelated to survivors' dependency scores. Implications of these findings for future research and clinical practice are explored.     

Serving families with child maltreatment and substance use disorders: A decade of learning

ABSTRACT

An increase in parental substance use disorders (SUD) and the number of infants and toddlers entering foster care has prompted federal and state efforts to change the treatment paradigm toward more integrated and family-centered strategies. The Regional Partnership Grant (RPG) program demonstrated that family-centered strategies can improve child and parent outcomes. The current challenge is to bring effective strategies to scale. This conceptual article highlights the lessons learned from 10 years of implementing and evaluating programs to meet the needs of families affected by parental SUD and child maltreatment. Effective family-centered strategies identified by the RPG program are illustrated with specifics from the Sobriety Treatment and Recovery Team program. These effective strategies could be implemented in any jurisdiction and include (1) collaboration toward integrated services between child welfare and SUD treatment, (2) timely access to SUDS treatment, (3) recovery management and support, (4) tailored family services, and (5) adaptation to local jurisdiction needs. When these strategies are operational, children are more likely to be safe and remain in parent custody, and parents are more likely to achieve sobriety and improve their parental capacity. Future research might examine the unique impact of each of the five strategies independently.     

Training Mental Health Professionals in Child Sexual Abuse: Curricular Guidelines

This study explored whether counseling practices with women survivors of child sexual abuse reflect the belief that women do not sexually abuse children. Canadian therapists (n?=?164) who work with women survivors of child sexual abuse were surveyed about their beliefs about what constitutes child sexual abuse, who commits child sexual abuse, and their practices regarding inquiries about abusive behavior. A majority self-reported that they ask women and think it is important to ask but most believe that clients will not spontaneously self-disclose inappropriate sexual thoughts or behaviors. How broadly or narrowly therapists defined child sexual abuse was not related to self-reported therapeutic discussion. Therapists demonstrated differential gender beliefs about child sexual abuse perpetration, but this did not relate to self-reported counseling practices. Implications for therapist education are discussed.     

Representation of children's views in court hearings about custody and parental visitations — A comparison between what children wanted and what the courts ruled

PurposeFollowing the UN convention on the rights of children, a shift in policy towards greater emphasis on child participation in child protection case processing has occurred. A growing body of research has emerged concerning participation processes in child protection cases and the experiences of children in child protection cases. Very few studies have looked into if and when children get what they want, however. The aim of this study is to assess children's views about living arrangements and visitations in dependency court hearings and to compare these views with the rulings of courts.MethodThe study uses a retrospective cohort design. Cases where child welfare board rulings are in line with the wishes of children are compared to cases where rulings differ from the wishes of children. Data were collected from regional social welfare board archives. The study included 151 cases that were randomly drawn from a total population of 2481 cases. Simple and multivariate logistic regression was used to identify factors associated with the rulings being in accord with the child's wishes in each sample case.ResultsA child advocate was appointed in almost 95% of the cases (n = 142). Fifty-nine percent of the children did not want a change in care. Rulings about care were in line with the wishes of the child in 39% of the cases. Rulings about care were most likely to be what the child wanted, if the child was presently living in public care and did not want to move. Children wanted more visitations with their mothers in 60.5% of the cases and with their fathers in 39.8% of the cases. Whether children wanted more visitations with their mothers was associated with more visitations being granted. What a child wanted was not associated with the ruling on visitations with the child's father.ConclusionThe impact of children's views on visitations on dependency court rulings depends on what a child wants and how these desires coincide with what is proposed by child protection services. Children's views can be quite effective in blocking certain decisions but are less effective if the child requested a specific change. If a child does not want to stay with his or her birth parents, then the odds that the birth parents will be granted custody is minimal.     

Partner Abuse Among Women Whose Children Have Been Sexually Abused: An Exploratory Study

ABSTRACT

To explore partner abuse among women in families in which a child has disclosed sexual abuse, 102 mothers completed a measure of partner abuse and the Coping Responses Inventory. Results suggest that, like women in the general population, mothers of children who have been sexually abused have often experienced partner abuse. As expected, physical abuse in a current relationship was found to be related to the use of avoidance strategies in dealing with the sexual abuse disclosure. The implications for practitioners and for future research are discussed.     

“I Felt Like I Was Being Abused All Over Again”: How Survivors of Child Sexual Abuse Make Sense of the Perinatal Period Through Their Narratives

ABSTRACT

Sequelae following child sexual abuse pervade the lives of adult survivors, significantly impacting on pregnancy and childbirth. Symptoms of this distress are recognized, but meanings for women are less understood. This research aimed to examine the meaning for women themselves of the impact of child sexual abuse on experiences of pregnancy, childbirth, and the postnatal period. Taking a critical feminist perspective, three open-ended interviews with three survivors enabled women’s narratives of pregnancy and childbirth to be heard, explored the structure of these narratives, including how experiences were connected, and identified key themes and how selves and others were positioned. Women themselves contributed to the analysis of their own narratives. The different struggles of each woman occurred within three domains of experience: identity, embodiment, and parenting. They were underpinned by a fluctuation between empowerment and disempowerment. These findings, although based on detailed analysis of the experiences of only three women, dovetail with, integrate, and extend the existent literature, offering a framework for understanding the complexity of meaning making for women. Further research might develop this. The framework may facilitate clinicians’ understandings of what it is like for some women having children who have experienced child sexual abuse.     

Characteristics of Sexually Abused Children and Their Nonoffending Mothers Followed by Child Welfare Services: The Role of a Maternal History of Child Sexual Abuse

Considering the importance of mother’s support in the adaptation of a sexually abused child, it is relevant to determine if the mothers and children involved in an intergenerational cycle of child sexual victimization differ from dyads in which only the child has been abused. The purpose of this study was to compare mother–child dyads with sexually abused children according to whether the mother had herself been victim of child sexual abuse. The sample included 87 dyads with sexually abused children aged 3–18 years old and their mothers (44 reporting maternal and child abuse), followed by social welfare services of the province of Quebec (Canada). The two groups of mothers were compared on their past family abuse experiences and past family relations, their mental health history, their current psychological distress, their parenting behaviors, and their current levels of family functioning. Children were compared on their adaptation. Multivariate analyses indicated that mothers reporting child sexual abuse were more likely to report more other maltreatments in their childhood and greater prevalence of lifetime history of alcohol abuse disorders, dysthymia, and panic disorder compared with mothers who had not experienced CSA. Compared to children whose mothers had not experienced CSA, those whose mothers had experienced CSA showed higher rates of problems behaviors and were more likely to report having been sexually abused by a trusted person. These results highlight the specific clinical needs for the assessment and treatment for sexually abused children whose mothers experienced child sexual abuse.     

War and Peace: Social Work and the State of Chemical Dependency Treatment in the United States

SUMMARY

In recent decades, treatment for alcohol and drug problems in the United States has been influenced by a number of factors. This article discusses several of these factors, including the “War on Drugs,” with its emphasis on law enforcement and interdiction, and managed health care, which has compromised access to treatment. In spite of these factors, the U.S. invests a goodly amount in alcohol and drug prevention and treatment services and research. Efforts are being made to ensure that research findings are being translated into improved clinical practice. Among the controversial issues in the treatment arena are recent efforts by the Bush administration to promote public funding of faith- or religious-based groups in delivering chemical dependency services. Social workers commonly see people with alcohol and drug problems in their practices, but only a small number of social workers are well prepared to treat this group of clients.     

A qualitative data analysis: family victim advocates in child advocacy centers

ABSTRACT

Family victim advocates in child advocacy centers provide a valuable resource to children and parents involved in child abuse investigations. This work requires that family victim advocates be knowledgeable in such areas as child development, crisis intervention, community resources, family relationships, child welfare and criminal justice systems. Because family victim advocates provide essential services to parents and caregivers, the role requires ongoing training and education to remain current on the ever-changing complexities of working with not only the children and families but also the criminal and child protection systems responsible for investigating these cases. The current study reports the findings from a nationwide survey of family victim advocates employed in child advocacy centers related to their motivation for doing the work as well as their perceptions of their training and potential training needs. A group of doctoral students comprised the research team and worked collaboratively under the supervision of university faculty to conduct the qualitative data analysis. The findings describe the characteristics and motivations of family victim advocates working in child advocacy centers and emphasize the need for more advanced trainings that focus on skill-building and strengths-based practices utilized to support children and parents in child abuse cases.     

Culturally Competent Substance Abuse Treatment for Asian/Pacific Islander Women

Summary

In response to the urgent need for substance abuse treatment among pregnant and postpartum Asian/Pacific Islander (A/PI) women, heath care and social service providers in a rural community of Hawaii established a culturally based, women-centered residential treatment program. The program was designed to address barriers that often prevent A/PI women from engaging and completing treatment. Treatment included Hawaiian healing practices or deep cultural therapy, provision for newborns to live with their mothers, infant health-care services, parent education, and infant-mother bonding guided by kupu-na (elders) of the community.

Analysis of twenty-one in-depth interviews revealed factors that A/ PI women participants found vital to their treatment process: having their children with them in a non-punitive, mutually respectful treatment milieu; working with consistent, competent residential staff and culturally-sensitive interdisciplinary professionals; and involvement in a range of substance abuse interventions, including cultural healing practices.

Findings underscore the importance of learning about and affirming women's lived-experiences and cultural contexts in the development of culturally competent practice models, interventions, research procedures, and policies that focus on the complex needs of chemically dependent pregnant and parenting women (Brindis & Theidon, 1997).     

Korean American Pastors' Perceptions and Attitudes Toward Child Abuse

Abstract

More than 80 percent of Korean immigrants in the United States attend church on a regular basis. Churches, as informal community organizations, can play a very significant role in protecting children from abuse. This study examines Korean American clerics' knowledge of child abuse, their definition of child abuse, and their familiarity with mandatory child-abuse reporting laws. The study also examines how culture, demographic variables, and individual theological orientation affect their attitudes toward child abuse, mandated child abuse reporting by clergy, and preference of intervention strategies. Major findings include that more than 50 percent of respondents have seen child abuse and neglect among their church members, but the majority who have witnessed child abuse prefer to provide pastoral counseling to the family instead of reporting the case to a child protective agency.     

Betrayed and Broken: A Study of the Experiences of Victims of Child Sexual Abuse in the Ga Community in Accra,Ghana

ABSTRACT

Child sexual abuse is increasingly becoming an issue of concern in most societies across the globe, including Ghana. This is a phenomenological study that sought to describe the lived experiences of victims of child sexual abuse in Ghana, using the Ga community as a case study. Purposive and snowball sampling techniques were used to identify 17 sexually abused children in the Ga Community. Using the interpretative phenomenological analysis (IPA), four main themes described the experiences of the victims: (a) forced sex (b) incest (c) joleying and (d) transactional sex. The findings illustrate the different circumstances in which children were sexually abused in the community studied. It also presents socio-cultural factors that normalizes the sexual abuse of children in the Ga Community. These findings underline the need for effective preventive programs and community interventions to protect children and support victims of child sexual abuse.     

Exploring the Relations Among the Nature of the Abuse,Perceived Parental Support,and Child's Self-Concept and Trauma Symptoms Among Sexually Abused Children

ABSTRACT

This study examined two resiliency factors: self-concept and perceived parental support, in conjunction with abuse factors that impact psychological functioning. Data were collected on 61 sexually abused children prior to treatment. Findings indicate that a child's self-concept was associated with all the trauma symptoms except sexual concerns and did account for a significant amount of variance in relation to trauma symptomatology. Parental support was only associated with the Dissociation and was not found to account for variance in relation to trauma symptoms. Factors specific to the sexual abuse found that when a child endured a lengthy abuse period, their self-concept was more negative.     

A Knowledge Based System for Assisting in Differential Diagnosis of Chemically Dependent/Mentally Ill Patients

Summary

This paper discusses the use of Knowledge Base 2.1, a computer program that administers a response dependent, structured interview to evaluate the presence of psychiatric disorders within the chemical dependency treatment setting. The writer reviews the problems commonly encountered when conducting clinical interviews, psychometric examinations and differentially diagnosing psychiatric disorders within this special population. Knowledge Base 2.1 utilizes combined computer techniques of rule driven logic, pattern matching, and an original algorithm that accomplishes a “real time retandardization” of the complete database. With each administration, standardization is implemented in an effort to adequately consider the effects of chemical dependency on psychological test performance and normative information regarding symptoms. Knowledge Base 2.1 also functions as a research tool inasmuch as all patient responses to this structured interview are permanently stored in computer files for ongoing analysis.     

The Use of Peer Support for Parents and Youth Living with the Trauma of Child Sexual Abuse: An Innovative Approach

ABSTRACT

This article describes and reports on an innovative intervention program for parents of sexually abused children and youth. Peer support provided by non-professional staff and volunteers, who have been personally affected by the trauma of child sexual abuse, is an approach with unique advantages. Many of these consumers have not been able to benefit from traditional service delivery approaches. Goals and objectives of the Peer Support Program (PSP) have been developed through inter-agency collaboration initiatives comprised of a coalition of existing social service agencies. This report examines characteristics of service delivery and level of consumer satisfaction of parents and youth who have participated in the peer support program. Implications for interventions with sexually abused youth and parents of sexually abused children are discussed.     

Natural Recovery from Substance Dependency

Abstract

The literature on cessation of drug and alcohol dependency without benefit of treatment or participation in self-help groups spans nearly forty years. While this literature is substantial and analyses of the processes of natural recovery well-developed, discussions directed at treatment providers around the value of these analyses for practice has been sparse. Drawing on our study as well as the research of others, this paper explores two dimensions of natural recovery that hold important implications for treatment providers who work with substance dependent clients. These include the common strategies used by remitters and the concept of recovery capital as a way to capture the embeddedness of these natural recovery strategies within a unique structural context of personal attributes and social environments.     

Mothers matter: A feminist perspective on child welfare-involved women

ABSTRACT

Mothers involved in child welfare services are often marginalized and misunderstood while the system focuses on protecting their children. These women are mothering within a context of poverty, violence, addictions, and racism, leaving them with minimal resources and supports. Using a feminist perspective, this article seeks to shift the common perception that children must always be regarded as needing to be protected from these mothers. Rather, a richer understanding of these women and more focus on attending to their needs may provide an added measure of safety and security for their children. An appreciation for the relationships central to these women’s experiences can provide child welfare workers with the ability to create strong working alliances and move families toward safe reunification.     

The health and development of children whose mothers are on methadone maintenance

The health and development of a group of children aged 3-7 years born to and reared by mothers who abused opiates when pregnant and who remain on methadone maintenance was compared to a group of age and socially matched control children. There was no difference between the two groups in terms of health and development although the children whose mothers were on methadone had smaller head circumference measurements than the controls. More than half of the index children had been on the child protection register during infancy; all but one were off the register at the time of the study. The results suggest that drug-abusing women who are on methadone maintenance and attending a drug dependency unit may rear and care for their children as well as parents from a similar social background who are not drug abusers.