Developmental issues in child abuse: Implications for intervention

This paper reviews some of the issues in child abuse such as problems of definition, characteristics of abuser and abused, and etiology. It emphasizes that child abuse can start at any age. A developmental approach is suggested in order to understand the relationship between the child's stage of development and its idiosyncratic potential for stimulating aggression on the part of the parent. This approach offers a broad framework in which phase specific stressors, characteristics of the child, the abuse prone personality of the abuser, as well as the family system and external stress factors, can be considered together and upon which intervention strategies can be planned.Lynn Ohrenstein is Administrative Supervisor at the Jewish Board of Family and Children's Services, a doctoral candidate at Yeshiva University, and in private practice.This is an expanded version of a paper delivered November 4, 1982 by the author at an interdivisional meeting at the Jewish Board of Family and Children's Services devoted to Issues on Domestic Violence.     

The use of metaevaluation to plan evaluations of conservation programs

The U.S. Department of Energy (DOE) is sponsoring and will be required to evaluate a wide range of conservation programs. The development of evaluation plans for such programs can often be improved by reviewing evaluations that have been done on similar programs. The Residential Conservation Service (RCS), sponsored by DOE, is discussed as an example of how conducting metaevaluations can improve evaluation planning. Many utilities have sponsored programs that are similar to the RCS. A review of the utility program evaluations suggested key methodological issues and data problems that should be considered in the development of an RCS evaluation plan. The implications of these metaevaluation findings for an RCS evaluation plan are discussed.     

Cost/effectiveness analysis of alcoholism and drug abuse treatment programs: the relevance of recidivism and resource absorption.

Cost/effectiveness measures are increasingly being applied to alcoholism and drug abuse treatment programs. Program evaluators usually regard readmissions as inadequate for assessing outcome, and resource absorption is rarely examined; this paper presents the argument that increased attention to recidivism and resource absorption is integral to the program evaluation process. Readmissions formed 53% of admissions to U.S. drug abuse programs, and in alcoholism treatment centers, 4% of the patients accounted for 24% of the detoxications. Problems with assessing cost/effectiveness are associated with duration of treatment, average cost, time span of analyses, quasi-experimental designs, multiple episodes of treatment, "silting up", and extrapolation. Five approaches to dealing with these problems are suggested: analyzing existing program data bases for recidivism and resource absorption, considering recidivism when evaluating programs, tempering clinical enthusiasm with skepticism, matching patients with levels of care appropriate to previous treatment history, and assessing additional benefit derived from increasing amounts of care per patient as part of cost/effectiveness analysis.     

Complexity of process and role in the evaluation of an interdisciplinary mental health education program: The deacon's masterpiece

Research and literature on program evaluation must attend to problems of application, which can have major effect on the outcome. Increasing numbers of innovative, multifaceted programs operating in complex settings are presenting for evaluation. Evaluation process must become flexible, creative, and multifaceted in order to produce valid and comprehensive results, and to meet the needs of this field. Evaluators and evaluation, the evaluated program, and the environment become a mutually interacting system in the process of evaluation. Evaluation goals and roles must be conceptualized, agreed upon, sanctioned, and appropriately implemented or conflict and ineffectiveness will result. Three models of evaluation emerge: objective and independent, objective but serving one interest, and pseudo-scientific public relations. Evaluation of an interdisciplinary mental health education program illustrates these issues. Evaluation technology, process, and roles must all be attended to or the weak link undermines the rest.     

Competing Values in Serving Older and Vulnerable Adults: Adult Protective Services,Mandated Reporting,and Domestic Violence Programs

State mandatory reporting statutes may directly or indirectly list domestic violence programs as among those that are mandated reporters of cases of suspected abuse, neglect, or exploitation of older individuals and those with disabilities. Domestic violence programs, however, may not consider themselves to be mandated reporters, because the responsibility of reporting abuse may be contrary to their programmatic philosophy. In the Commonwealth of Virginia, the potential conflict between domestic violence programs and Adult Protective Services about the issue of mandated reporting has created tension between these organizations as each entity continues interpreting the issues and policies of mandated reporting through its own lens. The authors draw out some of the reasons for the conflict as well as make recommendations for improving relationships between the two organizations, which will ultimately benefit vulnerable adults who are experiencing abuse.     

Structuring a multi-site evaluation for youth mentoring programs to prevent teen alcohol and drug use

Despite mentoring's rapidly increasing popularity as an intervention for the prevention of teen alcohol and drug abuse and associated problems, there is little research consensus on its overall effectiveness or on the core principles and components that define effective mentoring. To advance knowledge concerning this important prevention intervention, the Center for Substance Abuse Prevention has designed and funded a multi-site cooperative agreement involving seven mentoring programs. The programs are designed to provide a rigorous outcome evaluation that allows comparisons of differing approaches to organizing and delivering mentoring services to adolescents at high risk for substance abuse. The cooperative agreement guidelines set service parameters and options that focus on issues that are grounded in past research on mentoring prevention interventions. The cooperative agreement includes a quasi-experimental, longitudinal multi-site evaluation that provides evidence-based recommendations to advance the effective use of mentoring as a prevention strategy.     

Teachers’ Knowledge and Beliefs About Child Sexual Abuse

Child sexual abuse is one of the main types of abuse still to be addressed within the field of education, yet the education system itself can serve as a primary tool for its prevention. A better understanding of teachers’ knowledge and beliefs about child sexual abuse will allow us to establish key starting points from which to utilize the system for prevention. Four hundred and fifty teachers participated in this study, completing a questionnaire regarding their knowledge and beliefs about child sexual abuse. The study revealed that over half the teachers, 65.3% (n = 294), had never received any type of training in child sexual abuse education and that the majority were not familiar with methods of identifying child sexual abuse, 90.7% (n = 279). Various mistaken beliefs were identified among the participating teachers, such as pathological profiles of abusers, that the vast majority of child sexual abuse implies violent behavior, and that there cannot be abusers the same age as the victim. These results indicate that knowledge deficiencies do exist about child sexual abuse among teachers and highlight the need for training in this field.     

Referral to treatment: improving client-treatment match through process analysis.

This paper presents an expedient procedure for assessing referral counselor knowledge of the effectiveness of various treatment programs for different client types. Among the advantages of this technique are timely results, ease of application, and usefulness for process and formative evaluation. An empirical example using data from a drug abuse referral program is included to demonstrate one application of the technique. The discussion includes additional examples where the technique would have potential utility.     

Services for substance abuse-affected families: The project connect experience

With more families entering the child welfare system with problems of substance abuse, there is an increasing need for programs that can respond effectively to these families' needs. This article describes one community-based program designed to support and strengthen families with an identified problem of substance abuse. parents' progress in addressing their problems with substance abuse, reduction of risk in Project families. children's placement experiences, and client satisfaction are discussed. The article concludes with implications for practice with substance abuse-affected families.Project Connect is funded by a grant from the National Center on Child Abuse and Neglect, U. S. Department of health and Human Services. It is administered by the Rhode Island Center for Children-at-Risk, which is a program of Children's Friend and Service, Providence, Rhode Island. Project Connect is operated under contract from the Rhode Island Department of Children, Youth, and Families. The author wishes to acknowledge the staff of Project Connect and the Rhode Island Department of Children, Youth, and Families without whose contributions this work would not have been possible.     

The History of Child Sexual Abuse Prevention: A Practitioner's Perspective

ABSTRACT

This article examines the history and current condition of child sexual abuse prevention efforts in the United States, emphasizing the perspective of those engaged in developing and working in such programs. The author argues that child sexual abuse prevention programs had built-in challenges given the topical area as well as the rapid growth of such programs combined with a paucity of resources and, initially, research, to support and inform its growth. Common criticisms of child sexual abuse prevention programs are examined and alternative explanations are postulated to explain certain weaknesses of programs. Finally, the author challenges researchers to broaden their research of sexual abuse prevention efforts beyond single population, single variable (such as knowledge gain) designs to understand more fully what is currently being done nationally to prevent the sexual abuse of children. Additionally, clear broad-based support for prevention in the wider field of child abuse is encouraged to build on the successes of prevention efforts.     

CMHS/CSAT Collaborative Demonstration Program for Homeless Individuals

The Collaborative Demonstration Program for Homeless Individuals is providing an opportunity for several community agencies in the United States to explore innovative intervention and treatment strategies to address the needs of homeless people with co-occurring (mental illness and substance abuse) disorders. This cooperative agreement, funded jointly by the Center for Mental Health Services (CMHS) and the Center for Substance Abuse Treatment (CSAT), is a $3 million project supporting programs in various community agencies to develop, document, and evaluate programs for persons who are homeless with co-occurring disorders to be used as models in other communities. The program models include: Assertive Community Treatment, Psychosocial Rehabilitation, Therapeutic Community, and an integrated treatment model. The first phase of the two-phase project funded 16 programs in the U.S. to develop manuals within their primary treatment modalities for homeless people with co-occurring disorders. For Phase II of the project, six of the 16 model programs were competitively selected to demonstrate program impact through formal program evaluation efforts. The data derived from the various projects will be compiled into a compendium of information for state agencies and community service providers throughout the U.S.     

Young Fathers: An Analysis of Risk Behaviors and Service Needs

One hundred and twenty eight young fathers participated in an assessment of risk behaviors and service needs prior to entering a program for young fathers. Of this group, 73% were unemployed, 69% were school drop-outs, almost 40% had substance abuse problems, close to 30% had committed a felony, and less than half had declared paternity for their children. The majority of these young fathers desired employment services and educational/vocational training. Despite their risk behaviors, young fathers did not want substance abuse counseling, child support services, or help in obtaining a GED. There appears to be a discrepancy between the problems and needs, and the services which these young fathers requested. Many young fathers believed employment would be a panacea to all their problems. These findings suggest that more attention should be given to examining these issues in programs targeting young fathers. Services such as preventive health and mental health should be considered prior to the final goals of employment and establishment of paternity.     

The operation was a success but the patient died: A critique of “the implementation and evaluation of a problem-solving training program for adolescents”

This critique examines George S. Tellado's account of his evaluation of a problem-solving program for adolescents in a public junior high school in Pennsylvania. The program was apparently successful (i.e., it was shown by the evaluation to improve students' problem-solving capacities), and the evaluation was, for the most part, technically sound, but the program did not survive. This critique suggests that by examining the problem-solving program as an organizational change intervention, several problems can be uncovered regarding the program's design, implementation, evaluation, and institutionalization. In particular, it appears that the school system's staff did not have sufficient ownership of the program to understand it or to wish to carry it on after the program's originator and evaluator were no longer present. This article addresses these problems in detail and recommends techniques from the field of organizational change consultation to increase the likelihood that such programs will live on into the future.     

Design of a language stimulation program for children suffering abuse

This article proposes an intervention program, designed specifically for children in residential care who suffer institutionalized abuse, aimed at stimulating their use of language. The objective of the intervention procedure is to improve children's linguistic competence and their socio-affective development, as well as to enable parents to communicate and interact effectively with their children. Several studies have focused on the difficulties children suffering from abuse have with verbal expression and other areas of development. The research stresses the need to set up intervention programs that can improve the linguistic and social competence of children suffering from abuse. With such children, there is a fundamental need to develop a competence that will encourage their adaptive social skills, which are basic skills for interacting socially and which encourage the pragmatic language function, a skill needed for relating to adults and solving interpersonal problems.     

Project SAFE: an Armed Forces cooperative initiative for the prevention and treatment of family violence.

About one out of every eight persons residing in the State of Hawaii is either active duty military or a military family member. In the late 1970s, it became apparent that neither the military nor the state could meet a growing obligation to provide responsive protective services to abused and neglected children of military families. Inspired by a first-ever congressional appropriation for the development of military child abuse and neglect and spouse abuse programs, the Department of Defense funded a 3-year joint-Service family violence project. Operational since 1982, Project SAFE (Services Assisting Family Environments) consists of a family violence shelter, clinical outreach teams, and a prenatal prevention project. This paper chronicles the history of Project SAFE, provides retrospective commentary on planning and implementation, and identifies key evaluation questions yet to be answered.     

Alcohol abuse on a college campus: A needs assessment

This paper reports the results of a needs assessment study conducted by a university-based alcohol abuse prevention project. Data are presented on the drinking patterns and drinking problems of a random sample of 462 students. Results suggest that students are experiencing numerous difficulties in the physical, educational, legal and psychosocial areas due to their use of alcoholic beverages. Implications for prevention and intervention programming are discussed and the need for planning programs from a data-based perspective rather than a rational and intuitive approach is stressed.     

Pregnant and Postpartum Adolescents' Perceptions of the Consequences of Child Abuse

A study of 263 pregnant and postpartum indigent and minority teens was conducted in order to examine their perceptions of the consequences of child abuse and their own child abuse history. Teens identified drug and alcohol abuse and teen suicide as the most serious consequences of abuse. Interestingly, they did not identify pregnancy as a consequence. Twenty-seven percent reported a history of abuse. Identifying behavioral and emotional consequences of abuse is important because it affects both the well-being of the adolescent mother and her child. An experience of abuse and its behavioral consequences may interfere with a teen's ability to benefit from parenting intervention programs. Therefore, parenting programs may wish to consider the necessity of screening for a history of abuse as well as adding components on behavioral problems adolescent mothers are concerned about. Additionally, there is a need to reach out to pregnant, parenting and future parents in other settings such as prisons, psychiatric, and residential centers, since issues of abuse may coexist with other behaviors.     

Social Work Practice and Education in the US and Canada

This paper discusses shared origins and differences in the social work professions and education programs in the United States and Canada. Consideration is given to how the social work professions in the two countries attempt to resolve the possible inherent conflict between an emphasis on dealing with problems of individuals, with intervention approaches such as casework and therapy, and an emphasis on addressing the problems of society, with social reform intervention approaches. The paper also discusses social work employment in the U.S. and Canada and the structure of social work education in both countries, including consideration of how the profession is legally regulated in each country.     

Consumer evaluation of community treatment

Development of community programs for offenders requires innovation in program design and evaluation. The Complex Offender Project (COP) provided intensive community treatment, and its clients' opinions were used as a component of its evaluation. Treated clients perceived the same needs for services as did other offenders, but more of them reported receiving the services. Compared to probation, COP was perceived to be more helpful in resolving problems, more continuously helpful, and of helping more to learn useful skills and achieve meaningful goals. The Complex Offender Project provides a model for program development, and the techniques of consumer evaluation are recommended as a means of evaluating such programs.