Public attitudes toward child maltreatment in Israel: Implications for policy

Objective

The public view of the severity of social problems and their perceptions of how effectively they are being addressed have a major impact on public policies and resource allocation. The present study focuses on public attitudes toward child maltreatment. It examines perceptions of child maltreatment as a social problem, and attitudes toward prevention and treatment strategies in cases of child abuse and neglect.

Methods

A survey was conducted among a representative sample of 812 Israeli adults: 688 Jews, and 124 Arabs. Fifty additional Ultra-Orthodox Jews were added for comparisons among Jewish participants.

Results

The participants tend to view violence and alcohol consumption among youth as a more serious problem than parental maltreatment of children. Low-income participants tend to view child maltreatment as a more serious problem than did high-income participants. Jewish participants (except for ultra-Orthodox Jews) view child maltreatment as a significantly more serious problem than did Arabs and Ultra-Orthodox Jews. Most of the participants believe that parents who maltreat their children should be punished, but they should be taught how to refrain from maltreatment, and learn to change their behavior. Many participants believe that the courts do not sufficiently punish parents who maltreat their children. In their assessments of the quality of professional work, the highest evaluations are given to services provided by physicians and social workers, whereas the lowest evaluations are given to judges and police. Most of the participants (70%) believed that social workers play an important role in protecting children.

Conclusions

The survey findings have implications for enhancing public awareness of child maltreatment as well for policy making in the area of child abuse and neglect. The differences in the perceptions of participants based on their religious, cultural and economic background toward child maltreatment should be further studied and addressed in policy and interventions in this area.     

Ethical and legal challenges of mandated child abuse reporters

Background

Mandated reporters inconsistently report child abuse cases. Ethical dilemmas and legal challenges to reporting arise creating barriers to assist abused children and their families.

Purpose

The purpose of this study was to describe professionals' ethical dilemmas and legal challenges to reporting child abuse.

Method

A qualitative study was conducted to explore the ethical and legal challenges of mandated reporters when reporting child abuse. Individual interviews between 60 and 100 min were conducted with a purposive sample of 18 mandated reporters including physicians, nurses, social workers, and teachers. Grounded theory methodology was used to develop categorical themes that reflected mandated reporters' experiences and challenges.

Result

Three themes emerged from the data: conflicts, time, and law as refuge. Professionals described challenges in balancing autonomy, beneficence, nonmaleficence, and justice. There was no best solution to do no harm. The associated stigma and pressure of cultural and secular norms of child abuse inhibit professionals' action based on legal and ethical requirements. The theme of time included limited time and an uncertain future. The law provides security and refuge for professionals to find a solution to the challenges of reporting child abuse.

Conclusion

The ethical and legal challenges of reporting child abuse create complex dilemmas for mandated reporters. Ethical principles are in constant opposition when negotiating rights of children and rights of parents. Supportive structures and education are needed to assist professionals in meeting their reporting obligation and solving their dilemmas.     

Children adopted from China: Attachment security two years later

Background

This study continues the examination of the process of attachment formation of mothers and their adopted Chinese daughters two years postadoption.

Method

30 children adopted from China (mean age = 13.6 months at adoption) were assessed and followed two years following adoption. They were compared to 31 nonadopted Canadian girls of similar age and family background. In earlier reported longitudinal studies of the adopted children, maternal reports of attachment security were employed. In the current study the Strange Situation Procedure was used.

Results

Adopted children show signs of having a secure attachment with their mothers two years following adoption. There was some evidence that disorganized attachment characterized these children more so than for children in the comparison group.

Conclusions

The moderate degree of emotional deprivation experienced by Chinese adoptees does not hinder their ability to form a new attachment with adoptive mothers. Attachment appears open to change, even after a time when children should have already formed an attachment relationship and the change is maintained.     

Reflections on citizen-state child welfare partnerships: Listening to citizen review panel volunteers and agency liaisons

Objective

Previous research pertaining to the citizen review panel (CRP) initiative indicates that discrepancies exist between panel member and state agency liaison perceptions of CRP effectiveness in fulfilling the CAPTA CRP mandate. This study explores the impressions of both CRP members and liaisons involving barriers to effective CRP-state child welfare partnerships and recommendations to improve the relationship, provided through narrative survey responses from CRP liaisons from 30 states and D.C. and panel members from 32 states and D.C. Thematic categories which emerged from analyses of these responses are discussed, and a conceptual model and substantive-level theory of the CRP-child protective services (CPS) relationship developed from the results are presented.

Results

The complex nature of CRP-CPS relationships emerged as the central theme among CRP members' and liaisons' responses. Liaisons and CRP members identified a need for CRP members to become more educated globally on child welfare despite the relatively high level of education and experience of much of the sample. Difficulties encountered by panel members in the effort to partner surfaced in themes of mistrust and skepticism about the worth of citizen participation in child protection. Negative agency attitudes, lack of role clarity, and lack of commitment to authentic partnership were cited as negative influences upon the relationship by both liaisons and CRP members. The most important preferred outcome of the partnership was that citizen volunteers would become more knowledgeable partners who could meaningfully contribute to child welfare efforts. A second desired outcome important to CRP members was to form a shared vision with CPS.

Conclusions

Findings imply that when key components of mutual respect, legitimacy, CPS knowledge, shared vision, authenticity, citizen engagement, honest communication, and a serious, deliberative process are in any way impeded, the partnership is vulnerable to breakdown, and intended outcomes may be compromised.

Implications

Important relational difficulties that have formed barriers between volunteers and CPS agencies have been identified, and results suggest specific issues to target for improvement. These findings can prompt a more informed discourse about the challenges and opportunities presented when attempting to engage citizens in child welfare practice and policy-making, and can lead to new research paths. Suggestions for such efforts are offered.     

Suicidal behavior and associated factors in sexually abused adolescents

Objectives

The aim of the present study is to determine the rate of suicidal ideation and suicide attempts in sexually abused adolescents and to determine the factors associated with suicidal behavior.

Method

106 adolescents between the ages of 12–18 (94 girls, 12 boys) who were exposed to sexual abuse and referred for the preparation of forensic reports were included in the study. The investigators retrospectively examined the case files, forensic reports and social worker reports.

Results

It has been found that in cases exposed to sexual abuse, suicidal ideation developed in 63.2% (n = 67) of the individuals and 24.5% (n = 26) of them attempted suicide. The rate of suicidal ideation and suicide attempts was higher in cases who live separately from one or both parents, those who have ASD or PTSD after sexual abuse, cases in which abuse involved penetration, cases who were abused by someone known or someone from the family, cases where sexual abuse was accompanied by coercion and physical violence, and those who were exposed to abuse continuously. Among girls, in cases who have suicide history before sexual abuse and those who were abused by more than one abuser, the rate of suicidal ideation was higher.

Conclusion

It has been shown in many studies that sexual abuse in childhood increases the risk of suicidal behavior. Consideration of the factors associated with suicidal behavior in victims of sexual abuse will be helpful to clinicians in preventing suicide attempts.     

Examining the relationship between psychotropic medication use and testing positive for Chlamydia and Gonorrhea among detained adolescents

Objective

We examined whether psychotropic medication (PTM) use was related to testing positive for Chlamydia and Gonorrhea among detained adolescents.

Methods

A convenience sample of 550 detained adolescents ages 14-18 years were recruited from eight youth detention centers in Georgia. Using A-CASI technology, data was collected on demographic factors, use of PTM, and sexual risk behaviors. Chlamydia and Gonorrhea diagnoses were assessed by laboratory testing.

Results

Thirteen percent (13.1%) of adolescents not using PTMs tested positive for STIs compared to only 4.9% of those reporting PTM use. PTM users had a 62% smaller odds ratio for testing positive for Chlamydia or Gonorrhea.

Conclusion

Findings suggest that use of psychotropic medication, if deemed useful by detained youth, may be a protective factor against engaging in behaviors which may culminate in contracting some STDs. The practice implications are discussed within the context of these findings.     

Access visits: Perceptions of child protection workers, foster parents and children who are Crown wards

Objective

To report findings from a study of the perceptions of foster parents, child protection workers and children regarding supervised access visits for children who are permanent wards (Crown wards).

Methods

Interviews were conducted with twenty-four Crown wards having regular supervised access visits. Eight focus groups were conducted with twenty-four foster parents, and twenty-six child protection workers. Interviews and focus groups explored perspectives regarding supervised access visits. Interviews and focus groups were transcribed, coded, and thematically analyzed. Negative case analysis, prolonged engagement, and triangulation contributed to the trustworthiness of the research.

Results

While this study is explorative, findings suggest considerable dissatisfaction regarding access visits among foster parents and workers, inadequate training for workers and foster parents, poor communication and consultation regarding access visits, and confusion regarding the roles of supervisors.

Conclusions

The data suggest several possible explanations for children's distress associated with access visits including lack of communication among access supervisors, workers and foster parents; insufficient training for workers who supervise visits; and a lack of validation of the children's contradictory feelings towards their mothers.

Practice implications

Findings suggest the need for more consultation with and inclusion of foster parents in access visits. More training is required for workers supervising access visits including whether and how it is beneficial for children to express their feelings and address potentially difficult topics regarding their biological family members.     

Youth Substance Use in a Context of Family Homelessness

Objective

This study examines the relationship between family processes and youth substance use debuts among a sample of youth residing in urban family homeless shelters.

Method

Data regarding shelter experiences, youth and family characteristics, and the use of three substances (i.e., cigarettes, alcohol, and marijuana) were gathered from a sample of youth (11-14 years) and their respective parents residing in an urban family homeless shelter system. Multinomial logistic regression analysis was used to examine the influences on youth substance use.

Results

Of the 198 youth included in the statistical analysis, 72% (n = 143) reported no substance use debuts, while 18% (n = 35) indicated one and 10% (n = 20) indicated two to three substance use debuts. Within the final model, greater substance use debut was associated with being older (13-14 vs. 11-12; OR = 7.5; 95% CI = 1.8-30.9) and stressors exposure (OR = 4.8; 95% CI = 1.5-14.7). Furthermore, youth of adult caretakers that reported low levels of the three family processes considered were almost four and a half more likely (OR = 4.4; 95% CI = 1.2-16.5) to have made two to three substance use debuts.

Conclusions

Family processes may be a particularly important intervention target toward reducing the rate of substance use among youth residing in urban family homeless shelters.     

Social supports preferred by the teachers when facing school violence

Objectives

This study aims at examining whether the social support sources of teachers differ depending on the variables of gender and seniority when they encounter violence at school and investigating their opinions on precautions against school violence.

Methods

Data was collected via a questionnaire from a sample of 179 female and 166 male Turkish teachers. Chi-square and Mann-Whitney U tests were used for data analysis.Results: Male and female teachers preferred to share the experience of exposure to verbal (χ² (5) = 22.81, p < .01), physical (χ² (5) = 36.64, p < .01), emotional (χ² (5) = 26.13, p < .01) and sexual violence (χ² (5) = 37.43, p < .01) at school with different social support sources. Male teachers preferred their colleagues as social support sources whereas female teachers preferred their spouses/families. Social support sources which teachers prefer when they face any type of violence other than sexual violence differ due to the length of teaching experience. School administrators and counselors are not among the social support sources of teachers when they were exposed to violence.

Conclusions

Turkish teachers' preferences related to their victimization experiences indicate a need for prevention program encompassing teachers, school counselors and administrators.     

Job demands,emotional dissonance and elderly abuse: The moderating role of organizational resources

ABSTRACT

The present study focuses on elderly abuse committed by caregivers in nursing homes. It aimed at a better understanding of neglect and abusive behaviors by considering the working context and the emotional dissonance of these professionals. To achieve this goal, direct effects of emotional dissonance, job demands (workload and emotional demands) and organizational resources (high-quality relationships with the colleagues and the supervisor) on neglect and abusive behaviors were analyzed. Moreover, the moderating role of organizational resources was explored. The study was conducted among 481 nurses and healthcare assistants from different French nursing homes. Overall, results contributed to the literature by pointing out the impact of emotional dissonance and caregivers’ working context on neglect and abusive behaviors. Moreover, results highlighted the moderating effect of high-quality relationships with the colleagues and the supervisor and give rise to potential implications in preventing elderly abuse in nursing homes.     

The outcome of Solution-Focused Brief Therapy among foster care adolescents: The changes of behavior and perceived somatic and cognitive difficulties

Objective

To evaluate the outcome of Solution-Focused Brief Therapy as an individual intervention among foster care adolescents using “traditional” methods of between-group comparison as well as analysis at individual level by assessing reliable and clinically significant change.

Material and methods

The research was conducted at seven foster care homes in Lithuania. Treatment (age average 14.6) and control groups consisted of 46 adolescents each. Control group was similar to the treatment group considering gender, age and pre-treatment evaluation of behavior and perceived somatic and cognitive difficulties. Participants could attend a maximum of 5 sessions. Post-treatment evaluation was conducted 6 weeks after the pre-treatment evaluation. Behavior and perceived somatic and cognitive difficulties were assessed using Standardized Interview for the Evaluation of Adolescents' Problems. The outcome of Solution-Focused Brief Therapy was assessed using the following statistical methods: between group comparisons; effect size (Cohen d with Hedges adjustment), reliable and clinically significant change methods proposed by Jacobson and Truax (1991).

Results

Between-group comparisons revealed that Solution-Focused Brief Therapy is an effective method for reaching positive changes in the area of behavior difficulties among foster care adolescents. 31% of treatment group adolescents reached reliable and clinically significant change in the area of behavior and 29% in the area of perceived somatic and cognitive difficulties. Also, the issue of the necessity of the quantitative criteria allowing decision making about the effectiveness of the treatment at the individual level, when using reliable and clinically significant change method, was raised in the article.     

Childhood Sexual Abuse and Brain Development: A Discussion of Associated Structural Changes and Negative Psychological Outcomes

The effects of traumatic exposure have been researched for many years and studies have shown that the parts of the brain affected by sexually traumatic experiences in childhood are also linked to many physical and psychological problems, such as depression, posttraumatic stress disorder, somatic complaints and suicide. Neuroimaging studies have provided a breadth of evidence that childhood sexual abuse is related to structural changes in the brain. Taken together, childhood sexual abuse affects brain development, leading to differences in brain anatomy and functioning that have lifelong consequences for mental health. Several limitations of neuroimaging research on childhood sexual abuse are discussed, including a lack of refined and sensitive neuroimaging measures and problems interpreting results of structural imaged subjects with associated psychiatric conditions. Future, large‐scale studies are warranted to examine the type and severity of the sexual abuse and how each of the levels of childhood sexual abuse contributes to structural and functional changes. Furthermore, future studies are needed to control for comorbid psychiatric conditions in order to disentangle the effects of childhood sexual abuse from psychiatric conditions that damage brain development. © 2018 John Wiley & Sons, Ltd.

‘Childhood sexual abuse affects brain development, leading to differences in brain anatomy and functioning that have lifelong consequences for mental health’

Key Practitioner Messages

• Childhood sexual abuse is linked to observable structural changes in the brain.
• These structural changes in the brain are associated with a myriad number of negative psychological effects.
• Research is limited in elucidating the role of childhood sexual abuse on brain development, as the bulk of the research has focused only broadly on child maltreatment.

     

Emotional abuse and emotional neglect subscales of the CTQ: Associations with each other, other measures of psychological maltreatment, and demographic variables

The goal of this study was to explore the conceptual distinctness between the constructs of emotional abuse and emotional neglect. This was achieved through a comparison of the emotional abuse and the emotional neglect subscales of the Childhood Trauma Questionnaire (CTQ). The two scales were compared with respect to each other, demographic variables, and other measures of psychological maltreatment. Two hundred and fifty three employees at a social service agency completed five scales of adult recall of childhood psychological maltreatment including the CTQ-EA subscale and the CTQ-EN subscale. Results revealed moderate associations between the two scales, strong associations with other measures of psychological maltreatment, and a mixed pattern of associations with demographic variables. Data suggest considerable but not complete overlap between these two subscales. Directions for future research are discussed.     

Former system youth with mental health needs: Routes to adult mental health care, insight, emotions, and mistrust

Objective

Public health concern surrounding the mental health needs of former system youth is escalating. We know very little about mental health service utilization on the other side of the developmental transition to adulthood. The purpose of this study was to explore the mental health service use experiences among former system youth with childhood histories which included mental disorder, use of publicly-funded mental health services, and use of additional public systems of care.

Methods

In-depth face-to-face interviews were conducted with 60 participants currently struggling with mental health difficulties regarding their service use experiences over the transition. Participants were recruited from one Midwestern state. Multi-phase analysis was conducted utilizing immersion/crystallization, constant comparison and concept matrices.

Results

Few participants received continuous mental health care across the transition, with the majority experiencing interruptions or discontinuation of care. Important facilitators of service use emerged, such as physicians, former caseworkers and family. Health clinics and parenting programs emerged as potential entrée points for reconnecting disengaged young adults to mental health services. Insight, mistrust, and emotions emerged as novel factors associated with service utilization among young adults.

Conclusions

Mental health service utilization remains a complicated phenomenon over the developmental transition to adulthood. Future research is needed that closely examines the associations between insight, emotion, mistrust and service use among young adults.     

Risk factors and services for child maltreatment among infants and young children

Objectives

Child maltreatment (CM) causes injury in large numbers of U.S. children. This study uses a large, multi-state dataset of child protective services reports for infants and young children under five years of age to examine risk factors and the effects of services in confirmed maltreatment investigations and recurrence over five years.

Methods

The Child Files of the National Child Abuse and Neglect Data System (NCANDS) for 2003-2007 were used to study confirmed CM reports to child protective services (CPS) using regression models and survival analysis among a cohort of children first reported during 2003.

Results

There were 1.2 million confirmed maltreatment reports to state child protective services agencies in 22 states during 2003-2007 in NCANDS, including 177,568 infants and young children under five years. 19.3% had a second confirmed CM report within 5 years. White race, inadequate housing and receiving public assistance were associated with significantly increased risk of CM recurrence. Infants and young children received more services and had less recurrence than did older children.

Conclusions

Infants and young children have different risk factors and receive different services than do older children in the CPS system. We need additional research to further assess and better target services for the special needs of infants, young children and their families if we are to protect them and reduce future child maltreatment.     

Predictors of out-of-home placement following residential treatment

Objective

There is a lack of research examining predictors of out-of-home placement (OOHP) following residential treatment (RT). The current study examined how various child and family factors predict OOHP at discharge and 6-months post-discharge for a RT sample.

Methods

Three hundred and eighty-three children (11.92 years, SD = 2.63, 293 boys) with serious mental health disorders were assessed using the Brief Child and Family Phone Interview (BCFPI) and placement information forms at admission, discharge, and 6-months post-discharge from RT.

Results

OOHP at discharge was predicted by older age, OOHP at admission, child welfare involvement, deliberate self-harm, a history of physical abuse, neglect, witnessed domestic violence, and a poor family situation (p < .05). At 6-months post-discharge, OOHP was predicted by dual diagnosis, OOHP at admission, child welfare involvement, neglect, and witnessed domestic violence (p < .05).

Conclusions

Pre-treatment factors are predictive of OOHP following RT. Identifying these key predictors and developing permanency planning options for children to promote stability and consistency is essential. A systemic evidence-based approach is imperative in promoting resilience for children at risk of OOHP, including family intervention and collaboration with the community.     

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

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

Perception and determination of child maltreatment: Exploratory comparisons across three countries

Objective

Little is known about perception and determination of child maltreatment across countries. Although differences in perception and determination of maltreatment across regions of a single country are well documented, comparative knowledge across countries remains sparse. This internet survey examined perception of abusive behaviors and factors considered important in determining maltreatment in three countries (i.e., the United States, Ghana, and Nigeria).

Method

Forty-five abusive behaviors comprising physical, sexual, and emotional abuse, child neglect, and child labor, as well as 13 factors considered important in determining maltreatment, were examined among a convenience sample of 327 respondents in the United States, Ghana, and Nigeria. Respondents were recruited within and outside universities in the three countries and links to the survey were sent to respondents who are nonstudents.

Results

With all the countries combined, consensus was high for 15 of the 45 abusive behaviors, although levels of consensus and perceptions varied by country and race. Consensus was high for all of the abusive behaviors among respondents in the United States, 36 of the abusive behaviors among respondents in Ghana, and none of the abusive behaviors among respondents in Nigeria. Respondents who are White/Caucasian were significantly more likely to perceive 5 of the behaviors as abuse than respondents who are Black/non-Caucasian. Similarly, factors considered important in determining maltreatment differed by country and race. Respondents in the United States and Ghana were more likely to consider 9 of the 13 factors important in determining maltreatment compared to respondents in Nigeria. Also, Caucasians/Whites were more likely to consider 6 of the 13 factors important in determining maltreatment compared to Blacks/non-Caucasians.

Conclusion

Despite racial and regional differences, there are indications that cross-cultural consensus on perception and determination of abusive behaviors is possible. Understanding differences in socio-cultural experiences may help bridge the current gaps in cross-cultural consensus on perception and determination of abusive behaviors.     

Factors impacting intention to leave in social workers and child care workers employed at voluntary agencies

Introduction

To ameliorate high turnover in child welfare, researchers have attempted to identify factors that lead to undesirable turnover. While this has been studied extensively, little attention has been paid to turnover based upon job roles. Like social workers in child welfare, the field of child care also experiences high turnover. Child care workers employed in child welfare settings are no exception. The current study seeks to understand differential factors that impact intent to leave for preventive and child care workers employed in child welfare agencies.

Materials and methods

Data for prevention workers (n = 538) were obtained from all preventive service programs under contract with the City. Data for child care workers (n = 222) were obtained from three voluntary agencies located elsewhere in the State. The instrument was a modified version of a survey developed to examine job satisfaction and potential turnover among public child welfare workers. Domains measured included job satisfaction, intention to leave, career commitment, and agency investment. Data were analyzed using bivariate analysis and Structural Equation Modeling (SEM).

Results

Child care workers had more positive perceptions of child welfare and planned to stay in child welfare longer. Despite this, prevention workers felt more invested in their work. Child care and prevention workers had different levels of satisfaction with their jobs although overall job satisfaction did not differ nor did their intention to leave. Tenure at the agency was predictive of career investment. Investment, perceptions of child welfare, satisfaction with nature of work, and contingent rewards were associated with career commitment. Commitment and satisfaction with supervision were the greatest predictors of intention to leave.

Discussion

There is a gap in literature addressing child care workers in child welfare, and future study of this group is needed. Child care workers are just as likely to intend to leave their jobs as prevention workers. For both groups, it appears that investment in their jobs increases commitment to the field which reduces intention to leave.     

The prevalence and nature of abuse and neglect in children under four: a national survey

This paper reports the results from a Danish national survey of child abuse and neglect. Data were obtained by a written questionnaire sent to all home health visitors. All newborn Danish children receive visits by a home health visitor several times during their first year of life. For children in need of special care for social reasons the visits may continue until school age (at 6 or 7 years). The questionnaire included four checklists of signs of abuse and neglect. The home health visitors were asked to record what they had actually observed visiting the children in their homes. Eighty‐three per cent (covering about 80% of all newborns) answered the questionnaire. The objective was to establish a scientific based framework that could be used to guide preventive efforts. Ten per cent of all children under 1 year of age may be characterized as children in need of special care for social reasons, the most frequent single reason being reliance on social assistance, alcohol abuse or violence against the mother. A minimum of 4% of infants are subjected to broadly defined abuse or neglect from one or more of the four categories: physical abuse, physical neglect, emotional abuse and emotional neglect, physical and emotional neglect being the most frequent and physical maltreatment the most rare. Copyright © 1999 John Wiley & Sons, Ltd.