Developing practice learning and teaching in residential child care

The Residential Child Care Initiative was created in order to increase the numbers of qualified staff in residential children's homes in England. This paper explores some of the issues affecting practice placements for residential staff who undertook qualifying training between 1992 and 1997. Themes and issues arising from these experiences, with examples from practice, are considered in terms of their relevance to practice learning in group care situations for all social work students, highlighting the reciprocal benefits for students and residential services for children.     

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.     

Characteristics of child sexual abuse cases referred for psychological services in Hong Kong:a comparison between multiple incident versus single incident cases

This study examined 58 sexually abused children referred for clinical psychological services in 1999 in Hong Kong and compared the characteristics and disclosure patterns between those with multiple incidents of abuse and those with single incident. The former group was more likely to have been abused by a family member, took a longer time to disclose, and was more often abused in contexts where the abusers had control and power. Over 40% of subjects also reported presence of other persons during abuse. Myths and misconceptions among professionals are highlighted. Implications on future service development and training needs in child protection are discussed.     

In between formal and informal: Staff and youth relationships in care and after leaving care

This paper deals with the contact and relationship youth have with staff while in care and after emancipation and examines the young adults' needs in contacting staff after leaving care. The study was conducted through 60 interviews with young adults ages 21–26 who emancipated from residential settings in Israel. Results showed that most youth report having had a meaningful staff member in care and that 62% were in contact with staff after their transition to independent living for both emotional and practical needs that could not always be answered by staff. One of the study's conclusions is that despite their departure staff's relationship with these young adults continues informally years after. However, without formal recognition of the place staff have in the lives of aged-out youth, no resources are invested in training them to properly meet the young adults' needs. The discussion highlights the need for an integrative approach that sees residential settings and staff as a meaningful part in the continuity from care to independent living by supporting aged-out youth's gradual transition to adult life.     

Disability and Abuse in Relation to Substance Abuse

Abstract

This analysis reviewed five years of a state's substance abuse treatment admissions and discharges in order to identify specific patterns among persons who had a disability. Using a series of group comparisons, Chi-squares, and logistic regressions, specific patterns of violence and abuse to this population were identified. Results indicate that persons who had a disability and abused substances were more likely to be victimized by physical abuse and domestic violence when compared with their peers without a disability. A person with a disability had about one-half to one-third the odds of receiving long-term residential, short-term residential and intensive outpatient care when compared with persons without a disability.     

Mix and match: planning to keep looked after children safe

The risks which children run from other children in substitute care have received little attention. However, if children's safety in care is to be maximized, then placement planning will need to focus on the risks and vulnerability of both the child to be placed and others already in the setting. It should also ensure that full information is given to the caregivers. In an interview sample of 40 looked after sexually abused and/or abusing young people aged 10 or over, most of the young abusers were placed in foster care and the majority of the sexually abused young people went into children's homes. However, in fewer than a third of these placements was consideration given to how the young person would fit in with others in that setting. This meant that the potential risks which that child posed to others or vice versa were not addressed. More worrying still, in just under half of the sample, no information about the young person's history of sexual abuse or abusing behaviour was given to the caregivers. This meant that caregivers were unable to plan to provide the level of supervision which might have averted a number of instances of abuse. When the whole histories of the sexually abused young people in the study were examined, it was found that half of them had abused another child at some stage, generally another child in care. This evidence suggests that the experience of sexual abuse should be regarded as an important risk factor in the later development of sexually abusing behavior and that local authorities need to fashion policies which emphasize the prime importance of social workers providing full information about children's backgrounds when placements are made. Copyright © 1999 John Wiley & Sons, Ltd.     

Domestic Violence and Intergenerational Rates of Child Sexual Abuse: A Case Record Analysis

Using case review at a shelter for battered women and their children, this exploratory study investigated the association between physical abuse, exposure to domestic violence and intergenerational occurrence of child sexual abuse. The charts of 570 children were reviewed in an attempt to explore the relationship between the children's experiences with sexual abuse and their nonoffending parent's own history of having been sexually abused. Results indicated that a significant percentage of nonoffending parents who reported a history of child sexual abuse also had children who were sexually abused. Additionally, we found that most (93%) of the children studied had been exposed to domestic violence, and while the base rate of sexual abuse was relatively low (11%), the rate of physical abuse of the children was substantial (41%). Logistic regression results indicated that children of sexually abused nonoffending parents may be at heightened risk for sexual abuse. Implications for treatment and intervention are discussed.     

Employment-Based Training on Alcohol and Other Drugs in England: Bridging the Gap

The first of its kind in England, this study explored the extent and nature of employer-based training on alcohol and other drugs for social workers working in children's and adults' services. A national survey of workforce development departments was undertaken to find out how social workers are being prepared by their employers for engaging with people who use alcohol and other drugs. Based on a response rate of 46%, the findings show that a majority of departments (82%) provided training on these issues in the year 2011–2012. However, most of this training was not mandatory. These courses are targeted most often at those working in children's services rather than those in adults' services. Most courses are offered at basic or intermediary level, and content of training is covered inconsistently. These findings suggest a need to increase the priority of alcohol and other drugs' training across adults' services in particular and to make this training mandatory, as well as ensuring that staff have adequate time and incentive to attend. Effectiveness of social care practice for all social care practitioners around alcohol and other drugs use could be improved with more focus on training practitioners how to talk to service users about their substance use.     

Family Members' Reports of Non-Staff Abuse in Michigan Nursing Homes

Recent research showed that mistreatment of nursing home residents by other residents may be highly prevalent. The present study examined the issue from family members' perspectives. The data came from the 2005 and 2007 random-digit dial telephone surveys of Michigan households with a family member in long-term care. Based on family members' reports, about 10% of nursing home residents aged 60 and over were abused by non-staff in nursing homes (e.g., other residents and visitors) during the past 12 months. Family members were more likely to report non-staff abuse when the nursing home residents were younger, were female, had behavior problems, and had greater level of physical functioning. Family members who reported staff abuse were four times more likely to also report non-staff abuse.     

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.     

A National Survey of Child Advocacy Center Directors Regarding Knowledge of Assessment,Treatment Referral,and Training Needs in Physical and Sexual Abuse

Mental health services are a core component of child advocacy centers in the United States. Child advocacy center directors were surveyed about (a) trauma and posttraumatic stress disorder; (b) referral criteria for treatment of abuse victims; (c) evidence-based treatments for abused children; (d) reliable, valid, and normed measures helpful in assessment; and (e) training needs. Directors accurately identified posttraumatic stress disorder symptoms, but additional symptoms were misidentified. Directors identified best practices for assessment and treatment, but they misidentified non-evidence-based practices. Primary reasons for referral for services included severity of abuse and emotional response of the child. However, referrals based on assessment findings were not a high priority. Directors expressed some training needs for staff consistent with issues identified in the study.     

Irish child sexual abuse victims attending a specialist centre

We profiled a cohort of CSA cases referred for assessment to a specialist child sexual abuse (CSA) centre in a national paediatric hospital in Ireland. Historical and clinical data were drawn from records of 171 cases. The majority of cases were referred by social workers following purposeful disclosure of CSA. Three quarters of the cases were female with a mean age of 9 years. They were from a wide spectrum of socioeconomic groups and many had suffered a range of family adversities. In most cases, the abuse involved masturbation of the child by the abuser. Almost all of the perpetrators were male with a mean age of 28 years and in 60% of cases extrafamilial abuse had occurred. In 23% of cases, the perpetrator had a history of previous sexual offending. Anxiety was the most common emotional problem before disclosure and after disclosure the most common emotional problem was guilt. Before disclosure school refusal was the most common behavioural problem and after disclosure fighting was the most prevalent behavioural difficulty. The most common factors supporting the credibility of CSA allegations were labile mood, the child's ability to differentiate fact from fantasy and a detailed disclosure of contextual details. More adolescents showed deterioration in schoolwork after disclosure and for more pre school children clinginess following disclosure was a significant emotional problem. More primary school aged children were abused by perpetrators who had abused a number of children. For children abused by such perpetrators, vaginal intercourse was less common. Vaginal intercourse was more common in 6–11‐year‐old victims and those who were abused on a daily basis. The threat that disclosure posed to the integrity of the family structure was more often a factor hindering disclosure in victims abused by father figures and abused very frequently. Copyright © 2003 John Wiley & Sons, Ltd.     

From Adoption to Residential Treatment Centers

Although children who have been adopted are referred for mental health services more often than their non-adopted peers and might be overrepresented within residential treatment centers (RTCs), little is known about adoptive families' experiences with RTCs. The present study sought to understand the experiences of families whose children were placed in residential treatment facilities after a finalized adoption. Qualitative interviews were conducted with a total of ten families who had adopted 21 children. Of these, 13 children had been placed in an RTC after the finalized adoption. Most of the children in the sample were between zero and five years of age at placement. Adoptive families reported the need for in-the-trenches training and community-based services that could provide ongoing support post-adoption. Implications from these findings include increasing in-home services and other options within the adoptive families' own communities. Future research could incorporate a larger sample to assess whether the experiences of families in this study are similar to other adoptive families.     

The Extent and Nature of Practitioners,Encounters with Alcohol and Other Drug Use in Social Work and Social Care Practice

This article considers the extent and nature of social work and social care practitioners' experience of working with service users whose lives are affected by the problematic use of alcohol or other drugs (AOD). It draws on the findings of a national study of ‘working with alcohol and drug use’ which was conducted in England in 2010–2011. The study reported here comprised an online survey of front-line practitioners (n = 597), complemented by 12 practitioner focus groups and interviews with 21 key informants from participating local authorities and substance use treatment services. This paper focuses primarily on data from one element of the survey. Findings indicate that the great majority of staff encountered service users who are affected by AOD problems at some level, although there were differences between groups of practitioners in the extent and nature of AOD problems for different groups of service users. The differential experiences of staff according to their client groups underlines the need for education and professional development not only to provide training on working with AOD but to ensure that training is contextualised and relevant to practitioners across the range of social work and social care services.     

Sexually abused children's perceptions of family functioning

A clinical sample of 76 children in a day and residential treatment facility was administered the McMaster Family Assessment Device (FAD) at time of admission. Interviews with therapists enabled identification of students who had been sexually abused prior to admission. A comparison group of children who had not been sexually abused was selected to match age, grade level and gender of the sexually abused children. ANOVA yielded significant differences on the dimensions of problem-solving, roles, and general functioning, with the direction of the effect indicating greater pathology among the sexually abused group. Analyses of differences between victims of intrafamilial or extrafamilial abuse yielded significance in affective responsivity, affective involvement, and general functioning, with greater enmeshment and dysfunction reported by the victims of intrafamilial abuse. Some gender differences were also noted, with females reporting greater general dysfunction in their families. Implications of this research as supportive of current clinical beliefs about family functioning are offered.     

Mental health service utilization in children adopted from US foster care,US private agencies and foreign countries: Data from the 2007 National Survey of Adoption Parents (NSAP)

Aims

In this analysis, we (1) described the rate of mental health service utilization for children from domestic foster care adoption, domestic private adoption, and international adoption and (2) analyzed the effect of common risk factors on mental health service utilization.

Data

As part of the 2007 National Survey on Adoptive Parents (NSAP), parents with children 5–17 years old (N = 1722) were asked if their children had received mental health services and how helpful these services were. Parents also provided data on the children's demographics and likelihood of pre-adoption adversity (e.g., abuse).

Results

For boys, mental health services were utilized by 52.4% of domestic foster care adoptees, 41.0% domestic private adoptees, and 40.0% of international adoptees. For girls, the corresponding rates were 36.3%, 24.8%, and 30.9% respectively. Parents reported that the services were very helpful for about half of the children. Logistic regression analyses showed that adoptees from domestic foster care were more likely than international adoptees to have received mental health services, but there was no difference between domestic private adoptees and international adoptees. Older age at placement, older age at assessment, having special health care needs, and being male all increased the odds for having received mental health services.     

Risk factors and physical signs of child abuse in hospitalized children in Taiwan

PurposeThis study used the Criteria for Distinguishing Abuse from Accidents Chinese version (CDAA-C) to determine cases of child abuse, undetermined intent, and unintentional injury, and compared risk factors and injury profiles among hospitalized children in Taiwan.DesignA retrospective chart review study.MethodsWe selected children aged 0–3 who were hospitalized with a discharge diagnosis of injury or child maltreatment in a medical center in southern Taiwan between 2007 and 2009. The CDAA-C was used to collect children's demographics and injury types and to determine the intent of injury. Children's charts with records and notes of admission, surgery and emergency care were reviewed and analyzed.ResultsAmong 157 eligible cases, the CDAA-C identified 13 child abuse cases including additional 8 victims who were not previously coded in ICD-9-CM. Most abused children suffered from brain injuries, had ≥ 2 in jury incidents, and had a misdiagnosis in the previous visit. Abused children were younger and more likely to be born premature.ConclusionsThis study highlighted the under-diagnosis of child abuse in Taiwan. An easy-to-use standardized screening tool for child abuse in Taiwan is needed.     

Abusing victims: detention of child sexual abuse victims in secure accommodation

Sexually abused children and adolescents, in limbo between revelation of abuse and trial of an alleged offender, or in emotional turmoil after such abuse, need special care and support. Evidence indicates that a number of such children are held in local authority secure centres, on various grounds: to protect them from further sexual assaults by an adult offender; because of their persistent absconding from non-secure residential centres; and because of their disturbed behaviour (including suicidal behaviours), which may have been caused by the assault. Victims of sexual abuse are held with juveniles on remand for serious crimes (including rape and murder), or (because they are too young for youth detention centres) with young adolescents who are held in detention following conviction for such crimes. Evidence is produced from case histories, and from a survey of 15 of the 27 secure detention centres for children and young people in England, that the mix of abused, disturbed and very aggressive children is highly problematic. In worst case scenarios, victims of child sexual abuse are sexually assaulted by juvenile rapists with whom they are housed. © 1998 John Wiley & Sons, Ltd.     

Évaluation du rattrapage de la croissance chez les garçon d'âge préscolaire ayant souffert pendant une longue période de négligence et de maltraitance psychologique

Objective. To assess the catch-up growth of long-term physically neglected and emotionally abused preschool male children who have entered foster residential care and remained 1 year after initial placement.Method. Longitudinal study over a 7-year period (1994–2001). So that a child was eligible for the study, three selection criteria were included: (1) aged between 24 and 48 months at the time of entry into residential facility, (2) having sufffered both long-term (more than 6 months) physically neglected and emotionally abused, and (3) having stayed in foster care for 1 year after initial placement. Weight, height, and head circumference were established upon entry and re-assessed 1 year after initial placement, calculating the annual growth velocity. Results were compared with normal regional longitudinal standards of reference (Z score). Student's t test was used to assess statistically significant differences.Results. During the study perior, 87 children aged between 24 and 48 months (54 male/33 female) were admitted to residential facility after having suffered both long-term physical neglect and emotional abuse. Nevertheless, only 20 children (23 % of the total admissions) met the third selection criteria (having remained 1 year after initial placement). Of these children, all were males and at placement they were between the ages of 30 and 42 months, with an average age of 36 months (1.9 SD). At placement, the analysed parameters were below the normal standards, showing a statistically significant differences for height (Z score - −1.29; p = .008) and weight (Z score = − .75; p = .038). The annual growth velocity for all parameters was above the normal standards showing a statistically significant difference for height (Z score + 1.43; p = .009). One year after initial placement, the significant differences for height (Z score = 68; p = .102) and weight (Z score 31; p = .435) with respect to the normal standards disappeared, though still remained below, showing a significant catch-up growth for height (improvement height Z = +.61 SD).Conclusions. At placement, the both long-term physically neglected and emotionally abused preschool age male children showed a mild form of chronic malnutrition with growth failure was reversible after the first year of stay, which demonstrates that this delay in growth was secondary to nutritional and psychosocial factors. Placement in foster residential care was beneficial for the catch-up growth of these patients.