User-centred responses to child sexual abuse: the way forward?

Two parallel surveys were carried out based in the north-east of England and Cumbria: one ascertaining statutory social work services provided for child and adult survivors of sexual abuse, the other drawing upon the perceptions of adult survivors of child sexual abuse about existing and desirable forms of provision for adults and children. The surveys indicate the need for greater genuine partnership between service users and statutory agencies in the field of child sexual abuse, similar to that which is being pioneered in the field of adult care and disability. A community-orientated response to sexual abuse, centred on service-users, is required if one of the largest social problems facing us today is to be effectively challenged.     

Violence Across the Lifespan: Interconnections Among Forms of Abuse as Described by Marginalized Canadian Elders and their Care-givers

Elder abuse is recognized as a major problem, with profoundeffects on the health and quality of life of older persons.In our aging population, elder abuse represents an escalatingclinical issue for social workers and health care professionalswho provide care to older people. A major gap in our examinationof elder abuse is the potential contribution and applicationof knowledge developed within research derived from other formsof family violence. This paper explores the interconnectionsamong various forms of violence across the lifespan, and theexperiences voiced by marginalized elders and their care providers.We interviewed seventy-seven rarely consulted older adults andforty-three formal and informal care-givers of older adultsin focus groups in Ontario and Alberta, Canada. Study findingsrevealed four major themes that describe interconnections amongtypes of abuse: (i) intergenerational cycles of abuse; (ii)violence across the lifespan; (iii) exposure to multiple subtypesof elder abuse; and (iv) ongoing spouse abuse that shifted intoelder abuse. The results from this study indicate that victimsoften ‘suffer in silence’ and cultural factors,ageism and gender are ubiquitous to elder abuse. Recommendationsto reduce elder abuse include education, formal and informalsupports and services.     

Disability as the Basis for a Social Movement: Advocacy and the Politics of Definition

Many people with disabilities do not identify themselves as disabled or choose not to be part of a politically active community of disabled persons. This paper discusses both the barriers to the formation of a social movement of disabled people and the ways in which these barriers have been overcome. The role of public policy in the evolution of this movement is discussed, as are the current status and prospects of the disability rights movement.     

Defining the boundaries: social worker assessment of sexual abuse in a cultural context – multivariate analysis of personal and professional factors influencing social workers' labelling of intimacy behaviour

To explore personal and professional factors influencing social worker assessment of family intimacy behaviour in diverse cultural groups, a 27‐item questionnaire was mailed to a random, stratified sample of MSW‐level social workers. The instrument measured rank‐order responses to 10 questions about attitudes towards public exposure to sexual stimuli and rank‐order responses to questions about three vignettes depicting culturally informed family intimacy behaviour. The instrument also measured sample characteristics such as area of social work practice and per cent of caseload involving sexually abused as well as diverse clients. Completed questionnaires (n = 387) were analysed for association between respondents' definition of intimacy behaviour (dependent variable), attitude towards sexual stimuli, and intervening variables thought to explain variance in the dependent measure. Labelling theory provided a basis for hypotheses testing. When mean attitude scores were correlated with mean definition scores, Pearson's r returned a significant low, positive association between conservative attitudes towards exposure to sexual stimuli and definitions of cross‐cultural scenarios as sexual abuse. Holding attitude scores constant, regression modelling of the sample's definition of scenarios indicated that practice area, minority status, and per cent of caseload with sexual abuse clients were significant predictors of R² change in the dependent variable. Further analysis of data through regression tree modelling showed that a small group of conservative practitioners with ethnically diverse caseloads were more likely to label culturally influenced behaviours as deviant. Among conservative practitioners with less diverse caseloads, number of hours in sexuality training had a moderating influence on deviancy labelling. Tree modelling of the data also indicated that an ethnic minority subgroup within the sample accounted for the lowest ranking of scenarios as sexual abuse. Results support earlier work on social worker assessment of child maltreatment as a function of agency setting. Another implication for social work is the need for practitioners to understand their attitudes towards human sexuality in relation to assessment of diverse patterns of childhood sexual socialization.     

社区照顾在残疾人社会保障中的运用

社区照顾最早产生于英国,自诞生以来,便以其新型的理念与模式日益受到各国学者和政府的重视。社区照顾作为一种专业化的照顾模式,在残疾人社会保障方面具有广阔的发展空间。本文试图将社区照顾的制度安排应用于我国残疾人社会保障事业,并探析我国残疾人社区照顾的模式,以推动我国残疾人社会保障事业向人性化、社会化、专业化方向发展。     

Best practice guidelines for health service professionals who receive initial disclosures of sibling sexual abuse

Sibling sexual abuse is one of the more common forms of child abuse and involves a number of unique complexities. A gap in the literature exists with regards to the appropriate response to an initial disclosure of sibling sexual abuse and the values underlying such a response. This article employs a power and control analysis to consider the definition, prevalence and outcome of such abuse and presents best practice guidelines for health care professionals. The guidelines aim to promote ethical and respectful responses to disclosures of sibling sexual abuse. They reflect an explicit value stance, detailing appropriate responses to disclosure including interagency collaboration, parental notification and consideration of the special status of the abuser as a young person.     

Applying narrative analysis to the process of confirming or disregarding cases of suspected sexual abuse

This article analyses discourse about sexual abuse at a detention home for young women. At the centre of attention is staff members’ struggle with the process of confirming or disregarding cases of alleged sexual abuse. The determining factor for establishing an act as sexual abuse was whether or not the act involved a person who was defined as a victim. A core issue in the process was an evaluation of the credibility of the alleged abused girl and the degree of consent. The unintended result was that many of the girls’ narratives were never confirmed. The article argues that there is no objective ‘given’ regarding the definition of sexual abuse. To be involved in the process of understanding and establishing an act as sexual abuse means being involved in a process of social definition. To be able to handle such involvement constitutes a fundamental professional issue in social work. Adopting a narrative approach to the process of confirming or disregarding cases of suspected sexual abuse shifts the focus from developing categories of social problems and work on the basis of them to developing ways of listening to young people and allowing their narratives to provide a point of departure.     

Child protection social work and men's abuse of women: an Irish study

This paper reports the findings of an exploratory study of the response of social workers within a community care setting, in a large Dublin suburb, to cases involving men's abuse of women. This research aims to focus on what child protection workers do regarding this abuse, and what they say about what they do, thereby giving readers a sense of the action taking place in this social work team. The data, generated from both qualitative and quantitative methodological research, reflects this aim, as it taps into the working model of responses to men's abuse of women held by social workers, and identifies what influences that, thereby reflecting the realities and constraints of everyday work. At the time the research was carried out (2000), the results confirm that the prevalence of cases involving men's abuse of women on this team was in line with international findings. This research revealed an absence of a team policy, an agreed definition of intimate violence in this context and agency practice guidelines, and illuminated how these gaps act as a deterrent to effective intervention. This paper explores some of the ethical and practical dilemmas that may arise for child protection social workers intervening in cases where the abuse of women by men is present. Recommendations arising from this research identify a need for a clear policy and best practice guidelines for social work staff in relation to this abuse.     

Psychiatric Non-institutionalisation: Whose Needs are Served?

This article outlines the social problems experienced by persons with a chronic psychiatric disability, and their families. The disabled person's lifestyle is characterised by poor social and vocational skills, poverty, inadequate accommodation and alienation. Many of these problems increase the dependence of the disabled person, emotionally and financially, on their family of origin. The author suggests that these social problems will only be ameliorated if family members are provided with active support and information, and if hospital and community services are integrated and complementary. The disabled person's quality of life can only be improved by accessible intensive social and vocational rehabilitation programs. As these issues are not being comprehensively addressed at the present time family self-help organisations such as the Association of Relatives and Friends of the Mentally III (ARAFMI) will need to politicise their plight.     

Factors Associated with Suicidal Ideation Among Women Abused in Intimate Partner Relationships

This study examines factors associated with suicidal ideation among women abused in intimate partner relationships. Data were collected from the case records of 95 women screened upon in‐person contact with admissions workers in a domestic violence shelter in one Midwestern state. Forty‐three percent of the women reported suicidal ideation as significantly associated with childhood sexual abuse, childhood physical abuse, and adulthood intimate partner abuse lasting fewer than 12 months in duration. The results have policy and practice implications for those interested in the mental health needs of women abused in childhood and adulthood. Implications for research are presented that more precisely identify how the effects of past and current traumatic experiences intersect and contribute to suicidal ideation among women abused in intimate relationships.     

‘Disability is not a word we use’: Social workers' professional judgements about support for disabled young people leaving care

Disabled young people leaving care often experience a more complex transition to adulthood than other youths. Still, policy and services can fail to recognize the intersection between a young person's care experiences and disability. Drawing on data from a qualitative interview study with 14 social workers who work with aftercare in the Norwegian child welfare services, we investigate social workers' professional judgements about support for this subgroup of the leaving care population. Our analysis uses the theoretical construct of institutional logics and shows that social workers did not include concepts of disability in their judgements about support for these young people. Instead, the social workers' considerations were guided by three other organizing principles: a ‘medical logic’, an ‘activation logic’ and an ‘aftercare logic’. We discuss these findings in light of critical disability studies and argue for a more nuanced understanding of disability in social work practice with care leavers. Highlighting disability rights and going beyond diagnosis and categorisations of disabled people can challenge a medical model approach to service provision.     

Women's abuse of their children in the context on domestic violence: reflection from women's accounts

This paper draws upon the findings of a study that looked at women's experiences of mothering in the context of co-occurrence of domestic violence and child abuse, and considers the issue of women's violence towards children – while acknowledging the fact that men are the main perpetrators of violence towards women and children in these families. The paper first explores the relationship between women's victimization and women's violence, and suggests that women's abuse of their children can be seen as a consequence of their own experiences of domestic violence. The findings nonetheless suggest that abused women have agency, and therefore have responsibilities when they chose to use violence towards their children. The paper also considers the feelings of guilt and blame that tend to arise in these circumstances. Implications for research, policy and practice are identified.     

Domestic violence and child abuse: developing social work practice

This paper takes as its starting point the report produced by the Social Services Inspectorate (1995), entitled Domestic Violence and Social Care , which seeks to alert social workers to the links between domestic violence and child abuse and urges the profession to respond more effectively to these two interconnected forms of violence. Having examined the research findings which provide evidence for these links, the theoretical and service delivery contexts in which these two forms of violence have been studied and conceptualized by the social work profession, both in the United Kingdom and in the United States, are identified. Studies of the social work response to domestic violence are discussed and some of the difficulties experienced by social workers in responding effectively to the needs of families where both forms of violence are experienced are considered. In particular, the issues of 'invisible' men and 'trapped' women and children are explored. It is argued that effective social work intervention which challenges these stereotypes will require additional resources and the article concludes with a consideration of whether the Messages from Research report might herald a shift in the approach to child protection that would promote the allocation of resources to this area of work.     

Preliminary data on abuse during childhood among female university students

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

Exploring approaches to child welfare in contexts of domestic violence and abuse: Family group conferences

This article sets out to explore service provision for families affected by domestic violence and abuse. For most families where there are child protection concerns, there are possibilities for intervention from child welfare agencies and domestic abuse services, but these have been criticised as having distinct and disconnected practice cultures and orientation. Recognising this divergence, in this paper, we advocate for safeguarding children affected by domestic violence and abuse using the family group conference (FGC) model. This offers possibilities for a coherent response that integrates both child‐ and women‐centred concerns in a holistic approach to family safety and well‐being. Furthermore, it is well documented that safeguarding work involves professionally‐led decision‐making that is pre‐occupied with the management of risk. FGCs, however, promote a partnership approach that engages families in a more democratic decision‐making process. As such, FGCs offer families the opportunity to develop their own safety and support plans for the protection and care of children recognising the family's inherent strengths.     

Children's narratives of sexual abuse

Children rarely disclose sexual abuse. Hence, studies of children's abuse experiences are relatively rare. This paper reports on a qualitative analysis of 2986 cases of self‐disclosure of sexual abuse from children, aged 5–18 years, who contacted ChildLine Scotland, a free, confidential telephone counselling service. Children discussed their feelings regarding the abuse, the impact of abuse on their health and well‐being, sources of support, disclosure, coping strategies, the context in which abuse occurs and the various ways in which they were groomed or their compliance in abuse was gained. Children's narratives contained detailed contextual information on their experiences of sexual abuse, perpetrators of sexual abuse and the circumstances in which sexual abuse occurs. The way in which children communicated about sexual abuse was found to differ quite considerably, and the terminology they employed was often markedly different from adult constructs. Nonetheless, children of all ages were able to describe their experiences and their feelings around the abuse in considerable detail. This study provides a rare insight into children's accounts of sexual abuse. The findings illustrate the profound impact that sexual abuse has on the lives of children and their understandings of the circumstances in which abuse occurs.     

Webs of empire: locating New Zealand's colonial past

This article reports on the views of non-medical interest groups about sterilization and intellectually disabled people in New Zealand. The rationale for undertaking a study in this sensitive area is presented. Notes about survey distribution method are included and participants’ responses outlined. The study found that a majority of participants agreed that intellectually disabled people should make their own decisions about reproductive capacity. Yet a clear tension between an overall endorsement of individual choice and a majority who also considered that sterilization could be warranted in at least some cases emerged from the data. Reasons for sterilization included: the best interests of intellectually disabled people and carers; concerns about sexual health/well-being; lack of sexual control; and concerns about sexual abuse. The extent of agreement with sterilization as a desirable practice for intellectually disabled boys/men was an unexpected finding. The article concludes with questions posed to promote further discussion.     

Are dual and single exposures differently associated with clinical levels of trauma symptoms? Examining physical abuse and witnessing intimate partner violence among young children

A significant portion of children living in the United States have experienced trauma. Informed by the developmental traumatology model, we explored the effects of physical abuse and witnessing intimate partner violence (IPV) on childhood trauma symptoms. This study utilizes a convenience sample of 580 high‐risk children between 3 and 12 years who received services from one‐child advocacy centre during a 12‐month period. We performed a series of binary logistic regression analyses to examine if physical abuse, exposure to IPV, and dual exposure (i.e., both physical abuse and IPV) are distinctly associated with six trauma symptoms, including anxiety, depression, posttraumatic stress (PTS), dissociation, anger, and sexual concerns. The results indicated that dual exposure was predictive of all trauma symptoms, except for dissociation. Additionally, physical abuse was associated with PTS, anger, and sexual concerns, whereas exposure to IPV was associated with depression, PTS, and sexual concerns. Research and implications for practitioners working with young children are discussed.     

The future of adult safeguarding in Australia

Significant reforms to Australia's adult safeguarding laws and practices are in the process of occurring in the context of increasingly market‐oriented social care provision and rising human rights consciousness. Recent safeguarding developments have included federal regulatory reforms concerning disability and aged care service provision, together with significant reform activity stemming from a national inquiry into elder abuse. Despite this national activity, adult safeguarding continues largely to be an arena of state and territory responsibility. This article examines recent reform developments and asks how safeguarding laws and practices can be reformed to take account of increased federal involvement in social care regulation and the more market‐oriented ways in which social care is being provided. The article argues that while state and territory safeguarding laws and practices are unlikely to become uniform, 10 principles ought to guide continued adult safeguarding reform. These principles seek to balance respect for the autonomy of individuals with society's obligation to support those in need.     

More present than absent: Men who use domestic violence and their fathering

An earlier article referred to the “absent presence” of the perpetrator in the lives of children and their mothers who have lived with domestic violence. It identified the ways in which the shadow of the perpetrator continued and was evidenced in the “symptoms of abuse” that both women and children experienced in spite of his absence. The current article argues that fathers who use violence are actually more present than absent in the lives of children (and women), even following separation. A mixed method approach surveyed men in Men's Behaviour Change Programs (N = 101), and interviewed women who had experienced violence (N = 50). The studies reported that the majority of men in both the quantitative men's study (80%) and the qualitative women's study (77%) had substantial contact with children. The women's interviews highlight the problematic fathering that many of their children experienced, both before and after separation. They reported very high levels of child abuse and poor attitudes to both women and children. The article concludes that the family violence and child welfare systems are poorly configured to address fathers who use violence and continue to hold substantial parenting roles, including following separation.