Improving outcomes for children in out‐of‐home care: the role of therapeutic foster care

How best to support children and young people in foster care remains a challenge for child welfare. There has been little Australian research on the outcomes for children and young people placed in therapeutic foster care (TFC). This article aims to address this knowledge gap, presenting the evaluation of a state‐wide model of TFC known as the Circle Program operating in Victoria, Australia. Data sources for the study were case assessment analysis; surveys of foster carers, program workers and other stakeholders in the sector; and both focus groups and individual interviews with foster care workers. The evaluation found that the Circle Program lessened the number of unplanned exits of children from foster placements compared with generalist foster care. Another important finding was that the Circle Program positively influenced foster carers' decisions to stay in the carer role. Key components perceived as contributing to outcomes of the Circle Program included enhanced training of foster carers, intensive carer support, specialist therapeutic support to the child and carer, therapeutic service to family members and a network of services to provide support to the child.     

Irish Women’s Ongoing Experiences of Domestic Abuse in Cases of Separation and Divorce

The issue of postseparation abuse is a significant problem for women. This qualitative research examines Irish women’s experiences of domestic abuse in cases of separation and divorce. Findings show that methods of abuse change after separation and perpetrators can use institutions of the state to continue their abusive behavior in a new forum and can continue long after marital dissolution is finalized. Such behavior is legitimized by the state’s nonaction and enabled through women’s previous experiences of institutional processes associated with separation and divorce, which resulted in feelings fear and distress.     

Internet gambling in relation to Internet addiction,substance use,online sexual engagement and suicidality in a Greek sample

Research has found gambling to be related to a variety of other addictive behaviours. The study objective was to evaluate the association of Internet gambling with Internet addiction, online sexual engagement, suicidality and substance use, in a sample of Greek adults. The study sample consisted of 789 military personnel. During their annual medical examination the study participants anonymously completed a series of self-reported questionnaires in relation to socio-demographic data, Internet gambling practices, online sexual engagement, Internet addiction, suicidality and psychoactive substance use. We found that Internet addiction significantly predicted engagement with online gambling, followed by substance use in general, and, in particular, the use of cocaine or heroin. Finally, two other predictive indicators were self-reported suicide attempts and engagement with online sex. Online gambling is associated with various behaviours related to impulsivity such as Internet addiction, online sexual engagement, suicidality and substance use. Future research will increase our knowledge on the contribution of new technologies and the Internet in Internet gambling dimensions, as well as on the associations with other high-risk behaviours such as substance use, pornography and suicidality.     

Mortality among elder abuse victims in rural Malaysia: A two-year population-based descriptive study

Our study aims at describing mortality among reported elder abuse experiences in rural Malaysia. This is a population-based cohort study with a multistage cluster sampling method. Older adults in Kuala Pilah (n = 1,927) were interviewed from November 2013 to May 2014. Mortality was traced after 2 years using the National Registration Department database. Overall, 139 (7.2%) respondents died. Fifteen (9.6%) abuse victims died compared to 124 (7.0%) not abused. Mortality was highest with financial abuse (13%), followed by psychological abuse (10.8%). There was a dose-response relationship between mortality and clustering of abuse: 7%, 7.7%, and 14.0% for no abuse, one type, and two types or more, respectively. Among abuse victims, 40% of deaths had ill-defined causes, 33% were respiratory-related, and 27% had cardiovascular and metabolic origin. Results suggest a link between abuse and mortality. Death proportions varied according to abuse subtypes and gender.     

Developing an undue influence screening tool for Adult Protective Services

The study purpose was to develop and pilot an undue influence screening tool for California’s Adult Protective Services (APS) personnel based on the definition of undue influence enacted into California law January 1, 2014. Methods included four focus groups with APS providers (n = 33), piloting the preliminary tool by APS personnel (n = 15), and interviews with four elder abuse experts and two APS administrators. Social service literature—including existing undue influence models—was reviewed, as were existing screening and assessment tools. Using the information from these various sources, the California Undue Influence Screening Tool (CUIST) was developed. It can be applied to APS cases and potentially adapted for use by other professionals and for use in other states. Implementation of the tool into APS practice, policy, procedures, and training of personnel will depend on the initiative of APS management. Future work will need to address the reliability and validity of CUIST.     

Using clinical signs of neglect to identify elder neglect cases

Elder neglect is the one of the most pervasive forms of mistreatment, and often the only place outside of the individual’s residence to identify and assist neglected individuals is in a medical setting. However, elder neglect cases treated in hospitals do not present with a single diagnosis or clinical sign, but rather involve a complex constellation of clinical signs. Currently, there is a lack of comprehensive guidelines on which clinical signs to use in screening tools for neglect among patients treated in hospitals. Using the DELPHI method, a group of experts developed and tested a scale to be used as a pre-screener that conceptually could be integrated into electronic health record systems so that it could identify potential neglect cases in an automated manner. By applying the scale as a pre-screener for neglect, the tool would reduce the pool of at-risk patients who would benefit from in-depth screening for elder neglect by 95%.     

On the Road to Resilience: The Help‐Seeking Experiences of Irish Emigrant Survivors of Institutional Abuse

Understanding how survivors of complex trauma navigate towards resources can inform the design of interventions and health promotion strategies. However, there are little data on the resilience and help‐seeking experiences of this group or others who have experienced institutional abuse in childhood. This empirical study sets out to illustrate the help‐seeking experiences of Irish emigrant survivors of institutional childhood abuse (ICA). Twenty‐two survivors of ICA were purposefully recruited from community organisations in the UK and data were collected via semi‐structured interviews. As a result of negative initial help‐seeking experiences in Ireland, most participants engaged in long periods of self‐management and disclosed information about their childhood as part of a redress scheme in later life. Outside of this scheme, turning points, such as illness or family problems, and the needs of children were influential in seeking help. Peer support networks played an important role as a trusted signposting pathway towards formal interventions. Participants identified interpersonal barriers to formal help‐seeking as helping professionals' failure to share control, insensitivity to identity loss and literacy issues, and the lack of explicit boundaries. The paper concludes with a discussion about the implications for research and future practice.

‘This empirical study sets out to illustrate the help‐seeking experiences of Irish emigrant survivors of institutional childhood abuse’

Key Practitioner Messages:

• Turning points, such as illness and bereavement, and the desire to provide for children, influence the help‐seeking of survivors of ICA.
• Irish emigrant survivors of ICA cite failure to share control, insensitivity to identity loss, literacy issues and the lack of explicit boundaries as barriers to help‐seeking.
• General awareness of ICA can help practitioners in low‐threshold services prevent against culturally insensitive practice.
• Peer support networks can provide uniquely trusted signposting towards formal interventions.

     

Love is Not All You Need: A Revolutionary Approach to Parental Abuse

This case story is a composite of similar family situations where the parents were at risk of harm from their teenage children and commonly the father/step‐father has moved out of home leaving the mother to parent the children on her own. Several of these cases involved physical threats to the lives of the parents. These referrals occurred in a Child, Adolescent and Family Mental Health Service and a Family Therapy NGO between 1985 and 2005. This approach is offered as a complement to the widely published ‘non‐violent resistance’ approach of Haim Omer and his colleagues. We hope it goes some way to address what Lavi‐Lavavi et al ( 2013 , Journal of Systemic Therapies, 32(4), 79–93). describe as ‘the mother's plight’:

The plight of the mother continues to present a major challenge… We are also seeking ways to allow the mother more breathing space, help her to disengage from abrasive conflicts, acknowledge her contribution and sacrifice, and provide her with vantage points that may help her recognize and enhance small improvements. Hopefully, these measures will enable women to evolve from unacknowledged victims to pillars of the family’ (p. 92).

     

Note From Iran: Self-Reported Elder Abuse in Qazvin, 2012

This brief report provides a first look at self-reported instances of elder abuse by a sample of people 60 years and older living in Qazvin, Iran. Six hundred community-dwelling persons, drawn from the registry files of each health center in Qazin, completed questionnaires during April to October 2012. At least 80% of the participants reported experiencing some form of psychological abuse, financial abuse, and/or neglect at least once during a 2-month period. Physical and sexual abuse were rarely reported. Despite a strong Iranian cultural emphasis on respect for elders, the self-reporting of elder abuse, especially psychological abuse, is greater than our expectation. We recommend that health-related policies and programs begin to identify elder abuse and neglect as a first step in prevention.