Child abuse: differential diagnosis, differential treatment

This study assessed the relationship between treatment intensity and rehabilitation at discharge of child abusers whose MMPI profiles revealed high levels of psychological distress. It should be noted that this sample does not represent the child abuser who requires only a support group or outpatient counseling. Because of repeated failures at other social service agencies coupled with the court selection process, this sample may be described as having been screened for intransigence, severity of symptomatology, and resistance to previous attempts at treatment. It is noteworthy that participation in treatment was court-ordered, thereby diminishing the possibility of improvement because of subject characteristics, emotional availability or stamina in the treatment process. In this exploratory study, the association between treatment intensity and assessed rehabilitation yielded a positive and statistically significant relationship. The client who received intense weekly treatment for longer durations was assessed as having a higher degree of rehabilitation. This finding is important particularly for a population that exhibited an abnormally high degree of psychological distress. As an initial investigation, results support the need for differential diagnosis and subsequent differential treatment of child abusers. Without differential diagnosis, treatment needs may go unrecognized; without intense and sustained treatment, the needs of the highly distressed child abuser may go unmet.