Curtis McMillen

The Intergenerational Cycle of Child Maltreatment Continuity Versus Discontinuity

Few studies have focused on identifying characteristics that discriminate between parents who break versus those who perpetuate intergenerational cycles of child maltreatment. Both the dose and the attachment hypotheses were examined in this study of 213 mothers maltreated as children in one of three ways (beatings, neglect, or sexual abuse). Maltreatment continuity versus discontinuity was assessed through substantiated reports to a Child Protective Services (CPS) agency over a 7-year period. Findings were consistent with the attachment hypothesis. Poorer quality attachment relationships in childhood increased the probability of transmission. Findings were consistent with the dose hypothesis for only one conceptualization of dose. Those mothers who had experienced severe forms of sexual abuse (experienced coitus vs. did not) were more likely to have a maltreated child. These findings are discussed in terms of current theory and research on intergenerational maltreatment.

Positive by-products of the struggle with chemical dependency

Focus groups were conducted to identify ways persons in recovery from chemical dependence think they have benefited from their struggles with addiction. Categories of positive by-products were identified independently by two sets of readers. Several of the positive by-products discussed by the focus group participants are commonly reported from other kinds of challenging life experiences. These include increases in self-efficacy, family closeness, closeness with others, compassion and spirituality, and changes in life priorities. Additional positive by-products were discussed by the focus group participants that may be more unique to substance abuse and other similar stressors, including increased self-knowledge, enhanced ability to help offspring with substance abuse-related issues, and decreased naïveté. Ways to incorporate knowledge about these positive by-products into substance abuse treatment programs are introduced.

Differences Between Sexually Abused and Non-Sexually Abused Adolescent Girls in Foster Care

ABSTRACT This descriptive study examines the differences between sexually abused and non-sexually abused adolescent females in the foster care system who were participating in an independent living program. Fifty-four percent of the 190 girls met the criteria for being categorized as sexually abused. Those who experienced sexual abuse had also experienced significantly more of other types of child maltreatment. In addition, those who had been sexually abused were much more likely to be living in a congregate living setting, such as a group home or residential center, than those who were not sexually abused. The girls who had been sexually abused exhibited significantly more behavioral difficulties, including internalizing and externalizing problems, with 51 % of them having clinically significant scores on the Youth Self-Report version of the Child Behavior Checklist. When co-occurrence of substance use and mental health problems were examined, sexually abused girls were significantly more likely than the non-sexually abused girls to meet the established criteria.

Quality Assurance and Improvement Practice in Mental Health Agencies: Roles, Activities, Targets and Contributions

Accompanying the rise in the number of mental health agency personnel tasked with quality assurance and improvement (QA/I) responsibilities is an increased need to understand the nature of the work these professionals undertake. Four aspects of the work of quality assurance and improvement (QA/I) professionals in mental health were explored in this qualitative study: their perceived roles, their major activities, their QA/I targets, and their contributions. In-person interviews were conducted with QA/I professionals at 16 mental health agencies. Respondents perceived their roles at varying levels of complexity, focused on different targets, and used different methods to conduct their work. Few targets of QA/I work served as indicators of high quality care. Most QA/I professionals provided concrete descriptions of how they had improved agency services, while others could describe none. Accreditation framed much of agency QA/I work, perhaps to its detriment.