Donald C. Bross

What have we learned about treating child physical abuse? A literature review of the last decade

A literature review of articles on treatment of physically abused children and treatment of physically abused parents was undertaken. Only articles that had more than five subjects in the sample, at least 15% of the children in the sample having been physically abused and either pretest, posttest; comparison group; or randomization between different treatments used in the design were selected. Twelve papers meeting these criteria for abusive parents and 13 for treatment of abused children were found. Treatment duration ranged from 4 weeks to 12 months for parents and 4 weeks to 24 months for children. A wide range of treatments were used, the most popular for children being therapeutic daycare, with emphasis on improving developmental skills. While most programs showed some improvement with treatment, many had no, or very short, follow-up to see if improvement was sustained. More emphasis needs to be placed on rigorous evaluation and longer-term follow-up of children in physical abuse treatment programs.

The child protective service worker: a profile of needs, attitudes, and utilization of professional resources.

County child protection units throughout the United States were surveyed to (1) profile the attributes of child protection workers, (2) determine their prevailing attitudes and needs, and (3) assess their access to and utilization of professional literature and consultation resources. Responses were received from 301 child protection workers employed in 33 different states. Respondents were generally depressed about their working conditions, the burden of huge caseloads, and unrealistic expectations of them. Job dissatisfaction was especially prevalent among workers who had been in the field for longer periods of time. Many workers had developed attitudes of resignation to their inability to help clients and had a tendency to avoid client contact. Workers reported doing very little professional reading due to the service requirements of their large caseloads and inaccessibility to journals and other meaningful literature pertinent to the field of child abuse and neglect. The availability of consultation in major specialty areas related to the performance of their child protective duties was frequently inadequate to meet their needs. Participation in formal training prior to first case involvement promoted professional reading and worker confidence in the quality of service provided. Worker job satisfaction and self-perceived professional skills were enhanced by membership in professional associations or societies and membership in or use of multidisciplinary teams. These results suggest the need to further develop national and regional resource centers in support of the practice of child protective service (CPS) workers.

Client evaluation of a consultation team on crimes against children

OBJECTIVE Cases of child abuse filed in court as crimes against children represent a small percentage of the total numbers of children maltreated. However, studying crimes of maltreatment against children is important for individual victims and their families, and for theory and policy in order to assure that these cases are managed as well as possible. Forensic consultation teams can perform several functions related to child abuse crimes: provide multidisciplinary expertise in the evaluation of maltreatment cases, offer a method for allocating resources between cases managed by the criminal justice and child protection systems, and provide important research and teaching opportunities. This study reviews the role played by multidisciplinary team consultations based on the perception of client professionals whose agencies pay for an outside consulting forensic team. METHOD Professionals referring to a forensic team for consultative assistance were asked to evaluate the service during telephone interviews, responding to both structured and unstructured questions. RESULTS Responding professionals (N= 18) stated that the team increased their confidence that the approach being taken to a case was correct (94%), that missing expertise was provided (100%), that progress was made in cases that might otherwise not have been made (55%), and that ambiguity was reduced (in 83% of referred cases). Using the team sometimes caused delays. Some delays were unacceptable administrative delays while others were considered necessary to assure completeness of the evaluation. CONCLUSION The use of the team did not result in resolution of all of the cases referred, but referral to the team consistently provided closure for referring professionals. In one-third of the cases studied, if it had not been for the START consultation the cases would not have proceeded to an appropriate criminal or civil resolution.

Mandatory Reporting Laws and the Identification of Severe Child Abuse and Neglect

This book provides the first comprehensive international coverage of key issues in mandatory reporting of child abuse and neglect. The book draws on a collection of the foremost scholars in the field, as well as clinicians and practice-based experts, to explore the nature, history, impact and justifiability of mandatory reporting laws, their optimal form, legal and conceptual issues, and practical issues and challenges for reporters, professional educators and governments. Key issues in non-Western nations are also explored briefly to assess the potential of socio-legal responses sex trafficking, forced child labour and child marriage. The book is of particular value to policy makers, educators and opinion leaders in government departments dealing with children, and to professionals and organisations who work with children. It is also intended to be a key authority for researchers and teachers in the fields of medicine, nursing, social work, education, law, psychology, health and allied health fields.

The battered child syndrome : changes in the law and child advocacy

The Battered Child Syndrome (BCS) was followed by laws and policies intended to improve protections for maltreated children. Medical professionals were initially very reluctant to believe that parents might abuse their own child. The BCS provided irrefutable evidence that severe physical abuse of children could occur in the child’s own home, and established clear diagnostic criteria for evaluating a child suspected of being a victim of child abuse. Dr. Kempe and his colleagues acted purposefully to conduct research on the treatment and prevention of child abuse and to advocate practices and programs that would make it difficult to ignore child abuse in the future. Among the innovations resulting from the Kempe advocacy are multidisciplinary child protection teams, reporting laws, home visitation to prevent child abuse, guardians ad litem for abused children, termination of the parent–child legal relationship in severe maltreatment cases, and the international journal,Child Abuse & Neglect.

Using Law to Identify and Manage Child Maltreatment

This chapter identifies ways in which laws are capable of responding to child maltreatment, both as an immediate regulator of conduct, and as an influence on a society’s cultural development and approach to children’s welfare. Informed by practices and experiences in selected common law systems, the chapter provides examples of legal mechanisms that can inform discussion of optimal strategies to identify and manage child maltreatment in many different societies. Both positive and negative aspects of these mechanisms are noted. While controversies arise as to what kinds of laws are best in preventing and responding to child maltreatment, and even, more fundamentally, whether there is a role for law in protecting children, this chapter offers evidence that a variety of legal tools can be employed to address child abuse and neglect, for any cultural setting in which there is willingness to act to prevent and treat its various forms.

Professional and Agency Liability for Negligence in Child Protection

Theories and Defenses for C o u r t Recovery Child protection has become a multidisciplinary field, and therefore social workers, doctors, police officers and mental health professionals have been held to be negligent in carrying out duties to children. The diagnostic professions of medicine and mental health are often involved early in child protection proceedings because of legal requirements for diagnosis and reporting. Social workers and police officers have been charged with failure to respond appropriately to reports of child abuse. Cases of inadequate selection of, or monitoring of placements into, foster homes are also associated with social workers. This section will consider these cases, and discuss various defenses raised.

Medicolegal aspects of child abuse and neglect

Neurosurgeons that see children and care for those with traumatic injury are highly likely to see cases of child abuse and neglect. That fact makes it inevitable that they will encounter the legal system. It is hoped that this article has demystified the legal process and systems that one encounters in day-to-day practice. Avoiding the diagnosis of abuse because of lack of knowledge or phobia of the legal system is hazardous to the health and well-being of children.

Advocating new directions

Directions first appeared in Child Abuse & eglect in the December issue of 2013. In that rst Directions section, we included an explaation of we hoped it would accomplish. These oals included creating “attractive” articles in more reader-friendly and engaging format nd presenting alternative points of view. In articular, we wanted to ensure a global perpective, with particularly emphasis on hearing rom the majority world. Indeed, as stated in he introduction to the first Directions section, e wanted to demonstrate that there are many ifferent ways to address child maltreatment in owand middle-income countries which “may ronically result in creation of more responsive, ess intrusive, and more cost-effective modls for prevention and treatment.” We expected hat most of the Directions essays would be among diverse disciplines and communities from across the globe. In keeping with our interdisciplinary approach, the last Directions section under our editorship directly and indirectly considers the role of the arts in changing population awareness and framing of the problems of child maltreatment. The three articles included in this section provide an introduction to the need for and value of work that makes explicit the way literature – from classics to comics – addresses societal problems (in this case, child abuse and neglect). Works of literature can not only help us to understand how societal norms and views on children and childhood have change over time, but they also have the potential to help us create settings conducive to the prevention of maltreatment and that are supportive to nformed by science, and we hoped that we could ncourage more exchanges and communications