Dorothy Scott

Early identification of maternal depression as a strategy in the prevention of child abuse

Maternal suicide and infanticide are merely the extreme tip of the iceberg of psychological and social morbidity associated with post-partum depression. Despite research indicating an association between maternal depression and disturbed parent-child interaction, maternal depression has been largely ignored in the literature on child maltreatment and in child protection practice. Practitioners should be alert to the potential risks to the child associated with maternal depression. In cases where child abuse has occurred, they should consider the possibility that the mother is depressed and that this needs to be treated as a problem in its own right. In terms of prevention of child maltreatment, early identification of maternal depression is an important strategy in which primary health workers have an important role. This study investigates the feasibility of broadening the traditional infant health focus of the role of the Australian Maternal and Child Health Nurse or Public Health Nurse to encompass maternal emotional and social well-being. Using quantitative and qualitative methods, the conditions under which mothers would find this acceptable, and the factors that facilitate or constrain such role redefinition are analyzed.

Evaluating Standards of Social Work Supervision in Child Welfare and Hospital Social Work

Abstract Using the Recommended Standards for Social Work Supervision developed by the Australian Association of Social Workers, supervisors and supervisees who occupied social work positions in Community Services Victoria (CSV), a statutory child welfare department (N=94) and in nine Melbourne teaching hospitals (N=139) completed self-administered questionnaires on the nature of the supervision which they gave or received. The extent to which reported supervisory practices conform to key recommended standards is analysed. The standards were upheld to a greater degree in hospital social work than in statutory child welfare. However, only minor differences between the two fields were found in the degree to which supervision was perceived to encompass administrative, educational and supportive functions. The findings provide a baseline for evaluating changes in supervisory practices within and between different fields of practice. They are also useful for agencies trying to develop performance indicators in ...

The social construction of child sexual abuse: Debates about definitions and the politics of prevalence

Public and professional perceptions of the prevalence of child sexual abuse have been influenced by studies which use vague and inconsistent definitions of abuse including non‐contact behaviours. Overestimates of the prevalence of child sexual abuse, like that of other social problems, have been used as a form of “claims making” in order to place this previously unrecognised problem on the political and social agenda. However, there are risks associated with such a strategy. One of these is that if the prevalence of child sexual abuse is seen to have been exaggerated, those advocating for the needs of sexually abused children may be discredited and the seriousness of the problem minimised. Another risk is that professionals may overdiagnose cases of child sexual abuse, with serious consequences for both children and their families.

Ethical issues in practice research: A case study

Abstract Social work research poses complex ethical dilemmas which are yet to be adequately addressed. The complexity relates to the vulnerability of clients which can diminish their capacity for informed consent, and the risk of loss of privacy and emotional distress for subjects. While ethical guidelines clarify the principles and practices which should govern research, there are few descriptive accounts of how researchers actually deal with ethical dilemmas which emerge in the process of research. Drawing upon a qualitative study on child protection assessment, ethical issues relating to informed consent, intrusiveness and confidentiality are explored.

Family-centred practice in the interface between child welfare and the alcohol and drug field

Recently publicized cases of child abuse and neglect ahve highlighted the complexity of interaction between professionals in the alcohol and drug field and those in the child welfare field. Despite exhortations to practitioners in both fields to see their clients from a family-centred perspective, a range of psychological, ethical, conceptual, professional and organizational factors mean that this often remains an elusive goal. In this paper the obstacles to adopting a family-centred approach which cuts across different professions and fields of service are identified. These factors interact in complex ways and although workers feel the tensions, it is difficult for them to perceive the set of constraints as a whole from the vantage point of an actor in the process. By identifying and analysing these obstacles workers in both fields may be better able to collaborate in maximizing the opportunities which also exist for family-centred practice.

Short Term Adjustment to Rape and the Utilization of a Sexual Assault Counselling Service

Rape! is an act of violence which is perpetrated on the victim without her consent. It creates feelings of helplessness, fear and vulnerability. For the victim there is a recognition that her environment is not safe and she experiences an invasion of her personal space and loss of bodily integrity. Victims are also forced to confront the power relationships that exist between men and women in society. In recent years the Womens Movement has done much to focus attention on the plight of the rape victim and heighten the communitys awareness of her needs. As a result a number of services have been developed, ranging from self-help support groups to hospital based clinics where medical and social work assistance is available. There is, however, a lack of weIl controlled research data on the short and long term effects of rape on a victim. This is in part due to the relatively recent interest in the plight of the victim and in part due to the need to offer support treatment to victims, rather than to subject them to the rigours of a research project. Following rape, victims experience physical and psychological trauma. The manner in which the victim copes with the rape is dependent on several factors including her ego strengths, social network support, life cycle stage; the way she is treated as a victim, the circumstances of the rape and her cultural milieu. Sutherland and Scherl report three distinct patterns of response. These are (a) an acute re action immediately after the rape lasting a few days, (b) outward adjustment and (c) integration and resolution of the experience. In the acute phase the victim experiences shock, disbelief and dismay, followed by anxiety and fear. In the second phase of outward adjustment they state that various psychological mechanisms are used denial, suppression and rationalization. The victim appears to be coping. During the third phase, integration, the woman often becomes depressed. They state that this is normal if her depression is reactive, time-limited and non-psychotic. This phase is usually resolved in a few weeks. If it has not been resolved then they suggest that the victims response is not within normal limits and that the rape has created feelings which the ego cannot handle without resorting to symptoms at a psychotic, neurotic or behavioural level. Burgess and Holmstrorrr have identified two phases of adjustment which follow a rape or an attempted rape. They identify these as the acute and the long-term organization phase, both of which are stress reactions to a life threatening situation.

A promise unfulfilled on child abuse.

For those among us who have been advocating a ‘public health’ approach to the problem of child abuse and neglect, the WHO’s World Report on Violence and Health is welcome. It is an ambitious task to produce an international blueprint for action in regard to any aspect of violence, and especially that relating to children. The chasm between the conditions of children in the developed and the developing worlds – between child rearing methods in different cultures, between societies in which the notion of the child as a holder of human rights or the child as a psychological being exists and those where it does not – makes it a tall order. From the perspective of the developing world, it needs to be asked whether problems such as child abuse are really of great significance in the face of widespread child malnutrition and disease that is beyond parental capacity to change, and whether problems in which parents are implicated, such as the exploitation of child labour and child prostitution, are better understood in terms of family poverty than parental abuse? Even from the perspective of Western societies, the different legislation, policy and service delivery systems that exist in various countries make national comparisons and the development of common strategies problematic. Never theless, the need for a new approach to the problem of child abuse and neglect in Western societies is now widely accepted and comparative analysis can be a valuable tool. The child protection systems in many Western societies, especially North America and Australia, are in a state of crisis. Their reactive and bureaucratic systems are overwhelmed with escalating cases while delivering little in the way of effective prevention or intervention. To illustrate the magnitude of the problem, in the past decade most Australian States witnessed a doubling of child protection notif ications (and child protection workers), reaching a total of 115,471 cases of alleged abuse in 2000/01. Less than a quarter of these notif ications were substantiated and many that were received little more than repeated assessment along a legalistic assembly line. An appropriate analogy is that of a health system which consists of a giant emergency room overwhelmed to the point that it cannot get to the high-risk cases due to the flood of low-risk cases, and with no general practitioners or preventive programs and little in the way of treatment for identif ied cases. As our child protection systems implode, we have more knowledge about child abuse than ever before. We now know that the underlying risk and protective factors for child abuse and neglect are similar to those associated with poor health and educational outcomes and a broad range of other psycho-social problems of children and adolescents. With increasing understanding of the causal pathways involved and some promising evidence about prevention and early intervention, there is hope for a public health approach. The introductory chapter of the WHO repor t outlines the core components of a public health model and espouses an ecological understanding of violence, with the individual seen in the context of their relationships, community and society. The report also identif ies key def initional issues relating to violence, such as the inclusion of acts of omission as well as commission, the significance of intent to ‘use violence’ as a vehicle of power in addition to the intent to injure, and the core issue of cultural relativism. The latter is of central importance in a document aimed at an international audience.