Preventing Child
Abuse:
Is Treatment Too Late?
by Erna Fishhaut
National Studies About Effective
Treatment
- Between 1974 and 1984 the US government funded four major
studies about the effective treatment of child abuse and
neglect.
- 89 different treatment programs were evaluated.
- Data on 3,253 families experiencing abuse and neglect
were gathered.
The collective results provide useful and positive
program guidelines:
- There is a need to differentiate among different
types of maltreatment when determining treatment methods.
- It is imperative to expand intervention programs
to include direct services to both adults and children.
Need for Comprehensive Services
Findings of the four studies indicate:
Successful intervention with maltreating families requires a
comprehensive package of services which address the needs of all
family members.
Programs which provided services such as lay counseling and
Parents Anonymous as part of the treatment package had more
positive out comes.
Supplemental services such as group therapy and parenting
education classes also produced significant effects, particularly
for the physical abuser.
The studies report greater success with clients experiencing
difficulty with sexual abuse than other forms of maltreatment.
It must be noted that providing paraprofessional services
requires intensive on-the-job training and ongoing professional
backup and supervision for the lay personnel.
Major conclusions of the studies:
Strategies which rely upon costly professional therapy,
without augmenting services with group counseling and other
supportive and/or remedial services to children and families,
offer less opportunity for client gains.
Expansion beyond a strictly therapeutic or counseling service
model was not only beneficial to the clients, but was
cost-effective.
Length of Treatment
Findings from evaluation of the length of treatment time were:
- At least 6 months of treatment was necessary.
- Clients who
had treatment for less than 6 months were less likely to make
progress in treatment or to demonstrate a reduced propensity
toward future maltreatment.
- Treatment lasting longer than 18 months did not produce
significant changes after the first 18 months.
- Optimal treatment period may be between 7 and 18
months.
Cause for Concern
Overall, the studies show that 1/3 or more of the parents
served by these intensive demonstration efforts maltreated their
children while in treatment, and over 1/2 of the families served
continued to be judged by staff as likely to mistreat their
children following termination.
Conclusions:
Treatment efforts in general are not very successful.
Child abuse and neglect continue despite early,
thoughtful and often expensive intervention. Treatment
programs have been relatively ineffective in initially
halting abusive and neglectful behavior or in reducing
the future likelihood of maltreatment in most of the
severe cases of physical abuse, chronic neglect, and
emotional maltreatment.
Summary
The performance of families that are agreeable to intervention
can be changed overall by a combination of therapeutic and
supportive services.
A sizable core of parents appear to remain unchanged by
treatment, and their children remain at risk.
Strategies which serve families only after abusive and
neglectful patterns have surfaced were found to be severely
limited in these national program evaluations, stressing once
again the importance of prevention, not cure.
Policy makers should be aware of the diminishing rate of
return on services over time and invest the most intensive
resources during the early months of treatment, as close to the
point of initial referral as possible, in order to successfully
engage the family and begin altering behavior.
FACT FIND suggests:
This is one case where research findings can be useful in
setting policies.
The results of a decade of evaluative research on treatment
programs suggest that putting all resources into intervention,
after the fact, does not make sense. Perhaps the solution is
prevention--providing comprehensive services to families much
earlier--when the risk is apparent, but before abuse or neglect
patterns develop.
For additional information call FACT FIND at 625-2898.
The information provided here is based on an article titled
IS
TREATMENT TOO LATE: WHAT TEN YEARS OF EVALUATIVE RESEARCH TELLS
US written by Anne Cohn and Deborah Daro, National Committee for
Prevention of Child Abuse and published in the Journal of Child
Abuse and Neglect.
|
1990 issue (3rd of 4
issues)