摘要 :
Rates of child maltreatment in the U.S. have been relatively stagnant since the 1990s. This lack of progress suggests that prevention efforts, which have primarily focused on individual behaviors, have been unsuccessful. Building ...
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Rates of child maltreatment in the U.S. have been relatively stagnant since the 1990s. This lack of progress suggests that prevention efforts, which have primarily focused on individual behaviors, have been unsuccessful. Building on existing research, this conceptual paper identifies the need to refocus prevention efforts on changeable and causal risk factors. The Modifiable Maltreatment Factors (MMF), a new framework to classify risk factors for maltreatment, is introduced. Use of the MMF in social work education and child protective services work could increase the understanding of macro factors in child maltreatment and the possibilities of policy change and community organizing in maltreatment prevention.
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Child maltreatment is a leading cause of pediatric morbidity and mortality, described as one of the greatest threats facing the health, welfare, and social well-being of children in the United States (). Despite mandatory reportin...
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Child maltreatment is a leading cause of pediatric morbidity and mortality, described as one of the greatest threats facing the health, welfare, and social well-being of children in the United States (). Despite mandatory reporting laws, the poignant reality is that this public health problem is significantly underrecognized and underreported by heath care providers. The purpose of this project was to implement a series of strategies in a pediatric emergency department to identify children who are at risk of maltreatment and initiate interventions to ensure their safety and protection before a devastating outcome occurs. The results of this project support the implementation of nursing education, a screening program for risk of child maltreatment, and collaboration with interdisciplinary stakeholders to achieve best practice in emergency medicine.
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The purpose of this study was to examine rates of child abuse and neglect reports following a community implementation of Parent–Child Interaction Therapy (PCIT), an evidence-supported intervention for the prevention of maltreatm...
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The purpose of this study was to examine rates of child abuse and neglect reports following a community implementation of Parent–Child Interaction Therapy (PCIT), an evidence-supported intervention for the prevention of maltreatment. Among a group of families receiving PCIT, predictors of reports were examined including family demographics, course of treatment, changes in clinical measures, and caregiver report for prior maltreatment victimization and perpetration. Participants (n = 120) included families at-risk for future maltreatment with and without prior maltreatment history. Agency case records were linked with state administrative records of child welfare reports. Time to follow-up ranged from 13 to 40 months. Bivariate and multivariate survival analyses were used to model risk for a later report. During the follow- up period, 12.5 % of families had a report for physical abuse or neglect. Reports of prior victimization as a child and prior perpetration as an adult were strong predictors of a report of perpetration after PCIT. Dosage of PCIT and change in clinical measures did not increase risk for a later report. PCIT can be an effective intervention for preventing maltreatment. Family history of child welfare involvement is a prominent factor in assessing risk for future involvement.
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This study evaluated the effectiveness of the Adults and Children Together (ACT) Against Violence Parents Raising Safe Kids program, developed by the American Psychological Association in collaboration with the National Associatio...
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This study evaluated the effectiveness of the Adults and Children Together (ACT) Against Violence Parents Raising Safe Kids program, developed by the American Psychological Association in collaboration with the National Association for the Education of Young Children, as an economical primary prevention intervention for child maltreatment. Using an experimental design with random assignment to groups, program impact on participating parents' knowledge, behavior, and attitudes compared to those of a comparison group of parents receiving standard community-based support services was examined. As hypothesized, the ACT Parents Raising Safe Kids program achieved positive results in several areas related to effective parenting, including a reduction in the use of harsh verbal and physical discipline and an increase in nurturing behavior. Positive results were observable both at the conclusion of the ACT program and at three-month follow-up. Results further indicated a positive impact on parent expectations and social support for those parents with the greatest need in these areas. Qualitative data collected through focus groups demonstrated that parents themselves perceived numerous benefits to the ACT program, including assistance in controlling their anger, learning and implementing better parenting and discipline strategies, and recognizing when their child's behavior is developmentally appropriate. Overall, findings suggest that the ACT Parents Raising Safe Kids program is a promising primary prevention strategy that can be implemented across diverse community settings.
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The increased availability of treatment has not reduced the prevalence of mental disorders, suggesting a need for a greater emphasis on prevention. With chronic physical diseases, successful prevention efforts have focused on redu...
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The increased availability of treatment has not reduced the prevalence of mental disorders, suggesting a need for a greater emphasis on prevention. With chronic physical diseases, successful prevention efforts have focused on reducing the big risk factors. If this approach is applied to mental disorders, the big risk factors are adverse childhood experiences, which have major effects on most classes of mental disorder across the lifespan. While the evidence base is limited, there is support for a number of interventions to reduce adverse childhood experiences, including an important role for mental health professionals. Taking action on adverse childhood experiences may be our best chance of emulating the success of public health action to prevent chronic physical diseases and thereby reduce the large global burden of mental disorders.
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The objective of this study is to evaluate the effectiveness of parenting programs in reducing child maltreatment and modifying associated factors as well as to examine the moderator variables that are linked to program effects. F...
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The objective of this study is to evaluate the effectiveness of parenting programs in reducing child maltreatment and modifying associated factors as well as to examine the moderator variables that are linked to program effects. For this meta-analysis, we searched nine electronic databases to identify randomized controlled trials published before September 2013. The effect sizes of various outcomes at different time points were computed. From the 3,578 studies identified, we selected 37 studies for further analysis. The total random effect size was 0.296. Our results showed that parenting programs successfully reduced substantiated and self-reported child maltreatment reports and reduced the potential for child maltreatment. The programs also reduced risk factors and enhanced protective factors associated with child maltreatment. However, the effects of the parenting programs on reducing parental depression and stress were limited. Parenting programs produced positive effects in low-, middle-, and high-income countries and were effective in reducing child maltreatment when applied as primary, secondary, or tertiary child maltreatment intervention. In conclusion, parenting programs are effective public health approaches to reduce child maltreatment. The evidence-based service of parenting programs could be widely adopted in future practice.
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Often the focus of the field of child maltreatment has concentrated on identifying and intervening on risk and protective factors at the individual and family levels; however, since the 1970s, the important roles that communities ...
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Often the focus of the field of child maltreatment has concentrated on identifying and intervening on risk and protective factors at the individual and family levels; however, since the 1970s, the important roles that communities play in both exacerbating and preventing child maltreatment have received attention as well. This article outlines the development of this area of scientific inquiry, describes the theoretical frameworks utilized by existing programs, and describes several community-level programs aimed at preventing child maltreatment that show promise as scalable strategies to enhance individual and family strengths and reduce caregiver stress. Challenges inherent in community-level programming in increasingly diverse environments and in building/maintaining political will for sustainability of evidence-based efforts are discussed as well. A multilevel, holistic approach that takes into account developmental changes and needs of individuals as well as their environments is likely to bring about more sustainable change in protecting children from abuse and neglect than efforts focused solely on individuals.
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Child maltreatment is one of the most deleterious known influences on the mental health and development of children. This article briefly reviews a complement of methods that are ready to incorporate into child and adolescent psyc...
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Child maltreatment is one of the most deleterious known influences on the mental health and development of children. This article briefly reviews a complement of methods that are ready to incorporate into child and adolescent psychiatric practice, by having been validated either with respect to the prevention of child maltreatment or with respect to adverse outcomes associated with maltreatment (and primarily focused on enhancing the caregiving environment); they are feasible for integration into clinical decision making, and most importantly, can be included in the training of the next generation of clinicians.
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Preventing the maltreatment of children is a major public health challenge. Using the Triple P-Positive Parenting program as an example, this article makes the case that strengthening parenting and family relationships at a popula...
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Preventing the maltreatment of children is a major public health challenge. Using the Triple P-Positive Parenting program as an example, this article makes the case that strengthening parenting and family relationships at a population level is a potentially powerful means of taking on this challenge. We focus on the value of making parenting programs available to all parents in the community. We conclude by examining the key ingredients required to make a population-level parenting approach to reducing child maltreatment work.
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Abstract Substance use during the perinatal period and while parenting can pose a significant risk to children's safety and well‐being. Mothers who have experienced child maltreatment are more likely to use substances than mother...
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Abstract Substance use during the perinatal period and while parenting can pose a significant risk to children's safety and well‐being. Mothers who have experienced child maltreatment are more likely to use substances than mothers without a history of maltreatment. This study explores how child welfare social workers experience supporting young, maltreated mothers struggling with substance use to prevent the intergenerational transmission of child maltreatment. Semi‐structured in‐depth interviews were conducted with four social workers working with young mothers with a history of maltreatment and substance use. Interpretative Phenomenological Analysis revealed two themes: (1) grappling with system challenges and (2) supporting strategies for disrupting intergenerational transmission of child maltreatment. The results highlight the need for systemic changes around support for social workers who work with young mothers who use substances and have a history of maltreatment, and substance use treatment and mental health programs themselves. Mothers need access to prenatal programs that are trauma‐informed, non‐judgemental and that support participants' basic needs and parenting skills.
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