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1.
Counselors value both the confidentiality of client information and the sanctity of human life. These values come into apparent conflict, however, when counselors work with life-endangering clients in such situations as child abuse and homicidal and suicidal threats. Legal incursions into the activities of mental health professionals should not threaten counselors into abandoning good clinical judgment or into refraining from treating potentially dangerous clients. Ethical and legal standards guide counselors in their treatment of such clients. Breaching confidentiality is rarely necessary. Counselors should understand their ethical codes and their state statutes. 相似文献
2.
OBJECTIVE: This study aimed to establish the views of a group of mental health professionals from various disciplines working in mental health service in a British hospital about the needs of clients who had experienced childhood sexual abuse. METHOD: Staff members were asked to complete an anonymous survey which asked questions relating to knowledge of sexual abuse and its effects, and the needs of clients and staff in working with this client group. A total of 54 people responded to the survey, 42 were female, 11 male. Most (72%) reported having over 10 years experience working in mental health, working in both in-patient and out-patient settings. RESULTS: While respondents were reasonably knowledgeable about childhood sexual abuse, they were not very comfortable, competent or supported in their work with this client group. There were no differences in responses according to the age or gender of respondents, but less experienced staff were more likely to feel supported. Those that had received training and/or supervision felt significantly more capable in working with this client group. CONCLUSIONS: The study offers some support for the development of specialist training, consultancy and supervision programs for mental health staff in the area of child sexual abuse. 相似文献
3.
OBJECTIVES: This cross-sectional survey was conducted to evaluate the awareness and actual professional experience of pediatricians in Kuwait regarding child maltreatment, a topic rarely explored in this part of the world. METHODS: Data were obtained from all pediatricians in public hospitals with pediatric emergency services using a structured detailed self-completed questionnaire. RESULTS: The experience of child neglect was more common than that of child abuse in the clinical practice of surveyed pediatricians. Fifty percent of 117 pediatricians (69% of all eligible) reported having encountered at least 1 case of abuse and up to 3 cases of neglect in the past year. Women and younger doctors more commonly recognized hypothetical situations as maltreatment, and believed child abuse and neglect as being common or very common in Kuwait. Other demographic or professional variables did not affect recognition of maltreatment. Participants would most likely alert social workers about suspected maltreatment cases. More than 80% did not know whether there is a legal obligation to report or which legal authorities should receive reports of suspected cases. DISCUSSION AND CONCLUSIONS: National ethical guidelines regarding reporting suspected cases of maltreatment must be established. Laws protecting maltreated children and reporting physicians must be immediately enacted. Additional training is required to help pediatricians, especially expatriates from other cultures, to diagnose with certainty cases of child maltreatment in their practice in Kuwait. 相似文献
4.
This study systematically reviews research on child maltreatment and risk of gambling problems in adulthood. It also reviews adult problem gamblers’ risk of abusing or neglecting their own children. Multiple database searches were conducted using pre-defined search terms related to gambling and child abuse and neglect. We identified 601 unique references and excluded studies if they did not report original research, or did not specifically measure child maltreatment or gambling. Twelve studies that included multivariable analysis of childhood maltreatment exposure and problem gambling were identified. Six of seven studies examining childhood sexual abuse and four of five examining physical abuse showed a significant positive association between abuse and later gambling problems (odds ratios for sexual abuse 2.01–3.65; physical abuse 2.3–2.8). Both studies examining psychological maltreatment and two of three examining neglect identified positive associations with problem gambling. In most studies, risks were reduced or eliminated when controlling for other mental health disorders. The three studies measuring risk of child abuse and neglect among current problem gamblers suggest an increased risk for child physical abuse and medical conditions indicative of neglect although there is a considerable amount of variation among studies. Child abuse is associated with increased risk of gambling problems – gambling treatment providers should ask about maltreatment history as part of their clinical assessment. Problem gamblers may be more likely to physically abuse or neglect their children, but data here are more limited. Child welfare professionals should consider asking questions about parental gambling when assessing family risk. 相似文献
5.
School professionals have a unique vantage point for identifying child maltreatment and they are a frequent source of referral to child protective services. Disturbingly, past studies have found that maltreatment concerns reported by educators go unsubstantiated by child protective services at much higher rates than suspected maltreatment reported by other professionals. This study explores whether there are systematic differences in the characteristics of cases reported by educators as compared to other professionals and examines whether such variation might account for differences in investigation outcome. Analyses were based on 7,725 cases of suspected maltreatment referred by professionals to child protective services from the Canadian Incidence Study of Reported Child Abuse and Neglect – 2003 a national database on the characteristics of children and families investigated by child protective services. School professionals were responsible for 35.8% of professional referrals. Reports by educators were much more likely to be unsubstantiated (45.3%) than those by other professionals (28.4%) in subsequent child protective investigation. Cases reported by educators were found to contain significantly more child risk factors (e.g., child emotional and behavioural problems) and fewer caregiver and family risk factors (e.g., caregiver mental health problem, single parent family) than cases reported by other professionals. Even controlling for these differences, educator-reported concerns were still 1.84, 95% CI [1.41, 2.40] times as likely to be unsubstantiated as reports from other professionals. Contrary to the notion that educators are mostly reporting non-severe cases, suspected/substantiated cases reported by school professionals were more likely to be judged as chronic and more likely to involve families with a previous child protection history. Results are concerning for the capacity of the education and child protection systems to work together to meet their shared goal of promoting healthy child development. Additional research is needed on the way in which child risks and problems influence child protective service, particularly in the context of chronic abuse and neglect and lack of availability of child and family mental health interventions. Potential problems with credibility of school professionals as reporters of child maltreatment concerns also warrant further investigation. 相似文献
6.
OBJECTIVES: To explore pediatricians' attitudes and experiences with the court system in child maltreatment cases. DESIGN: An anonymous, cross-sectional survey of a random sample of pediatricians registered with the North Carolina Medical Board. RESULTS: The response rate of the study was 60% (N=270). Few pediatricians (10%) reported that they had "ever" suspected maltreatment but decided not to report it. Pediatricians were equally likely to recall positive and negative experiences in court for child abuse cases. Pediatricians with negative court experiences were more likely to view reporting as time-consuming and were more than twice as likely not to report suspected cases of maltreatment (OR 2.4, 95% CI 1.04, 6.0). Seventy-five percent of pediatricians felt that court is harmful or distressing for children. CONCLUSIONS: The majority of pediatricians report suspected cases of child maltreatment. Pediatrician's court experiences play a role in the response to child maltreatment cases, influencing attitudes towards the legal system and the process of caring for maltreated children. Future research efforts should address physicians' concerns about the impact of court on children, ways to improve the working relationship between the legal system and physicians, and the training needs of physicians in child maltreatment, including testifying and understanding the court process. 相似文献
7.
OBJECTIVE: The main objective was to know social representations about child maltreatment (severity, etiology, and intervention strategies) of the general population and the professionals working with children in the Caribbean area of Colombia. METHOD: Sample was composed for 402 participants. From this pool of participants, 111 of them were working in child protection, 95 worked with children but not in the child protection system and 196 pertained to the general population. All participants answered to a questionnaire composed by 86 items. The questionnaire was developed to assess (1) the perceived severity of different typologies of child abuse, (2) opinions about risk factors for child maltreatment and sexual abuse, and (3) opinions about the most adequate ways of intervention with perpetrator of child abuse. RESULTS: Sexual abuse is considered as the most severe typology of child maltreatment and emotional abuse is considered as more severe than physical abuse. No differences between groups were found in perceived severity of typologies of child maltreatment. Differences in the social representation about the etiology of child maltreatment were found. Professionals working in the child protection system give more value to characteristics of parents and to the socio-economic and familiar environment in the etiology of child maltreatment than participants from the general population. Prevention and treatment programs for abusers were considered as the more relevant strategies against child maltreatment. DISCUSSION: Findings of present study suggest that social representations about child maltreatment of general population and professionals from the Caribbean area of Colombia are similar than social representation observed in other regions and countries. It is important to take into account that child labor and child poverty were considered as non-severe typologies of child maltreatment. Moreover, findings suggest that people from general population in the Caribbean area of Colombia have a relevant knowledge about agencies working for child protection. 相似文献
8.
Kenny MC 《Child abuse & neglect》2004,28(12):1311-1319
OBJECTIVE: The purpose of this study was to determine teachers' self-reported knowledge of the signs and symptoms of child maltreatment, reporting procedures, legal issues surrounding child abuse and their attitudes toward corporal punishment. In addition, a factor analysis was performed on the Educators and Child Abuse Questionnaire (ECAQ) (Kenny, 2001a). METHOD: Two hundred teachers, who work in the southeast region of the US in a large, ethnically diverse school system, were administered the ECAQ which contains questions on knowledge concerning: (1) signs and symptoms of child abuse, (2) laws, and (3) procedures for reporting child abuse as well as number of reports filed. RESULTS: Most teachers reported being unaware of the signs and symptoms of child maltreatment, as well as reporting procedures. They also felt administration would not be supportive and were in disagreement with their legal role as mandated reporters. The ECAQ was found to be a reliable measure with four factors: (1) Awareness of signs and symptoms of child abuse, (2) Knowledge of reporting procedures, (3) Attitudes toward discipline, and (4) Seriousness of child abuse. CONCLUSIONS: In general, teachers reported a lack of awareness of the signs of child abuse and reporting procedures, which may affect their ability to report cases of suspected abuse. There is a need for standardized training in child maltreatment for all teachers as well as clear, concise institutional guidelines for reporting child abuse and support for teachers confronted with suspected victims. 相似文献
9.
The increasing rate of child abuse and neglect is a special concern for educators who are legally mandated reporters of suspected maltreatment, are often the first to identify and refer children who have been harmed, are in contact with parents and are aware of the family conditions contributing to child maltreatment, and who must often work closely with other professionals in their efforts to support child victims and prevent further abuse. Moreover, children's emotional or behavioral problems, learning disabilities, or other difficulties often reflect broader problems that are associated with abuse or neglect. Consequently, understanding the causes and consequences of child maltreatment, and contemporary child protection efforts, is essential to educators in their efforts to assist victimized children. This article surveys current research on child maltreatment with particular attention to the challenges of child protection, the multidimensionality of child maltreatment (distinguishing physical abuse, physical neglect, sexual abuse, and psychological maltreatment), and hopeful new avenues for prevention. The implications of this research for educational professionals are emphasized. 相似文献
10.
This article compares multiple types of child maltreatment among Puerto Rican youth. We seek to expand the limited knowledge of the effects of multiple types of maltreatment on depressive symptoms in a specific Latino population as emerging studies indicate that children who are exposed to one type of maltreatment are often exposed to other types. This study examines the predictive strength of different and multiple types of lifetime child maltreatment (i.e., physical, sexual, and emotional abuse; and neglect), and the effect of youth support from parents, youth coping, youth self-esteem, and place of residence on depressive symptoms among Puerto Rican youth. Secondary data analyses were performed using three annual waves (2000–2004) of data from the Boricua Youth Study. The analytic sample consists of 1041 10–13 year old Puerto Rican youth living in New York and Puerto Rico. Results indicate that: (1) youth who experienced ‘sexual abuse only’, ‘multiple maltreatment’ (2 or more types of maltreatment), ‘physical abuse only’ have a significant increase in depressive symptoms (75.1%, 61.6%, and 40.5% respectively) compared to those without maltreatment; and (2) place of residence, exposure to violence, and mental disorders were significant risk factors. When developing psychosocial interventions, professionals should particularly focus on youth who report past lifetime experience with child maltreatment. Particular attention should be given to children living in the Bronx, New York and similar urban low-income areas who report past lifetime experience with multiple types of child maltreatment and who present symptoms or a diagnosis of co-occurring mental health problems. 相似文献
11.
Saskia Euser Lenneke R.A. Alink Fieke Pannebakker Ton Vogels Marian J. Bakermans-Kranenburg Marinus H. Van IJzendoorn 《Child abuse & neglect》2013
The prevalence of child maltreatment in the Netherlands was in 2005 first systematically examined in the Netherlands’ Prevalence study on Maltreatment of children and youth (NPM-2005), using sentinel reports and substantiated CPS cases, and in the Pupils on Abuse study (PoA-2005), using high school students’ self-report. In this second National Prevalence study on Maltreatment (NPM-2010), we used the same three methods to examine the prevalence of child maltreatment in 2010, enabling a cross-time comparison of the prevalence of child maltreatment in the Netherlands. First, 1,127 professionals from various occupational branches (sentinels) reported each child for whom they suspected child maltreatment during a period of three months. Second, we included 22,661 substantiated cases reported in 2010 to the Dutch Child Protective Services. Third, 1,920 high school students aged 12–17 years filled out a questionnaire on their experiences of maltreatment in 2010. The overall prevalence of child maltreatment in the Netherlands in 2010 was 33.8 per 1,000 children based on the combined sentinel and CPS reports and 99.4 per 1,000 adolescents based on self-report. Major risk factors for child maltreatment were parental low education, immigrant status, unemployment, and single parenthood. We found a large increase in CPS-reports, whereas prevalence rates based on sentinel and self-report did not change between 2005 and 2010. Based on these findings a likely conclusion is that the actual number of maltreated children has not increased from 2005 to 2010, but that professionals have become more aware of child maltreatment, and more likely to report cases to CPS. 相似文献
12.
A M Steinberg R S Pynoos A K Goenjian H Sossanabadi L Sherr 《Child abuse & neglect》1999,23(8):771-777
OBJECTIVE: To discuss issues concerning mandatory reporting of child abuse in research settings. METHOD: An overview of existing Federal and State statutes regarding mandatory reporting of child abuse is presented. A critical review of the literature addresses the following issues: (1) whether researchers have a moral duty to place the health and safety of children above concerns about confidentiality and the benefits of obtaining new knowledge; (2) whether the Certificate of Confidentiality preempts reporting requirements; (3) whether researchers who are not health professionals (such as child developmentalists, psychobiologists, neuroscientists) should be required to report; and (4) whether researchers should be required to expand their protocols to include more in-depth investigation of potential abuse. RESULTS: Existing child abuse reporting laws do not specifically designate researchers as among the category of individuals mandated to report suspected child abuse. Currently, Human Subject Protection Committees and Federal funding agencies are tending to interpret reporting laws as applying to researchers, including requiring that research subjects are informed of this responsibility in consenting procedures. It is unclear whether the Certificate of Confidentiality preempts child abuse reporting laws. CONCLUSION: The authors recommend that legislatures specifically designate researchers as mandated reporters to ensure more uniform reporting practices in research settings. For both investigators and Human Subject Protection Committees, inclusion of researchers among the categories of those mandated to report would also help address issues of immunity from civil and criminal liability for "good faith" reports that turn out to be false and injurious. 相似文献
13.
Professionals who make decisions in child abuse cases often deny that their decision-making has a moral basis, claiming that they have a “non-judgmental” attitude, and that they only make decisions in the “interests” of their clients, reaching their conclusions on an assessment of the circumstances. This paper considers the implications of this for practice, and particularly for the ways in which cases are reported to the authorities. The study suggests that the general public are reluctant to report cases to the authorities, or even to suggest that professionals should intervene in an authoritarian way. This may arise from suspicion, often in effect justified, that the child will be removed and placed in an institution. Normally the decision to remove a child from home is taken in two stages: first professionals decide whether a child has been abused or whether he is in acute danger of being so; only if this is so can the second decision be taken, namely whether to remove the child or offer some less drastic form of help. This paper is primarily concerned with the first issue and with forms of abuse which are not in themselves life-threatening. Five types of criteria are considered for determining whether child abuse has taken place and the implications for each for public perception of professionals and for practice. The types are: legal, social norms, professional expertise, client subjectivity and no criteria. All present difficulties and may sometimes be in conflict with one another. The paper argues for standards to be clearer, criteria more available and for a shift of resources from therapy to education. 相似文献
14.
OBJECTIVE: To determine how often and for what reasons a hospital-based multidisciplinary child abuse team concluded that a report of alleged or suspected child abuse was unnecessary in young children with fractures. METHODS: A retrospective review was completed of all children less than 12 months of age who, because of fractures, were referred to the hospital multidisciplinary child abuse team for consultation regarding the need to consider child abuse. RESULTS: The team received 99 consultations, reported 92 (93%) children as alleged or possible victims of physical abuse, and did not report 7 (7%). Age at presentation of those who were reported was 4.2 months compared to 3.0 months in the non-reported group. The average number of fractures in the reported group was 2.9 (SD 3.53) compared to 3.4 (SD 4.6) in the non-reported group. Factors that led to cases not being reported included: (a) a trauma history consistent with the fracture (n=4), (b) a diagnosis of bone fragility secondary to genetic, nutritional or medical therapy etiologies (n=2), and (c) iatrogenic fracture (n=1). CONCLUSIONS: Seven percent of the children less than 12 months of age and with at least one fracture referred to the multidisciplinary team for evaluation of possible child abuse were not reported as alleged or suspected physical abuse. The involvement of the hospital multidisciplinary child abuse team may have prevented unnecessary investigation by the county social services agency and/or police, and possible out-of-home temporary placement. 相似文献
15.
Elizabeth Conroy Louisa Degenhardt Richard P. Mattick Elliot C. Nelson 《Child abuse & neglect》2009,33(6):343-352
ObjectiveTo examine the prevalence, characteristics and risk factors for child maltreatment among opioid-dependent persons compared to a community sample of similar social disadvantage.MethodThe study employed a case-control design. Cases had a history of opioid pharmacotherapy. Controls were frequency matched to cases with regard to age, sex and unemployment and were restricted to those with a lifetime opioid use of less than five times. The interview covered child maltreatment, family environment, drug use and psychiatric history.ResultsThis study found a high prevalence of child maltreatment among both cases and controls. Despite the elevated prevalence among controls, opioid-dependent males had a higher prevalence of physical and emotional abuse; female cases had a higher prevalence and greater severity of sexual abuse. The prevalence of neglect was similar for both groups. Early parental separation was more prevalent among female cases compared to female controls; otherwise the prevalence of the risk factors was comparable for both groups. The risk factors significantly associated with child maltreatment were also similar for both cases and controls.ConclusionsGiven the documented association between child maltreatment and adult mental disorder, child maltreatment may be an important antecedent of current psychological distress in persons presenting to treatment for opioid dependence. Apart from a possible association between early parental separation and sexual abuse among female cases, the increased prevalence of child maltreatment associated with opioid dependence did not appear to be related to differences in early childhood risk factors considered in this paper. Other risk factors may be more pertinent for those with opioid dependence.Practice implicationsThe high prevalence of child maltreatment among the opioid-dependent sample has implications for the assessment and treatment of clients presenting with opioid dependence. Assessment of child maltreatment history could help inform the development of individual treatment plans to better address those factors contributing to the development and maintenance of opioid dependence. Specifically, management of co-morbid mental disorder associated with child maltreatment could be the focus of relapse prevention programmes and also have a positive influence on treatment retention. 相似文献
16.
OBJECTIVE: To examine whether and to what extent specific chronic health conditions place young children at risk of maltreatment. METHODS: The study used a sample of Illinois children (born between January 1990 and March 1996) who were through age 3 continuously enrolled in Medicaid, a public health insurance program for low-income families. The study used "paid claims" data and ICD-9-CM health codes to identify children with one or more of three chronic conditions: chronic physical illness, developmental delay/mental retardation (dd/mr), and behavior/mental health conditions (b/mh). The analysis used Cox proportional hazard models to estimate the risk of substantiated child maltreatment that each of these health conditions confer on children under age 6. RESULTS: Among children under age 6, 24.1% had chronic physical health conditions, 6.1% had b/mh conditions, and 4.2% had dd/mr. Among the children, 11.7% were maltreated (abused or neglected). Children with b/mh conditions were 1.95 times more likely than children without such conditions to be victims of child abuse or neglect. Children with chronic physical health conditions were 1.1 time more likely to be maltreated (p相似文献
17.
The primary purpose of the child protective services system is to protect children from the recurrence of child maltreatment. Understanding more about what predicts recurrence may help us more adequately target interventions to reduce the risk of future maltreatment. OBJECTIVE: The specific objective of this study was to identify correlates of recurrence during CPS intervention for families who were provided continuing intervention following a confirmed index report of physical abuse or neglect. METHOD: This nonconcurrent prospective study selected 446 subject families who met study eligibility requirements from 1,181 families randomly selected from the 2,902 families who had experienced a substantiated report of child abuse or neglect during the sampling year. Data were collected and coded from archival sources for 5 years following the index report. Each record was coded by two research analysts to increase inter-rater reliability. Data were analyzed with survival analysis methods: (1) Kaplan Meier and (2) the Cox Proportional Regression Model. RESULTS: Predictors of recurrence were child vulnerability, family stress, partner abuse, social support deficits, and an interaction between family stress and social support deficits. CONCLUSIONS: Implications of this and earlier research suggest that increasing social supports may help families cope with life events that increase stress and the risk of continued child maltreatment; that collaborations between CPS and domestic violence agencies are needed; and that screening maltreated children for mental health problems and other disabilities and assuring that children with these needs and their families get effective treatment may reduce the likelihood of continued maltreatment. 相似文献
18.
OBJECTIVE: This study investigates the opinions of social workers, pediatricians, and physician assistants in their support for the existing child maltreatment mandated reporting policy and an alternative reporting policy. Differences in professional training, age, gender, reporting behavior, attitudes towards reporting, and level of certainty needed to report were considered in determining which group of mandated reporters was most likely to support either the existing or an alternative policy. METHOD: A total of 382 social workers, pediatricians, and physician assistants in Connecticut and Massachusetts completed a self-report questionnaire. This sample represented an overall adjusted response rate of 76%. RESULTS: There was slightly more support for the existing reporting policy compared to the alternative policy. After controlling for age, attitudinal variables, and reporting behavior, social workers were significantly more likely to favor an alternative child maltreatment reporting policy than pediatricians or physician assistants. Also, those mandated reporters who had not consistently reported all suspected cases of maltreatment were significantly more likely to favor the alternative policy than consistent reporters. CONCLUSIONS: Because the majority of mandated reporters do not consistently report all suspected cases of maltreatment and support for an alternative reporting policy varies among different groups, consideration of alternative strategies and policies that address the concerns of different types of professionals may be appropriate. 相似文献
19.
OBJECTIVE: The goal of this research was to study how different groups of child welfare professionals prioritize and use information to make placement decisions following instances of child abuse. METHOD: A total of 90 juvenile court judges and guardians ad litem, Court Appointed Special Advocates (CASA), social workers, and mental health professionals responded to a detailed questionnaire describing four case studies of child physical abuse in which a parent was the perpetrator, the child was either 2 years or 6 years of age, and the abuse was either first time or chronic. Participants rated the impact of specific pieces of information regarding child, family, and system-level characteristics on their decision-making process. RESULTS: Analyses of reactions to these vignettes demonstrate that professional groups use different kinds of information when making decisions about foster care placements. Social workers and mental health providers rely on information about the severity and pattern of abuse and on information about services offered in the past and parental responses to those services. Judges and guardians ad litem rely more heavily on information about the likelihood of a reoccurrence of abuse and the child's ability to recount the abuse, whereas CASA volunteers rely on information about the stability of the family. CONCLUSIONS: Professional group membership, rather than factors such as age or ethnicity of the child or chronicity of abuse, accounts for different patterns of prioritizing and using information when making decisions about whether a child should remain in the home or be placed in foster care. The implications for community-based training and intervention efforts are discussed. 相似文献
20.
Child maltreatment is a public health problem worldwide, and China is no exception. However, the pattern of child maltreatment remains unknown, including whether the gender of children and their parents has an impact on the occurrence of maltreatment. This study aims at examining the rates and frequency of child maltreatment, including physical abuse, psychological abuse and neglect perpetrated by mothers and fathers. We also test whether the interaction between parents’ gender and their child's gender affects the occurrence of child maltreatment in China. 997 children from the China Jintan Child Cohort Study participated in the present study and reported their maltreatment experience perpetrated by their mothers and fathers using the questionnaire, Parent–Child Conflict Tactics Scale (CTSPC_CA). Generalized linear model analyses show that boys were more likely than girls to report physical abuse, and, in particular, boys were more likely than girls to be physically abused by their fathers. On the other hand, mothers were more likely than fathers to exhibit psychological aggression and use corporal punishment for both boys and girls. There was no difference based on the child's or parent's gender in the occurrence of neglect. The findings present empirical evidence that enhances the understanding of the pattern of child maltreatment in China, provide implications for social workers and health professionals to identify children at risk of child maltreatment, and shed light on future research studies. 相似文献