Child Abuse And Neglect: A Discussion Paper
and Overview of Topically Related Projects
This publication was developed under contract
By
Andy Wachtel
Research Services
United Way of the Lower Mainland
for
the National Policy Circle on Child Abuse
Family Violence Prevention Unit
Health Canada
Copies of the report may be obtained by contacting:
National Clearinghouse on Family Violence
Family Violence Prevention Unit
Health Programs and Services Branch
Health Canada
Ottawa, Ontario
K1A 1B4
Tel: 1-800-267-1291
TDD (Telecommunication devices for the Deaf) line: 1-800-561-5643
Fax: 613 941-8930
Findings and opinions expressed are those of the researcher
and are not necessarily those of Health Canada. Contents may
not be commercially reproduced, but any other reproduction,
with acknowledgements, is encouraged.
Published by the authority of the Minister of National
Health and Welfare
@Minister of Supply and Services Canada 1994
Cat. H72-21/113-1994E
ISBN 0-662-22513-9
Aussi disponible en français sous le titre Mauvais traitements
et négligence envers les enfants:
Document de travail et Aperçu des projets mis en oeuvre dans
le domaine
Acknowledgements
This discussion paper was commissioned by the National Policy
Circle on Child Abuse and Neglect, a volunteer consultative
body to the Family Violence Prevention Unit, Health Canada.
Its members are:
Margo Buck
Child Protection Centre, Manitoba;
Ross Dawson
Institute for Prevention of Child Abuse, Ontario;
Thérèse Johnson
Ministère de la santé et des services sociaux, Québec;
John Meston
Vanier Institute of the Family, Ontario;
Marilyn Peers
Children's Aid Society, Nova Scotia;
Brian Raychaba
National Youth-in-Care Network, Ontario;
and participating program staff from Family Violence Prevention Unit, including:
Gisele Lacroix, Liette Lalonde, Carole Miron, Gordon Phaneuf,
Nycole Roy and Cynthia Waugh.
My thanks for their overall direction, advice and constructive
criticism. Thanks also to the staff of the Family Violence Prevention Unit (and the National Clearinghouse on Family Violence)
for their assistance in securing materials and for their suggestions
along the way. I also owe a special mention to the following
people who acted as resources to me:
Ruth Annis
Nisha Family and Children's Services Society
Bill McFarland
Parents in Crisis
Richard Sullivan
School of Social Work, University of British Columbia.
Overview
This paper assesses the current direction of child abuse and
neglect policy in Canada. The first part of the report defines
physical abuse, neglect, and other categories of child abuse.
It catalogues how, during the current period of interest in
this issue (which started with the coining of the term "battered
child syndrome" in 1962), physical abuse gained the limelight,
and neglect was pushed somewhat into the shadows. Then, when
child sexual abuse became a strong focus, attention shifted
away from physical abuse. Similarly, the initial emphasis on
intrafamilial child sexual abuse ("incest") diverted
the interest that was just starting to be paid to institutional
abuse, only to redirect our interest to that topic again when
sexual scandals came to light.
During this same period, the concept of family violence gained
ground because it crystallized broadly held fears about problems
in our society. Family violence gradually became an acceptable
umbrella category under which all forms of child abuse fell.
Because not all child abuse is intrafamilial (or for that matter
violent in the ordinary sense), the concept of family violence
had to stretch to accommodate it. But the process also forced
some corresponding changes in the way we defined various categories
of child abuse. As well, it added a new category that had become
evident in work with battered women, the abuse suffered by children
having to be "witnesses to violence" in their families.
The argument below is that the focus on family violence has
led to the ascendancy of a family support agenda and to the
repositioning of physical abuse and neglect within it. In a
sense, that has provided a fresh opportunity, a new platform
from which to address physical abuse and neglect. In fact, this
impetus has been further increased by the force of some other
policy trends. These include a long-term movement towards "least
restrictive measures" in child welfare; a new focus on
child poverty, and the issues raised by the development of a
parallel Native child welfare system. From each of these trends,
the paper draws a number of implications for our efforts against
child abuse. Some of these suggest directions for continued
or additional involvement by federal authorities.
The second part of the paper is a brief overview of 20 topically
related projects funded (in whole or in part) by the Family Violence Prevention Unit. Because no single initiative guided
these projects, they are a rather diverse assemblage. For that
reason, they are not reviewed, but are grouped by category:
i) training materials; ii) literature reviews and analyses;
iii) research and evaluation studies; iv) conference proceedings;
and v) program inventories. The aim is to provide a sense of
the kinds of activities that the Division has supported and
what role that represents.
Appendix I contains abstracts of the topic-related aspects
of each of the reports. These will help readers develop a view
of the salience of particular projects.
Thesis
A few years ago, there still seemed to be some debate about
the directions that the field of child abuse and neglect would
take. One of the unresolved issues then was the extent to which
child abuse and neglect might be subsumed under family violence.
I The thesis of this paper is that this issue has largely been
resolved at a ."small-p political level", that is,
with support that crosses all lines. Child abuse and neglect
are increasingly seen as foci for prevention and intervention
within a broad family support agenda. Moreover, this wider agenda
is now relatively well defined. What remains unclear is to what
degree it will be realized. What is certain is that this new
agenda has profound implications across the health and welfare
spectrum.
Definitional Re-alignment
Definitions in the area of child abuse have not changed fundamentally
over the course of the last few decades. Rather, there has been
a process of differentiation into new types as the significance
of various phenomena became better understood. Thus, to the
original concern with physical abuse were added first neglect,
then emotional abuse and sexual abuse, and, more recently, witness
to family violence and ritual abuse.
Unfortunately, these different "types" of abuse were
not defined in the same fashion. That is, they were not generally
presented as relating to each other in any clear-cut way. Moreover,
shifts in our focus have meant that the various categories of
child abuse do not line up neatly in terms of their scope; in
particular, there are inconsistencies over whether harms that
take place within the family context are to be regarded in the
same manner as those that occur in other contexts. We briefly
illustrate both these points below.
The current era of renewed interest in child abuse is usually
dated (Pfohl, 1977) from the publication of the article on the
"battered child syndrome" (Kempe, et al., 1962) that
alerted physicians to recognize physical abuse when it was presented
as accident or illness.2 Within a remarkably short
period, physical abuse rose on the public agenda and was translated
into legislation on reporting and child protection intervention.
In that process, the focus broadened to include neglect.
In this schema, child abuse and neglect were two complementary
types of child maltreatment. Physical abuse covered harms (that
threatened the health, development, or life of the child) arising
out of the direct actions of a parent or parents (i.e., acts
of commission). Neglect covered harms arising out of failure
of a parent or parents to provide minimally adequate care in
terms of health, nutrition, shelter, education, supervision,
affection, attention, or protection (i.e., acts of omission).3
Both were defined primarily within the family. Existing criminal
laws on assault, negligence, etc. covered parallel abuses against
children committed by other caregivers or strangers.
Child sexual abuse was defined somewhat later and covered the
whole range of sexual exploitation and sexual assault of children.
Where it occurred within the family, the child protection literature,
from the beginning, pushed for a broad definition in terms of
what range of acts and what victim-offender relationships constituted
"incest" (MacFarlane, 1978). This position implied
several beliefs: among these, that it was not only intercourse
that was harmful, and that the betrayal of trust in intrafamilial
child sexual abuse stemmed from the social relationship rather
than a biological one. The criminal law, which had been focused
on sexual offenses which were not defined in terms of a family
context (e.g., sexual assault, "statutory rape", gross
indecency), was caught up in this concern and reformed to allow
better prosecution of offenders against children (see Badgley,
1984). New broadly framed offenses such as sexual interference
and sexual invitation were defined. Narrowly constructed offenses
(e.g., incest, parent procuring), that had not been widely used
anyway, were largely abandoned (Hornick and Bolitho, 1992).
Emotional or psychological abuse and neglect is the fourth
commonly defined type. This covers acts (and failure to act)
that attack or undermine the child's self-esteem, sense of safety,
social attachment, sense of reality, etc. or that otherwise
compromise the child's psychological health or development.4
Of all the categories of abuse, this is arguably the most important
construct from a therapeutic perspective. As well, it is also
theoretically central because psychological abuse crosscuts
and unifies the other types (Garbarino, et al., 1986). However
because it is difficult to document, this category has not been
prominent as a focus for reporting and criminal or child protection
investigation or intervention (Mulford, 1958; Class, 1960; Downs,
1963; Isaacson, 1966; Drews, et al., 1979).
Psychological abuse tended to be considered mainly within the
family context. However, it was recognized as a feature of extra-familial
child sexual abuse and ritual abuse (where terrorizing and indoctrinating
the child victims are central). Similarly, emotional abuse and
neglect were acknowledged as special aspects of institutional
abuse (a point returned to later in this document).
These definitions of child abuse were affected when the whole
area became a province of family violence. This broad topic
includes the major trilogy of wife assault, child abuse in all
its forms, and elder abuse (and in that order of prominence).5
The unifying concern is with the family as a central social
institution that is in trouble on many fronts. This concern
has been strong enough to override existing definitional boundaries
(for child sexual abuse, elder abuse, and even to some extent
violence against women) that otherwise extend beyond the family.
Instead, the focus on family violence has emphasized certain
perspectives common to all its constituent types of abuse. Most
notable has been an analysis of power imbalances and social
cleavages (sexism, agism, racism, "able-ism"), all
supposedly subsumed under the ideology of "patriarchy".6
In this schema, certain groupings (females, children, the elderly,
persons of colour, persons with disabilities, etc.) are rendered
more vulnerable, "at risk" for abuse.
This feminist-derived perspective has influenced theory (and,
to a lesser extent, policy) on child abuse. However, much of
the popular discussion and mobilization under the banner of
family violence has been conservative. In fact, family violence
is also viewed from a (fundamentalist Christian-influenced)
perspective that sees the decline of the family as resulting
from attacks on "patriarchy" (an ordained social order)
and resultant societal destabilization.
Indeed, because family violence has become an umbrella term
covering a broad spectrum of views, it can gloss over real differences
in our use of words, starting with what is meant by "family"
and what is regarded as "violence".7 As
we try to fit all sorts of abuse within it, the boundaries of
family violence broaden and blur, family becomes a metaphor
that stretches to include institutional abuse, "date rape",
and virtually any child abuse issue.
If there are dangers in losing clarity of focus by adopting
a family violence perspective, refocusing also promises some
gains. For example, the juxtaposition of child abuse and wife
assault has had one clear-cut impact on our definitions. That
has been to add (formally in child protection policy in some
provinces, and as a service issue across the country) the category
of witness to wife assault as a fifth type of child abuse.8
This issue was defined and championed very largely by persons
connected with the transition house movement.
In effect, the broader issue of the impact on the child of
growing up in a violent, chaotic, or dysfunctional household
is also raised by a family violence perspective (Fairholm, 1990).
This would include the impacts of sibling abuse (including sexual
abuse), parental alcoholism, parental psychosis, etc. Some of
these abuse and neglect-related categories have emerged as social
issues in their own right, for example, through self-help programs
like Adult Children of Alcoholics. Others may eventually come
to be defined as specific types of child abuse.
By extension (i.e., the state as "parent"), the secondary
abuse suffered by children-in-care if that alternative care
is inadequate (e.g., multiple placements, high turnover among
caregivers, separation of siblings, etc.) is another family
violence related issue (Community Panel, 1992).
To summarize, "family violence" is a broad and distinctly
fuzzy concept. It is invoked by persons at opposite ends of
various ideological spectrums; they may draw divergent policy
implications from their analyses of the issues. Furthermore,
subsuming child abuse within it (or elder abuse, much of which
is also extra-familial in the usual sense) requires that "family"
be treated more as a metaphor than as variants of a coherent
social institution. Similarly, the concept of "violence"
has to be broadened to include aspects of neglect and psychological
abuse that injure by with-drawal, abandonment, etc. In short,
using "family violence" as an organizing concept introduces
real risks of misunderstanding. All that said, falling under
the banner of family violence appears to have presented some
advantages for those seeking to respond to child abuse. in fact,
in another sense it has forced greater definitional clarity.
That is, making the family the effective focus for intervention
realigns the various categories of child abuse and creates a
dearer typology.
In this perspective, emotional or psychological abuse crosscuts
all the other types of child abuse (Garbarino, et al., 1987).
Among the other categories, there is a major divide, certainly
in terms of intervention (e.g., the role of criminal justice)
and largely in terms of prevention as well (e.g., whether to
focus on the offender or the victim). On one end are ritual
and sexual abuse: here, the criminal justice system is important
and prevention focuses largely on the child. On the other end
are physical abuse and neglect: the justice system is secondary
and prevention focuses mainly on the adult. Witness to violence
falls somewhere in-between. Physical abuse, neglect, and witness
to violence form the subjects of this paper.
The Neglect of Neglect
From the first interest in child abuse in North America in
the last quarter of the nineteenth century through to the "rediscovery"
of child abuse with the identification of the "battered
child syndrome", much of the effort of child protection
workers was focused on neglect. That is to say, neglect was
the generic term under which children were taken into care (this
removal was called ."child separation"). Physical
abuse and other categories of child abuse typically were considered
as specific examples of neglectful parents' failure to provide
adequate care (Matheson and Neave, 1971). One distinction that
became important in policy (Hennessey, 1970) was between parental
failure to provide care (covering neglect and abuse) and parental
inability to provide care (often termed "dependency").
Both circumstances might place children at risk and necessitate
intervention, but one was seen as arising out of moral failing,
the other out of poverty, illness, incapacity, or other misfortune.
Thus, the nature of state intervention and assistance might
depend on a moral judgment.
The naming of the "battered child syndrome" and the
resultant focus on physical abuse marked a new era. It both
narrowed the definition of neglect and pushed that issue somewhat
into the background. Child welfare was not a particularly rich
area; new resources tended to go towards the "new",
high-profile problem of abuse. Research and policy attention
on neglect also languished. Overall, neglect became something
of an appendage to abuse - as in "abuse and neglect".
Two decades after this reordering of the terms, Wolock and
Horowitz (1984) were able to argue convincingly that neglect
was a neglected issue (even though there were generally estimated
to be more cases of neglect than abuse and an acknowledged potential
for serious harm to children). The authors stated that the body
of literature on neglect had been judged "diffuse and rudimentary"
(citing Polansky, et al., 1975) and that it still fit that description
a decade later.
Part of the reason for lack of attention to neglect, it was
argued, was that this social problem did not fit the ideological
agenda of those promoting action against child abuse. Physical
abuse (and child sexual abuse even more so) was identified as
a problem that cut across all social classes (Bakan, et al.,
1976; Fairholm, 1990). This fact was viewed as important because
child welfare proponents wanted to attract and maintain wide
social support for action. Also to the good in this effort to
elevate child abuse on the social agenda, violence is a dramatic
and central societal concern. By contrast, neglect is a problem
mainly of the poor and marginal. Therefore, neglect, as an issue,
suffered from a lack of connection (and identification) with
powerful segments of the public. A war on neglect is a battle
against poverty; Wolock and Horowitz argue that the alleviation
of poverty is costly, slow, and has simply not been a serious
social priority.9
In some respects, this analysis still stands. Neglect continues
to be a large (and often the largest) cause for taking children
into care. But neglect gets little media attention or research
support. While there was early interest in differentiating "abuse-prone"
from "neglect-prone" parents and in researching the
differences in sequelae, this has not been widely translated
into distinct program and policy emphases. Thus, articles dating
back a decade (such as Alter, 1985 on what factors child protection
workers consider in substantiating cases of neglect) have not
apparently been superseded. Most research continues to consider
both abuse and neglect (see Éthier, et al., 1991) without trying
to disentangle them.
The Eclipse of Physical Abuse
After an initial period of prominence, physical abuse also
has had to share the social arena with a growing number of other
concerns. In fact, physical abuse was elbowed out of the spotlight
rather quickly when child sexual abuse was identified as a significant
concern.10 For one thing, the pairing of sex and
violence in the case of child sexual abuse proved a nearly irresistible
combination of societal concerns. But more significantly, child
sexual abuse mobilized a different institutional response, especially
in terms of the extent of the involvement of the criminal justice
system. Other actors had to respond to the demands of criminal
investigation, treatment and prevention programs required a
very different focus, training had to be developed from scratch,
protocols had to be revised or renegotiated. Once again, the
case load exploded, and resources and energy went into dealing
with the "new" social problem.
Child sexual abuse also benefited from the identification of
a "survivor" movement - adults who had lived through
a history of sexual victimization. Not only did survivors come
forward to tell their own stories (see Myers, 1980), but survivor
organizations grew up as well.11 By contrast, there
has not been a survivor movement organized around a history
of "abuse and neglect".
As attention shifted to child sexual abuse, research interest
in physical abuse lost some of its impetus. A good indication
of that is the space given various topics in the major literature
review on family violence compiled within Health Canada in 1989
(Frankel-Howard, 1989). It devoted just over one page to neglect,
just under one to emotional abuse, 11 pages to physical abuse,
and 21 to sexual abuse. The reprinted articles on physical abuse
on the National Clearinghouse's shelves are aging, but still
relevant (e.g. Wolfe, 1985, on parental competence as a program
focus).
Institutional Abuse - Delayed Launch
Although physical abuse and neglect were defined very largely
within the family context, there was a clear connection with
"institutional abuse", that is, abuse by other caregivers.
Indeed, over and above the parallels to abuse and neglect within
the family, institutions were perceived to present unique abusive
aspects. Just by the very fact that they represented non-family
(" substitute") care and labeled the children in them
(as abused, delinquent, abandoned, orphaned, handicapped, or
whatever), they were stigmatizing. Large residential institutions,
necessarily organized in a bureaucratic fashion not generally
calculated to optimize a child's individuality and unique developmental
potential, were regarded as inherently even more abusive in
this sense (Hanna, 1977). If institutionalization presents this
special aspect of emotional abuse or neglect, it was important
to put in place policies and practices to minimize that harm,
first of all by ensuring that the placement represents the "least
restrictive" alternative for the child (Besherov, 1977).
Small institutions, well resourced and supervised, and sensitive
to cultural and community ties of the children in care, were
the first choice. This analysis formed the focus of a National
Conference on the Institutional Maltreatment of Children held
at Cornell University in June 1977. Institutional abuse appeared
to be on the threshold of identification as a significant social
problem.
However, as child sexual abuse became the predominant issue
within the abuse spectrum, institutional abuse faded along with
the rest. Initially, the focus in child sexual abuse was very
strongly on abuse within the family. Moreover, the rise in the
number of child sexual abuse cases placed additional pressures
on finding residential resources (especially foster homes) for
children who had to be brought into care. There was a concern
that these resources be safe, but there was little impetus to
confront institutional abuse. And, at the same time, the large
institutions, which had been regarded as most infamous, were
being dosed or reduced in size as the tide of "deinstitutionalization"
washed across the continent. Institutional abuse remained a
concern in the background.
Somewhat paradoxically, it was largely child sexual abuse which
eventually brought institutional abuse into the limelight. With
the public so sensitized to child sexual abuse, this aspect
of institutional abuse took on special importance. By contrast,
revelations of physical abuse and neglect in institutional settings
had not received the same level of media and public attention.
For example, survivors, stories about harsh "discipline",
forbidding the use of their mother tongue, and systematic devaluing
of native cultures in residential schools, while acknowledged
as deplorable, had not provoked the same public reaction as
have allegations of sexual abuse. And the Mount Cashel Orphanage
scandal in Newfoundland was seized on much more for the cover-up
of sexual abuse than for its other aspects.12
A survivor movement has begun to emerge around institutional
abuse; the National Youth-in-Care Network provides one focus.
It is instructive that the analysis arising from these survivors
does not emphasize sexual abuse but returns much more to the
special aspects of institutionalization that were identified
earlier.13
The Family Support Agenda - A Rising Trend
If child abuse and neglect have declined as social issues in
their own right, it has only been to rise again within the growing
family support agenda. This is the context in which nearly all
work is currently being framed (see Meston, 1992 for an extensive
review).
In effect, however, policy and practice in child abuse and
neglect were moving towards a full-fledged family support approach
before development was arrested by the shift in societal attention
to child sexual abuse. Indeed, the general notion of family
support is an old and established one within child welfare (Sheridan,
1959; Salmon, 1962; Shames, 1964; Jacobucci, 1965; Giovannoni,
1970). Ideas about family preservation and enhancement framed
much of the child welfare policy debate in the 1960s and 1970s.
"Traditionally, social services have been implemented
at the point of breakdown of a family - this is thus a residual
conception. We are sure we would all agree that an institutional
approach would be the right one. We recognize that first,
attention needs to be given to efforts to sustain and support
family ties. We believe in the strongly emphasized need
for additional day care and home-maker services. These should
be seen as family supporting rather than family repairing
services." (Easterbrook, et al., 1965, p.4.)
This program remained one vision of "best practice"
throughout the period.
"Many social workers feel the best way to handle maltreatment
is to make every effort to keep the child in the home and
keep the family intact while intervening with supportive
services (homemakers, daycare, counselling, etc.)... The
current trend is ...[to] teach the parents more effective
parenting skills." (Eskin and Kravitz, 1980; pp.37-8.)
The family violence banner has revitalized these same approaches.
"Rather than perpetrating a system that necessitates
a serious breach in legally acceptable childcare before
intervention is applied, we should provide responsive, proactive
help for healthy and culturally appropriate family development.
Currently there is new emphasis on maintaining family integrity,
rather than resorting to out-of-home placements. In keeping
with this movement, social service and mental health agencies
are looking for ways to reduce the need for protective supervision,
while providing necessary assistance to families."
(Wolfe, 1990.)
Many programs emphasize positive parenting. For example, Acton
and During (1990) described a program for re-educating abusive
parents. This approach covered arousal and anger management,
communication and problem-solving, empathy and appropriate expectations
of children, all in a 13-week, 20-hour treatment group. The
authors noted that the program was being expanded to 40 hours
to allow greater skill rehearsal and was coupled with a follow-up
group on attachment issues for abusive parents who are themselves
abuse survivors.
In fact, Wolfe (1985) had noted some time back that the psychological
literature did not indicate a psychopathological origin of child
abuse. Rather, it directed attention to psychological variables
that influence parental competence and thus argued in favour
of program approaches that reduce the demands on parents and
provide compensatory learning opportunities.
What seems new in placing family support within a broad family
violence perspective is the scope of the initiatives that are
put forward (Wachtel, 1990). That is, the issue became much
larger than a search to uncover the psychological problems of
abusive parents (focussing on the individual) or to describe
the interactional spiral between difficult children and parents
with unrealistic expectations (the dyad or the family as a closed
system). These notions might still enter into programs but now
within a broader "ecological" context - the personal
social network, the social milieu, the community. Social marginality,
isolation, poverty, lack of positive models or supports for
parenting, all include a community or even a societal dimension.
That is, ongoing research that has this social aspect (such
as the body of work by Garbarino and his colleagues) is gaining
in influence. For instance, Polansky, et al. (1985), in seeking
empirical verification for the proposition that neglect was
concentrated not simply among poor but among the most marginal
families, placed these parents in a social context. This is
an ecological approach that demonstrates an interaction between
personal deficits, poverty, and social impoverishment.
In this light, parent education programs aim to address a social
dimension: the parent's isolation, lack of positive supports,
or inability to engage in friendly reciprocity. (See Lovell,
1991 for a good example.) Similarly, programs aimed at reworking
the parent-child dyad, so that competence and self-esteem are
engendered on both sides, tend to take an increasingly comprehensive
view (e.g., the program implications stressed in Bradley and
Akhtar, 1989).
As the brief history above attempted to demonstrate, much of
the family support program was already well formulated a decade
or more ago. For example, Frankel-Howard (1989) cites the Ontario
Association of Social Workers (1983) child abuse handbook recommendations:
"helping parents to have more appropriate expectations
of parenting performance and child behaviour, enhancing
child-parent bonding, emotional ties and communication,
increasing parents' skills in coping with the stresses of
infant and child care;...of caring for a child with special
needs; reducing family isolation and loneliness; increasing
access to...community health, welfare and recreational services;
increasing parental skill at home/child management, and
in interpersonal relationships so they are more satisfying...;
improving living conditions and reducing economic hardship;...providing
or arranging parent-relief programs; arranging day care
services to lessen the pressures of baby or child care."
(p.34)
Nor has there been much controversy about the continuum of
care and the program elements that need to go into a preventative
family support approach. The "Better Beginnings, Better
Futures" prevention program initiative and follow-up study
in Ontario is a guidebook for program development (Ministry
of Community¼ ,1990). Movement towards
a family support approach implies a commitment to very large-scale
service development and major reorganization, not only of child
protection services, but also of broad child and family health
and welfare programs that are key to prevention. It requires
coordinated policy development around education, day care, housing,
and the like.
An unanswered question is whether there is sufficient political
will to consider such large-scale reform seriously (especially
when political resolve is tempered by the broad concern about
budget deficits). 14 At the very least, however, coordination
and policy development initiatives in this direction are evident
in a number of provinces. For example, the federal government
established a Children's Bureau in early 1991 to coordinate
federal policy development interdepartmentally and consult with
provincial and non-governmental counterparts (Health Canada,
1992). New Brunswick created an office for Children's Services
(Minister of State.... N.B., 1991). Quebec, which already had
an intricate social service delivery system at the regional
and local level, is going through another round of reorganization
and coordination (Ministry of Health and Social Services, Quebec,
1990). Ontario is responding to the latest articulation of a
broad family support agenda set out in Children First (Advisory
Committee on Children's Services, 1990) and has assembled a
very broad interministerial. coordinating committee (Interministry
Committee.... Ontario, 1992). British Columbia has various broadly
similar initiatives. The Child and Youth Secretariat brings
together four mandated ministries to focus on child welfare
concerns and to support regional and local planning coordination
somewhat reminiscent of Manitoba or Alberta. The recently announced
regional health boards and community health councils radically
decentralize health care planning and funding in ways that appear
analogous to Quebec (Ministry of Health.... B.C., 1993).
Implications
Recasting the battle against child abuse, neglect, and witness
to violence in terms of a broad family support agenda has many
implications for planning and service development. One of the
most complex, coordination and governance, was flagged above.
Further to that, there is a clear need for government periodically
to assess and to publish "report cards " on the success
with which current coordinating mechanisms are keeping child
abuse issues and the family support agenda front and centre.
Many of the services in the family support agenda (and particularly
the counselling and community development components) have been
developed as small-scale programs or demonstration projects.
It is not yet clear how we gear up from individual projects
to province-wide family support programs. As noted above, one
of the best efforts at developing this kind of information is
the "Better Beginnings, Better Futures" series of
primary prevention demonstration projects targeted at young
children living in economically depressed communities in Ontario
(Ministry of Community..., 1990). It would be useful to promote
discussion at a national level of the experience of trying to
implement such programs. The federal "Brighter Futures"
initiative could provide a vehicle for such discussion.
Canadians are engaged in highly contentious debate as to whether
we can afford universal programs (daycare for example) and,
on the other hand, whether we have the ability to effectively
assess and target those most at risk. Family support programs
can be developed any where along this universal and targeted
continuum; however, most pilot projects have been aimed at "high
risk" populations (for example, see the positions taken
in two evaluations of risk assessment projects in Montreal -
Cournoyer, et al. (1991) on a program for babies and Ethier,
et al., (1991) on one for children at the transition to school).
It is important to provide evaluative information on the logic
of developing particular programs at an inclusive level as opposed
to progressively more targeted levels.
Similarly, there is ongoing debate about the value of a broad
family support agenda and the general question of whether prevention
programs are deficit expenditures or investments in human capital.
Considerable effort has gone into thinking through "cost
effectiveness" arguments. It is important that this information
be regularly reviewed and presented in as accessible a fashion
as possible.
Fiscal concerns also tend to raise arguments against service
"duplication". However, a family support agenda suggests
the value of alternative approaches. If families are not all
identical, then we need to be able to tailor our services. Moreover,
in a pluralist and multicultural society, we should be sensitive
to the need to provide for cultural diversity. Program evaluations
that are funded should aim not merely to assess whether a particular
approach works, but also to focus, in as detailed a way as possible,
on the question of whom it serves well and whom badly.
The logic of a family support approach is to provide integrated,
interdisciplinary services. But this is a real trick to achieve
in practice because of interdisciplinary jealousies and interorganizational
struggles over turf. 15 We need "success stories "
that address not only the nature of the service provided, but
how the project was negotiated and how interorganizational and
interdisciplinary problems were solved.
Supporting Trends: Least Restrictive Measures
The large-scale shift to a family support approach came about
not simply from our concern about family violence, but because
of a confluence of different policy trends. The first (and most
closely related) of these was an ongoing dissatisfaction with
"intrusive" child protection policies. There has been
a tendency (currently being played out in British Columbia)
to rewrite family and child service legislation so that "least
restrictive" measures are mandated (Ministry of Community...,199
1). The push for this has come from an uneasy coalition of interests
across the political spectrum.
Implications
One danger in any swing in policy is that of "over-correction"
in this instance, ignoring the continuing need for a well-resourced
and managed child protection system. Until family support programs
are fully developed and have been functioning for some time,
a significant number of children will still have to be brought
into care and will require good alternative arrangements. Declaring
intensive services (and particularly residential care) "sunset
programs" creates problems of caregiver morale, recruitment,
and turn-over that threaten to further victimize children in
care.
Moreover, policy requiring "least restrictive" alternatives
means that the intensive resources within the service continuum
have to be particularly well prepared and supported. That is
because the bulk of the children they will be serving will be
those for whom in-family care and less intensive resources did
not prove adequate or did not succeed. Even if we try not to
label the children "hard to serve" or "system-resistant"
(inappropriate and unconstructive blaming), it is critical to
acknowledge that they require a very skilled response.
These points underline the need for careful and accurate assessment.
The crux of the matter is to determine what will enable the
family or, if that is not possible at this point, what represents
the least restrictive alternative that will succeed in meeting
the child's needs. There has been considerable development of
assessment systems within child protection and mental health
services. 16 One such tool is currently undergoing an ambitious
test in some Children's Aid Societies in Manitoba and Ontario.
17 Clearly, we should support more research and evaluation of
assessment tools and approaches.
Another focus is on evaluation, virtually every report seems
to recommend more and better research into "what works".
This is a watchword among those preaching fiscal accountability,
who want to shift resources away from programs that have not
demonstrated effectiveness to those that can be shown at least
to be efficient. Evaluation is also on the agenda of service
providers, who want to improve and then "fine-tune"
their programs. Regrettably, however, program evaluation rarely
answers these questions in a definitive fashion. The problem
is that we want quick evidence of results when our analysis
of the problem should suggest to us that a long-term process
is involved. The logic of family support approaches is that
the child's entire life prospects can be improved. Therefore,
there is a need for longitudinal research to under-pin the host
of program evaluations. One initiative in this direction is
the National Longitudinal Survey of Children, proposed under
the "What Works" component of the federal "Brighter
Futures" program. It is important that an advisory group
(of persons with a background in child abuse and neglect research)
work with the survey planners to try to ensure that, insofar
as possible, data are collected that speak to family support
and family violence issues.
Supporting Trends: Focus on Child Poverty
Neglect is strongly associated with poverty. And, even if we
acknowledge that physical abuse is found across the class spectrum,
it is also true that this problem is related to many correlates
of poverty - such as parental stress, isolation, and limited
resources. As noted above, an argument has been made that too
low a priority has been given to fighting poverty. However,
at least at a rhetorical level, that situation has changed.
Various initiatives are attempting to raise "child poverty"
as a national focus for action. One lever (in this regard and
in terms of Native child welfare discussed next) was provided
by the signing of the United Nations Convention on the Rights
of the Child (see Health and Welfare..., 1992).
Child poverty was taken up by a wide range of national NGOs
at a 1991 symposium (and federal lobby). That meeting adopted
positions including:
"Children have a fundamental right to "first
call" on the nation's resources;..."
"A children's agenda must be addressed with comprehensive
solutions within a strong social and economic policy framework,
and not through continued reliance on quick fixes and single-focus
programs; [and]"
The eradication of child and family poverty is a top priority
that must be attacked on all fronts, i.e. labour market
strategies, income support and social services." (National
Symposium..., 1992, p.v.)
This manifesto is being translated in various parts of the
country into "First Call" coalitions.
Even more focused on the task of making child poverty a high
priority issue is the "Campaign 2000" project. It
also brings together a consortium of national NGOs and links
to provincial steering committees representing various child,
family, and poverty advocacy groups.
Similarly, poverty is being identified as a key issue in various
provincial reforms. For example, the recent review of child
welfare legislation in British Columbia (Community Panel¼
,B.C., 1992) stated:
"Poverty is the number one problem facing families,
children, and youth today. The eradication of poverty in
all its forms should be a major focus of government policy
at all levels."
"Poverty is a child welfare issue and when governments
allow children to live in poverty, they are, in effect,
committing systemic child neglect." (p.9)
Implications
The focus on child poverty is itself a tacit recognition of
the difficulty we have as a society in agreeing on how to confront
poverty. Concentrating on children bypasses debate about moral
failings and emphasizes a collective responsibility to protect
our common future. But poor children imply poor families and
the issue begins to broaden again.
Child poverty draws our attention to the family support agenda
and perhaps especially to its macro aspects (taxation, income
policy, housing, education, health).
However, this emphasis is also consistent with the micro level,
that of direct services to help enhance family functioning.
The notion is that if we are willing to expend resources once
the family has failed and children have to be taken into care,
significant amounts should be available to assist families before
they go into crisis. Thus, for example, some very intensive
(and intrusive) programs have been developed along a "family
preservation" model, dedicating weeks of direct service
involvement over a short period to trying to strengthen the
family. In evaluating such programs, it is important to consider
whether families are left materially better off and whether
that improvement is maintained over time.
Supporting Trends: Native Child Welfare
If poverty, marginality, and inadequate supports for parenting
contribute to child neglect and other child abuse issues, it
is not surprising that Natives are heavily over-represented
in the child welfare system. In recent years, allegations of
child sexual abuse, starting in the residential school system
and becoming endemic in many Native communities, have had a
very high profile. But it is "neglect" that has led
to the largest number of removals of Native children and it
is the reaction to the imposition of culturally inappropriate,
insensitive, and destructive child protection policies that
has largely driven the demand for development of Native child
welfare programs.
Native child welfare policy is closely tied to the larger issue
of self-government. However, in many cases it has been targeted
for immediate action, not only because of current system dysfunction,
but also because of its extreme symbolic value, communities
regaining control over their "future". This policy
trend is strongly articulated in the recent Native Committee
report in British Columbia (White and Jacobs, 1992):
"Your present laws empower your Superintendent of Child
and Family Service and your family courts to remove our children
from our Nations, and place them in the care and custody of
others. The first step to righting the wrongs done to us is
to limit the authority to interfere in the lives of our families,
and to provide remedies other than the removal of our children
from our Nations. This must be accompanied by the financial
resources we require to heal the wounds inflicted upon us. At
the same time, the responsibilities and jurisdictions vested
in your Superintendent and the family courts must be vested
in our Nations. Finally, as our Nations assert our own family
laws to meet our contemporary needs, as we rebuild the authority
usurped from our Nations, the laws of our Nations must have
paramouncy over your laws as they apply to our people."
(p.viii)
Implications
Raising the issue of abuse and neglect within Native communities
has underlined the need to develop a whole range of child abuse
prevention programs that are culturally appropriate. That in
turn has focused attention on some directions in native child
welfare that differ from (but also are attractive to) those
in the larger society. One of these is the centrality of community
focused intervention (i.e., the importance of addressing the
whole community rather than working only with individuals or
even individual families). The other is the fairly generic "spiritual"
regeneration approach represented by the "healing circle".
18
Obviously, a great deal of research and evaluation could be
undertaken in this area; this is well beyond the scope of this
paper. However, the ways in which ideas from Native child welfare
are being applied experimentally in mainstream programs is a
fascinating focus for study.
Child Abuse and Neglect Revisited
The argument in this paper is that physical abuse and neglect
had been pushed far down the public agenda by child sexual abuse.
However, once these issues were taken under the umbrella of
family violence, there was new opportunity for attention. A
broad family violence perspective supports the logic of family
support approaches, policies and programs that have long been
touted as fundamental prevention for abuse.
Having said that, it is neither necessary nor desirable to
submerge the topic of physical abuse and neglect entirely. In
fact, it is important to remain aware of the exact nature of
the problems that we are seeking to solve so that we can frame
our policies and evaluate our programs in terms of clear end
goals.
Implications
There is a danger of adopting the family as our "unit
of analysis" and holding to some view of overall family
good at the possible expense of the needs of the children. The
"best interests of the child" is a doctrine that requires
attention in a family support context. It is important to articulate
how children's rights and advocacy can be built into family
support programs.
To help maintain a perspective on child abuse and neglect,
we need periodic up-dates on the best current information and
most interesting new thinking. Ideally, such material should
be available in various forms, to make the information accessible
to a general public, but also to meet the special needs of professionals
in the field on one hand and policy makers on the other. For
example, it would be useful to have an enlarged range of "fact
sheets " available through the National Clearinghouse on
Family Violence - covering aspects of neglect, institutional
violence, emotional abuse, and the like. Similarly, it would
be helpful to review the research and practice literature on
child abuse and neglect and add to the list of available reprints.
And the collection should include a separate emphasis on materials
that evaluate policies and analyze trends.
An Overview of Topically Related Projects Funded
by the Family Violence Prevention Unit
There has not been a special emphasis on physical abuse and
neglect per se in the Public Health Agency of Canada's research or demonstration
project agenda in recent years. Nevertheless, Family Violence Prevention Unit staff identified 21 documents for review
from among their projects of the last half-decade. Brief summaries
of these are included as Appendix I so that readers can judge
some of the scope of that work. Here, we will restrict ourselves
to a few observations that place these reports in context. A
more formal review would not be appropriate because there was
never any intention that these projects should cover the field
or address the range of abuse and neglect issues in depth (although
the variety of training packages supported may represent the
mass required to consider them as a body of work). Note that
some of the reports were also cited above in Part I.
Broadly speaking, these reports fall under five headings:
i) training materials;
ii) literature reviews and analyses;
iii) research studies;
iv) conference proceedings; and
v) program inventories.
Training Materials, Guidebooks, and
Discussions of Standards
The largest number of project reports are in this category.
These include the following numbered reviews in Appendix I:
{3}: Church Council ... (1988), a discussion guide on family
violence for the use of church groups; {7}: Fairholm (1990),
a curriculum for volunteers teaching child abuse prevention
in secondary schools; {8}: Hutchinson (1988), background on
family violence for correctional service workers; {9}: Kinnon
(1988), promoting interdisciplinary activity in ten national
professional associations; {10}: Lovell (1991), a curriculum
for social support training for moms at risk of maltreating
their children; {12}: Morris (1988), a training package for
pastoral care workers; {14}: Nicholas (1989), an introduction
to groupwork for Spanish-speaking lay counsellors; {19}: Subcommittee...(1989),
a guide for setting and monitoring standards of care for medical
institutions responding to child abuse and other family violence;
and {20}: Topley (1991), a manual for transition house workers
leading children's groups.
It often seems that every organization or association wants
to design its own training package and write a new manual. The
scope for nationally funded resource materials, especially if
they can be tied to an umbrella organization or national group
of some kind, is dearly great. The notion is to promote resource
material effectively at a national level and either avoid needless
duplication or provide local groups with parts and models for
their training packages.
Child abuse and neglect were relatively "old" social
problems when this set of materials was written. Indeed, few
of these materials focused on child abuse and neglect alone;
the impetus was to introduce various publics and workers to
the varieties of family violence. In this regard, the major
organizing ideas come from the study of violence against women,
and wife assault in particular. In various instances, this perspective
was quite radical (e.g., addressing "patriarchy" as
an underlying ideological distortion of social relations in
our society). Perhaps more important, however, is the way in
which this broader family violence focus carried information
on child abuse to groups that had not participated before in
extensive sensitization and training on these issues. Another
positive effect was to spread the understanding that children
who witness assault of their mothers or other family violence
are "battered" by that situation.
It is important to monitor and assess the opportunities for
new training initiatives. Along the lines suggested earlier,
for example, it would be useful to support further sensitization
on institutional abuse and abuse prevention and consider a series
of resource materials on how to implement various family support
programs.
Literature Reviews and Analyses
A few of the reports were (or included) broad-ranging analyses
of literature on child abuse:
{1}: Bradley and Akhtar (1989) covered the research on social
information processing deficits in aggressive (and abused) children
and the corresponding literature on parenting approaches that
promote social competence in children; and {11}: Meston (1992),
provided an analysis of the impetus for family support approaches
to prevention and intervention in child abuse and neglect and
a descriptive typology of such programs. 19
Literature reviews, if well focused, can be of great service
to the field in several ways. One is simply to provide a shortcut
to relevant materials and the latest findings for workers (who
tend to be genuinely pressed for time). Better still, this can
be a careful and rigorous appraisal of the studies, something
average readers might not feel competent to do themselves. A
second service the literature review can provide is to generate
a common context for workers in an inherently multi-disciplinary
field where no group's training prepares workers with the whole
range of perspectives they will require. Thirdly, an adventurous
review can bring to bear findings and theoretical perspectives
from outside the immediate field in a way that enriches discussion
and opens up new avenues of dialogue. The best literature reviews
accomplish all of these tasks; some even accomplish this in
a readable fashion.
As the history outlined in part I of this paper suggests, the
topics of child abuse and neglect are prime candidates for periodic
review and up-date: the literature is very diverse, of variable
quality, sometimes technical, crosses many disciplinary boundaries,
is often diffuse and hard to locate, and tends to come in waves.
Research and Demonstration Studies
Four of the reports cover actual studies, evaluations of demonstration
projects, or are exploratory works leading to possible research:
{5}: Cournoyer et al. (1991), an evaluation of a major pilot
project on perinatal service coordination; {6}: Ethier, et al.
(1991), a multidimensional evaluation of abused children, aged
4 to 6, and the development of a method for early identification,
{16}: Péladeau and Tourigny (1991), an analysis of a parent
help-line service, trying to establish who calls and for what
reason; and {21}: Wilson-Nolan (1992), a pre-study on the home
support service worker role in cases where family violence is
an issue and identification of training needs.
The lack of practice-relevant research and evaluation is a
common complaint, and certainly one that has been voiced repeatedly
in the field of child abuse and neglect. While the Family Violence Prevention Unit has not had a funding initiative directed
at child abuse and neglect, other programs within Health Canada
have funded work which integrates well with the diverse studies
noted here. For example, the better half of National Welfare
Grant's child welfare and family support projects compared in
recent reviews (Carignan, 1992; Wachtel, 1993) speak directly
to issues in this paper.
It is important to help research and demonstration projects
remain aware of related initiatives (whether these are funded
under one or diverse programs). Similarly, funders benefit by
coordinating their initiatives so that projects they supported
relate to each other and build up a more significant knowledge
base. That suggests the utility of better databases on funded
projects, consultation among funders about priorities and directions,
and communication strategies that promote interchange among
projects, planners, and policymakers.
Proceedings and Collections of
Papers from Conferences
A number of reports either document conferences or collect
selected papers given at conferences supported in part by Health
Canada. These include:
{2}: Brown (1990), an administrative (process) review of a
provincial conference for transition house staff, {14}: Clarke
Institute... (1989), an outline of papers presented at a symposium
for psychiatrists and mental health workers; {13}: National
Symposium... (1992), the proceedings of a meeting that sought
to build a broad coalition of children's groups; {17}: Roesch
et al (1990), a collection of papers that defined an agenda
for an institute on family violence; and {18}: Sawyer (1988),
the proceedings of an Atlantic provinces conference on health
service standards for child abuse cases.20
At their best, conferences and workshops help create and maintain
a sense of community among participants, define issues and directions,
alert people to ideas and resources, and help establish mandates
for action. Proceedings or collections of papers can bring some
of that to a wider audience, and also serve as a tangible document
of that moment. If every conference deserves some documentation,
only the most timely or successful ones generate truly useful
collections of papers and addresses. Of these reports, {13}:
National Symposium... (1992), Canada's Children - The Priority
for the 90s, is important in the context of this paper, that
is, for defining the current directions for efforts against
child abuse and neglect.
Inventories
Two of the projects are national
inventories of services or programs. These are:
{11}: Meston (1992), on the range of family support programs;
and f 15): Nikolai and Meston (1991), on a broad (and perhaps
diffuse) set of services for street youth.
Inventories are sometimes thought of as referral tools, helping
people identify what services are available in a particular
area and what organizations (or professionals) self-identify
as providing certain specialized services. However, this use
is almost always secondary to other functions inventories perform.
These include: a) providing an overview of the range (and maybe
something of the distribution or spread) of programs; b) by
that means, presenting some ideas and possible lines for follow-up
for planners and service providers; c) helping to define a community
of interest; and d) implicitly offering a critique of programs
simply by juxtaposing them.
For the purposes of this discussion, {11}: Meston (1992), the
inventory of family support programs, is an important work.
In these same terms, {15}: Nikolai and Meston (1991), is marginal
but informative precisely because it appears that few programs
for street youth focus directly on these youths' histories of
abuse or plan interventions in terms of an abuse prevention
and treatment analysis. Perhaps this provides as good a summary
of our task as can be found in this collection of reports. That
is, it remains surprisingly easy for physical abuse and neglect
to fade as issues in our programs. As advocates, we need to
find ways to have every program make explicit how it aims to
improve the situation of our children and youth.
Notes
1. For the pros and cons of this argument, see Wachtel, 1989.
2. For a good brief history, see Wolock and Horowitz, 1984;
much of the argument here follows their excellent analysis.
3. A member of the Child Abuse and Neglect Policy Circle,
Ross Dawson, notes that an emergent sub-category of abuse
and neglect is that of infants born addicted (and possibly
also with fetal alcohol syndrome or drug-related impairments)
because of substance abuse by their mothers. Because the
fetus is not in law a child and therefore cannot be taken
into care, some child protection authorities have tried
to find ways to influence and exert control over the pregnant
woman - a highly contentious issue.
4. For an early realization that even simple lack of emotional
engagement was profoundly damaging to children, see Spitz
(1945).
5. For an illustration of this "pecking order",
see 17): Fairholm (1990).
6. For a good example, see {3}: Church Council...(1988).
7. For example, see {12}: Morris (1988):
"Families consist of people living in intimate relationships,
intended to foster life... The term "family violence"
refers to many kinds of families: extended families, single-parent
families, blended families, as well as the nuclear family.
Some of the dynamics of family violence occur among intimates
who do even identify themselves as family. People living
common-law and people who do not live under one roof can
still suffer violence at the hand of their sexual partner,
parent or child." (p.3)
8. For some examples, see {13}: National Symposium... (1992);
Jaffe et al., 1986; Moore et al., 1990; the article by Pepler
and Moore in {4}: Clarke Institute... (1989); and Wachtel,
1993.
9. Whether poverty has or has not been a serious focus
for action is a contentious point. In the U.S., a "War
on Poverty" was declared by the President in 1964.
In Canada, despite a better developed ."social safety
net", poverty was declared a "cancer on the body
politic" in a landmark Senate report some years later
(Special Senate Committee on Poverty, 1971). The studies
and reports since then would fill a small library and yet
there is still room for disagreement about whether the issue
has been addressed fundamentally at all (e.g., Ross and
Shillington, 1989; Ryerse, 1990; Advisory Group..., 1992)
or, on the contrary, has been much overblown (Sarlo, 1992).
However, the preponderant opinion is that social reform
towards eradicating poverty has not gone very far (Campaign
2000, 1992).
10. For a detailed discussion of this argument, see Wachtel,
1989; and by way of illustration, consider the imbalance
in (31: Church Council... (1988), {16}: Péladeau and Tourigny
(1991), and {17}: Roesch et al. (1990), where discussion
of child sexual abuse predominates, sometimes to the virtual
exclusion of physical abuse and neglect.
11. In British Columbia, for example, an early organization
was Sexual Abuse Victims Anonymous (SAVA), which developed
several chapters on Vancouver Island, and Sexual Assault
Recovery Anonymous (SARA), with groups in the Lower Mainland.
- See supra, note 10.
13. For a sense of this survivor perspective on institutional
care, see the National Youth-in-Care Network's bulletin,
Youth Exchange.
14. One argument is that the planning and service integration
implied by a family support approach is ultimately more
cost-effective.
15. As an indication of how hard cooperation is, consider
the extreme tentativeness of the recommendations in Kinnon
(1988).
16. For example, the Ontario Association of Children's
Mental Health Centres is testing a "standardized client
information system" based on work by Offord and his
associates.
17. See the proposal by Reid, G. and Sigurdson, E. (1991).
18. There is a spiritual aspect in "12-step"
self-help programs (Alcoholics Anonymous being the prototype).
However, the healing circle approach tends not to separate
persons by particular problems".
19. Note as well that, as is customary, the research studies
[in section v] also present some views of the literature.
Sometimes, that is not well enough developed to stand on
its own; this was not the intent in these cases.
20. Note the relationship between this project and {19}:
Subcommittee... (1989).
Appendix I:
Brief Reviews of 20 Family Violence Prevention Unit Funded
Projects Related to Issues of Child Abuse and Neglect
{1} Bradley, E.J. and Akhtar, N. (1989) Social information
Processing Deficits of Aggressive Children and Child-Victims
of Family Aggression: What treatment strategies can we learn
from studying socially competent children and their families?
Halifax: Dalhousie University, Depts. of Psychiatry and Psychology.
This literature review covered a huge swath of studies on the
social information processing deficits of aggressive children.
The authors used Dodge's information processing model of the
steps involved in social problem solving and interaction: encoding;
interpretation; response research and decision, enactment, and
evaluation. The literature (despite various methodological limitations
and lack of studies on girls) clearly demonstrates that aggressive
children (and those with histories of abuse), as a group, exhibit
deficits across this whole spectrum. They do not attend well
or are hyperactive. They tend to assign hostile intentions to
their social partners. They exhibit a narrower repertoire of
problem-solving strategies. They do not follow through well
or evaluate the response to their actions appropriately.
The authors then turn to the research literature on parent
and child interaction and those strategies and styles that encourage
the development of social competence in children. These studies
show that clear direction, reasoning, use of non-violent behavioural
consequences for non-compliance, warmth and emotional reward,
modeling empathy, and allowing emotional expression, all encourage
prosocial behavior. Again, while many of the studies have weaknesses,
as an ensemble, they create a clear picture.
One major gap in the research is how the optimal mix of parenting
strategies might change with the developmental level of the
child.
The argument arising out of this review is that
"...the growing convergence in research findings would
suggest that it is time to attempt to incorporate these
parenting strategies into our treatment programs for aggressive,
abused, and socially unskilled children." (p.115)
By implication, the researchers believe this has not been happening
to any extent. They assess many social skills training programs
for children as unsuccessful because they are overstandardized
("the myth of the single factor solution"), do not
assess the child across the whole spectrum of the social information
processing cycle, and fail to involve key individuals in the
child's environment (teachers, parents). Two established treatment
programs, the Prepare Curriculum and the Yale-New Haven Primary
Prevention Project, are presented as appropriate models.
{2} Brown, B. (1990) "Rapport Administratif du Colloque
Provincial - Pareilles, Pas Pareilles, On S'Appareille - Tenu
à Montréal les 16, 17, et 18 Mars 1990." Montréal: Regroupement
Provincial des Maisons d'Hébergement et de Transition pour Femmes
Victimes de Violence Conjugale, Mai 1990.
As the title suggests, this is a report to funders about the
planning, organization, and costs of a colloquium. for transition
house workers. Health Canada contributed travel subsidies. one
hundred and seventy participants, from 42 transition houses,
attended. The major work-shops covered drug abuse and alcoholism,
mental health, immigrant women, Native women, and (cancelled
at the last minute) disabled women. There was no apparent, explicit
focus on children's issues (e.g., abuse or witness to abuse).
Proceedings were to be published (with provincial funding).
{3} Church Council on Justice and Corrections.
(1988) Family Violence in a Patriarchal Culture: A Challenge
to Our Way of Living. Ottawa: Church Council on Justice and
Corrections and Canadian Council on Social Development
This kit organizes a large variety of material (excerpts, quotes,
illustrations, along with an audiotape of dramatized readings,
a set of slides, and a selection of suggested "worship
experiences") into a study guide for individual or group
use. It includes victim/survivor experiences, the thoughts of
analysts, social commentators and feminist Christian theologians.
The collage is meant to foster reanalysis, break down the tendency
to distance the issues by treating violence in abstract terms.
This document arose out of reaction to the Badgley Report on
child sexual abuse. While the issues raised in that research
report were compelling, members of the Church Council on Justice
and Corrections
"...were convinced that some of the Report's recommendations,
if implemented, would "prevent good prevention",
and would discourage many victims from seeking help. From
our analysis, this problem can not be addressed in any effective
way as long as society relies on the criminal justice system
to solve it...
The issues around family violence reveal the limitations
of our usual "alternatives to the criminal justice
system". We are not dealing with something that can
easily be mediated away, it brings us face to face with
deeper spiritual dilemmas..."(p.4)
The relatively radical focus is on patriarchy as a "social
sin" and its relationship with sexuality, violence, roles
in the family, the criminal justice system and the church. In
all this, physical abuse gets at least peripheral attention,
neglect barely any at all. Child sexual abuse, sexual assault,
and wife assault are much more prominent.
{14} Clarke Institute of Psychiatry. (1989) Challenge and Change
in Childhood Psychopathology - Abstracts of Conference Sessions.
Interim report of the conference held in Toronto, Nov. 17-18,
1988.
This conference dealt with a number of emergent issues: the
effects of divorce and remarriage on children, autism - etiology
and assessment; gender identity development; play in childhood
psychopathology; autism - effects on the family; language and
communication disorder; brain behaviour relationships; and (the
session that was the subject of the Health Canada support) child
sexual abuse and family violence. Related to the latter was
a keynote address by David Finkelhor on "Recent Findings
on Child Sexual Abuse Epidemiology and Treatment".
One family violence paper was by Pepler, D.J. and Moore, T.E.
(1988) "The Impact of Witnessing Domestic Violence on Children's
Adjustment: A Preliminary Analysis". It found a significant
minority of children at transition houses were very disturbed.
{5} Cournoyer, M., et al. (1991) Le système de référence post-natale:
évaluation du projet-pilote réalisé avec huit établissements
de santé et de services sociaux du Montréal métropolitain (06-A).
Montréal Comité régional Famille-Enfance.
This is a carefully documented, multi-year pilot project evaluation
concerning the development and implementation of a coordinated
service referral system for parents and newborns in eight health
and social service centres in Montreal. The origin of the project
was an inquest in 1985 into the death of an infant due to parental
neglect; it recommended better information sharing among service
providers in order to support families during the perinatal
period.
Investigation revealed that shorter hospital stays made parental
teaching and assessment more difficult for nurses; that the
mother, not the family was the focus; that not all families
were visited by a community health nurse; that there was no
system in place to priorize home visits; and that social service
staff were so stretched that they might not seek any connection
with the family. The pilot project sought to establish a standardized
comprehensive assessment form and the basis for deciding which
cases to refer and what priority to assign them, and to pass
on that information to initiate home visits and other referrals.
While the system appeared to improve in the pilot project, all
the initial barriers were noted as continuing limitations.
{6} Éthier, L., et al. (1991) Évaluation multi-dimensionnelle
des enfants victimes de negligence et de violence. Trois-Rivières:
Groupe de Recherche En Développement de l’Enfant (GREDE),
UQàTR.
This is the final report of a multi-year project funded by
Health Canada. The project sought to describe the social and
psychological profiles of children, aged 4 to 6, at risk of
physical abuse or neglect, and characterize their family milieu
(in terms of parental stress factors, their own abuse (and attachment)
histories, and their expectations and perceptions of their children).
It also experimented with a projective test that might be used
in pre-schools and schools for the early detection of children
at risk.
The authors note that, if the overall numbers of abuse reports
have increased markedly during the 1980s in Quebec, the numbers
involving severe violence have not (a general trend in North
America). Seventy-five percent of abuse cases involve neglect.
They argue for the importance of looking carefully at neglect
and physical abuse.
A sample of 41 maltreated children was drawn: 14 victims of
neglect, 7 of physical abuse, and 20 of both. A control group
(matched to age, sex, socioeconomic status, and family structure)
was used; various efforts were made to screen out any that might
have been abused. A battery of tests and questionnaires provided
the main data. The children, parents, and teachers each had
separate sets of tests.
The projective test involved asking the child to talk about
ten drawings of a child (a girl for girls; a boy for boys) in
some situation with an adult or parent (six involving a female,
four a male). The situations were chosen to allow for abuse
problematic interpretations: refusal to obey, aggressive behavior;
bed-wetting; playing with forbidden objects; mealtimes; toileting;
sleeping. A trial (in which the scoring was done blind) differentiated
abused from non-abused children in 80% of the cases. Abused
children see parents as much more hostile, rejecting and punitive
and see themselves as more misbehaving.
The tests showed systematic deficits among the maltreated children
as a group but few clear differences between abused versus neglected
groupings. Their mothers were more likely to have a history
of physical abuse (or family violence), a smaller, less varied
social support network, and very significantly greater stress
across all dimensions. The service implication of these findings
is long-term family support programs and stronger general anti-poverty
measures.
{7} Fairholm, J. (1990) Child Abuse Prevention Program for
Adolescents. Vancouver: Canadian Red Cross Society.
This is a sourcebook for volunteers in the Society's Child
Abuse Prevention Program for Adolescents. That program involves
class presentations in secondary schools covering the whole
range of abuse as experienced by teenagers (more recently the
program has included a major emphasis on date rape).
As a broad abuse prevention program, a universal stance is
evident:
"Children of all ages are maltreated. Caregivers in
all social, economic, racial and ethnic communities abuse
their youth. All families and children are at risk. There
is no single cause or easily "abusive" personality"
(p.i)
The sourcebook is carefully reasoned and unusually complete.
Each topic section is referenced and also supported by brief
quotes from abused teens. The author tries to focus on those
aspects of abuse that are particular to adolescence (e.g., special
risk of psychological and sexual abuse for teenaged girls);
however, this proves difficult because the research base is
thin.
The chapter on emotional abuse begins: "Emotional maltreatment
is the cornerstone of abuse and neglect. It is the core, the
inner trauma of all the hurts." (p.93) Consistent with
that perspective, this discussion precedes that on the other
categories of abuse.
The chapter on physical abuse and neglect defines each, discusses
incidence and prevalence, and impacts. The statements on neglect
are very compressed. The relationship to poverty and marginality
is mentioned.
"The actual incidence of physical neglect is unknown.
Severe neglect is easily recognizable, but low grade, smoldering,
ongoing neglect is difficult to diagnose. Poverty, cultural
values and parental capacity are all factors to be considered."
(p. 115)
However, the linkage between abuse and strains and dysfunctions
in the family is discussed at some length. Abusive parents are
likely to have: inappropriate expectations of children, impaired
parent-child attachments, erroneous understanding of discipline,
lack of support systems, and various chronic and precipitating
stresses (poverty, unemployment, substance abuse, etc.).
The second, much briefer part is a manual on how to prepare
the in-class presentations, monitor the effectiveness of the
communication, and handle disclosures if these occur.
{8} Hutchinson, B. (1988) Breaking the Cycle of family Violence:
A Resource Handbook prepared for the staff of Correctional Service
Canada. Ottawa: Correctional Service Canada.
An excellent handbook, thoughtful, clear, and pragmatic. It
begins with a rationale for Correctional Service involvement
in this issue. The rationale stresses that a significant proportion
of the correctional client population are family violence victims,
abusers, or both, that preventing family violence will require
attention to perpetrators, and that staff have a mandate to
work with perpetrators both to protect the public and to prepare
offenders for successful re-integration.
The main sections cover: "understanding family violence";
characteristics (and range) of abusers; service needs of abusers,
family members, and workers; and what is available in terms
of programs and services. The last section indicates a careful
and realistic perspective. It includes brief discussions of
when abusers seem most amenable to treatment, what assumptions
underlie treatment approaches, what are the components of an
effective program, what is not recommended, and how to work
within the limitations posed by uneven or non-existent community
resources.
Although the discussion covers child abuse (mainly physical
abuse) and touches on intrafamilial sexual abuse, it is inherently
patterned on dealing with wife assault. That reflects a service
reality, but also limits its importance in our particular context.
{9} Kinnon, D. (1988) The Other Side of the Mountain: Working
Together on Domestic Violence Issues. Report 1. Summary of Findings
and Conclusions. Ottawa: Interdisciplinary Project on Domestic
Violence.
Ten national professional associations were co-sponsors of
this project. The first phase involved a definition and better
understanding of interdisciplinary cooperation, a description
of present practices, and 13 broad recommendations about changes
and supports to professionals in providing interdisciplinary
service.
The report notes that:
"Although many professionals have embarked upon ambitious
and sophisticated programs to build cooperative approaches,
the majority are still untouched by the development of interdisciplinary
methods." (p. 15)
The cautious tone of the project was well reflected in the
final recommendation:
"To be most effective, national and provincial/ territorial
initiatives to promote interdisciplinarity should be facilitative
rather than directive in nature". (p.2)
{10} Lovell, M.L. (1991) The Friendship Group: Learning the
Skills to Create Social Support. A Manual for Group Leaders.
Vancouver: University of British Columbia, School of Social
Work.
This manual was designed for professionals working with parents
of children at high risk for abuse and neglect. it presents
a formal skill-training curriculum taught in a weekly group
meeting ("The Friendship Group") over 16 sessions.
The course was meant for persons (single-parent mothers in the
first instance) who lacked basic social skills and therefore
experienced isolation. Many of those parents had a history of
destructive friendships and relationships or at least an unfavorable
balance between supportive and negative social contacts. Their
lack of personal supports arguably increased the risk of child
maltreatment.
The course was built around a sort of board game metaphor,
with a "relationship roadmap" that ran from the relatively
populous Acquaintanceville through progressively more intimate
Buddyborough, Friendly City, and Personal Friendsville to Partnersburg
(population 1). Using this game imagery, the manual for group
leaders covered the nature and stages of relationships, communication
skills, and access to community resources for network development.
Attention was given to helping participants determine whether
a relationship seemed safe (or was exploitative or threatening).
The approach was low-key, collaborative rather than competitive,
and, as much as possible, humorous, to make learning a rewarding
experience.
This short formal intervention was seen only as a beginning.
Members were encouraged to develop plans for further work during
the last month of the group. Participants were recognized in
a formal "graduation" ceremony. Beyond that, follow-up
was offered on an individual basis to support ongoing personal
social network change.
{11} Meston, J. (1992) Child Abuse and Neglect Prevention Programs:
An Overview of Trends in Canada. Ottawa: Vanier Institute of
the Family, for the Family Violence Prevention Unit, Health
and Welfare Canada.
This ambitious report reviews the literature on child abuse
and child abuse prevention programming as a preamble to a large
descriptive survey of child abuse and neglect prevention programs
across Canada. The author characterizes the range of programs
in terms of the following typology:
1. strengthening the supports to family functioning provided
by neighbourhoods and communities;
2. services intended to improve... healthy patterns of
fan-lily interaction,
3. services to complement the functional capabilities of
families identified as particularly at risk;
4. assisting families through particular transitional stages;
5. assisting families or family members with special needs
or special problems;
6. assisting children and youth to address issues that...
might lead them to become abusive, that reduce their potential
for being abused.
Various implicit and explicit program recommendations are drawn
from these descriptions.
{12} Morris, R. (1988) Ending Violence in Families: A Training
Program for Pastoral Care Workers. Toronto: United Church of
Canada.
An inter-church group, Ecumenical Family Ministries, commissioned
this training package for volunteer and professional pastoral
care workers. It adopts a very wide definition of the family
and acknowledges:
"At times Christian churches have contributed to the
silencing of victims of family violence. The churches have
perpetuated attitudes and beliefs that have helped justify
the patterns of violence within families. In our ministries
we have failed to attend to the needs of victims of violence,
putting other concerns before their health, safety and well-being.
In confessing these failures, we commit ourselves to becoming
agents of social change." (p.3)
The manual starts with a chapter on theological reflections
on violence in families. It notes that violence within the family
is acknowledged throughout the Bible. And with regard to child
abuse and neglect, "we do know that people who are actively
involved in religion have a greater than average adherence to
the kind of rigid, authoritative beliefs that are typical of
abusive parents". (p.7) It cites scripture in support of
a pro-child position.
Successive chapters deal with wife assault, child abuse, and
elder abuse. The child abuse chapter touches on neglect, physical
abuse, emotional abuse, and sexual abuse, defining each, listing
indicators, indicating the obligation to report, and discussing
some additional support that can be offered.
Note that neglect is seen as tied to poverty and marginality
in many cases but not in all; it is explicitly stated as occurring
in all classes and among educated parents.
The manual ends with a discussion of three new forms of ministry
that should be adopted: information and referral, ombudsman/woman,
and advocacy.
{13} National Symposium Steering Committee...
(1992) Canada's Children - The Priority for the 90s. Ottawa:
Final Proceedings of the National Symposium on Canada's Children,
October 27-30, 1991.
The symposium was co-sponsored by the Child Welfare League
of America/Canada, CEYJ, the Children's Aid Society of Metropolitan
Toronto, the Canadian Public Health Association, and a score
of others on the steering committee.
It reached consensus on major points:
"Children have a fundamental "first call"
on the nation's resources;
Canadians have a collective responsibility to ensure a
healthy economic and social environment for all children...;
A children's agenda must be addressed with comprehensive
solutions within a strong social and economic policy framework,
and not through continued reliance on quick fixes and single-focus
programs;
The eradication of child and family poverty is a top priority
that must be attacked on all fronts..." (p.V)
It is a breezy, journalistic-style summary.
Delegates endorsed better coordination and integration of services,
more sophisticated assessment of risks, national standards,
effective information systems, research and evaluation.
{14} Nicholas, L. (1989) Amor Sin Violencia (Love Without Violence):
A Manual for Spanish Speaking Lay Counsellors and Group Leaders.
Vancouver: Family Services of Greater Vancouver.
This manual was designed to introduce issues of family violence
(especially wife assault) to Spanish-speaking lay counsellors
who might be planning therapy groups. It has sections on working
with children (who have witnessed family violence), women (who
have been assaulted), and men (who are abusive). The author
sketches a sample curriculum for each and includes certain sample
materials: a booklet from Seattle for children on domestic violence,
"Something is Wrong at My House"; a "bill of
rights" for assaulted women; and a chart on using "I"
- messages in the men's groups.
It advises lay therapists to learn empathy by imagining what
it is like to risk coming to such groups as a participant or
to take therapy themselves.
It also includes a brief discussion of the social and cultural
aspects of Latin American societies that permit, promote, or
complicate family violence. The author notes that it is not
true that
"Latin or South American cultures necessarily require
special focus in terms of domestic violence. The cultures
referred to here are no more or less predisposed to it than
are other cultures. It must always be remembered that Canadian
society also has a tremendous domestic abuse problem..."
(p.1)
However, the subsequent description does outline many problematic
issues for therapy (the sacrosanct family circle, the importance
of men being able to control women and children within their
family, the sexual double standard, ostracizing of women who
leave an abusive relationship, etc.).
{15} Nikolai, D. and Meston, J. (1991) Services to Street Youth:
A Directory of Services for Street Youth in Canada. Edmonton:
Association for Youth in Care.
The National Committee on Street Youth sent a questionnaire
to 1,000 youth-serving agencies across Canada. This directory
compiled program information from the 300 responses. The listing
is by province and municipality. For each program, information
includes a contact person, address and telephone and fax, hours
of service, target populations served and age range, brief description,
and a set of service codes. While many street youth have a history
of abuse or neglect, this directory does not focus specifically
on that. Rather, programs may be responding to attendant problems,
such as substance abuse, poor life skills, low self-esteem,
etc.
{16} Péladeau, N. and Tourigny, M. (1991) Rapport statistique
annuel concernant les appels reçus au centre d'écoute téléphonique
pour parents en difficulté (CET) entre le mois d'avril 1990
et mars 1991. Montréal: Parents Anonymes.
Parents Anonymes is a help-line service for parents in difficulty
that covers all of Quebec and part of Ontario. It is staffed
from 9 a.m. to 9 p.m. weekdays and until 5 p.m. on weekends.
Through it, various referrals are made, including to Parentaide
self-help groups (in just over 20% of all calls).
This research project analyzes one fiscal year's calls received
(N=7711). It documents some seasonal effects (fewer calls during
the summer, more in the fall), weekly patterns (more calls in
the first three days of the week, little usage over the weekend),
and daily patterns (more calls in the morning, fewer over meals).
It shows most usage is by parents, and predominantly mothers,
who raise problems of parent-child relations. In 44% of these,
there is a conflict, in 5% some issue of aggression, and in
just over 9% some abuse (6.1 % is about physical abuse, 3.0%
is about sexual abuse, and 0.2% about neglect). Many further
breakdowns of calls by caller, content, type of referral, etc.
are discussed and also displayed in figures and tables. This
research was designed to improve service and training provided
to the volunteer operators.
{17} Roesch, R., et al., eds. (1990) Family Violence:
Perspectives on Treatment, Research, and Policy. Vancouver:
British Columbia Institute on Family Violence.
This is a collection of presentations at what was, in effect,
the inaugural conference of the British Columbia Institute on
Family Violence in 1989. The conference aimed to give a broad
overview of the three major areas of family violence (child
abuse, spousal assault, and elder abuse) and recognize their
interconnections. In fact, the child abuse section was entitled
"sexual abuse" and only one paper focused to some
extent on physical abuse and neglect. Even that paper, "Chesterfield
House: A Community Program for the Prevention and Treatment
of Child Abuse and Neglect" by M. Dawson, talked a good
deal about how the program had recently shifted to deal with
an influx of referrals of sexually abused children and their
(non-abusive) mothers, many of whom were themselves abuse survivors.
Chesterfield House's core program was an intensive day program
for mothers and children, augmented by a mother's support group
session while the children nap after lunch, and a volunteer
program that provided the generally isolated mothers with non-threatening
emotional support.
{18} Sawyer, E., ed. (1988) Atlantic Regional Workshop on Sexual,
Physical, and Emotional Abuse, Assault and Neglect. Proceedings
of the Atlantic Regional Workshop, Halifax Infirmary Hospital,
Halifax. Ottawa: National Welfare Grants.
"This project provided funding for a two-day work-shop
to provide...input to the development of national guidelines
for the care being given by health institutions in response
to sexual and physical abuse...The goal of the workshop
was to hear directly from existing programs and service
providers who have a particular concern about how the immediate
need for augmented services for child sexual abuse could
be integrated into such programs.
There were 49 participants in total... The participants
each presented their organization's approach toward the
topics of child abuse, sexual assault of children, adolescents
and adults, and abuse of the physically and mentally frail."
(From the abstract; emphasis added)
The first section of the report deals with hospital protocols
in child physical abuse cases - using Janeway Child Health Centre
in St. John's as the example. The discussion touched on a lot
of thorny issues from a hospital's perspective - feedback between
departments, confidentiality (especially in a small community),
conservative recording on the health file versus the possible
forensic needs, responsibility for follow-up care, problems
of staff burnout. A multi-disciplinary team approach can help
with some of this; some predisposed staff become expert over
time. Ideally, they will also have strong linkages with other
professionals and other parts of the community (e.g., family
doctors).
In fact, this presentation and discussion were largely paralleled
in the child sexual abuse presentation (using the I.W. Killam
Hospital for Children in Halifax as the example), but with dearer
recommendations in terms of supports required in child sexual
abuse cases.
{19} Subcommittee on Institutional Program
Guidelines. (1989) Guidelines for Establishing Standards: Health
Care Related to Abuse, Assault, Neglect and Family Violence.
Ottawa: Health Services Directorate, Health Canada on behalf
of the Federal and Provincial Advisory Committee on Institutional
and Medical Services.
This set of guidelines was developed by an expert working group
from across Canada - involving professionals from various fields
of medicine, nursing, medical and community social work, and
administration. One of the contributing task groups concentrated
on child abuse. The focus is on the elements of successful programs.
It was recognized that the problems are multi-factorial and
have no real medical treatment or "cure". At the same
time, however, medical facilities are involved in various ways,
often playing complex roles involving support, investigation,
and assurance of safety, and have an obligation to take a dear
position against violence. Increasingly, medical professionals
need to work as part of an inter-disciplinary team and in community
collaboration.
The chapter on child abuse defines physical abuse, sexual abuse,
emotional abuse, neglect, and substantial risk of these. It
advocates creation of an inter-disciplinary child abuse committee
to identify, assess, plan, and review cases. Reporting, protocols
(a sample set is included), and record keeping for medical and
forensic purposes are covered. Support for parenting programs,
self-help groups, respite programs, public education, etc. is
suggested.
{20} Topley, M. (1991) How to Develop a Group Activity Program
for Children in Transition Homes and Shelters: A Self-Study
Manual. Winnipeg: YM-YWCA.
This manual sketches the impact of domestic violence on children,
including observable behaviors: anxiety, acting-out, and depression
(including a checklist for suicide symptoms).
The author sets out, in textbook style (complete with end of
chapter review sections and study guides), the use of play in
group activities, how to design a group activity, how to plan,
implement, and evaluate the activities, how to act as a facilitator
(whether to have co-facilitators, how to handle problem behaviours
aggression, non-compliance, attention-seeking), and how to engage
the mothers in the process. Various group activities are illustrated,
mostly taken from various [U.S.] source materials.
Topley also devotes a chapter to creation of an on-going support
group (either in the Transition House or in a more neutral location).
Commonalities and differences between this therapeutic group
and the skill-oriented group activity program are noted.
{21} Wilson-Nolan, B.E. (1992) Canadian Child and Family Home
Support Services: Responding to Family Violence. (Summary) Home
Support Canada with CEJY.
This is a survey to investigate the role of home support services
in family violence. Specifically, it was designed to see whether
there was a need for worker training in how to deal with family
violence. The principal questions were: 1) how frequently are
home support services being used in cases of family violence?
2) are the services being used effectively? 3) what, if any,
changes need to be made in the way home services are being used
in these cases? and 4) do home support workers need additional
training to respond appropriately to family violence? If indications
were positive, the second phase of the project would be to design
a curriculum.
They used four data sources: a) eight focus groups with HSWs
from four provinces; b) focus groups with child services workers;
c) surveys with managers of home support service agencies (N=79;
a 48% response rate) and managers in the child service sector
(N=72; A 33% response); d) a HSW feedback group of one worker
from each province to continent on the manager perspectives.
The focus groups indicated that abuse was often an issue (but
not always indicated as such). Sometimes their relatively non-threatening
and supportive position makes HSWs a likely candidate for abuse
disclosure. HSWs lacked the training to respond appropriately
and act as a useful referral resource.
HSWs worried about leaving children in risky situations at
the end of the day.
HSWs were unhappy about not knowing the eventual outcome of
cases.
HSWs were conflicted about "spying" on the family
and reporting abuse.
Child services staff worried that HSWs were being asked to
perform tasks that demanded CSW training, that many were in
a situation where they could become overinvolved with the families,
and that some HSWs were at risk of reliving their own abuse
history (and reacting inappropriately) by being sent into families
with similar dynamics. Better training and more careful worker
matching were advocated.
HS managers ranked the HSW tasks: housekeeping, child care,
teaching, physical care, substitute parenting, monitoring, assessment,
and protection. CSS managers responded quite differently. The
HSW feedback group perceptions matched the CSS managers - ranking
housekeeping very near the bottom among their duties. Similarly,
many HS managers did not feel that their workers encountered
family violence in any large proportion of their cases.
On average, perhaps one case in four that involves family violence
is assigned a FSW.
Managers in both sectors felt that HSWs made a considerable
impact in family violence cases. The HSW feedback group felt
that HSWs had negligible success. This difference in viewpoint
was apparently one of level: managers considered case-by-case
success, HSWs considered the issue systemically.
There was extreme variation in the amount of HSW training that
managers reported providing, and, in parallel, what they thought
was required. From 1/4 to 1/3 included some training in family
violence issues either in-house, from community experts, in
community colleges, or some combination.
in-house
30
7 6
5
experts 21 7 9 college
Very few respondents felt that HSWs were adequately trained
in this respect.
Thirty-three percent of HSWs indicated their agency had no
worker safety protocols about how to handle violence.
The HS managers ranked the most important supports for HSWs
as more training, quality supervision, better prior briefing,
better communication with CSS, increased agency support, higher
wages, more input into case management, more varied caseloads,
and knowledge of case outcomes (least). The HSW feedback group
chose higher wages (#6) and knowledge of case outcomes (#10)
as their top two.
Managers endorsed all topics suggested for the training package
and also wanted the agency to develop guidelines for the use
of HSWs in family violence cases.
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{n} Family Violence Prevention Unit-funded project
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{3} Church Council on Justice and Corrections. (1988) Family
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{6} Éthier, L., et al. (1991) Évaluation multi-dimensionnelle
des enfants victimes de négligence et de violence.Trois-Rivières:
Groupe de Recherche En Developpement de l'Enfant (GREDE), UQaTR.
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{7} Fairholm, J. (1990) Child Abuse Prevention Program for
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