Bette L. Bottoms, PhD, has been arguing for years that psychologists should play a greater role in the world of child maltreatment, a field dominated by social workers and police officers.
"We believe that the best practices grow from the best research," says Bottoms, past-president of the Section on Child Maltreatment of APA's Div. 37 (Child, Youth and Family Services) and an associate professor of psychology at the University of Illinois at Chicago. "We want to reach out and help all practitioners in this field understand the research and use the results of that research in their own practices."
Now her wish has come true. For the first time ever, the Div. 37 section was actively involved in planning the annual National Conference on Child Abuse and Neglect sponsored by the Office on Child Abuse and Neglect of the Administration on Children, Youth and Families at the U.S. Department of Health and Human Services. Also involved--offering recommendations for speakers, workshops and abstract reviewers--were APA Divs. 43 (Family), 16 (School), 53 (Society of Clinical Child and Adolescent Psychology) and 54 (Society of Pediatric Psychology).
APA cosponsored the event, "Gateways to Prevention: the 14th National Conference on Child Abuse and Neglect," held in St. Louis, March 31-April 5.
A spotlight on research
With APA's Public Interest Directorate acting as a liaison, members of the Section on Child Maltreatment worked with the Office on Child Abuse and Neglect to suggest topics and speakers for the conference. They also helped review submitted proposals. Their goal was very specific--to increase the research-based offerings at the conference.
"Child protective service administrators and front-line workers really need to be informed about the latest research," says section member and Past-president Gail Goodman, PhD, a psychology professor and director of the Center on Social Sciences and the Law at the University of California, Davis. "And psychologists and the science of psychology have a huge amount to offer to child-abuse work."
Take Byron Egeland, PhD, who offered an overview of child-abuse research in a kick-off plenary session. Based on findings from his own 28-year longitudinal study of high-risk children and their families, Egeland is convinced that prevention efforts involving home visitation that emphasize parent education are not successful. The goal or focus of such programs, particularly for parents who were abused as children, is to enhance the quality of the parent-child relationship and revise parents' beliefs and expectations about the relationships.
"You can lecture parents about how to discipline their children, but it's not really effective," says Egeland, the Irving B. Harris Professor of Child Development and co-director of the Irving B. Harris Training Center for Infant and Toddler Development at the University of Minnesota in Minneapolis. "And there's a good reason for that: Parents enter these programs with a set of beliefs, and you've got to focus on those expectations if you expect to make changes in how parents relate to their kids."
Psychologists at the conference also shared innovative prevention efforts grounded in empirical evidence rather than the conventional wisdom.
Georganna Sedlar, PhD, for instance, described work she and colleagues are doing with an intervention called parent-child interaction therapy. The team's National Institute of Mental Health-funded research found the program to be effective in reducing children's behavioral problems and parents' stress in physically abusive families.
Aimed at families of children with disruptive behaviors, the approach transforms the therapist into a coach. The therapist watches parent-child interactions through a one-way mirror and offers the parent suggestions and encouragement via a special device the parent wears in one ear. This approach contrasts with the typical approach, in which a therapist sees the parent and child separately, and a week can go by before the parent gets any feedback.
"I'm a big believer in empirically supported treatments," says Sedlar, a clinical specialist at the Child and Adolescent Abuse, Resource, Evaluation and Diagnostic Treatment Center at the University of California, Davis. "Especially in this age of funding limitations and budget cuts, it's our professional obligation to provide our patients with treatments that have data behind them."
A comprehensive approach
Other psychologists described interventions that focus not on individual families but on entire communities.
Robert Margolies, PhD, a school psychologist in the New Haven, Conn., public school system, discussed his ongoing research on school-based prevention. For the last four years, Margolies has been piloting a program that puts the school at the center of abuse-prevention efforts.
Currently in two schools, the comprehensive program he has developed targets practically everyone who comes in contact with schools. Children receive training in victimization prevention, dating safety, parenting and other skills, depending on their ages. Parents come in for ice cream socials and other events that include prevention information and go home with brochures that guide them through abuse-prevention conversations with their children. Teachers get in-depth training on identifying and reporting suspected abuse, while a child-safety committee serves as a resource for teachers.
"When it comes to prevention programs, most school districts offer something, but rarely or never is there a comprehensive approach," says Margolies, who also has a private practice. "The research shows that you need high levels of repetition and a comprehensive program that addresses the issue from a lot of angles if you're going to be effective."
Rebecca A. Clay is a writer in Washington, D.C.