A Guide for Including Information on Child Abuse and Neglect in Graduate and Professional Education and Training
Section I: A Graduate Course on Child Abuse and Neglect
Section II: Specialized Training for Clinical, Counseling, and School Psychologists
Section III: Basic Materials on Child Abuse and Neglect
Definitional Issues.
Although several attempts have been made to develop definitions for the various forms of child abuse and neglect, debate in this area continues. There is consensus about the abusive nature of some acts (beating a child with a board, having sexual intercourse with a young child), but lack of consensus about other acts (spanking a child with one's hand, bathing a 9-year-old child). It is important for students to know about the variety of definitions that currently exist and the factors that have been used for arriving at the definitions. Discussions of the impediments to developing generally accepted definitions can help students understand the difficulties of arriving at clear definitions of many important psychological, legal, and public policy issues.
Berkowitz, C. D. (1995). Pediatric abuse. New patterns of injury. Emergency Medicine Clinics of North America, 13, 321-341.Dubowitz, H., Black, M., Starr, R., & Zuravin, S. (1993). A conceptual definition of child neglect. Criminal Justice and Behavior, 20(1), 8-26.
Giovannoni, J. (1989). Definitional issues in child maltreatment. In D. Cicchetti & V. Carlson (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 3-37). New York: Cambridge University Press.
Hart, S. N., & Brassard, M. R. (1991). Psychological maltreatment: Progress achieved. Development and Psychopathology, 3(1), 61-70.
McGee, R. A., & Wolfe, D. A. (1991). Psychological maltreatment: Toward an operational definition. Development and Psychopathology, 3, 3-18. (Following this
target article, there are 12 responses from other authors and a reply from McGee and Wolfe)Meadow, R. (1995). What is, and what is not, 'Munchausen syndrome by proxy'?. Archives of Disease in Childhood, 72, 534-538.
O'Hagan, K. P. (1995). Emotional and psychological abuse: Problems of definition. Child Abuse & Neglect, 19, 449-461.
Zuravin, S. J. (1991). Research definitions of child physical abuse and neglect: Current problems. In R. J. Starr & D. A. Wolfe (Eds.), The effects of child abuse and neglect: Issues and research. New York: Guilford.
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The Prevalence of Child Abuse and Neglect.
Even the most conservative estimates of the prevalence of child abuse and neglect show that it is a significant public health problem. Describing the prevalence research will demonstrate to students the significance of the problem of child abuse and neglect. Comparing prevalence estimates based on different sources (e.g., reported cases, community surveys) will provide interesting examples of how sample selection can influence research results. Furthermore, discussing the influence of differences in the definitions of abuse and neglect used by various researchers will reinforce the importance of defining abuse and neglect clearly.
Cappelleri, J. C., Eckenrode, J., & Powers, J. L. (1993). The epidemiology of child abuse: Findings from the Second National Incidence and Prevalence Study of Child Abuse and Neglect. American Journal of Public Health, 83(11), 1622-1624.Finkelhor, D. (1994). Current information on the scope and nature of child sexual abuse. The Future of Children, 4(2), 31-53. (Available from the David
and Lucille Packard Foundation, 300 Second Street, Suite 102, Los Altos, CA, 94022)Haugaard, J. J. (1992). Epidemiology and family violence involving children. In R. Ammerman & M. Hersen (Eds.), Assessment of family violence: A clinical and legal sourcebook (pp. 89-107). New York: Wiley.
National Center on Child Abuse and Neglect. (1995). Child maltreatment 1993: Reports from the states to the National Center on Child Abuse and Neglect. Washington, DC: Author.
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The Consequences of Child Abuse and Neglect.
Abuse and neglect have been shown to have significant physical and psychological consequences. In addition, abuse and neglect influence children's attachment to their parents and relationships with their peers. Some research suggests that the consequences of abuse and neglect can last throughout a person's life. On the other hand, research also shows that some abused and neglected children show few if any indications of the adverse consequences seen in other children. Aside from helping students understand the range of consequences of abuse and neglect, discussions in this area can be used to illustrate a variety of theories about personality and behavioral development (e.g., how abuse might influence the development of an insecure attachment style, why abused children might be more prone to experiencing abusive relationships in their adult lives) and of resilience and vulnerability (e.g., why some children might appear less influenced by their abuse than others). Methodological issues, such as why results from research with clinical samples can differ from results from research with nonclinical samples, can also be explored.
Aber, J., Allen, J., Carlson, V., & Cicchetti, D. (1989). The effects of maltreatment on development during early childhood: Recent studies and their theoretical, clinical, and policy implications. In D. Cicchetti & V. Carlson (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 579-619). New York: Cambridge
University Press.Beitchman, J. H., Zucker, K. J., Hood, J. E., daCosta, G. A., Akman, D., & Cassavia, E. (1992). A review of the long-term effects of child sexual abuse. Child Abuse and Neglect, 16(1), 101-118.
Crittenden, P. M., & Ainsworth, M. D. S. (1989). Child maltreatment and attachment theory. In D. Cicchetti & V. Carlson (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 432-463). New York: Cambridge University Press.
Kendall-Tackett, K., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychological Bulletin, 113(1), 164-180.
Malinosky-Rummell, R., & Hansen, D. J. (1993). Long-term consequences of childhood physical abuse. Psychological Bulletin, 114(1), 68-79.
Polusny, M. A., & Follette, V. M. (1995). Long-term correlates of child sexual abuse: Theory and review of the empirical literature. Applied & Preventive Psychology, 4, 143.
Spaccarelli, S. (1994). Stress, appraisal, and coping in child sexual abuse: A theoretical and empirical review. Psychological Bulletin, 116(2), 340-362.
Starr, R.H., & Wolfe, D.A. (Eds.). (1991). The effects of child abuse and neglect: Issues and research. New York: Guilford.
Trickett, P. K., & Putnam, F. W. (1993). Impact of child sexual abuse on females: Toward a developmental, psychobiological integration. Psychological Science, 4(2), 81-87.
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Theories About the Development of Abusive and Neglectful Behaviors in Adults.
A variety of theories have been put forward to explain the development of abusive and neglectful behavior in adults. Theories to explain sexual abuse are often quite different from those explaining other forms of child maltreatment. An exploration of these theories can broaden students' understanding of the variety of influences on adult behavior and can provide concrete examples of the mechanisms by which several theories explain human behavior.
Becker, J. V. (1994). Offenders: Characteristics and treatment. The Future of Children, 4(2), 176-197. (Available from the David and Lucille Packard Foundation, 300 Second Street, Suite 102, Los Altos, CA 94022)Belsky, J. (1993). Etiology of child maltreatment: A developmental-ecological analysis. Psychological Bulletin, 114(3), 413-434.
Crittenden, P. (1993). An information-processing perspective on the behavior of neglectful parents. Criminal Justice and Behavior, 20(1), 27-48.
Brayden, R., Altmeier, W., et al. (1992). Antecedents of child neglect. Journal of Pediatrics, 120, 426-429.
Marshall, W. L., Laws, D. R., & Barbaree, H. E. (1990). Handbook of sexual assault: Issues, theories, and treatment of the offender. New York: Plenum.
Milner, J., & Chilamkurti, C. (1991). Physical child abuse perpetrator characteristics: A review of the literature. Journal of Interpersonal Violence, 6(3), 345-366.
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Recognition and Referral of Abused and Neglected Children and Adults.
A discussion of the variety of avenues available to report abuse and neglect of others or to discuss previous abuse or neglect experiences may be beneficial to some students. Discussion of the several sides of the mandatory abuse and neglect reporting laws can be used to explore the sometimes conflicting rights and responsibilities of individuals, families, and the state.
Besharov, D. (1990). Recognizing child abuse: A guide for the concerned. New York: Free Press.Kalichman, S. C. (1993). Mandated reporting of suspected child abuse: Ethics, law, and policy. Washington, DC: American Psychological Association.
Monteleone, J. A. (1994). Recognition of child abuse for the mandated reporter. St. Louis, MO: G.W. Medical.
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Responses to Child Abuse and Neglect--The Child Protection System.
Reports of abuse and neglect have increased dramatically in the past two decades. Child protection agencies are responsible for initial investigations of allegations of abuse and neglect. They must make complicated and important decisions about the substantiation of abuse and neglect allegations, possible removal of children into foster care, and services for abusive and neglectful families. A basic description of the process that child protection agencies go through in abuse and neglect cases and the difficulty of many of the decisions that caseworkers must make will provide students with a clearer understanding of the issues involved when governmental agencies must intervene in the lives of children and families.
National Commission on Foster Care. (1991). A blueprint for fostering infants, children, and youths in the 1990s. Washington, DC: Child Welfare League of America.Pelton, L. H. (1989). For reasons of poverty: A critical analysis of the public child welfare system in the United States. New York: Praeger.
U.S. Advisory Board on Child Abuse and Neglect. (1993). Neighbors helping neighbors: A new national strategy for the protection of children. Washington, DC: U.S. Government Printing Office.
Wald, M. S., Carlsmith, J. M., Leiderman, P. H., Smith, C., & French R. D. (1988). Protecting abused and neglected children. Stanford, CA: StanfordUniversity Press.
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Responses to Child Abuse and Neglect--Medical Intervention.
Physicians are often involved in the process of assessing whether a particular child is abused or neglected. Descriptions of the ways in which various professionals collaborate to meet both the physical and psychological needs of abused and neglected children will provide useful examples of the interdisciplinary work that is becoming more common in health care.
Dubowitz, H., & Newberger, E. (1989). Pediatrics and child abuse. In D. Cicchetti & V. Carlson (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 76-94). New York: Cambridge University Press.Ludwig, S., & Kornberg, A. E. (Eds.). (1992). Child abuse: A medical reference. New York: Churchill Livingston.
Paradise, J. (1990). The medical evaluation of the sexually abused child. Pediatric Clinics of North America, 37, 839-862.
Reece, R. M. (1993). Child abuse: Medical diagnosis and management. Baltimore, MD: Williams & Wilkins.
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Responses to Child Abuse and Neglect--Legal Involvement.
Abused children and their families may be involved in the legal system in a variety of ways. Describing these can help students understand the functioning of the legal system in abuse and neglect cases and the influences of their involvement on children and families. Discussions can focus on important conflicts between defendants' rights and victims' rights (e.g., should hearsay testimony be allowed more easily in abuse cases) and between family rights and state rights (e.g., what process must the state complete to remove a child from an abusive home). Furthermore, discussions of the roles of police, prosecutors, social workers, and mental health professionals in abuse cases can provide important information about how they can function smoothly together or work at cross-purposes to each other.
Kalichman, S. C. (1993). Mandated reporting of suspected child abuse: Ethics, law, and policy. Washington, DC: American Psychological Association.Levine, M., & Doueck, H. J. (1995). The impact of mandated reporting on the therapeutic process. Thousand Oaks, CA: Sage.
Melton, G. B. (1994). Doing justice and doing good: Conflicts for mental health professionals. Future of Children, 4(2), 102-118. (Available from the David and Lucille Packard Foundation, 300 Second Street, Suite 102, Los Altos, CA 94022)
Myers, J. (1992). Legal issues in child abuse and neglect. Newbury Park, CA: Sage.
Shepherd, J. R. (1987). Law enforcement's role in the investigation of family violence. In R. Helfer & R. Kempe (Eds.), The battered child (4th rev.& exp. ed., pp. 392-400). Chicago: University of Chicago Press.
Whitcomb, D. (1992). When the victim is a child (2nd ed.). Washington, DC: National Institute of Justice.
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Responses to Child Abuse and Neglect--Mental Health Interventions.
A variety of forms of psychotherapy have been used with victims and perpetrators of abuse and neglect. A description of these therapies can provide for an interesting exploration of theories on the development and amelioration of mental health problems. For example, therapy to change victims' attributions for their abuse can illustrate the foundations on which cognitive therapy exists, and some interventions with perpetrators of sexual abuse can be used to explore behavioral theories on behavioral change.
Briere, J. N. (1992). Child abuse trauma: Theory and treatment of the lasting effects. Newbury Park, CA: Sage.Fantuzzo, J. W. (1990). Behavioral treatment of the victims of child abuse and neglect. Behavior Modification, 14(3), 316-339.
Finkelhor, D., & Berliner, L. (1995). Research on the treatment of sexually abused children: A review and recommendations. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1408-1423.
Friedrich, W. N. (1990). Psychotherapy of sexually abused children and their families. New York: Norton.
Gaudin, J. M. (1993). Child neglect: A guide for intervention. Washington, DC: National Center on Child Abuse and Neglect.
Gentry, C. E. (1994). Crisis intervention in child abuse and neglect. Washington, DC: National Center on Child Abuse and Neglect.
Giarretto, H. (1982). Integrated treatment of child sexual abuse. Palo Alto, CA: Science and Behavior Books.
Jones, D. P. (1995). The outcome of intervention. Child Abuse & Neglect, 19, 1361-1362.
Lutzker, J. R. (1990). Behavioral treatment of child neglect. Behavior Modification, 14(3), 301-315.
Oates, R. K., & Bross, D. C. (1995). What have we learned about treating child physical abuse? A literature review of the last decade. Child Abuse & Neglect, 19, 463-73.
Pearce, J. W., & Pezzot-Pearce, T. D. (1994). Attachment theory and its implications
for psychotherapy with maltreated children. Child Abuse & Neglect, 18(5), 425-438.
Wolf, E., & Alpert, J. (1991). Psychoanalysis and child sexual abuse: Review of the post-Freudian literature. Psychoanalytic Psychology, 8(3), 305-327.
Wolfe, D. A. (1994). The role of intervention and treatment services in the prevention of child abuse and neglect. In G. B. Melton & F. D. Barry (Eds.), Protecting children from abuse and neglect: Foundations for a new national stragegy. (pp. 224-304). New York: Guilford.
Wolfe, D. A., & Wekerle, C. (1993). Treatment strategies for child physical abuse and neglect: A critical progress report. Clinical Psychology Review, 13(6), 473-500.
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Prevention of Child Abuse and Neglect.
The most effective ways of preventing child abuse and neglect have been debated for many years. Most strategies to prevent physical abuse and neglect focus on abusers and potential abusers, while many strategies to prevent sexual abuse focus on potential child victims. A comparison of these different strategies can be used to examine the general issue of prevention. The difficulties that researchers have encountered in assessing the value of the prevention programs can provide material for interesting methodological discussions.
MacMillan, H. L., MacMillan, J. H., Offord, D. R., Griffith, L. & MacMillan, A. (1994). Primary prevention of child physical abuse and neglect: A critical review: I.Journal of Child Psychology and Psychiatry, 35(5), 835-856.
Melton, G. B., & Barry, F. (1994). Protecting children from abuse and neglect: Foundations for a new national strategy. New York: Guilford.
Olds, D., & Henderson, C. (1989). The prevention of maltreatment. In D. Cicchetti & V. Carlson (Eds.), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect. New York: Cambridge University Press.
Wekerle, C., & Wolfe, D. A. (1993). Prevention of child physical abuse and neglect: Promising new directions. Clinical Psychology Review, 13(6), 501-540.
Willis, D., Holden, E. W., & Rosenberg, M. (1992). Prevention of child maltreatment: Developmental and ecological perspectives. New York: Wiley.
Wurtele, S. K., & Miller-Perrin, C. L. (1992). Preventing child sexual abuse: Sharing the responsibility. Lincoln: University of Nebraska Press.
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Education about child abuse and neglect is of special importance for psychologists who expect to have a career in practice or research in school, counseling, or clinical areas. Most practitioners and researchers in these areas will have contact with abusive families or with children or adults who have experienced child abuse and neglect. Consequently, it is important for these psychologists to have more than a basic knowledge about child abuse and neglect. Education at this level should include thorough training for the variety of roles that psychologists take on in cases of child abuse and neglect (e.g., assessment, psychotherapy, work with law-enforcement agencies, consultation with other professionals).
Ethical Issues.
A variety of complex ethical issues may arise when working in the area of child abuse and neglect. Familiarity with the issues and the ways in which others have handled them will increase the likelihood that they are handled effectively.
American Psychological Association. (1992). Ethical principles of psychologists. American Psychologist, 47, 1597-1611.
Barker, L. H., & Howell, R. J. (1994). Munchausen syndrome by proxy in false allegations of child sexual abuse: Legal implications. Bulletin of the American Academy of Psychiatry & the Law, 22(4), 499-510.
Koocher, G. P., & Keith-Spiegel, P. C. (1990). Children, ethics, and the law: Professional issues and cases. Lincoln: University of Nebraska Press.
Malmquist, C. P. (1994). Psychiatric confidentiality in child custody disputes. Journal of the American Academy of Child & Adolescent Psychiatry, 33(2), 1158-168.
Oberlander, L. B. (1995). Psycholegal issues in child sexual abuse evaluations: A survey of forensic mental health professionals. Child Abuse & Neglect, 19, 475-490.
Thelen, M. H., Rodriquez, M. D., & Sprengelmeyer, P. (1994). Psychologists' beliefs concerning confidentiality with suicide, homicide, and child abuse. American Journal of Psychotherapy, 48(3), 363-379.
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Research in child abuse and neglect is impeded by a variety of ethical and legal concerns. Psychologists need to know about these impediments to understand the limitations of available research. In addition, psychologists planning to engage in research in this area need to know about the research strategies that have been found to be most effective in the past, as well as the strengths and weaknesses of the variety of strategies that have been used.
Briere, J. (1992). Methodological issues in the study of sexual abuse effects. Journal of Consulting and Clinical Psychology, 60(2), 196-203.
Kelley, S. J. (1991). Methodological issues in child sexual abuse research. Journal of Pediatric Nursing, 6, 21-29.
Melton, G. B., & Flood, M. F. (1994). Research policy and child maltreatment: Developing the scientific foundation for effective protection of children. Child Abuse & Neglect, 18(suppl. 1), 1-28.
McGee, R. A., Wolfe, D. A., Yuen, S. A., Wilson, S. K., & Carnochan, J. (1995). The measurement of maltreatment: A comparison of approaches. Child Abuse & Neglect, 19(2), 233-249.
Rosenberg, M. (1987). New directions for research on the psychological maltreatment of children. American Psychologist, 42(2), 166-171.
Widom, C. (1988). Sampling biases and implications for child abuse research. American Journal of Orthopsychiatry, 58(2), 260-270.
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Child abuse and neglect cases often involve professionals from the fields of psychology, social work, medicine, education, and law. Individuals from each profession may have separate goals in an individual case, and these goals can be competing. Consequently, effective management of individual cases of abuse and neglect often requires that each professional understand the functions and goals of the other professionals involved in the case and that strategies to maintain effective communication between the professionals be instituted.
Brown, L. (1995). Your therapy client as plaintiff: Clinical and legal issues for the treating therapist. In J. L. Alpert (Ed.), Sexual abuse recalled: Perspectives for clinicians. Northvale, NJ: Jason Aronson.
Butler, S., Atkinson, L., Magnatta, M., & Hood, E. (1995). Child maltreatment: The collaboration of child welfare, mental health, and judicial systems. Child Abuse & Neglect, 19(3), 355-362.
Goodman, G. S., & Bottoms, B. L. (1993). Child victims, child witnesses: Understanding and improving testimony. New York: Guilford.
Perry, N. W., & Wrightsman, L. S. (1991). The child witness: Legal issues and dilemmas. Newbury Park, CA: Sage.
Pogge, D. L., & Stone, K. (1990). Conflicts and issues in the treatment of child sexual abuse. Professional Psychology: Research and Practice, 21(5), 354-361.
Wissow, L. (1990). Child advocacy for the clinician: An Approach to Child Abuse and Neglect. Baltimore: Williams & Wilkins.
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Psychologists may be asked to provide information about a child or family that will be used to determine whether or not abuse or neglect has occurred. This is a complicated process and one that must be handled carefully.
Morgan, M., & Edwards, V. (1995). How to interview sexual abuse victims: Including the use of anatomical dolls. Thousand Oaks, CA: Sage.
Myers, J. (1992). Legal issues in child abuse and neglect. Newbury Park, CA: Sage. (Chapter 2: Legal implications of interviewing children who may be abused or neglected.)
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The needs of abused and neglected children must be determined in order for interventions to be effective. Needs can range across a variety of areas, including medical, psychological, social, and educational.
American Professional Society on the Abuse of Children. (1995). Practice guidelines: Psychosocial evaluation of suspected psychological maltreatment in children and adolescents. Chicago: Author.
Berliner, L., & Conte, J. (1993). Sexual abuse evaluations: Conceptual and empirical obstacles. Child Abuse & Neglect, 17(1), 111-125.
Bernet, W. (1993). False statements and the differential diagnosis of abuse allegations. Journal of the American Academy of Child & Adolescent Psychiatry, 32(5), 903-910.
DePanfilis D., & Scannapieco M. (1994). Assessing the safety of children at risk of maltreatment: Decision-making models. Child Welfare, 73(3), 229-245.
Gaudin, J. M. (1995). Child neglect: A guide for intervention. Upland, PA: Diane.
Halikias, W. (1994). Forensic family evaluations: A comprehensive model for professional practice. Journal of Clinical Psychology, 50(6), 951-964.
Milner, J. S. (1994). Assessing physical child abuse risk: The Child Abuse Potential Inventory. Clinical Psychology Review, 14(6), 547-583.
Quinn, K., & White, S. (1992). Validation interviews of child sexual abuse allegations. In D. Schetky & E. Benedek (Eds.), Clinical handbook of child psychiatry and the law (pp. 119-144). Baltimore: Williams & Wilkins.
Quinn, K., White, S., & Santilli, G. (1989). Influences of an interviewer's behaviors in child sexual abuse investigations. Bulletin of the American Academy of Psychiatry and the Law, 17(1), 45-52.
White, S. (1991). Using anatomical dolls in play assessment. In C. Schaefer, K. Gitlund, & D. Sandgrund (Eds.), Play diagnosis and assessment (pp. 317-330). New York: Wiley.
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Working on abuse and neglect cases may be quite stressful. Understanding the sources of this stress and effective ways of dealing with it increases the likelihood that the psychologist will be able to function effectively.
SECTION II
Specialized Training for Clinical, Counseling, and School Psychologists
Bradley, E. J., & Lindsay, R. C. (1987). Methodological and ethical issues in child abuse research. Journal of Family Violence, 2(3), 239-253.
Brodsky, S. L. (1991). Testifying in court: Guidelines and maxims for the expert witness. Washington, DC: American Psychological Association.
Melton, G. B., & Limber, S. (1989). Psychologists' involvement in cases of child maltreatment: Limits of role and expertise. American Psychologist, 44(9), 1225-1233.
American Academy of Pediatrics, Committee on Child Abuse and Neglect. (1991). Guidelines for the evaluation of sexual abuse of children. Pediatrics, 87, 254-260.
McElroy, L., & McElroy, R. (1991).
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