Child Abuse and Neglect Final

Highlights of Arkansas Child Abuse Reporting Act

- 12-12-503: nonaccidental physical injury including striking a child with a closed fist, throwing (most commonly into a wall) /biting/cutting/burning; does not include "reasonable discipline" with "transient pain or minor temporary marks." - 12-12-505: Central Registry (records of allegations determined to be true; keep a history of substantiated cases) - 12-12-507: Mandated Reporters (medical personnel, coroner, domestic violence workers, DHS workers, law enforcement, mental health professional, social worker, school personnel, clergy, etc.) - No privilege for reporting. · 12-12-512 Investigative determination - Unsubstantiated (not supported by a preponderance of the evidence- the burden of proof. Three burdens: "beyond a reasonable doubt,"- 100% "clear and convincing evidence," - 75% "preponderance of evidence" - 51%. Child abuse follows the last one) - True (supported by a preponderance of the evidence) - Determination not entered "when a parent practicing his or her religious beliefs does not, for that reason alone, provide medical treatment for a child, but in lieu of such treatment the child is being furnished with treatment by spiritual means alone, through prayer, in accordance with a recognized religious method of healing by an accredited practitioner."

Factors related to risk

- Age of the child - Child's temperament, behavior, emotional makeup - Type of injury or harm --> location of injury --> type of injury --> frequency of injury - Parental characteristics --> willingness to acknowledge the maltreatment and to take steps to protect the child --> parental conditions that affect functioning ---> parenting skills - concurrence of emotional abuse and physical harm - access of the offender to the child - condition of the home and immediate environment - previous reports or incidents of maltreatment - family prone to crisis.

Reporting and Investigation of Child Abuse

- Intervention Process - Risk Assessment - Interviewing Adults

Assessment sex abuse perpetrator

- Personality testing - Physiological penile assessment - There is no psychological test or combination of tests that can tell whether one is a child molester. · No measurable pathology... - Penile Plethysmography (useful in treatment but cannot detect whether one has committed an offense)

Sex abuse treatment models

- Punishment via criminal justice system vs. Treatment (sex abuse as a criminal offense vs. sex abuse as pathology) - Because sex abuse is foremost a criminal offense, intervention must seek to hold him legally accountable. - Securing treatment for the victim and prosecuting the offender ignores the fact that a total family system is involved. - A combination of family systems treatment combined with behavior therapy to change the offender's behavior is suggested by expert clinicians. Marital therapy, family therapy, and individual therapy are recommended. Treatment rates for sex offenders who have offended multiple times is extremely minimal- very discouraging research results.

Non-Offending Parent Interventions

- Research suggests that the ability of nonoffending parent to provide support following a child's disclosure of sexual abuse may the most critical factor influencing that child's post-abuse psychological adjustment. - Nonoffending parents do not always receive a great deal of support from the professional community. They have been portrayed in the literature as collusive, denying, and indirectly responsible for the abuse of their children. Most mothers do not fit these stereotypes. - Many nonoffending parents may be unable to provide adequate support to their children due to their own emotional distress as well as limited knowledge and skills in responding to abuse-related disclosures and difficulties. - The aim of sessions with the parents is to provide support as well as information and skills that will assist them in coping with their own emotional reactions and their child's potential difficulties.

Settings for Prevention

- Schools · life skills training (how do you cope with stress and crisis? How do you make good decisions/ what does good decision-making look like? What are appropriate ways to get your needs met? How do you build a positive self-image) · preparation for parenthood (healthy sexual relations, child development, parenting skills) · self-protection training (teaching basic personal safety- how does victimization occurs? Who can you tell if someone approaches you?) · educational services for community · help at-risk families (evening program for working parents; after-school programs) - Families (home visits; parenting programs that promote positive parenting; resources) · Programs that focus on · Improving coping skills · Educating about child development · Facilitating bonding, communication with children · Increasing ability to approach helping resources - Community (awareness programs; libraries; youth-serving organizations) · Educating residents · Awareness programs (April is child abuse prevention month) · Libraries (books about maltreatment) · Support-school-based programs

Intervention Process

- Suspicion of abuse - Call to Hotline - Screened in and out - Investigation

Factors affecting the treatment of perpetrators

- Type of violation - Where perpetrator resides (in prison, most will not get any treatment approaches) - Gender of perpetrator (most treatment programs are designed for males, because males are usually the perpetrators)

Commonalities Among Reporting Laws

- selected individuals mandated to report suspected child maltreatment - reportable circumstances defined (i.e., forms of child maltreatment are defined) - reporting procedures described - agencies designated to receive and investigate reports - provisions for immunity from prosecution - reporting penalties for failure to report and false reporting - the abrogation of certain privileged communication rights - exemptions of certain acts or omissions from the definitions of child maltreatment - the existence and operation of a central registry NOTES- · Common Core Components -- Specify what constitutes CAN. ---- They will have a definition of the clear behaviors that constitute child maltreatment. -- Have specific definitions. -- Address who may be considered a perpetrator. -- Enumerates individuals who are mandated to report suspected CAN. ---- Mandated reporters vary by state. ---- Clergy are now mandated reporters nationwide. ---- Confidentiality is secondary to the protection of a child. -- Anyone not mandated may report voluntarily. ---- Neighbors, friends, etc. -- Privileged communication waived. ---- Includes therapist and client relationships, lawyer and client, doctor and patient- should break confidentiality and report. -- If made in good faith, one is immune from liability. -- Punishment for failure to report. ---- As long as a MR- Fines, loss of license, etc. -- Delineates a process and protocol for accepting reports and conducting investigations. · Impact of National Events to Elicit Changes in Reporting Laws -- Knee-jerk reactions or thoughtful and well-grounded in good practice? -- More penalties for failure to report? -- Sanctions on those who witness abuse and do not report. -- Expanding who is mandated to report. ---- When there is substantiated evidence, the vast majority are professionals. ---- Wh

Arkansas statutes have begun the process of risk assessment by defining a category of severe maltreatment that requires response in 24 hours. Severe maltreatment includes:

- sexual abuse, sexual exploitation - act or omissions that may or do results in death - abuse involving a deadly weapon - bone fracture - internal injuries - burns - immersions - suffocation - abandonment - medical diagnosis of failure to thrive - causing a substantial and observable change in the demeanor of a child

What are situations that require an immediate response- in addition to severe maltreatment- in which a reasonably prudent person would initiate the maltreatment assessment immediately?

- the parent is making a self report - the alleged victims are infants or toddlers - the allegation concerns dehydration in young children - young child left alone - parent/caregiver's behavior is bizarre or psychotic - the child victim is making the report

Physical Child Abuse Treatment

- treatment goals - assess environmental stresses --> inadequate housing, unemployment, income insufficiency - negative self-image (identify strengths) --> most abusive parents have low self-esteem, and need to identify their strengths - family preservation services - treatment of child --> medical services --> social services --> psychotherapy - treatment of parents --> nurturing and reparenting --> addressing psychic conflicts, pathology --> improving parent-child relationships --> family preservation services

Five Appropriate Functions

1. Demonstration Aid (child lacks verbal ability to communicate; clarifies disclosure) - The child can demonstrate what happened to him or her rather than be limited to words to indicate what happened. --> (Keep in mind, you are asking the child about something that can be extremely difficult to communicate- it may be easier for them to disclose by showing instead of having to tell what happened.) - As a demonstration aid, dolls can be used in the following ways: --> To facilitate disclosure- when children lack the verbal ability to communicate, are reluctant to disclose or are otherwise impeded in their verbal communication. --> To clarify disclosure- when it is not entirely clear what behaviors the child is describing. --> To corroborate disclosure- when the interviewer seeks support for the verbal disclosures. - The interviewer should choose and use as many dolls as are needed to show the child's alleged abuse circumstance. - The interviewer should not interrupt the child's demonstration to conduct a body-parts inventory but should inquire about the names of body parts that the child indicates is his or her demonstration. · Anatomical Model (have child identify non-sexual and sexual body parts) - The dolls are used initially to gather information about the names the child uses for body parts and acknowledge of body parts functions. - The dolls are usually introduced independent of any statements related to sexual abuse. - Guidelines vary in how many dolls an interviewer should use, be it two, three, or four dolls. - The interviewer should have the child identify non-sexual and sexual body parts. - After the body parts inventory has been completed, the interviewer may ask focused questions about body parts, such as "Have you ever seen a peepee like this?", using the child's terminology. - It is also approp

Types of information used to decide whether or not a child has been sexually abused.

1. Information from the child interview -Information about the sexual abuse ---explicit description of sexual acts ---evidence of advanced sexual knowledge for the child's age ---a description of sexual acts from a child's perspective. - information about the context of the sexual abuse ---where the abuse occurred ---when the abuse occurred ---what inducements the abuser used ---where the other persons were ---what clothing the child was wearing ---what clothing of the child's was removed ---what clothing the offender was wearing ---what clothing of the offender was removed ---any admonitions from the offender or others about disclosure ---whether the child disclosed and to whom - affect or emotional state consistent with disclosure ---reluctance to disclose ---embarrassment ---anxiety ---anger ---fear ---disgust ---sexual arousal 2. Information from other sources - information related to the child ---psychological test results statements from witnesses ---physical evidence - information related to others ---about the offender ---physical evidence ---other victims 3. about other family members - family functioning -marital relationship of parents - accuser functioning

Interview phases (interviewing the child)

1. establishing a relationship 2. fact-finding 3. child-protection assessment 4. intervention planning

Three types of prevention

1. primary 2. secondary 3. tertiary

Parents Anonymous, Inc

Is a National Organization that promotes mutual support and parent leadership in order to build and support strong, safe families

Responsibility for Investigation of child abuse and neglect

Priority I by Arkansas State Police -- Fractures, death, burns, internal injuries, all forms of sexual abuse including trafficking. Priority II by DCFS -- Abandonment, all forms of neglect, striking child, close confinement, failure to thrive.

Treatment issues of sex-abused child

o "Damaged Goods" Syndrome --- Child victim may feel "damaged" because of the experience; feel conviction; In younger ages, "will I be normal when I grow up?," "what if I get married . . ." --- family's response can influence this- do they respond with intense disgust, are overly curious, etc. --- A physical exam is done so the child knows they are alright- message the child can get is not physically damaged and if they are, the doctors can fix it --- Education and letting them ask questions/ express concerns. o Guilt --- Children can experience this on a number of levels from this process. --- Can feel guilty for feeling good about the attention they were getting from a trusted individual. --- Must be conveyed to child that the responsibility resides completely with the perpetrator- they are never to be held responsible for the sex abuse that happened to them. Reiterate it is not your fault to the child. --- May feel guilt because disclosed and all that followed; feel betrayed perpetrator. --- May feel guilt over the disruption that happens- family unravels. o Fear --- Fear subsequent episodes of sex abuse- why need to reinforce protections in place; can also educate on how to say "no" --- Need to assist child in ventilating fears and expressing feelings- can help instruct/develop a safety plan, so feel in place so it won't happen again. o Depression --- Can also be profound sadness, withdrawal, fatigued, physical discomfort that they can't identify --- Premature exposure has been linked to eating disorders; with teenagers suicidal ideation may be apparent as well o Low self-esteem and poor social skills --- Can be influenced by age of onset and how long abuse occurred- need to help them explore their strengths. Can ask them to name 3 things that are reasons they are a good friend, etc. · Th

Treatment Goals sex abuse perpetrators

o (applicable for males and females; extra- and intra- familial) -- Take responsibility for abuse. (many will not and will blame offenses on alcohol, lack of attention from spouse, etc. trying to make themselves look like the victim.) -- Increase understanding of the events, circumstances, that led to the sexual offense. (take larger look at context, what predisposes one to act) -- Learn to break patterns that lead to abuse. (learn to step outside/ avoid patterns that trigger impulse- alcoholic can't go to the bar) -- Develop positive self-esteem. -- Establish a way to meet sexual and interpersonal needs without victimizing others. Treatment seldom works for dangerous predators who molest many children over a lifetime of deviance.

Coping Skills Training- Cognitive Coping Skills

o (means of identifying and challenging any dysfunctional thoughts underlying parents' distressing emotions) · Educational information that corrects dysfunctional thoughts to reduce distress that arises from misconceptions. · Assist parents in examining and enhancing their coping styles by presenting the interrelationships between thoughts, feelings, and behaviors.

Phases of sex abuse treatment

o Disclosure-Panic · Crisis intervention · (About 70-75% of disclosure is nonintentional; this phase is when the family finds out/ it is discovered causing panic; during this phase blame can be projected, even on the abused child; fear emerges.) o Assessment-Awareness · Realigning generation boundaries · Marital therapy · Strengthening mother-child bond · Perpetrator accepts responsibility · (During this phase, accepted that abuse has occurred; non-offending parent may begin deciding if they will restructure relationship or not; during this stage perpetrator may apologize.) o Restructure · Reunited · Work to keep balance achieved · Maintain boundaries, communicate effectively · Give nonsexual stimulation and affection · (if perpetrator stays in home have to restructure- maybe offender will not bathe or put kids to bed; even if perpetrator does not continue to remain in home, must adjust and learn to live/adjust with life without them)

Continuum of Sexual Behavior

o Natural and healthy sexual behaviors (information gathering process/ similar size and age) --- Information gathering process, curiosity/ interest in differences; larger concern with greater age gap; healthy sexual play = may play doctor or house assuming different roles where exposure takes place; similar size/age, consensual --- 40% of non-sexually abused children will have behaviors like underdressing at home, rubbing oneself, etc. --- Balance of curiosity in other things in their life- not any more curious about sexual behavior than other things; spontaneous --> redirection can be utilized o Sexually-Reactive Children (sexually overwhelming environment) o Children who engage in extensive, mutual sexual behaviors (sex used to connect) o Children who Molest (sex and aggression linked/problems in all areas) Across all sexually abused children, it is less than 50% who will ever engage in worrisome sexual behavior.

Training Parents in Discussing the Abuse with the Child

o Open lines of communication · Encourage questions · Reinforce the sharing of problems · Encourage he expression of feelings in an appropriate manner · Special parent-child time (predictable, consistent activity) o Initiating Parent-child Communication about Sexual Abuse · Model open communication · Encourage dialogue gradually and naturally · Avoid catastrophizing (overreactions) · Do not alter normal expectations and limits · Do not expect child to share parents' view o Training Parents in Providing Age- appropriate Sex Education · Importance of developmentally appropriate sex education · Correct any misconceptions child may have developed concerning sex as a result of abuse experiences May help reduce the sexually abused child's vulnerability to further abuse, premature sexual activity, and/or adult sexual dysfunction

Physical child abuse treatment goals

o Stop battering o Parent(s) learn to cope differently in instances that provoked abuse in the past -- Recognizing feelings and events that led to initial abuse. -·- (learn when the anger, tension, etc., is building and they are about to lose it, so they cannot act on feelings and collect themselves) -·- Learning to read warning signals that precede abusive behavior. -·- Learning alternative coping skills to handle anger and frustration. · (What they are doing right now is not working, if children are suffering.) -·- Gaining more pride in themselves as parents and enhancing parenting skills. · (need to restore self-esteem; learn to enjoy parenting) -·- Understanding child development so they can adopt more realistic expectations of their children.

· Mother or nonabusing parent

o Strengthen role in future protection of child o Group therapy to address her needs (still will have anger, resentment, shame, guilt, etc.; mom is rarely a collusive partner, so has her own needs that must be addressed.; may not pick up on it/believe child and incest relationship- if mom does believe it quickly it may suggest she knew to some degree, or acknowledged signs) o Areas needing attention --- Communication --- Lack of assertiveness --- Low self-esteem --- Denial --- Unrealistic expectations --- Increased ability to enforce role boundaries --- Anger and hostility o Support (provide info on child development, skills to raise child appropriately, etc.) o Other interventions: --- Coping (validate feelings; needs encouragement) --- Skills Training (correct dysfunctional thoughts) --- Educate about typical childhood sexual development (child may lose any healthy understanding of sex- when does child's behavior become problematic vs explorative) --- Discussing abuse with child (open communication; gradually and naturally; avoid overreaction)

Natural and Healthy Sexual Behavior

· 40 to 85% will engage in at least some sexual behaviors before age 13 years. · Information gathering process, lighthearted, spontaneous · Limited in type and frequency (are of similar age, size, and developmental status/voluntary) · Balanced with other curiosity. · Can be associated with embarrassment, but not deep feelings of anger, shame, fear or anxiety. · Can include masturbation, experimenting with other children, being curious.

Nurturing Parenting Program

· Active in-home protective service · Evidence-based · Intensive, 16-session (2.5 hours each) family intervention with assessments conducted at identified phases throughout the education process. · Competency-based (learn new parenting skills/time is spent practicing the skills as a family) · Deliver in a group-based setting, home-based setting, or a combination. Individual tutorials are provided as needed. · Constructs of program o Understanding age-appropriate developmental expectations for a child. o Develop a sense of caring and compassion for self, others, and the environment. --- (most have never developed empathy, so must be taught) o Providing children with positive discipline --- Teach child management strategies o Increasing self-awareness and appropriate family roles o Developing a healthy sense of empowerment in both parents and children.

Survivor Stages

· Although most of these stages are necessary for every survivor, a few of them- the emergency stage, remembering the abuse, confronting your family, and forgiveness- are not applicable for every woman. · The decision to heal: • Once you recognize the effects of sexual abuse in your life, you need to make an active commitment to heal. • Deep healing happens only when you choose it and are willing to change yourself. · The emergency Stage: • Beginning to deal with memories and suppressed feelings can throw your life into utter turmoil. • Remember, this is only a stage. It won't last forever. · Remembering: • Many survivors suppress all memories of what happened to them as children. Those who do not forget the actual incidents often forget how it felt at the time. • Remembering is the process of getting back both memory and feeling. · Believing it Happened: • Survivors often doubt their own perceptions. Coming to believe that the abuse really happened, and that it really hurt you, is a vital part of the healing process. · Breaking Silence: • Most adult survivors kept the abuse a secret in childhood. Telling another human being about what happened to you is a powerful healing force that can dispel the shame of being a victim. · Understanding that it Wasn't Your Fault: • Children usually believe the abuse is their fault. Adult survivors must place the blame where it belongs- directly on the shoulders of the abuser. · Making Contact with the Child Within: • Many survivors have lost touch with their own vulnerability. Getting in touch with the child within can help you feel compassion for yourself, more anger at your abuser, and greater intimacy with others. · Trusting Yourself: • The best guide for healing is your own inner voice. • Learning to trust your own perceptions, feelings, and i

Children with Sexual Behavioral Problems

· Belief that all children who molest were themselves victims of sexual abuse. (transgenerational issue; research suggests less than 30% though.) · Child Sexual Behavior Checklist (developed by Toni Cavanagh Johnson) · Children who live in homes with domestic violence associate sex and aggression (angry sexual language and witness violent interactions) · A Continuum of Sexual Behavior

Treatment of sexual offenders

· Cognitive-behavioral treatment o Confronting denial/correcting thinking errors/ increasing ability to empathize with victim/ identify the sequence of events that triggers cycle of offending/ increase social competence/ alter patterns of deviant sexual arousal/ role of law (this is criminal activity and there are therefore penalties). · Effectiveness of Treatment o Mixed results. o Offenders with one victim often have the greatest motivation to change. (and the best chance of successful treatment; but depends on how long has it been going on, etc.) o There is no "cure." · Have also used chemical treatments to reduce testosterone via medicines, or chemical castration. · Classical conditioning has been used before as well.

Repressed Memories

· Describes those who have no memory of the abuse they suffered. · Much controversy. · Repressed: cast completely out of consciousness to avoid psychic pain; mind denies access to consciousness so that person remembers nothing of the event(s). · Judicial setting: struggle with admissibility of expert testimony · Scientific community: do not accept the concept as valid (Significant events tend to be remembered; PTSD is a perfect example- can't leave the horrific memories behind; memory as a survival mechanism concept)

Developmentally Inappropriate/ deviant sexual behaviors: adolescence and teenage years

· Deviant level one: • High degree of preoccupation/ anxiety • Frequent use of porn/ sex shows • Indiscriminate sexual acts with multiple partners • Sexually aggressive remarks, obscenities, graffiti • Embarrassing other with sexual _ · Deviant level two: • Compulsive masturbation • Degradation/humiliation of self or others with sexual overtones • Attempting to expose genitals of others • Chronic preoccupation with sexually aggressive porn • Sexually explicit conversation with young children • Sexually explicit threats • Obscene phone calls · Deviant level three: • Genital touching without permission • Sexual contact with significant age difference • Forced sexual contact or penetration (vaginal, anal) • Sexual contact with animals • Causing genital injury to others

Residual Effects of Child Maltreatment

· Difficulty trusting others. · Low self-esteem (self-destructive behaviors such as suicide attempts, emotional cutting, substance abuse, eating disorders). · Relational imbalances. · Self-blame (don't know how to identify external causes of problems). · Problems experienced contribute to diagnosable mental health issues such as depression, anxiety, PTSD, eating disorders, and sexual disorders/ dysfunction (traumatic sexualization).

Coping Skills Training- Emotional Expression Skills

· Encourage parents to explore, clarify, and express the wide range of emotions that they may be experiencing. · Important in enabling parents to respond to the child in well-thought-out and effective ways and preventing parents from responding based on their own emotional distress. · Allows validation of parents' feelings. · Some parents express feelings that could be considered unsupportive of the child (disbelief, anger toward child, concern for perpetrator). Even these "nonsupportive" feelings need to be acknowledged and accepted. A judgmental or confrontational stance could be nonproductive early on. · Parents' thoughts and feelings often change dramatically as they develop a greater understanding of the impact and circumstances of the abuse. They realize that they are capable of coping with life without the offender. · Early on, it is not appropriate for parents to share their feelings with their children. Encourage them to carefully monitor their expression of emotions regarding the abuse when in the presence of children. · Encourage parents to identify others adults with whom they can share their feelings without exposing the children to those conversations.

Children who Molest

· Histories reflect a growing pattern of sexual behavior problems and intense sexual confusion. · Sexuality and aggression are closely linked in their thoughts and actions. · Some type of coercion (trickery, bribery, manipulation, physical coercion) is used to get children to participate in sexual behaviors · Physical force is seldom necessary as victims tend to be selected due to vulnerabilities (social isolation, developmental delays, emotional neediness) · There are problems in all areas of their lives. Impulsive, resistant to stop despite consequences. · There is a progression from healthy sexuality to sexually reactive behaviors to molesting behaviors.

Children who engage in extensive, mutual sexual behaviors

· Hurt and abandoned by adults, distrustful. In the absence of close, supportive relationships with adults, they use sexual behaviors to connect with other children. · Sex is a way to cope with feelings of hurt, sadness, despair. · They do not force other children into sexual behaviors but find other lonely children. · Look to other children to help meet their emotional needs and need for physical contact. Many have been sexually or emotionally abused.· Hurt and abandoned by adults, distrustful. In the absence of close, supportive relationships with adults, they use sexual behaviors to connect with other children. · Sex is a way to cope with feelings of hurt, sadness, despair. · They do not force other children into sexual behaviors but find other lonely children. · Look to other children to help meet their emotional needs and need for physical contact. Many have been sexually or emotionally abused.

Myths about adults abused as children (survivors)

· Individual who was abused or neglected will abuse or neglect their own children. · Abused and neglected children become deviant adults, involved in crime, drugs, or prostitution. · Effects of abuse and neglect are irreparable and render the future adult incapable of leading a fulfilling and happy life.

Charting behaviors related to sex and sexuality in young children

· Natural healthy: child touches, rub genitals when diapers changed or when tense, excited. · Of Concern: continues to touch genitals in public after being told consistently not to do this. · Seek Professional Help: touches/rubs self to the exclusion of normal childhood activities, even hurts own genitals by rubbing. · Natural and Healthy: take advantage of opportunity to look at nude people. · Of Concern: stares at nude people even after having seen many nude people. · Seek Professional Help: asks people to take off clothes. Tries to forcibly undress people.

Anatomical Dolls

· Not a psychological test. -- Thus, the mere demonstration of sexual activity with anatomical dolls is not sufficient to diagnose sexual abuse; it is only a red flag. -- The evaluator must ascertain whether the child's sexual demonstration derive from an experience of victimization or from some other experience. -- The absence of sexualized behavior with anatomical dolls should not be interpreted to mean the child has not been sexually abused.

Coping Skills Training: Identifying Abuse-related Feelings and Underlying Thoughts

· Parent records a list of emotions experienced in response to child's abuse on a sheet of paper. Identify the thoughts that seemed to be underlying those emotions. · Disputing Dysfunctional Thoughts --- Inaccurate thoughts: provide parent with accurate information about sex abuse (may believe that sexually abused children become offenders). --- Nonproductive thoughts: regardless of their accuracy, these thoughts (anger toward perpetrator) are nonproductive, unhelpful. Redirect thoughts (replacement thoughts) in a more productive way by focusing on how the parent can best help the child adjust. Thoughts could be characterized as pessimistic thinking, guilt for not preventing abuse, sadness/grief, anger self, child, perpetrator), confusion.

Parent Training Programs

· Parent training programs operate on the premise that parents will be less likely to abuse if they improve and expand their child-rearing skills, rely less on coercive child management strategies, and modify attitudes linked to harsh parenting (knowledge about child development and child management skills). o Supplemental components include: enhance parents' emotional well-being (anger and stress control) · Parent training programs are designed to reduce child maltreatment by changing parental factors associated with child abuse: o Increase parents' healthy child-related attitudes (range of emotions at risk for child abuse such as anxiety, anger, depression, stress) and increase parents' feelings of competence in child rearing. o Child- rearing attitudes (beliefs about the value of harsh, parenting practices, expectations about children's developmental competencies, perceptions of children's needs, and beliefs about children's level of responsibility). o Child rearing behaviors (aggression, praise, criticism, communication patterns, corporal discipline, or warmth). · The study found the following to be true for parent training: o Parents who completed parent training were more likely to rely on noncoercive strategies, such as expression of warmth and democratic reasoning when interacting with children. o Home visitors make a substantial positive impact on parents. § Theory suggests visitors can provide parents with emotional support and help them individualize information learned in parent training. § Programs that provide a mixture of office and home settings were more successful. o Parents may readily adopt the child management skills taught in parent training because teaching new strategies that promise to make parenting more desirable. o Changing long-held attitudes and beliefs is difficult and ma

Guidelines in determining the authenticity of a child's report of sexual abuse

· Quality of interview · Evidence of hoax o Must have very sophisticated thinking skills and abstract thinking (often around age 9/10-12) · Evidence of coaching o Are the responses one you would expect out of a child; does child use their language? o Use colloquial terms o Does it seem rehearsed and like child is speaking from memorization? o Do they have details one would only know if they were there? (what they were wearing, what was said, does the child describe pain, etc. - often not thought about when coaching a child) --- Also, should consider, does a child have a strong emotional response? (this is normal) Could be a point where the child does not want to talk about it anymore- withdrawal, etc. · Ulterior motive o Factor you must see from the child's point of view. (i.e. divorce and child doesn't want one parent to get custody) · Fear of blame o A child rarely will make up a lie to get in trouble... o Much more likely one will hide the truth in an abuse case because of what all occurs when it is shared. o Not unusual for a child to be protective of perpetrator. --- not want to see bad things happen to them. · Protecting a loved one o Victims often have positive as well as negative feelings toward the perpetrator o Child may be very protective of perpetrator o This condition makes it even less likely that a child would make up a lie · Story is direct, concrete o Typically, preschoolers are most suspect when it comes to imagining abuse. o Preschoolers imagine vagaries such as monsters, not explicit details of sexual activity or abuse. · Story is consistent over time · Overstimulation in the home · Known pattern of sexually abusive (particularly incestuous) relationships · Family dynamics consistent with incest · Overall adjustment of child · Behavioral signs among young children

Sexually- Reactive Children

· Self-stimulating behaviors or sexual behaviors with other children, perhaps adults. · Environmental cues that are overly stimulating and awaken other traumatic or painful memories. · Lived in sexually overwhelming environments. · Sexual behavior is seen as a way of coping with overwhelming feelings of which they cannot make sense. · Used for tension release. · Coercion is not used and no intent to hurt others. · Not getting messages about unacceptable sexual contact. ***group most likely to gain attention; usually dysfunctional home, and need to seek professional help.

Developmentally Appropriate Sexual Behaviors: adolescence and teenage years

· Sexually explicit talk with peers · Obscenity/ jokes within cultural norm · Interest in erotica · Sexual innuendo, flirting, courtship · Solitary or mutual masturbation · Hugging, kissing, holding hands · Foreplay, even intercourse with consenting partner

Teaching Effective Parenting

· Spoiling myths o Overindulgence vs. providing security --- Particularly raised when a child is crying, for instance. --- Responding to a child when they are crying only builds trust. o Rushed independence vs. independence built on security --- Independence should not be forced upon child prematurely; independence should come gradually with support/encouragement from parents. o Break child's will vs. promote a disposition to comply · Corporal Punishment (excessive corporal punishment needs to be eradicated due to link to abuse) o Punishment of bad behavior vs. discipline or guidance --- Discipline comes from the inside out. o Stop the behavior vs. teach the value --- If a child adopts value, it will prevent behavior. o "I have control" vs. "You can learn self-control." --- Learning to manage their emotions and temper, etc.

The Use and Interpretation of Drawings

· The drawing is a child's way of communicating, a way of telling his/her story - Observe primary themes as feelings, child's perspective, specific events, and what happened. - Drawings may be sexualized, with emphasis on genital areas or breasts. They may show sexual contact between people and indicate sexual knowledge beyond their years. · Features useful in interpreting drawings: - Size of figures (small=helpless) - Position of figures on paper - Omission of specific persons (feeling abandoned) - Facial expression may indicate feelings - Show people in dangerous situations - Sexual themes - Compartmentalization (a child's way of protecting him/herself from danger)

Long Term Effects and Disclosure of Survivors

· Understanding disclosures to romantic partners • Could directly disclose verbally; could be triggered that leads to recall and adverse reaction; could show up behaviorally. • More likely for a therapist, close family member, or close friend to respond appropriately with empathy, etc., not romantic partners usually. · Struggling in private about disclosure (identity/traumatic intrusions/ fear of disclosure/ choosing not to) • Go through a phase in struggling to disclose or not. Can be influenced by the identity chosen- how does she see herself right now in light of abuse, as a victim or a survivor? Changes how one presents themselves. • Traumatic intrusions include flashbacks, could be brought up in a romantic relationship, like with intimacy • Afraid to tell because of all the stuff that could happen- rejected, abandoned, minimizes it, doesn't understand, etc. · Experience of disclosing (shame/ emotional volatility/ absence of affect/ timing of disclosure) • Phase 2, could generate stigmatization and shame and cause romantic partner to see partner differently. • Can't predict how it will be interpreted by individual. • Fear of not being able to control emotions when trying to share. • Absence of affect because they don't know how to respond to it; don't acknowledge it/ just sit there. • Timing is critical- if done too early typically leads to the dismissal of the relationship. · Aftereffects (adverse responses/ intrigue/ positive and transformative) • Once someone has shared information, the partner might engage in the mirroring of abuse dynamics- have an adverse response • Partner doesn't understand process- why stay so long with that, etc. • Critical for one to have a positive response, which can come from one's own history of trauma, for instance. · Implications (differen

Child-Protection Assessment

• Child's assessment • History of threats/use of force/violence • Presence of functioning adult ally -- Reaction at time of disclosure -- Past history regarding child -- Present attitude toward child -- Present attitude toward perpetrator

Intervention

• Designed to cause least damage (to already traumatized child) and prove to be most helpful • Goal is to stop maltreatment of child • Reporting • Investigating and validating • Home visits

Developmentally Appropriate Sexual Behaviors: pre-adolescence · Children below the age of four:

• Exploring/touching private parts in private or public • Rubbing private parts with a hand or against objects • Showing private parts to others • Trying to touch a mother's or another woman's breast • Removing clothes and wanting to be naked • Attempting to see others undressing. • Talking to same-aged children about "poop" and "pee"

Interviewing the Child objectives

• Facilitate a quiet engagement of the child. • Provide first therapeutic session. • Helps validate or negative allegations. • Assess a child's need for immediate protection.

Parenting Challenges for Survivors

• Fears of parenting, delayed parenting, and lack of desire to have children. · Fear of being abusive · Increased level of awareness, in family of origin contexts · Entitlement issues (don't feel one is entitled to have a child- unclean etc. ) · Sexuality and conception issues • Learning to parent, without positive role models from one's family of origin. · Concerns about parental competence · Overreacting to ordinary problems and normalizing the experience (ex. Child doesn't like babysitter, so mom is concerned about abuse) • Setting boundaries, and difficulties with limit-setting, · Sense of right and wrong is skewed. • Reenactments of early childhood deprivations and abuse. • Problems arising when one's child reaches the age when her own abuse began. • Issues with how friends are raising their children. • Family of origin issues, including disclosure cut-off, and reconnection. • Disclosing past abuse to one's children, and teaching children to protect themselves. Abuse changes how you see the world.

Fact-Finding when interviewing a child

• How did it begin? • What happened after that? • Where did it happen? • Where was everybody else? • When did it happen? • How long has this been going on? • Did anyone else know? • Why did you go along? • Feelings about perpetrator? • Physical aspects? • Why tell now?

Three conditions that constitute an emergency (risk assessment)

• Imminent danger of physical harm to child • Dangerous home situation • Abandonment of child

Four Critical Questions of Risk Assessment

• Is the child at risk from abuse or neglect and to what degree? • What is causing the problem? • Are there services that could be offered to alleviate the problem? • Is the home a safe environment or must the child be placed?

Developmentally Appropriate Sexual Behaviors: children 7-12 years of age

• Masturbation but usually in private • Playing games with children their own age (truth or dare, playing family, playing boyfriend/girlfriend) • Looking at pictures of naked people • Viewing/listening to sexual content in media (TV, movies, games, internet, music) • Wanting more privacy (when undressing, etc.) • Beginnings of sexual attraction to peers

Establishing a relationship when interviewing the child

• Personal introspection • Engaging child -- Introduce self. -- Demonstrate interest. -- Establish credibility. -- Clarify initial expectations. -- Stress self as a support person.

Concerning sexual behaviors: pre-adolescence

• Placing child's mouth on a sex part • Asking to engage in sex acts • Masturbating with object • Inserting objects in vagina/ anus • Imitating intercourse • Making sexual sounds • French kissing • Imitating sexual behaviors with dolls • Asking to watch sexually explicit behavior

Developmentally Appropriate Sexual Behaviors: children ages four to six

• Purposely touching their genitals • Attempting to see others naked or undressing • Mimicking dating behavior (kissing, holding hands) • Talking about private parts and using "naughty" words they don't understand • Exploring private parts with children their own age (playing doctor, "show me yours, ill show you mine")

Key issues in Interviewing the child

• The first report is almost never the first incident. • Interview the child alone in a neutral setting or with a supportive ally. • Establish credibility. • Use the child's terminology and clarify the meaning. • Be aware of the child's sense of time/use special events to pinpoint incidents. • Multiple interviews? (In forensic interview settings, it's recorded so you can avoid multiple interviews; multiple interviews should be avoided if possible because every interview will cause the child to relive what happened.) • Nature of abuse. • Responsibility for establishing a relaxed atmosphere and diffusing anxiety rests with the interviewer. Don't get abuse-focused until the child becomes comfortable with you. · Before moving to abuse-focused questions need to determine if the child will correct misinformation, to help determine how valid their info. May be. • Use the child's name frequently and ask more "Tell me . . ." questions. (Open-ended questions, not leading questions, like "did..." - these get struck down in court . . .) Get the child used to answering questions. · It is okay to prep., take notes, and have a list of questions you need to answer in the interview. • Discuss non-abusive situations with the child first. Part of trust-building and reducing reluctance to talk. · Must remember the child has been groomed to trust the perpetrator so their ability to trust is broken. • Half of the kids who disclose do not realize that the police will be called. · Don't guess but try to explain to the child what will likely occur. • Most recantations are among 8- to 9-years-old. Recantations do not mean that allegations are false. • Recantations are more likely when: · Children have little peer support and are very dependent on parents. · Unsupportive caretaker contributes t

Interviewing Adults

• Validate or not validate without antagonizing • Open-ended questions • Parental history and functioning (discipline; family background of abuse) • Parent's view of child (expectations, affectionate; child seen as difficult) • Functioning of family (marital conflict; boundaries blurred; family activities) • Environment (stresses; neighborhood safety; safe home environment) • Family support system (isolated; support in crises)

Tertiary Prevention

• engage with maltreating families/ reduce negative consequences *target is families who perpetrate; interventions/ treatments occur here* · Intensive family preservation services; parent mentor programs; mental health services (for parent and child)

Primary Prevention

• stop before starts/ public at large/ raise awareness · Public awareness campaigns; public service announcements

Secondary Prevention

• targets high-risk families- like teen moms, families with substance abuse issues, families with special needs child/ alleviate conditions · Parent education programs for teen mothers; substance abuse programs for mothers of young children; respite care for families with special needs children; family resource centers