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1.
The At Risk Parent Child Program is a multidisciplinary network agency designed for the secondary prevention of poor parenting and the extremes of child abuse and neglect. This model system of service delivery emphasizes (1) the coordination of existing community resources to access a target population of families at risk of parenting problems, (2) the provision of multiple special services in a neutral location (ambulatory pediatric clinic), and (3) the importance of intensive individual contact with a clinical professional who serves as primary therapist, social advocate and service coordinator for client families. Identification and assessment of families is best done during prenatal and perinatal periods. Both formal and informal procedures for screening for risk factors are described, and a simple set of at risk criteria for use by hospital nursing staff is provided. Preventive intervention strategies include special medical, psychological, social and developmental services, offered in an inpatient; outpatient, or in-home setting. Matching family needs to modality and setting of treatment is a major program concern. All direct services to at risk families are supplied by professionals employed within existing local agencies (hospital, public health department, state guidance center, and medical school pediatric clinic). Multiple agency involvement allows a broad-based screening capacity which allows thousands of families routine access to program services. The administrative center of the network stands as an independent, community-funded core which coordinates and monitors direct clinical services, and provides local political advocacy for families at risk of parenting problems.  相似文献   

2.
OBJECTIVE: Cases of child abuse filed in court as crimes against children represent a small percentage of the total numbers of children maltreated. However, studying crimes of maltreatment against children is important for individual victims and their families, and for theory and policy in order to assure that these cases are managed as well as possible. Forensic consultation teams can perform several functions related to child abuse crimes: provide multidisciplinary expertise in the evaluation of maltreatment cases, offer a method for allocating resources between cases managed by the criminal justice and child protection systems, and provide important research and teaching opportunities. This study reviews the role played by multidisciplinary team consultations based on the perception of client professionals whose agencies pay for an outside consulting forensic team. METHOD: Professionals referring to a forensic team for consultative assistance were asked to evaluate the service during telephone interviews, responding to both structured and unstructured questions. RESULTS: Responding professionals (N= 18) stated that the team increased their confidence that the approach being taken to a case was correct (94%), that missing expertise was provided (100%), that progress was made in cases that might otherwise not have been made (55%), and that ambiguity was reduced (in 83% of referred cases). Using the team sometimes caused delays. Some delays were unacceptable administrative delays while others were considered necessary to assure completeness of the evaluation. CONCLUSION: The use of the team did not result in resolution of all of the cases referred, but referral to the team consistently provided closure for referring professionals. In one-third of the cases studied, if it had not been for the START consultation the cases would not have proceeded to an appropriate criminal or civil resolution.  相似文献   

3.
This article addresses how Maslow's hierarchy of basic human needs can be used as a framework for cross-cultural counseling with children in crisis; that is, children of the world who are unable to fulfill adequately their basic human needs because of extreme circumstances such as natural disaster, violence, various forms of child abuse, extreme poverty, lack of school and community resources, and emotional abandonment. Assessment of child needs is discussed and counseling strategies are presented; strategies that include supportive counseling techniques, crisis intervention techniques, program development, delivery of social services and resources, referral to helping agencies, and counselor consultation with parents and other significant adults in the lives of children.  相似文献   

4.
Supporting child welfare (CW) workers’ ability to accurately assess substance abuse needs and link families to appropriate services is critical given the high prevalence of parental substance use disorders (SUD) among CW-involved cases. Several barriers hinder this process, including CW workers’ lack of expertise for identifying SUD needs and scarcity of treatment resources. Drawing from theories and emergent literature on interagency collaboration, this study examined the role of collaboration in increasing the availability of resources for identifying and treating SUDs in CW agencies. Using data from the second cohort of families from the National Survey of Child and Adolescent Well-Being, study findings highlight a lack of SUD resources available to CW workers. On the other hand, the availability of SUD resources was increased when CW agencies had a memorandum of understanding, co-location of staff, and more intense collaboration with drug and alcohol service (DAS) providers. These results provide evidence to support efforts to improve collaboration between CW and DAS providers and showcase specific collaboration strategies to implement in order to improve service delivery.  相似文献   

5.
OBJECTIVES: To assess the impact of a home visiting program in reducing malleable parental risk factors for child abuse in families of newborns identified, through population-based screening, as at-risk of child abuse. METHODS: This randomized trial focused on Healthy Start Program (HSP) sites operated by three community-based organizations on Oahu, HI, USA. From 11/94 to 12/95, 643 families were enrolled and randomly assigned to intervention and control groups. Mothers in both groups were interviewed annually for 3 years (88% follow-up each year) to measure mental health, substance use, and partner violence. HSP records were reviewed to measure home visiting services provided. Home visitors were surveyed annually to measure their perceived competence. RESULTS: Malleable parental risks for child abuse were common at baseline. There was no significant overall program effect on any risk or on at-risk mothers' desire for and use of community services to address risks. There was a significant reduction in one measure of poor mental health at one agency and a significant reduction in maternal problem alcohol use and repeated incidents of physical partner violence for families receiving > or =75% of visits called for in the model. Home visitors often failed to recognize parental risks and seldom linked families with community resources. HSP training programs were under-developed in preparing staff to address risks and to link families with community resources. CONCLUSIONS: Overall, the home visiting program did not reduce major risk factors for child abuse that made families eligible for service. Research is needed to develop and test strategies to improve home visiting effectiveness in reducing parental risks for child abuse.  相似文献   

6.
Implementing changes that support a preventative approach in early childhood education (ECE) requires the collaboration of skilled professionals. The present case study describes a change effort to implement multitiered systems of support (MTSS) in early childhood settings that included collaboration of agency personnel, school psychology program faculty and trainees, and ECE faculty. It describes a competency-based training initiative that provides applied experiences in consultation, supervision, and change facilitation for systems change efforts. The implementation of a systems-level approach for promoting positive behavior at three ECE agencies is described, with resulting teacher and child outcomes. Implications for future consultation research, training, and practice are discussed in relation to a consultation training model that provides competency-based field experiences to support change in ECE.  相似文献   

7.
This study examined professionals' knowledge of a relatively rare form of child abuse, Munchausen syndrome by proxy (MSBP). Eighty-six professionals representing hospital or other medical settings, community services programs, the state children's service agency, and various law enforcement agencies were surveyed. Results indicated that professionals employed in medical or hospital settings were three times more likely to have heard of the syndrome than those employed by community service agencies. Journal articles and colleagues were the most popular sources of information pertaining to MSBP. Respondents identified 77 possible cases of MSBP in their caseloads over the past year. Findings suggest the need for educating community professionals as well as the possibility that the incidence of MSBP has been grossly underestimated. Implications for future research and preventive efforts are discussed.  相似文献   

8.
This paper describes the application of some principles, taken from the modern psychotherapies by a therapeutic team, to the assessment and treatment of serious child abuse. Factors and dilemmas identified from the assessment and decision-making process are outlined, with particular reference to the roles of the various statutory and community agencies involved with such families. The paper demonstrates the ways in which the range of community and professional agencies may play a pathological role, unintentionally contributing to and maintaining child-abusing dynamics in families. The significance of dangerous unintended consequences of well-meaning agency interventions and of covert interagency activities are stressed.  相似文献   

9.
This study examined the presence and strengths of determinants associated with consultation of an in-house expert on child abuse and neglect (CAN) by preventive child health care professionals who suspect CAN. This study also assessed the relationship between in-house CAN expert consultation and professionals’ performance of six recommended activities described in a national guideline on preventing CAN for preventive child health care professionals. A total of 154 professionals met the study’s inclusion criteria. They filled in a questionnaire that measured in-house consultation practices and twelve determinants associated with the professional, the in-house expert, and the organizational context. Bivariate and multivariate regression analyses were performed. Almost half of the participants (46.8%) reported to consult the in-house expert in (almost) all of their suspected CAN cases. Professionals who reported better recollection of consulting the in-house expert (i.e. not forgetting to consult the expert) (p = .001), who were more familiar with consultation (p = .002), who had more positive attitudes and beliefs about consultation (p = .011) and who reported being more susceptible to the behavior (p = .001) and expectations/opinions (p = .025) of colleagues regarding in-house expert consultation were more likely to consult the in-house expert. Furthermore, in-house expert consultation was positively associated with two of six key guideline activities: consulting the regional child protection service and monitoring whether support was provided to families. The implications of these results for improving professionals’ responses to CAN are discussed.  相似文献   

10.
Evaluation of Mental Health Consultation in Child Care Centers   总被引:2,自引:0,他引:2  
Mental health professionals have speculated that their consultation services should improve the overall quality of a child care center, but few research studies have shown this effect in child care settings. In the present study, mental health consultation services were provided by four agencies to 25 urban child care centers to enhance children's emotional lives and social abilities, and to strengthen child care center staff's capacity to work with children who have difficult behaviors. A one-year evaluation was conducted to assess the impact of the mental health services on the teachers and child care centers using observational measures, director- and teacher-completed questionnaires, and qualitative focus group data. Centers with more than one year of consultation showed increases in overall quality, teachers' self-efficacy, and teachers' competence. In addition, staff expressed satisfaction with the mental health consultation services provided. Implications of findings and suggestions for future interventions are discussed.  相似文献   

11.
OBJECTIVES: To describe the characteristics and repertoires of community practitioners serving families involved in child physical abuse that may inform training and treatment dissemination efforts. The aims are to: (a) describe the background characteristics of these clinicians; (b) document their most common intervention techniques; (c) examine clinicians' attitudes toward manualized treatment; and (d) understand the organizational climate of community agencies. METHOD: Practitioners from nine different agencies who have worked with cases in which there was child physical abuse (n=77) completed focus group discussions and three self-report questionnaires. Qualitative and quantitative analyses were conducted in tandem. RESULTS: Practitioners reported that they most often focused on family issues and employed family therapy techniques. Although treatment manuals were important, it was difficult to determine how practitioners used or would use these materials with families. An almost equal number of concerns and benefits were raised regarding using manuals in treatment. There was moderate agreement in how practitioners perceived their work environments. Age and attainment of a graduate degree were positively related to greater caring and job satisfaction, respectively, while length of time at a given agency was positively related to greater reports of emotional exhaustion on a measure of organizational climate. CONCLUSIONS: Given the promising benefits of evidence-based treatments for child abuse, it is important that researchers begin to form partnerships with community agencies that will lead to the dissemination and evaluation of effective treatment strategies.  相似文献   

12.
This study addresses the following questions in cases of suspected child abuse and neglect (CAN) in children up to four years of age: 1) How many professionals intend to seek inter-organizational consultation? 2) What types of organizations do professionals prefer to consult? and 3) What factors can be identified as facilitator(s) or barrier(s) regarding inter-organizational consultation, based on professionals’ experiences? Professionals working with children in 101 organizations in a medium-sized Dutch city were invited to fill in an online questionnaire. The questionnaire included a vignette about a suspected case. Quantitative, qualitative, and social network analysis approaches were used to analyze the data. Seventy-eight questionnaires were available for analysis. Fifty-five respondents (71%) intended to seek inter-organizational consultation. Ten different organization types were mentioned. The most frequently mentioned organization was preventive child healthcare. In total, 82 text fragments from 39 participants were available to analyze barriers and facilitators to inter-organizational consultation, 60 fragments that entailed a facilitator and 22 fragments that entailed a barrier. The text fragments were subdivided into twelve factors. The three factors that were most often identified as a facilitator were ‘support’, ‘undertaking action’, and ‘regard’. Barriers were found in relation to all twelve factors. No specific barrier(s) stood out. This study demonstrated that most professionals are inclined to seek inter-organizational consultation when they suspect CAN. They are especially likely to seek consultation from preventive child health care organizations. Their experiences mainly revealed facilitators and few barriers. The implications for research and practice are also discussed.  相似文献   

13.
An experimental evaluation of in-home child abuse prevention services   总被引:3,自引:0,他引:3  
Perinatal child abuse prevention projects are rarely rigorously evaluated. Women were referred to the Child Parent Enrichment Project (CPEP) project during or just after pregnancy if identified as at-risk of engaging in child abuse by community professionals. Clients were randomly assigned to CPEP services (n = 97) or traditional community services (n = 94). CPEP services are based on ecological theory and involve six months of home visiting by paraprofessional women and linkage to other formal and informal community resources. No advantages on self-report measures for the CPEP group were measured at posttest, and follow-up reports of child abuse were similar for both groups. Consumer satisfaction indicates that clients highly valued the program. Some indication of greater success with families with less serious problems was observed. The results argue for caution regarding the capacities of perinatal child abuse prevention services to serve the high-risk clientele they often receive.  相似文献   

14.
Child abuse and neglect have recently been found to occur among American Indians at rates comparable to other American population groups. Little is known about the clinical spectrum of Indian maltreatment, the psychodynamics and effective treatment modalities. Cultural misunderstanding, modernization, poverty, situational stress, poor parenting skills because of early break-up of Indian families, alcoholism, unusual perceptions of children, handicapped children, and divorce constitute factors associated with maltreatment in cases cited. Old solutions of removing children from families were largely inappropriate and ineffective and are being replaced by local efforts to develop foster homes, supportive family services, and legal procedures to protect children. Communication between agencies involved and mistrust of outsiders plus a lack of trained personnel and available community resources continue to pose major barriers to effective treatment and prevention efforts. Recent federal policies and laws clearly place the responsibility for child welfare in the hands of Indian tribes and tribal courts. The non-Indian health professional has an important but limited role in providing technical expertise and in aiding development of community resources, taking care to support but not usurp the emerging leadership of Indian people.  相似文献   

15.
The transition to adulthood can be a challenging time for adolescents with intellectual and developmental disabilities. Its complexity, however, may be magnified for families who have immigrated to the United States. This study examined the transition expectations and experiences of six first-generation, Latino parents and their transition-aged (14–22) children with intellectual disability, autism, and/or multiple disabilities. Through individual interviews held in Spanish or English, parents offered insights into (1) their visions of success for their child, (2) the distinct barriers they face as immigrant families, and (3) their suggestions for schools and adult agencies related to supporting strong transitions. Their portraits of desired outcomes were quite individualized and reflected high expectations. Factors identified as inhibiting successful transitions included persistent language barriers, the views of certain professionals and community members, and exclusion from typical school experiences. Parents encouraged schools to support family advocacy, foster greater student independence, expand adult programming, and reduce segregated educational placements. We present implications for educators on working with Latino families, as well as offer recommendations for future research.  相似文献   

16.
Though every state has laws requiring the report of suspected child abuse and neglect, failure to report remains a significant problem. Review of previous research on failure to report suggests that the reporters' anxieties about disrupting their relationship with the child's family as well as the reporters' gender, experience, and training affect willingness to report. Countertransference fear, guilt, shame, and sympathy are discussed as a basis for understanding the reporter's anxieties. We suggest that countertransference issues should be addressed in the training and ongoing practice of mandated reporters. The following mechanisms are offered to deal with this issue in training and practice: (1) teaching professionals about how countertransference reactions may arise during the reporting process (this training may include the use of risk management groups for private practitioners); (2) identification of a community child abuse expert for consultation; and (3) educating child protection workers about psychodynamics aspects of case management.  相似文献   

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19.
Very often statutory intervention in child abuse cases can prove to be costly, inappropriate or even unwelcome. “Home-Start” began as a voluntary home-visiting scheme in Leicester, England, 8 years ago with the objectives of offering support, friendship and a practical approach to any young families experiencing difficulties. A recent evaluation by Willem van der Eyken, suggests that Home-Start enjoys a high success rate, particularly with the 25% of families referred to the scheme, who have children on the nonaccidental injury “At Risk” register. This paper outlines details of the objectives. the volunteers, the families visited and the Home-Start approach with child abuse cases. It highlights some elements of the scheme which have proved vital to its success, such as close liaison with the related statutory agencies, the intensive support to families in their own homes, and the meticulous preparation and support of the volunteers themselves. The Home-Start approach is now being used effectively in many other areas of Great Britain and consequently Home-Start Consultancy has been established at 22 Princess Road West, Leicester. England, to provide the opportunity for consultation, liaison and development with existing and new Home-Start schemes.  相似文献   

20.
A personal microcomputer data base program was used to study 184 substantiated 1981 child abuse and neglect cases in the city of Lansing, Michigan. Data on 18 variables were entered directly into the microcomputer from the agency case closing forms in 712 hours. The microcomputer can sort by one or more variables. In analyzing the data, the following questions were addressed: Who reports the child abuse cases? In what types of families does abuse occur? Who are the perpetrators in relation to the child? Who are the victims by age and race? What types of abuse are substantiated? How many of the cases are repeats? Where are substantiated cases located? This study was both simple and inexpensive, requiring minimal staff time, a microcomputer with a data base program, and data already available in agency files. This study could be duplicated in any area by noncomputer persons to help professionals, community organizers, and others to better understand their community and help the abusive family.  相似文献   

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