Multidisciplinary Approaches to the Treatment of Abused and Neglected Children and Their Families: It Takes a Village

By Dr. James P. Madry

This project produced a manual containing various approaches for utilizing counseling theories and strategies in innovative ways, along with mechanisms for developing multidisciplinary efforts. It is anticipated that the use of the manual will enhance cooperation and communication among various disciplines involved with the problem of child abuse. An improved level of interdisciplinary efforts will, hopefully, have a positive impact on this very serious problem. Additionally, there is the expectation that further research will be generated by some of the propositions in this project.

• Language: English
• Publisher: Xlibris US
• Release date: Sep 30, 2013
• ISBN: 9781483690148

Dr. James P. Madry

Dr. James P. Madry has worked in all areas of the mental health field. His practice which includes concentration on mood disorders; grief and anger management, chemical dependency, marital and family relationships and oppositional defiant behavior/conduct disorder. He is certified as a USDOT-Substance Abuse Professional (SAP), and for the treatment of pathological gamblers. He is a former Professor in the Graduate School of Social Work at the State University of New York in Buffalo, NY. One of his assignments, for several years, included teaching at Attica Prison, the maximum security facility in upstate New York. Dr. Madry has developed and administered several innovative mental health agencies and programs in Ohio, New York and Michigan. He has served as a clinical consultant to several agencies as they prepared for visits by accreditation bodies, such as the Commission of Rehabilitation Facilities (CARF). He has specialized training and certification in the following areas: United States Department of Transportation Substance Abuse Professional – USDOT-SAP, treatment of pathological gamblers, State of Michigan Licensed Appeal Division and Substance Abuse Evaluations for reinstated driver’s license.Dr. Madry affirms that a strong spiritual element is an integral part of his counseling approach and philosophy. He has 20 plus years in private practice.

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Copyright © 2013 by Dr. James P. Madry.

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Rev. date: 09/19/2013

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Contents

Acknowledgments

Chapter 1

Introduction and Statement of Purpose

Statement of the Problem

Definition of Terms and Symbols

Chapter 2

Review of the Literature

A.   Current Perspectives on Child Abuse and Neglect

B.   Changing Norms, Roles, and Relationships in the Contemporary American Family

C.   Problems of Parent-Child Relationships

D.   Multidisciplinary Roles, Relationships, and Strategies to Impact the Problem

Chapter 3

Methodology

Chapter 4

A Manual of Interdisciplinary Practice

Topic I

Introduction and Purpose

Statement of the Problem

Definition of Terms and Symbols

Topic II

The Contemporary American Family

Topic III

Etiology of Family Dysfunctioning

A.   Prevalent Characteristics of Abusive Parents

B.   Problems in Parent-Child Relationships

C.   Environmental Factors

D.   Prevalent Characteristics of Abused Children

Topic IV

Some Ethical Principles of Intervention and Treatment

A.   Individualization

B.   Purposeful Expression of Feelings

C.   Controlled Emotional Involvement

D.   Acceptance

E.   Nonjudgmental Attitude

F.   Client Self-Determination

G.   Confidentiality

Topic V

Multimodal Assessment and Treatment Strategies

A.   Crisis Theory

B.   Social Role Theory

C.   Social Group Work

D.   Parenting Education and Training

E.   Activity Group Therapy with Children

Topic VI

Multidisciplinary Roles, Relationships, and Policy Implications

Child Abuse Resources, Evaluation, and Social Services Team (CARESS-TEAM)

Chapter 5

Conclusions, Recommendations, and Summary

References

Acknowledgments

My deepest appreciation and most sincere gratitude are expressed to Dr. Leon T. Ofchus of Wayne State University, Detroit, Michigan, who served as my dissertation adviser. Dr. Ofchus provided the profound insight and scholarly guidance which were necessary to complete this dissertation project. His expertise, skill, knowledge, and generosity as a scholar, as an educator, and as a licensed clinical psychologist impacted all phases of the research and presentation.

No student who commences a dissertation has a grasp of the amount of time, energy, and personal and professional commitment required of a major adviser. The untiring effort and assistance of Dr. Ofchus were frequently demonstrated by his willingness to completely revise his schedule in order to accommodate a conference and to assist me over a research or an educational hurdle. He continuously contributed to the refinement of the research data to ensure that it would be developed in a logical, integrated, and coherent manner. To Dr. Ofchus, for all your guidance, insight, encouragement, and assistance, a special and sincere thank-you is extended.

To innumerable family members and friends, for your encouragement, assistance, and firm support, especially during those times when the magnitude of the task seemed formidable, I thank you very much. For all the cajoling, pressuring, prompting, motivating, insisting, and helping—in all the phases of the completion of this dissertation—I shall always be grateful.

Chapter 1

Introduction and Statement of Purpose

The purposes of this dissertation are to provide innovative and practical treatment strategies and to make recommendations for increasing cooperation and communication among the professionals involved with the problem of child abuse and neglect.

The problem of child abuse and neglect has received considerable attention in recent years from such professionals as medical personnel, clinicians, members of the criminal justice system, and educators (Ebelin and Hill 1983). Reports which have appeared with great frequency in the media have described horrifying cases of severe cruelty and injuries caused by violent and abusive acts by parents and caretakers upon their children.

Children in America and many other societies have, for decades, been subjected to a wide range of abuse and maltreatment, including deliberate mutilation to evoke passion in their roles as beggars; hazardous, dehumanizing conditions and expectations of child-labor practices; schoolmasters thrashing their students with cat-o’-nine-tails; and children legally bartered, sold, and in some cases, killed, with the matter remaining the exclusive province of parents and caretakers (Thorman 1982).

Ebeling and Hill (1983) chronicled a series of events which eventually led to the establishment of the Society for the Prevention of Cruelty to Children in 1875. They elucidated the efforts of a volunteer church worker in New York City to get help for an eight-year-old child who had been brutally beaten by her guardian. The church worker was advised by her pastor, her attorney, and the police to drop the matter since no law had been broken. Following her persuasive appeal to the president of the New York Society for the Prevention of Cruelty to Animals, the president decided that if that child has no rights as a human being, she shall, at least, have the justice of a cur on the streets. The child was eventually placed with the church worker after being brought into court, and the guardian was sentenced to prison. Shortly thereafter, the New York Society for the Prevention of Cruelty to Children was established. Similar organizations were soon formed in other cities and states.

In 1962, Kempe and his associates published an article in the Journal of the American Medical Association entitled The Battered Child Syndrome (Kempe, Silverman, Steele, Droegmueller, and Silver 1962). The article caused an explosion of interest in the phenomena of child abuse by a wide range of medical, mental health, and legal professionals (Frude 1981). The results have seen increased awareness of the problem and wide-ranging efforts to develop new treatment approaches and policies. Even as there has been greater attention to the problem of child abuse as a result of the paper by Kempe and his colleagues, the heightened attention has generated considerable debate and disagreement among many professionals addressing the issue.

While the gory details of child abuse are presented with great frequency, many feel that there are often overly sensationalized descriptions which do more to distort and alarm rather than to report and inform (Gerbner, Ross, and Zigler 1980). There is great difficulty in accumulating accurate and reliable data to carefully document the incidence of the problem. Gil (1970) conducted a national survey and estimated that between 2.5 and 4 million adults each knew of a case of child abuse during the previous year. In a reanalysis of Gil’s statistics, Light (1973) published a study in the Harvard Educational Review which suggested that between two hundred thousand and five hundred thousand children are abused each year. Gerbner et al. (1980) state that the estimate which the public hears most often is the one that was released by the National Center on Child Abuse and Neglect in 1975, which reveals that approximately one million cases of abuse are reported each year. Gerbner et al. (1980) explain that despite the figure’s questionable reliability or accuracy, it has become the most commonly cited estimate of child abuse.

It may be virtually impossible to determine the precise magnitude of the problem. It is known, however, that the number of cases reported to the authorities has dramatically increased over the last decade, which indicates to many that the problem is getting worse. Many professionals firmly maintain that heightened public awareness and improved reporting have swelled the statistics. In spite of debates regarding the accuracy of incidence trends and despite a definitional dilemma, there is a widespread consensus among doctors, social workers, psychologists, lawyers, and policy makers that the knowledge and expertise of these professions must be brought to bear on the problem (Gerbner et al. 1980).

Some questions which may be useful in the process of approaching the problem include the following:

1.   Can cooperative efforts of interdisciplinary personnel be increased? If so, how?

2.   Can practitioners be assisted in utilizing different helping modalities? If so, how?

3.   Can interdisciplinary efforts be enhanced in order to intervene at various social policy and community levels? If so, in what way can this be accomplished?

4.   Is it possible that constructs of various theories of counseling systems (i.e., psychoanalytic, behavioral, social role) can be adapted and creatively applied? If so, how?

Statement of the Problem

There exists a need for additional counseling strategies and increased communication and collaboration among interdisciplinary personnel before solutions to child abuse can be found. This statement is not meant to imply that there has been a lack of concern and commitment by dedicated practitioners. In fact, Costa and Nelson (1978) speak of the diversified concerns of various groups regarding child abuse. These authors explain as follows:

Professionals in the disciplines of medicine, law, social work, education, psychology, and psychiatry each have some stake in the problem. Many of these professions frequently feel the frustration of not being very effective because the problem has passed beyond their purview.

Similar concerns regarding fragmented, piecemeal approaches are evident throughout the literature.

Definition of Terms and Symbols

Battered Child Syndrome

This term was introduced in 1962 by C. Henry Kempe, MD, in an article describing a combination of physical and other signs indicating that a child’s internal and/or external injuries resulted from acts committed by a parent or caretaker (US Department of Health, Education, and Welfare, National Center on Child Abuse and Neglect, DHEW Publication Number [OHDS] 78-30137).

Child Abuse and Neglect

An all-inclusive term as defined in the Child