CALIFORNIA STATE UNIVERSITY, NORTHRIDGE
CURRENT PROBLEMS
OF CHILD ABUSE AND NEGLECT
A thesis submitted in partial satisfaction of the requirements for the degree of Master of Arts in Education,
Educational
Psychology~
Counseling and Guidance
by
Suzan Rood Wilson
August, 1979
The thesis of Suzan Rood Wilson is approved:
Dr. Ezra Wyeth, Chairman
California State University, Northridge
ii
TABLE OF CONTENTS
Chapter
Page
1.
INTRODUCTION
1
2.
PROBLEM DEFINI'riON .
4
3.
EXPLANATION
4.
RESEARCH .
5.
INTERVENTION • .
27
6.
PREVENTION .
38
7.
SEXUAL ABUSE •
44
8.
PROPOSAL .
51
9•
SU:f\1MARY
.
.
.
• .
13
•
. . . . . . . . . . . .
• .
20
53
REFERENCES
54
iii
ABSTRACT
CURRENT PROBLEMS
OF CHILD ABUSE AND NEGLECT
by
Suzan Rood Wilson
Master of Arts in Educational Psychology
1979 is the Year of the Child.
This thesis concerns
itself with child abuse and neglect, and those persons
and/or agencies that not only contribute to the problem,
but also those that are attempting to deal with and
eliminate the problem.
A working definition of child abuse and neglect is
offered, as well as descriptions of the various forms of
child abuse and neglect, specifically, physical, nutritional, psychological, verbal and sexual.
In examining the possible causes of child abuse and
neglect, the abusive parents and their motivations for
becoming abusive parents are considered in terms of both
psychol0gic2l and environmental etiological factors.
"-..
iv
The sources used by the U.C.L.A. Child Trauma Clinic
to determine abusive behavior in parents, particularly
mothers, include the Parent Attitude Research Instrument
(PARI) and the Minnesota Multi-phasic Personality
Inventory (MMPI).
While the test results are not conclu-
sive in and of themselves, the findings do point toward
a possible method for earlier intervention.
Intervention by various community agencies such as
social service agencies, health services, the juvenile
court system, mental health agencies and law enforcement
agencies is presented as an effective tool, once abuse
has been recognized.
However, it is concluded that a
method for prevention must be sought and implemented.
A possible proposal for prevention is offered to
administrators of child abuse and neglect programs.
Preventive measures, such as parent-testing to determine
the possible presence of abusive tendencies in couples,
and parent-licensing, to prevent parents who have abusive
tendencies from having children, are offered.
The
drawbacks of such a severe plan for prevention are recognized and considered.
A final discussion is on sexual abuse, based on
conclusions drawn from personal observation within a
clinic setting.
v
Chapter 1
INTRODUCTION
This is the Year of the Child.
The purpose of this
paper, dealing with child abuse and neglect, is to assist
clinicians and administrators in instituting a program to
prevent, not merely to treat, such abuse.
During the course of my research, it became apparent
that there are no easy solutions to this problem.
The
solutions that are offered are dependent upon social
agencies, many of which are reluctant to interfere in the
absence of clear evidence of child abuse for fear of exceeding their authority.
The involvement of private
citizens in reporting such abuses, is minimal, not only
because of the fear of legal ramifications, but also
because of their fear of direct reprisal by the parents.
There is also the concern that they might be exaggerating
the situation, or worse, that they may be totally incorrect.
One of their main excuses for non-involvement
is that they are not professionals.
As the roles of the various social and educational
agencies are examined, it becomes apparent that they share
a sense of helplessness because they encounter the child
after he has been abused.
Realistically, too, all these
sources of intervention must rely on access to the victim.
1
The policeman who answers the call to quell a family dispute, must rely upon his own judgment as to whether or
not there has been any abuse of a child.
He must attempt
to prevail, despite parental objection to further examination of the child.
The teacher who perceives that there
migh·t be a case of child abuse or neglect in the class,
can report this suspicion to the proper school authorities.
They in turn, can carry this information to the proper
social agency.
The effective solution, however, must
ultimately rest on the cooperation of the parents.
The only two intervening agents with any immediate
affect, are the public health nurse and the medical
practitioner.
Of all the above-mentioned groups, these
two share expertise in recognizing physical abuse.
Un-
fortunately, as with the other agencies discussed, there
is here, too, a reluctance to disclose the act of abuse
to the proper authorities.
Assuming tha·t all these agencies perform to their
maximum effectiveness and intervention is deemed necessary,
it wil1 be seen that even the necessary intervention can
be psychologically damaging to the child and his family.
In attempting to design a program for effective
intervention, I realized that intervention, in and of
itself, was not the solution.
There needed to be something
that \vould obviate the problem completely.
The idea of
prevention, rather than intervention, became my focus.
3
In the next section, I will investigate more closely,
the apparent causes of child abuse, the various kinds of
abuse, the statistical incidence of abuse, and the effects
of abuse, both physical and psychological, on the child.
4
Chapter 2
PROBLEM DEFINITION
"Professionals, scholars, administrators, and legal
experts tend to define child abuse and neglect as
'intentional acts of commission or omission on the part
of individual caretakers of children, which result in
physical or psychological injury or damage to children.'
Although this definition may be used as a working one,
closer scrutiny reveals serious limitations along at lsast
two importan·t lines:
Firstly, this definition lacks a
frame of reference against which injury and damage may be
identified and measured.
Secondly, the definition is
based against individuals of sole agents of child abuse
and neglect.
These shortcomings of the definition are
not unusual for social science problem definitions in our
culture.
We tend to look at problems from a descriptive
point of view rather than from an analytic one, as
isolated fragments, without a frame of reference that
specifies desired conditions against which the problem
can be identified and measured, and lastly, in a manner
that blames the individual as agents, rather than societal
factors."
(Gil, 1976)
Before determining what constitutes child abuse and
neglect, it would be important to examine alternate
5
approaches to the above definition.
One alternative
approach would be to focus on the ideal state of childhood, and the rights of children in ·the society.
Perhaps
it might then be tentatively considered that actions that
violate these ideals and the rights of children, could
be judged as child abuse and neglect.
If this society is indeed democratic and egalitarian,
then every child should be entitled to equal social,
economic, civil, and political rights, so that each child
may develop freely and fully in accordance with his
innate potential.
If this value position is accepted as
a frame of reference, then child abuse and neglect means
the wasting of a child's developmental potential, or the
interference with a child's development due to existential
circumstances that are not conducive to optimal development.
Having proposed that children should be entitled to
equal rights to free and complete development, and having
stated a tentative definition of child abuse and neglect,
it is now possible to pursue the nature and dynamics of
child abuse and neglect in today's society.
The above definition transcends the conventional
notion that the only place where child abuse and neglect
occur is in the child's home, and that the sole agents of
child abuse and neglect are the individual caretakers,
i.e., parents, or foster parents.
While interference with
6
the child's optimal growth and development does indeed
take place in the home, the home itself is rarely, if eve4
the sole source of abuse and neglect; but it is the final
link in a long chain of societal conditions and factors.
These conditions are also present at the institutional
level where ab11se and neglect of children is practiced
through school policies,which imply that the teacher is
always right, the child is always wrong in any confrontation.
Carl Rogers, at a recent seminar in San Diego,
stated that the public school is a humiliating experience
for the child because of this teacher-right student-wrong
frame ..
He further stated that these programs ignore the
needs and interests of the child as do public agencies
such as nursery schools, daycare centers, foster homes,
/
child care institutions, juvenile courts and correctional
facilities, health care delivery systems and public
welfare and support programs.
Under this operative definition, these agencies
cannot be cleared of charges of child abuse and neglect.
The public welfare system seems to be the main offender,
in that the assistance levels provided by this system
fall
far below those levels defined as "minimal" by the
UoS. Government's own measures.
For example, the food
support programs provided by the U.S. Department of
Agriculture have recently been cited in a congressional
investigation for not meeting minimal expectations for
7
a survival diet.
The inadequate dietary level of expect-
ant mothers and infants are known to be a contributing
factor to mental retardation.
Therefore, if the federal
and state agencies involved in feeding welfare participants provide inadequate sustenance, then they too are
guilty of child neglect and abuse.
The poor levels of
care provided by our health care systems are reflected in
high infant mortality rates, and the severe shortages of
mental health care for children.
Juvenile courts and correctional institutions may
be the actual catalysts for adult criminal careers, since
juveniles who conrnit minor crimes are often incarcerated
with·those who have committed more serious offenses.
Many of the child care institutions and foster care
programs for neglected, abused, disturbed and homeless
children, provide little more than physical shelter,
where emotional and psychological support are equally, if
not more,important.
If the proper study of mankind is man, then the
educatirinal institutions of this country fail to support
this philosophy.
It appears that the goal of our educa-
tional system is to launch faceless groups of conforming
men and women who will fit into the existing occupational
structures; men and women whose main function is to make
money, rather than to concentrate on individual
self-direction, self-expression and self-actualization.
8
Having stated and defined the problem, I will now
concentrate on the many areas of child abuse and neglect,
namely, physical, nutritional, psychological, verbal and
sexual.
I will also include a brief examination of the
epidemiology and the etiology of child abuse and neglect.
Physical Abuse is defined as non-accidental trauma
inflicted by a caretaker.
The child will usually bear
signs of injury--bruises, welts, contusions, cuts, burns,
fractures, lacerations, or strap marks.
The severity of
these injuries can range from simple bruises, to fatal
subdural hematomas.
While internal injuries are seldom
detected without a hospital work-up, anyone in close
contact with children should be alert to multiple injuries, a history of repeated injury, new injuries added
to old, and untreated injuries, especially in the very
young child.
Nutritional Neglect is the most common cause of underweight in infancy.
Caloric and water deprivation are the
chief reasons that infants fail to thrive.
_!'h,~chological
Abuse is far more difficult to
identify than its physical counterparts.
Broadly defined,
psychological abu3e and neglect would include abandonment,
unreasonable and/or cruel confinement, purposefully
confusing or inflicting "crazy-making" communications
upon a child.
More specifically, children are abandoned
in public places; they are locked in closets or small
rooms.
" ... Parents' lack of love and proper direction,is
inability to accept a child with his potentialities as
well as his limitations.
The parents of an emotionally
abused and neglected child may be over1y harsh and
critical, demanding excessive academic, athletic, or
social performance.
On the other hand, the parents may
withhold physical and verbal contact, care little about
the child's successes and failures, and fail to provide
necessary guidance and praise."
The psychological damage
is often more serious than the physical damage (Paulson,
1976b).
Verbal Abuse includes excessive yelling, belittling,
and teasing.
Verbal abuse is found to be the most wide-
spread type of child abuse.
A child who is constantly
made to feel "not OK" by his or her parents, grows up
lacking self-confidence and self-esteem.
The result of
negative verbal transactions from parent to child is
always, "I'm OK (parent), You're not OK (child)."
Sexual Abuse is the most underdiagnosed form of
child abuse.
It ranges from exposure and fondling to
intercourse, incest and/or rape.
Approximately 75% of
the offenders, usually males, are known to the child or
the child's family.
Some 90% of the victims are girls
from infants through adolescents.
This form of abuse will
be discussed in detail below.
The sexually abused child lacks the classical
symptoms of battering.
Therefore, identifying the sexu-
ally abused child is much more difficult.
Unfortunately,
the best indicators of sexual abuse, short of the child's
informing someone, are inadequate.
They are a sudden
change in behavior and signs of emotional disturbance.
The difficulty in diagnosing a sexual abuse is that these
symptoms are indicative of many other childhood traumas.
The immediate goal of therapy in dealing with the sexually
abused child is to separate the child from the offending
adult.
The epidemiology of physical abuse includes the
following statistics:
a.
Physical abuse involves 6 out of every 1,000
children born in the U.S.A.
b.
There are 300 - 375 cases per 1,000,000 popula-
tion per year.
c.
In the emergency rooms, approximately 10% of the
injuries seen in children under 5 years of age are
inflicted with a mortality of about 1%, leading to 600
deaths per year in the
d.
u.s.
Failure to thrive in infants is reported with
one quarter the frequency of physical abuse.
e.
The victims of physical abuse are estimated to
be 1/3 under 6 months old, 1/3 from 6 months to 3 years,
l/3 over three years.
Premature infants, because
mother-bonding does not take place, have a threefold
greater risk; stepchildren are also an increased risk.
11
f.
The child with failure to thrive is usually
less than 2 years of age, because he or she can usually
obtain food for him/herself after that age.
g.
In certain bizarre circumstances, an older child
may be confined to his or her room and be starved.
h.
Parents who abuse their children come from all
ethnic, geographic, religious, educational, occupational
and socioeconomic groups
(which leads me to conclude the
reasons are more psychological than sociological).
i.
Socio-economically disadvantaged families may
have an increased incidence of child abuse owing to the
greater number of crises and frustrations as a result of
their limited material resources.
j.
Women are more often involved in abuse than are
men, because mothers are the primary caretakers.
This,
however, is not the case when fathers are not employed.
The etiology of child abuse is multi-faceted.
For
physical abuse to occur, it requires not only the right
parent, but also the right child and the right day.
The
right child has characteristics that make him or her
demanding; the right day is usually a day of crisis.
The
most com.mon crises include, losing a job, being evic·ted,
having the car break down, having a new baby, child
becoming ill.
A startling statistic is that over 90% of abusing
parents have tendencies toward being psychotic or
].2
sociopathic.
1975).
This apparently is the right parent (McKay,
These parents have injured their children in
anger, after being provoked by some misbehavior or other
behavior that the parents felt that they could not
control.
Finally, abusing parents may have experienced physical abuse themselves as children, and their poor impulse
control is a repetition-compulsion pattern.
"t ..,
·•· -I
Chapter 3
EXPLANATION
There is probably one basic explanation for the abuse
and neglect of a child.
This explanation is most helpful
in eliminating an attitude of anger and punitiveness
toward the abusing parents.
Their negative parenting is
often a result of their own negative upbringing.
Almost
without exception, the parent of an abused child was
himself or herself an abused or neglected child.
And
like most parents who were faced with this dilemma, they
raise their children in much the same manner.
"In the paper Remembering, Repeating.and WorkingThrough,
(19l4c), Freud, for the first time, mentions
repetition-compulsion, a special aspect of resistance,
namely, the tendency of the patient to repeat a past
experience in action, instead of remembering."
(Greenson,
1967).
For us to understand the background of abusive and
neglectful behavior, it is important to look at two basic
definitions of neglect:
Ma~erial
Neglect - is one of the more common, and pertains
to the lack of adequate food, clothing, shelter, cleanliness and other material needs.
Serious nutritional
neglect, especially in the first two years of the infant's
14
life, can lead to serious permanent deficiencies in
general physical growth and brain development.
Material
neglect may or may not have been present in the early
lives of abusive and neglectful parents, and may or may
not appear in the parents' present situations with their
own children.
Psychological Neglect - a factor far more important in
the life history of the parents, is the lack of warm,
sensitive interaction that is necessary for optimal
growth and development.
Marasmus, a condition developing
from the fifth month of life, is a direct result of total
emotional and physical neglect.
It's tragic result is
death in 60% or more cases (Julie Marks, Spring 1979).
If the child receives minimal attention and survives, the
result is often a deep lack of basic trust and confidence,
combined with a very low sense of self-esteem that continues into adulthood (Itamar Yahalom, May, 1979).
As children, most abusive parents were expected to
perform at much higher levels than their peers.
parents demanded too much too soon.
Their
If the child did not
live up to his parent's expectations, he was then subjected to scolding, belittling, and criticism, and was
often physically abused for his failures.
There are certain psychological factors common to
abusive and neglectful parents.
They are often described
as being immature, needy and dependent.
They have
15
extremely low self-esteem and feelings of incompetency.
They have great difficulty in dealing with pressure.
They
tend to be socially isolated from family and friends.
They suffer misconceptions about their children; they fear
spoiling the children, they have a strong belief in punishment; they suffer a serious lack of ability to be empathic
to the children's conditions and needs.
The additive
effect of these psychological factors make it extremely
difficult for the parent to succeed in meeting the
demanding tasks of child care.
parents are accurate.
The descriptions of these
Unfortunately, they are too often
used i.n a judgmental/derogatory sense, and not as a
valuable clue to the basic character difficulties that
must be dealt with in treatment.
The developmental arrest and/or blockage of a normal
personality growth can be best understood in terms of the
parents' immaturity.
As children, these parents were
generally forced to disregard their own feelings and
thoughts in favor of strict obedience to their parents'
demands.
Because of this, the child's own maturation and
development were inhibited.
The child then was unable to
use his innate abilities to develop independent thought
that would allow him to use good judgment later in life.
This psychological block prevents the child from maturing,
and he remains helpless, needing perceived authority to
tell him what to do and how to do it.
And, ironically,
16
the perceived authorities were the abusive parents who
set the rules they learned as children.
The problem of dependency can be viewed as a close
companion of the parents' immaturity.
Children who have
their inner directional controls blocked tend to become
dependent on external authority for direction, evaluation
and reassurance regarding their own successes and failures
in life.
One type of dependency that seems to be present in
almost all abusive and neglectful parents is a painful
and, usually, unsuccessful search for love, affection and
approval, which they need in order to become adequate and
capable adults.
The immaturity and dependency discussed above seem
to be related to emotional deprivation in early life.
According to a government study, a small but significant
number of parents exhibiting these traits, suffered
organic brain damage in their early years as a result of
abuse and/or neglect.
Because of either head trauma or
malnutrition during critical growth periods, they showed
perceptual difficulties, delayed language development,
and lowered IQ.
One aspect of this immaturity is the great need for
approval by an authority.
These abusive parents suffer
from an obvious lack of self-confidence in their knowledge of what is the best thing to do.
They need constant
17
reassurance that they have not made a mistake.
Their
childhood experiences were often solely critical, and
they cannot trust their own performance.
Abusive and neglectful parents, as a group, can also
be characterized by their lack of ability to experience
pleasure.
They
cc~nnot
describe rewarding, pleasurable
interaction with family and friends.
If these parents
have friends, the friendships tend to be shallow, their
social activity minimal and lacking in meaning.
Although the followihg statement is also true of
non-a0usive mothers, abusive mothers in particular may
have difficulty in experiencing sexual pleasure with
satisfying orgasms.
Sex, instead, is overshadowed by a
general sense of needing to be loved, cared for, petted
and held in an almost childlike way.
Abusive mothers and fathers tend to shmv little
pride and joy in their children.
They view their child-
ren's performance as an expected compliance to duty rather
than as pleasurable discovery and admirable development.
The terms "unmotivated" and "untreatable 11 are often
used by therapists because of the parents' immaturity,
excessive dependence and failure to respond to help.
These are the very factors which must be treated in order
for the parent to be helped.
The phenomenon of role reversal seems to be common
to abusive parents.
This reversal of roles is that _
18
pattern of interaction that involves the parent as the
helpless child looking to his or her own
care and comfort.
child~parental
Because the child is incapable of
performing and validating authority, the parent's anger
is even further exacerbated.
Another common misperception
of the abusive parent is that the child is in some way
innately evil, deficient or destructive, and is deliberately trying to make the parents' life miserable.
The
child may be described as being "as bad as I was when I
was a kid" or "just like his no good father".
A major problem with misperceptions is that they may
be exaggerated by the presence of real biological abnormalities in the child:
prematurity, congenital defects,
illness, genetically determined hyperactivity.
Some
babies are inevitably more demanding and less rewarding
than others in their response to their parents.
On the
other hand, babies who are normal, but born at an
inappropriate time in the life of his parents, can be
seen as troublesome and unsatisfactory.
The abusive and neglectful parent often feels that
the child should not be "given in to", nor allowed to
"get away with anything."
When the baby is crying, or
shows discomfort, he or she should not be picked up nor
be permitted to become too dependent.
Contrary to popular belief, the abusive parent who is
punitive does not attack on impulse, nor has he an
19
uncontrollable discharge of aggress1on.
It appears that
the punishment is specially organized and designed to
punish and correct specific bad conduct or inadequacy
in the child.
The true problem may be in the parents' unrealistic
estimates of the child's abilities.
Abusive parents tend
to view the child as more mature than he or she really is.
Conceivably, this may relate to the aforementioned demand
that the child parent the parent.
Two common manifestations of parental aggression seem
to be that only one child in a family of multiple siblings
is abused, and psychological testing indicates that impulsiveness is not a common characteristic of abusive
parents.
~-- ~----
--
---"--
20
Chapter 4
REASEARCH
I would now like to consider those psychological
tests used to determine what differences, if any, exist
between the abusive and non-abusive parent.
The Parent Attitude Research Instrument (PARI), and
the MMPI are two types of research tools employed to
determine why and for what reasons parents abuse and
neglect their children.
In the study, "Clinical vs. Statistical Influences
in Understanding Abusive Mothers", the PARI (Paulson,
1975) was used to determine whether or not the test could
differentiate between court-identified abusive mothers
and a control sample of non-abusive, well-baby clinic
mothers of comparative socio-economic classes.
Briefly
the results of the PARI show that this test alone should
not be used to identify potentially abusive mothers.
The
results also caution, and call to the therapist's attention, that the test is limited because it uses
one-variable tests of statistical significance in dealing
with clinical data.
The PARI was initiated because the 23 child-rearing
attitudes measured by this tool appeared relevant to a
better understanding of abusive as opposed to non-abusive
21
mothers.
It also shed light on the etiology of abuse and
neglect of children.
The purpose of the PARI was two-fold:
1) to assess
the credibility of the test as a means to differentiate
between the child-rearing attitudes of both abusive and
non-abusive mothers and 2) to examine the shortcomings
involved in the routine application of standard statistical methods pertaining to clinical data.
The court identified test subjects for this study
were referred to the UCLA Child Trauma Intervention
Project (CTIP)
(Paulson, 1975).
Forty-four mothers were
accepted into the program and were administered the PARI
as part of an initial psychological battery of tests
immediately prior to entering psychotherapy.
The data showed that the families involved were of
socio-economically lower backgrounds.
The majority of
the 44 had been referred by the Los Angeles County
Department of Public Social Services (DPSS).
The levels
of abuse and neglect ranged from mild to severe, in which
the abused child was permanently crippled, blind, and
mentally retarded.
However, no child died as the result
of the abuse or neglect.
The control sample for this study included 70 mothers
from the UCLA well-baby clinic who volunteered to take
the PARI while their children were participating in a
routine medical examination.
These mothers were under no
pressure to take the test that might produce negative or
inaccurate results.
In the procedural part of the PARI, Paulson states
that by the use of Alpha=.05 to determine significance,
Univariate E-tests v1ere performed on the 23 scales of the
PARI to test equality of means between the abusive and
non-abusive mothers.
A multivariate procedure was used
to determine the collective significance of all 23 scales.
Table 1 (see page 23) was taken from the article,
"Parent Attitudes Research Instrument (PARI):
Clinical
vs. Statistical Inferences in Understanding Abusive
Mothers 11
(Paulson, 1975).
The table shows the mean and standard deviation for
all 23 pair scales for both abusive and non-abusive
mothers.
Also included in this table, is the hypothetical
direction which an abusive parent might take in child
rearing.
The control mean scale shows a possible differ-
ence in direction, and whether the direction was
confirmed, regardless of significance level.
It is
interesting to note that the encouraging verbalization
and egalitarianism scales were opposite to what was
predicted.
Many personality and character traits have been
identified in abusive families by using the PARI in a
clinical setting.
The 44 abusive families used in the
study were described as isolated, withdrawn, lacking in
23
TABLE ONE
P.A.R.I.
Subscale Differences Between Abusive and Non-Abusive Mothers
Abusive S 5
N=44
....
P A R I
Sub scales
x
SD
Control S 5
N=70
x
SD
Pn*. VPn" ..P
l.
Encouraging Verbalization
17.9c 1. 77
17.23
2 • 0 I LOW INO
2.
Fosterin9: Dependency
10.7~
2.81
10.37
2 6tlHI(';H IYBS
3.
Seclusion of the Mother
ll.7C 2.55
11.24
3 27 ar.-:;H I YES
4.
Breakin9" the Will
10.6C 2.80
10.16
2 9' IHIGH [YES
5.
Martyrdom
10.6
3.21
10.19
3.01 iHIGH YES
6.
Fear of Havinq the Babv
14.2
2.93
7.
Marital Conflict
15.6C 2.93
3. .!IGH IYES I' 05
.
15.31 2.5· HIG!-:: YE<::
8.
Strictness
12. 4L 2.62
13.04
2.97 HIGH NO
9.
Irritability
13.2( 3.21
14.23
3. 16UUGH NO
1 o.
Excluding Outside Influences
10.6
2.59
10.67
3.1~
1 1.
Deification
11.7~
3.25
11.63
3.42!HIGH YES
1 2.
Suppression of Agression
11.09 2.73
10.80
2.43 HIGH YES
1 3.
Rejection of Homemakinq Role
11.20 3.83
11.81
2.7 HIGH NO
1 4.
Egalitarianism
16.8
2.02
15.70
1. 88
1 5.
Approval of Activity
11.8
2. 7l
12.21
3.26 HIGH NO
1 6.
Avoidance of Communication
9.55 2.39
9.73
2 60lHIGH NO
1 7.
Inconsiderateness of Husband
1 8.
Suppression of Sexuality
8.36 2.59
8.44
2.61 !HIGH INO
1 9.
Ascendance of the Mother
10.95 3.37
11.24
3.33 IIGH NO
2 0.
Intrusiveness
11.11 3.28
10.36
3.56!HIGH YES
2 1.
ComradeshiP and Sharing
17.07 1. 77
17.30
2.03 ow
2 2.
P.cce1eration of Developement
11.02 3.39
10.99
3.40 HIGH YES
2 3.
Dependency of the Mother
12.65 3.18
12.56
3 29 HIGH I YES
13.34 3.52
*PO - Predicted Direction for Abusive Hothers
13.09
()<)
I
H
1
!HIGH
~ow
=
NO
01
12.53. 3.35!HIGH YES
.
YES
#VPD - Verification of PO
24
communication skills, self-centered, and often expecting
too much from their children.
Paulson hypothesized that the PARI as a measure of
child rearing attitudes and expectation, would show a
significant differentiation between abusive and non-abusive
mothers.
It can be seen from the table, that abusing mothers
had a higher mean score on encouraging verbalization, a
surprising result not expected for families in which
suppression, over-control and high expectations characterize a general life style.
One of the more surprising
results of the test was that the abusive mother scored
high in her fear of harming her child.
must be closely examined.
The term "fear"
Was the fear initiated because
of actual abuse and/or neglect, or was the fear present
before the birth of the child?
Was it fear of eventual
discovery or was it some mystical fear, almost a psychotic
fear that something or someone outside of her control
would hurt the child?
(NB:
psychosis has been found to
be a predominant factor in abusing parents).
A third area in which the abusive mother scored
higher than the non-abusive mother was egalitarianism.
It appears from the data that within the home of the
abusive family, an egalitarian attitude exists, as well
as a positive response to independent speech, and the
rights of each family member.
Also, a strong sense of
25
role identity was present in family members.
On the
other hand, this egalitarianism does not occur consistently, and is not incorporated by the child.
The scale names of the PARI represents psychological
constructs important in understanding and predicting
future behavior.
On the other hand, however, as with
many other psychological instruments, the test may not
measure what it purports.
In fact, the test fails to
discriminate significantly between many traits found in
both the abusive and non-abusive mother.
Indeed the
abusive mother is similar to the non-abusive mother in
the sense that she, too, holds high aspirations for her
children.
But these high aspirations are merely projec-
tions of her own unfulfilled needs and desires, not those
of her children.
Whereas this PARI study (1976a) dealt with character
traits in abusive mothers, in another study, Paulson used
the Minnesota Multi-Phasic Personality Inventory (MMPI)
as a descriptive measure of psychopathology in abusive
mothers.
The purpose of this study was two-fold:
1) to
identify the characteristic M..MPI profiles in order to
distinguish between a sample of abusive parents and a
comparable study of non-abusive parents;
2) to differ-
entiate personality characteristics within subcategories
of those parents with various degrees of responsibility
with regard to abuse, neglect, or maltreatment of their
26
children.
The results of this study show that females who are
passive abusers "are those who either were aware of the
risk of potential abuse and made no intervention, or in
an indirect manner participated passively in the maltreatment"
(Paulson, 1976).
'I'he abusive mother scored
highest on the scales that measure interpersonal isolation,
paranoid-type thinking, anti-establishment or radical
behavior, and depression.
Eighteen abusing females,
"those positively identi-
fied as responsible for the injury or neglect of their
child"
(Paulson, 1976a) showed an amazing absence of
measured neurotic anxiety, with little evidence of
self-doubt, depression or expressed insecurity.
However,
they did use projection as a defense.
The lowest psychopathological traits were found in
6 absolute non-abusers, those mothers who "are in no
apparent way responsible for the maltreatment of the
child"
(Paulson, 1976a).
for all female subjects.
Their neuroses were the lowest
These 6 showed no evidence of
psychotic disturbances characterized by paranoia or
interpersonal withdrawal.
By using the MMPI as a tool for the measure of
personality, various degrees of psychopathology, as they
pertain to abusive mothers, have been identified.
''i.
27
Chapter 5
INTERVENTION
Having examined the causes and effects of child abuse
and neglect, the next step is to examine intervention and
the sources of intervention.
Violence as a behavioral response to intrapsychic,
interpersonal and social conflict, has been characteristic
of man since the beginning of his history.
In the past
decade, acts of violent crimes have increased manifold,
and yet these violent crimes are viewed by many as
necessary for a meaningful social change and political
maturity.
The abuse and neglect of children, like other
acts of violence, has an equally long_history.
In the
early 1960's, Kempe recognized those failures in parenting
that resulted in what is now called the "Battered Child
Syndrome" .
Prior to Kempe's work, the medical profession had
'
a difficult
time in understanding the unexplained physical
traumas related to children.
Many investigators, such as
Sullivan in 1953, reported puzzling findings associated
with unexplained multiple skeletal trauma, contusions, and
a history of injury inconsistent with medical signs and
symptoms.
Fairburn and Hunt (1964) compiled numerous papers
28
describing the personal factors attributed to abusive and
neglectful parents.
While these various papers proved to
be clinically significant, their approach was primarily
descriptive and did not say much about understanding the
underlying intrapsychic and interpersonal conflicts which
are manifested in the abuse and neglect of children.
Along these lines, while a psychiatric diagnosis is useful
as a labeling procedure, it does not, however, help to
explain the psychodynamics of the abusive parents who are
termed non-psychotic, non-retarded, non-brain damaged.
What needs to be implemented today, is a set of
hypotheses that can be applied in the community in order
to create a program of identification and intervention.
The knowledge acquired from an appropriate program will
hopefully lead to prevention, rehabilitation and education
for the "now" children who may or may not be "tomorrow's"
high risk abusive parents.
In deciding whether or not to intervene, two issues
must be reviewed:
1) Whom is the intervention serving?
2) Is it always positive to intervene?
In answer to these questions, in deciding whether or
not to intervene, Freitag (1979) focuses on four points
of view:
1) the parent or parents, 2) the client--the
child, 3) society or a social agent, e.g., a police
officer, and 4) intervention with particular emphasis
on the mental health professional, e.g., the psychologist
or counselor.
Along these lines, another important issue
is generated by Freitag's question, namely, who should
decide the question of whom the intervention is serving,
and on what basis or bases should this question be
decided?
The answer to these questions is that society decides
and that the society's basis for intervention deals with
the {a) legal right to intervene when child abuse and
neglect is suspected,
(b) the decision of a mental health
professional who has expert knowledge in this field and
who can, therefore, make the necessary judgments based
upon his experience,
(c) public agencies, such as the
police, who have the right to remove the child from the
suspected offending parent or parents,
(d) societal
values that no parent has the right to abuse or neglect
the child, and (e) the motivation to allow children the
enjoyment of life without any interruptions in productivity, growth, and achievement.
The second issue, is it always positive to intervene,
is dealt with by Paulson who states that "intervention
is always indicated, but not always helpful.
carceration can be therapeutic.
Even in-
Most important is the
immediate protection of the child.
Intervention, if
effective, hopefully enables all family members to grow
emotionally and gain insight."
(Paulson, 1977)
If the child abuse and neglect is diagnosed in a
30
particular family, the parent or parents who are responsible for the crime may be sent to prison for an indefinlle
amount of time.
In a prison situation¥' the parent may
be involved in an educational, rehabilitational program,
may experience private or group therapy, or any combination
of treatment, education and therapy.
However, the child
may be removed from the home and placed in a foster home.
According to Paulson (1977), "dealing with rehabilitation
~ust
recognize not only the needs within each of the
parents and the family unit, but also the physical,
emotional and medical needs of the abused child, whether
maintained within the home, referred to temporary or
permanent placement, or required to adjust to a life with
permanent physical and/or mental impairment."
Even though
removing the child from his home environment may be
indicated in cases where the question o£ life or death
is at issue, Spitz reports that, "the existence of the
mother, her mere presence, acts as a stimulus for the
responses of the infant ... her actions--be they ever
insignificant, even when not related to the infant--act
as a stimulus."
(Spitz, 1945).
Indeed, even if it is
obviously advantageous to remove the child from a lifethreatening situation, one unfortunate problem arises,
namely that the child does not want to leave his or her
biological parent.
Along with early treatment of abusive parents, equal
31
identification must be given to the child who is experiencing unrecognized neglect, abuse, or maltreatment, in
order to prevent continuing or more severe psychological
trauma, physical injury or perhaps death.
As stated
previously, the generally accepted incidence of child
abuse and neglect in the U.S. is now 300-375 identified
cases per one million population.
With the increasing frequency of divorce combined
with an increasing tendency of young couples living in
step-family relationships, what are the consequences of
such varying home environments in contributing to such
postulated causes of child abuse and neglect?
With
increasing evidence of family separation, where is the
proper "home" in which a child can experience permanent
attachments in a positive, psychologically "healthy" and
"normal" family?
Where is the opportunity for the child
to share and to learn interpersonal communication that
will later become essential to adult adjustments?
According to Erikson (1964), "Where is the environment
of family learning that will lead to the establishment of
basic trust and the concomitant growth in capacity for
interpersonal sharing, without loss of identity or
self-respect?"
As previously stated, it has been recognized that 2/3
of the identified child abuse occurs in children under
the age of four years.
It is therefore apparent that
32
intervention must occur early, and must be aimed toward
younger families in the early years of childbearing.
There is a great need for 24 hour parenting and supervision for the child who is under the age of four, and there
is an even greater need for parenting and supervising for
the child under two years old.
For many overwhelmed
young mothers, unable to handle the cries and needs of
the child, there is no temporary time-out.
Such a
demanding family situation can be compounded by a fatherhusband who is not sensitive to the child's crying and
who may see the child as a rival for his wife's affections.
Out of necessity, the mother may be more attentive
to the infant's needs and demands than to her husband's
need for support, affection and fulfillment.
Thus, the
child becomes a potential target for the 24 hour a day
frustrations of the mother; the child also becomes the
father's scapegoat to which he may direct his anger,
frustrations, and rage.
And even though the marriage,
in and of itself, is unhappy, unproductive, and lacking
emotion, the child is the immediate provoking stimulus.
If early identification is essential for an early
successful intervention, i t is even more important that
procedures for equally early recognition of high risk and
potentially abusive parents be initiated.
The young, new
parents, married or not, emotionally too immature for
parenthood, and faced with the responsibilities of
33
establishing their own adult lives, and now themselves
separated from their biological paren·ts, must assume
independent recognition as homemakers and caretakers.
Intervention should begin during the pregnancy.
Prenatal health care professionals, such as an obstetrician or family planning counselor, should be alert to
early expressions of anxiety, concern or a cry for help.
Expectant parents should have the opportunity during the
pregnancy, to work through their fears, insecurities and
conflicts regarding the responsibilities of parenthood.
It is here that preparation for parenthood through
regularly scheduled classes or through individual and
group psychotherapy can allow parents to address their
fears wi·t.:h other couples who share a corrunon ground.
If
the expectant parents can be recognized early as being
in a high risk group, a parent surrogate, therapist or
a physician-nurse intervention team can help these
emotionally anxious expectant parents to become aware of
their possible tendencies and help them to work through
the problem.
Hopefully, the idea of positive parent-
surrogates will aid the parents when they are faced with
actual marital and parental conflicts.
A successful community approach to intervention must
involve medicine, law, social services, public health,
community mental health, law enforcement and the judicial
system-- examples of multi-disciplinary inter-agency
34
cooperation.
The role of the court system as it applies specifically to child abuse and neglect cases, is very important
for successful prevention and intervention.
The fifty
states now require the reporting of all suspected cases
of the maltreatment of children.
The details for re-
porting abuse and neglect may vary from state to .state;
however, specified professionals must report suspected
cases and, in many instances, are granted immunity from
civil and criminal charges for alleged violations of
privileged communications.
Controversy has stemmed from
the use of a central registry to which all cases must be
reported.
There is national concern regarding the ethics
and effectiveness of such central reporting.
According to Paulson, "Currently acknowledged
failures of the central registry can be attributed to:
(a} underreporting of cases by professionals and agencies,
(b) negative feelings about reporting to the Department of
Justice instead of the Department of Health, Education
and Welfare,
{c) the central registry's lack of feedback
to the professionals, other than to law enforcement
agencies,
(d) ethical attitudes regarding the infringement
upon the civil liberties of an individual,
(e) psycho-
logical and emotional consequences visited upon a family
who are reported for an injury that, in fact, does not
fall in the category of neglect, abuse, or maltreatment,
35
and (f) generally accepted attitudes among many professionals in medicine and social welfare that such a
r~gistry
appears more punitive than therapeutic."
(Paulson, 1976).
While the Central Registry's purpose
is the protection of high risk children, the lack of
communication between the Central Registry and the
Community Agencies decreases the value of the mandatory
reporting law.
Early intervention is essential for both primary
prevention and secondary treatment.
An integrated,
multi-disciplinary community based program must coordinate
the total resources available to prevent continued violence against children by adults who were, themselves,
subject to severe child-rearing practices and/or physical
abuse.
To meet these needs, the following proposals
are recommended by Paulson for implementation in
accordance with the combined efforts of the professional
and lay corrununity: "(a} Recognition that neglect, abuse
and maltreatment of children by parents and caretakers
do occur,
(b) provision of manpower and resources to plan
and activate an integrated, multi-disciplinary multiagency regional center that will make the most efficient
use of all community resources,
(c) development within
the community of educational and training programs for
professionals, para-professionals, and volunteer lay
citizens that will allow individuals and agencies to
36
respond to the needs of both the parents and the afflicted
child, with maximum efficiency, understanding, speed and
therapeutic concern,
(d). establishment of classes for
parenting and family life, where preparation for parenthood can take place before persons assume the responsibilities of caring for, nurturing and rearing of children,
(e) development within the community of resources that
offer immediate support and aid for parents under stress.
These facilities should include therapeutic day care
centers staffed by trained professionals, drop-off
facilities, homemaker services, 24 hour hot lines, and
immediately available person-to-person contact with an
identified therapist or other trained volunteer parents~rrogate."
(Paulson, 1976b).
Only through cooperation
within the multi-professional organizations can the needs
of abused children and their families be met.
Basic to any court of justice is the recognition of
the rights of every citizen, including the abused child.
Such rights must be defined clearly, not only for the
child who seeks protection now from trauma resulting in
physical abuse and neglect, but for those children in the
future who will be the offspring of unidentified high-risk
parents.
The specific and immediate goal of a multi-disciplin·ary. community based approach for the early treatment of
abused children is the reduction and elimination of
neglect and emotional abuse of children; the more global
aim is the enrichment of parenting skills and an enhancement of marital communication.
The establishment or
the re-establisrunent of equilibrium within the family
will provide for more effective parenting and family
functioning in which new patterns of family living will
hopefully follow.
38
Chapter 6
PREVENTION
As stated in the Introduction, a child abuse program
should ultimately be based on prevention whenever possible.
An administrator of such a program, needs to know about
the types of prevention and the available sources.
Preventing child abuse and neglect incorporate both
primary and secondary prevention.
In secondary prevention,
a community that has a well-coordinated program of identification, treatment and education directed at the problem
of child abuse and neglect has already initiated preventive
measures.
These types of programs can limit the extent
and recurrence of child abuse and neglect.
Primary prevention is a political, rather than a
professional issue.
According to the conceptual framework
of primary prevention, a social problem can be prevented
only when its causes are identified and eliminated or
modified, if the causes can be known.
In specific terms,
this means replacing the now prevailing inegalitarian and
competitive social philosophy, and the social, economic
and political order shaped by it, with an egalitarian,
cooperative philosophy, and societal organization fitting
this philosophy.
What must happen next is redefining
childhood and the rights of children.
Children must be
39
considered as people, and must be given the legally
enforced right to live in conditions that can provide for
full development in accordance with their innate potentials.
Hopefully, this will mean the elimination of all
sources of physical and psychological disturbance--a
heavy prescription, indeed.
Paulson states that a child-oriented primary
prevention program involves four areas:
2)
public health care, 3)
1)
the law, and 4)
Hospital,
schools
(Paulson, 1978a).
Each discipline within the hospital situation has an
important responsibility not only in accepting the fact
that parents do physically abuse their children, but also
in identifying those early signs of intrapsychic and
interpersonal conflicts, which may later be attributed to
child abuse.
The sensitive and psychologically alert
obstetrician may well be the first health specialist to
hear of any particular problems that the new parents, or
more specifically, the expectant mother, may be having.
During regular office visits, the pediatrician might make
a point of asking if there are any problems with raising
the children.
This type of questioning may well lead to
other questions about the possibility of marital problems.
The pediatrician might offer sources to which a family
might turn for support when problems occur.
Gentle and
supportive inquiry may permit the parents to share
40
questions and fears with a non-judgmental accepting
professional.
Also, within the hospital setting, well-baby and
emergency room staff should be responsive to behaviors
and verbal clues both during regular visits and in the
waiting room, prior to emergency or walk-in clinic
appointments.
What is also important to note is the
presence of isolation, indifference and detachment between
parent and child.
A mother who repeatedly brings a child
to a pediatric clinic or emergency room with minor injuries and illnesses, may be displaying signs of
deep-seated insecurities about being an ineffective
parent.
A parent's loud and impatient yelling to control
a crying or distraught child, may be a sign of a
potentially explosive and out of control parent.
The second area of responsibility is the public
health nurse.
In the past, public health nurses were
assigned the duty of providing community based physical
care needs outside the hospital.
This individual has a
most important function to observe carefully, those
families who live in areas far removed from health
maintenance organizations, who might display the behaviors \vhich might lead to child abuse or neglect.
What is vital to recognize is the psychological climate
within the home and the nature of the attachmentrelationship between parents and children.
The third viable area in a successful attempt at
primary prevention of child abuse and neglect, involves
law enforcement.
There are conflicting attitudes which
prevail regarding the role of social services and/or law
enforcement in the evaluation and recognition of child
abuse and neglect.
When the police, for example, investi-
gate a disturbance at a home, they must pay particular
attention to the children within this home.
If the police
officers observe even minor cuts or bruises on any child,
they must investigate more closely to determine whether
there are more severe cuts or bruises anywhere else on
the child's body.
If the children appear fearful in the
presence of one or both parents, this may indicate
parental hostilities of an unusual nature.
In such cases,
a family referral to a local protective agency should be
initiated instead of arresting and/or imprisoning the
parent or parents, since the legal position of such an
extreme action by the police would be legally questionable.
There is, of course, the obvious problem of the defensive
responses from the parent or parents to the suggestion
of closer examination of the child for further physical
abuse.
However, if there are gross signs of abuse or
neglect, then separating the child from the parent.s must
be accomplished as quickly as possible.
The fourth area of responsibility for early
prevention of child abuse and neglect focuses on the
42
school system.
Many times the alert teacher will recog-
nize early signs of physical abuse and psychological
neglect.
The obvious signals, such as bruises and minor
cuts, should be referred to the school nurse for further
examination.
Other possible signs and symptoms of
emotional and physical abuse and neglect, include school
performance below the child's potential, unusual restlessness, chronic fatigue, lack of attention, fear of going
home, poor physical hygiene, hunger and malnutrition.
If
the school has a nurse, psychologist, or counselor, these
professionals should pool their services and explore with
the parents, sensitively and non-judgmentally, the
possible ways in which the parents might be abusing their
children.
If there is a suspicion of non-accidental
injury or serious neglect, the school o£ficials must
alert the law enforcement or protective agencies within
36 hours (in the State of California).
Reporting the
abuse is not in an attempt to punish or imprison the
parents, rather it should be seen as a step in the
therapeutic rehabilitation of the family and its toxic
environment.
The child's right to a safe, secure life should be
the motivating principle for a community agency to
intervene.
It is recognized that separation from parent
and howe can have a psychologically damaging effect on
the child.
Therefore, wise caution must be exercised
43
before any decision to intervene is made.
Year of the Child.
This is the
44
Chapter 7
SEXUAL ABUSE
In this final section, I will examine sexual abuse,
which is the least obvious form of abuse, and, in my
opinion, one of the most psychologically damaging.
The reason I have chosen Child Abuse and Neglect as
the topic for my Masters Thesis is that I am currently
involved with a client who was herself the victim of
child abuse, particularly sexual abuse.
old she was raped by her father.
At five years
The pathological result
was that she had an hysterical pregnancy when she was
16 (she actually missed nine menstrual periods, appeared
pregnant, and went into labor in her "ninth month").
This
client was unable to recall the actual event of the rape
until February of this year--her 20th year.
Also, in
keeping with the International Year Of The Child, and
the guidelines of this paper, my final consideration will
be the subject of a commuhity based program for sexual
abuse intervention, rights, issues in child abuse intervention, and my own concluding remarks and some personal
thoughts on how child abuse and neglect might be
prevented.
According to Paulson (1978b), little pro-
fessional concern has been granted to the identification
and treatment of children who are sexually abused and
45
maltreated.
However, there has been some concern about
pornography as it pertains to children.
It is paradoxi-
cal that the producers of pornographic films and .the
judicial system appear to be more concerned with the
protection of their rights granted under the first
amendment, than the rights and the protection of children.
The UCLA Child Trauma Intervention Project has
recently incorporated a bi-lingual multi-cultural program
for the diagnosis and treatment of families who have as
members children who are victims of incest or sexual
abuse (most of the data collected has focused on the male
parent as the offending parent) .
The families are
referred to this program by the courts, social service
department, and community health delivery agencies.
At
the time of identified sexual trauma, there is also an
obvious acute psychological disturbance.
A flexible and
immediate program of intervention must be instituted.
It
is customary for the court to order the separation of the
sexually abusing parent and the child because there is
always the danger that further abuse will occur.
This separation will obviously create intra-family
stress and anxiety.
The,victim of sexual abuse is usually
a child in the latent or adolescent stages of development.
In many families the victim is held responsible for the
break up of the family unit.
The burden of guilt is
almost always carried by the victim.
The child-victim
feels responsible for the molestation.
If the molester
is identified as a parent, and the identification results
in incarceration, even for a short period of time, the
loss of financial support for the family, the social
isolation and rejection from the community, and the
resulting breakdown in the family nucleus, caupes extreme
hostility between the siblings, parents and the victim.
In the early evaluation of the families referred to
the UCLA Intervention project for reasons of sexual abuse,
the parents were found to have difficulty with corrmunication, and the mothers were violently opposed to any
immediate intervention.
(In contrast, the parents of
battered children were not opposed to entering the prograrrt
and frequently justified the battering as being acceptable
discipline according to their social cultural values.)
When a mother is made aware of the details of the
perverse and repeated acts of sexual assault upon her
child or children, she may feel guilt and shame that she
did not recognize the situation at the beginning.
Initially, many mothers are often unwilling to face the
sexually abusive fathers.
Therefore, upon completion of
the clinic's evaluation, these women are placed in a
mother's group where they can meet and can share their
anxieties, guilt, and ventilate their frustrations and
despair.
For the abusing person, who is not imprisoned,
a similar approach to group therapy or private
psychotherapy must be provided so that the father, too,
can share and ventilate his own anxieties, guilt and despair.
Like physical abuse, sexual abuse may be a symptom
of a malfunctioning family unit.
It is therefore of
extreme importance that the victim and his or her siblings
be given additional evaluation in order to assess the
effects of such family trauma, and also to provide the
necessary preventive and secondary intervention.
At the
UCLA Child Sexual Abuse Clinic, there are separate groups
for fathers and mothers, as well as separate on-going
"victim" groups:
latency age groups and adolescent groups
who have experienced either single or multiple incest by
the biological father, step-father, grandfather, or
boyfriend of the mother.
Sexual abuse has multiple effects upon both the male
and female child.
When the abused child, who is capable
of cormnunication, is confronted soon.after the molestation, the child exhibits guilt, shame, remorse, depression,
social withdrawal and at times, mutism.
The child cannot
discuss the sexual experiences or feelings related to the
assault.
For the children who are confronted several
years after the trauma, there is much denial, depression
and repression.
There have also been instances when the
child's repression results in a total memory loss of the
event, as was the case with my client.
Female children
who have experienced molestation in the passive sense
(e.g. caressing, fondling, mutual masturbation) are less
overtly anxious than those victims who had oral, vaginal
or anal penetration.
For successful intervention to occur, the interdisciplinary team must meet regularly to discuss not only
treatment plans, but administrative coordination between
themselves and outside agencies.
It is important for
each of the therapists to share with each other his or
her own feelings and report any progress or problems in
the actual therapy.
In order for the therapist to be
effective in working with sexual abuse victims, his own
conscious and unconscious sexual feelings must be recognized, understood and resolved (counter-transference
issues).
(See Stein, Incest and Human Love, 1973).
Because of the stressful nature of this type of
treatment program, there must be both male and female
therapists, from social workers to psychiatrists, from
diverse disciplines and cultures.
The heterogeneous
make up of such a team can offer the greatest support
in alleviating the stress.
High suicide rates exist
among physicians in general and mental health professionals in particular, due to the emotional stress within
those groups which provide psychological intervention to
families who live by violence (Amy Steinitz, April 1979,
Lecture, Center for Counseling and Education).
To reduce
this phenomenon of stress, intervention cannot and must
not be taken on solely by one person.
In most families, the abuser wants to be granted the
privilege of an early return home.
Such a reunion between
the abuser and the family must be viewed in two ways:
(a) manifest and latent motivations of the abuser, and
(b) therapeutic value to the abused child and the family.
In some cases, from the abuser's point of view, it can be
a matter of economics and a hope for a fresh start.
Hmv-
ever, for the abused child, the question of the return of
the abusing father, often provokes acute anxiety, fear
of anticipated assault, and the accelerated frequency of
guilt.
If such situations do arise, the therapist must
fully explore the assets and liabilities of such an action
for the family and the child.
Throughout this report, special emphasis has been
placed on the rights of children.
We must remember that
parents involved in sexual abuse also have rights.
A new
federal child abuse intervention act (PL 93-247) provides
many guidelines aimed at protecting not only the rights
of the parent with regard to court-appointed legal
representation, but also the rights of privacy with regard
to the· length of time in which a suspected abuser or
neglecting caretaker has his or her identity and case
history on file with a central registry.
By putting the
greatest burden on the prosecutor, this provides for the
50
greatest safeguard for the parents in dealing with
criminal standards and procedures.
It must be remembered that while the rights of the
parents must always be considered, it is the child's
welfare that is of primary concern.
51
Chapter 8
PROPOSAL
My specific proposal to administrators who are
interested in instituting a child abuse program focusing
on prevention, is that they consider a psychological
"fitness" test to determine whether a couple should be
permitted to bear and raise children.
In today's society,
licenses are required for nearly everything we do; driving,
flying, fishing, etc.
This proposal, although apparently
something out of Orwell's 1984 might serve as a beneficial
tool both for future parents and society.
An instrument could be created like the PARI and
~mPI
that would test for both abusive tendencies and/or psychopathology.
The test, for licensing, could be administered
early in a new marriage or in pre-marital counseling, and
again when the couple has decided they wish to have a
child.
Some test items might involve the couple's
backgrounds, early childhood experiences, and what type
of parenting they experienced themselves (for example,
were their own parents mistreating, did they expect "too
much too soon", in what ways were they punished for
misbehaving, etcetera).
In evaluating the test results, the mental health
professional or "board of examiners" could rule on the
52
fitness of the couple to become parents.
Recomn1endations
could be made as to whether counseling is indicated from
the test results.
If so, the couple could receive
therap~
and if they are determined to have high risk characteristics, could be educated in the area of child abuse.
There are many drawbacks, naturally, in applying a
test of this type with the goal of licensing.
For one,
different cultures have different cultural attitudes
toward discipline.
The test would have to allow for
these cultural differences.
A second drawback is that couples might resent
government control over their lives, especially when the
government would attempt to regulate biological urges.
I feel, however, that until someone with greater
scientific validity offers a viable alternative to
licensing, I would tentatively recommend licensing for
parenthood a concept worthy of, at least, some form of
consideration.
53
Chapter 9
SUMMARY
This paper has defined the problem of child abuse
and neglect; it has examined the characteristics of those
parents who are prone to becoming child abusers and those
public agencies who are co-conspirators in the abuse; it
has dealt with the difficult problem of intervention and
the delicate balance between helpful and destructive
intervention; finally, it has looked at the hopeful
attitude of prevention.
Most importantly, this paper has focused on a
program for prevention.
possib~
Despite its drawbacks, the pro-
gram for Parent Licensing has advantages that exceed the
disadvantages.
It is my hope that his recommendation for licensing
will be given serious consideration by administrators of
child abuse prevention programs.
54
REFERENCES
55
REFERENCES
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California Dept. of Justice. Information Pamphlet #8.
The Problems of the Abused and Neglected Child.
Sacramento: 1977.
Child Abuse Listening Line, P.O. Box 49797, Los Angeles,
California 90049: 1979.
Child Sexual Abuse Task Force, P.O. Box 26, San Jose,
California 95109: 1979.
Children's Village, U.S.A. National Office, 22554
Ventura Blvd., Woodland Hills, California 91364:
1979.
Ebling, Nancy and Hill Deborah, Eds. Child Abuse:
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Erikson, Erik. Childhood and Society.
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56
Paulson, Morris. ~he Minnesota Multi-Phasic Personality
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·
Chil~
Stein, Robert.
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The
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c:-.
... ) i
United States Dept. of Justice, National Institute
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Yahalom, Itamar. Lecture Series at the Center for
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