YUBA COUNTY INTERGENERATIONAL CHILD ABUSE, BEST PRACTICES
Adrienne Buhacoff
B.A, California State University, Sacramento, 2009
PROJECT
Submitted in partial satisfaction of
the requirements for the degree of
MASTER OF SOCIAL WORK
at
CALIFORNIA STATE UNIVERSITY, SACRAMENTO
SUMMER
2011
YUBA COUNTY INTERGENERATIONAL CHILD ABUSE, BEST PRACTICES
A Project
by
Adrienne Buhacoff
Approved by:
____________________________________, Committee Chair
Francis Yuen, DSW
_____________________
Date
ii
Student: Adrienne Buhacoff
I certify that this student has met the requirements for format contained in the University
format manual, and that this project is suitable for shelving in the Library and credit is to
be awarded for the project.
___________________________________, Division Chair
Robin Kennedy, Ph.D., M.S.W.
Division of Social Work
iii
____________________
Date
Abstract
of
YUBA COUNTY INTERGENERATIONAL CHILD ABUSE, BEST PRACTICES
by
Adrienne Buhacoff
Social workers can play a pivotal role in helping families dealing with intergenerational
child abuse issues. Appropriate and sufficient services however have to be in place to
assist these families in properly addressing these concerns. Without the appropriate and
much needed services for these families they will continue to flood the child welfare
system in Yuba County. The purpose of this study was identify the factors associated
with families who have patterns of intergenerational child abuse in Yuba County and the
best practices in working with these families. This study was a mixed method study
utilizing secondary data from the Child Welfare Services/Case Management System
(CWS/CMS) and qualitative date from service provider interviews. Drug abuse and child
neglect are the common factors that transfer from generation to generation. There is a
need for intensive and centralized wraparound services to these families. Implications for
social work, recommendations for services and future research are also discussed.
____________________________________, Committee Chair
Francis Yuen, DSW
_____________________
Date
iv
DEDICATION
I dedicate this work to all the social work teachers and instructors who have
guided me in my journey to becoming a social worker. I would not have made it without
them and I would not be the social worker I am today had they not touched my life. To
my children who have watched their mom change and grow through this process, I hope I
have inspired you to follow your dreams. I am truly blessed to have the two of you, and
your brother or sister who is on the way!
To my husband and hero, Jonathan Buhacoff, thank you for all your support
during my incredible journey. You have been a wonderful father and provider to my
children. I know you will be a great father to the one to come. I love and miss you, hurry
home from Iraq!
v
TABLE OF CONTENTS
Page
Dedication ........................................................................................................................... v
List of Tables ..................................................................................................................... ix
Chapter
1. INTRODUCTION ......................................................................................................... 1
Background of the Problem .................................................................................... 2
Statement of the Research Problem ........................................................................ 4
Purpose of the Study ............................................................................................... 5
Theoretical Framework ........................................................................................... 5
Definition of Terms................................................................................................. 7
Assumptions............................................................................................................ 8
Justification ............................................................................................................. 9
Limitations .............................................................................................................. 9
Summary ............................................................................................................... 10
2. LITERATURE REVIEW ............................................................................................ 11
Child Abuse Risk Factors ..................................................................................... 11
Effects of Child Abuse on Individuals .................................................................. 13
Effects of Child Abuse on Child Protective Services Social Workers ................. 15
Re-Referral and Foster Care Re-entry Risks ........................................................ 17
Intergenerational Transmission of Child Abuse ................................................... 18
Protective Factors.................................................................................................. 19
Interventions ......................................................................................................... 21
Gaps in Literature ................................................................................................. 23
Summary ............................................................................................................... 25
3. METHODOLOGY ...................................................................................................... 26
Study Design ......................................................................................................... 26
Sampling Procedures ............................................................................................ 27
Data Collection Procedures................................................................................... 28
vi
Instruments Used .................................................................................................. 29
Data Analysis Approach ....................................................................................... 29
Human Subjects Review ....................................................................................... 30
4. DATA ANALYSIS AND STUDY FINDINGS .......................................................... 31
Findings from Secondary Data ............................................................................. 31
Demographics. ............................................................................................... 31
Parents drug use vs. grandparent drug use..................................................... 33
Parent drug use vs. parent maltreatment type. ............................................... 34
Grandparent child removed vs. grandparent received services. .................... 34
Parent child removed vs. parent received services. ....................................... 36
Grandparent child removed vs. parent child removed. .................................. 37
Grandparent received services vs. grandparents child returned home. ......... 38
Parent received services vs. parents child returned home. ............................ 39
Statistical significance. .................................................................................. 40
Summary of Analysis of Secondary Data ............................................................. 41
Findings from Interviews ...................................................................................... 42
Summary of Interview Findings ........................................................................... 45
Conclusion ............................................................................................................ 46
5. CONCLUSIONS, SUMMARY, AND RECOMMENDATIONS............................... 47
Recommendations ................................................................................................. 48
Review of Findings and Relevance....................................................................... 49
Implications for Social Work ................................................................................ 50
Evaluation ............................................................................................................. 51
Recommendations for Further Research ............................................................... 51
Summary ............................................................................................................... 52
Appendices
APPENDIX A. Yuba County Intergenerational Child Abuse Data Collection Form ..... 54
APPENDIX B. Interview Guide ..................................................................................... 54
APPENDIX C. Informed Consent .................................................................................. 58
vii
APPENDIX D. Support Letter ........................................................................................ 63
References ......................................................................................................................... 65
viii
LIST OF TABLES
Page
1.
Table 1 Parent Drug Use vs. Grandparent Drug Use ............................................ 33
2.
Table 2 Parent Drug Use vs. Parent Maltreatment Type ...................................... 34
3.
Table 3 Grandparent Child Removed vs. Grandparent Received Services .......... 35
4.
Table 4 Grandparents Child Placement vs. Grandparent Received Services ....... 36
5.
Table 5 Parent Child Removed vs. Parent Received Services .............................. 37
6.
Table 6 Parents Child Placement vs. Parent Received Services ........................... 37
7.
Table 7 Grandparent Child Removed vs. Parent Child Removed ........................ 38
8.
Table 8 Grandparent Received Services vs. Grandparents
Child Returned Home ........................................................................................... 39
9.
Table 9 Parent Received Services vs. Parents Child Returned Home .................. 40
10.
Table 10 Statistical Significance ........................................................................... 41
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1
Chapter 1
INTRODUCTION
Child abuse is a major problem within the United States. Many of the cases are
those who continue the cycle of abuse. Parents who have been abused as children grow
up to abuse their own children. They come into the child welfare system and receive
services, but are these services the best for this group of individuals?
This researcher has been working in the field of Child Protective Services (CPS)
and has seen first hand that there is no information given on the cycle of abuse. CPS
does not address the fact many parents were abused as children. What would happen if
they did? What would happen if they also addressed it with the children? What if there
was an intervention for families to identify the stressors or triggers that cause them to
become abusive? Maybe parenting will work for some, but if the abuse were “normal”
for them, would they be likely to stop abusing with parenting classes?
In one case two children came from a home where there was domestic violence
and drug abuse; which caused the parents to be neglectful to the children. One child went
on to engage in domestic violence and drug abuse and was extremely neglectful toward
her own children. The other child grew up and never engaged in domestic violence.
When she was placed in foster care she had used drugs with her mother; however, she
went into treatment and quit using. She ended up gaining custody of her sister’s child
when she was born under the influence of methamphetamines. Both girls received drug
treatment. What was it that made the two children different? Why did one grow up and
2
enter into relationships with partners and children the same as what she grew up in and
why did the other grow up to get out of and stay out of the same situations? What if any
services where provided to her that helped her not to become an offender?
Background of the Problem
During 2008 in the United States, there was an estimated 3.3 million referrals sent
into Child Protective Services agencies; which involved approximately 6 million children
(NCANDS, 2010). California accounts for 351,958, approximately 11% of the total
national referrals. In 2008 Yuba County had 1,765 allegations of child maltreatment
(Center for Social Services, 2009).
It is estimated that 3.3 million and up to 10 million
children in the United States witness domestic violence each year and child abuse is 15
times more likely in these families. Of those families where either child abuse or
domestic violence is present, 30 to 60% of these families have both; there is evidence of
intergenerational transmission of these abuses (Postmus & Ortega, 2005; Avery,
Hutchinson & Whitaker, 2002; Renner & Slack, 2006). Women in domestic violence
shelters report some form of child abuse and only seek protection after a child has been
abused (Avery et al., 2002).
Some of the factors involved in child maltreatment are: domestic violence,
socioeconomic status, age, parental skills, and parental involvement in family violence as
a child (whether witnessing or experiencing it) – many of which overlap. Parental skills
have been related to child abuse in that the parenting practices affect the quality of
parent-child interactions (Dixon, Browne & Hamilton-Giachritsis, 2005, Newcomb &
3
Locke, 2001). According to Newcomb and Locke (2001), a major contributor of
intergenerational transmission of maltreatment is parenting practices. Parents who do not
receive much nurturance during childhood use physical punishment while mothers who
feel more rejection during childhood are more negative toward their children (Newcomb
& Locke, 2001). Neglectful behavior has been a basic factor of intergenerational
transmission of child abuse (Langeland & Dijkstra, 1995).
Dixon, Browne & Hamilton-Giachristsis (2005) state that parents are seventeen
times more to abuse their own children if they have a history of childhood abuse; while
Newcomb and Locke (2001) state that about one-third of parents who were abused as
children will abuse or neglect their own children. Rates of transmission vary across
studies; parents who were maltreated as children are likely to abuse their own children if
their parents have a history of depression and mental illness, are young parents, live with
a violent adult and/or have poor parenting (Newcomb & Locke, 2001; Renner & Slack,
2006; Dixon, Browne & Hamilton-Giachritsis 2008). Mothers who experienced physical
childhood abuse and are first time mothers of low socioeconomic status are twelve times
more likely to abuse their children (Dixon et al., 2008) than first time mothers who had
not been abused.
While having a history of abuse does not a mean someone will be abusive,
children who report abuse are twice as likely to have a parent who has a history of
childhood abuse (Pears & Capalidi, 2001). While being maltreated as a child does
increase a person’s chances for becoming abusive, the cycle of abuse can be broken, and
4
frequently is, this shows there are interventions that can break the cycle of violence
(Langeland & Dijkstra, 1995; Renner & Slack, 2006). What are the factors that helped
abused children not continue the transmission of violence to their children? Since half of
the abused children have parents who were abused, what can social workers do to stop
the transmission of violence to the abused children’s children?
Statement of the Research Problem
Intergenerational child abuse is a problem within families entering the child
welfare system encompassing approximately half of all referrals received by Child
Protective Services (CPS) agencies. Due to the lack of prevention and therapeutic
services provided to foster youth to stop the cycle of abuse the number of child abuse
reports continues to flow in. The damage caused to these youth and their future children
is one that can be minimized and even prevented. However, interventions are not in
place to stop this cycle.
The barriers for workers are the lack of funding; CPS is interested in quick and
inexpensive fixes. When considering this it is interesting that they are willing to provide
the expense of foster care for these youth rather than providing prevention services to
lower the number of cases entering the system. Foster parents have to go through
training to maintain their license and parents have to attend treatment for alcohol and
drug abuse issues as well as domestic violence; what if the children had a group they
attended with other abused children to address the issues they face with having been
abused, removed from their families, and being in foster care? What if in this group they
5
learned about the cycle of abuse? What if the parents addressed their past abuse as
children and also learned about the cycle of abuse? Would this help stop the cycle from
continuing?
Purpose of the Study
This study aims to identify the factors involved in intergenerational child abuse as
well as identify best practices when working this population. This researcher hopes the
research done will encourage other social workers to write proposals to form appropriate
and adequate services for this population. The programs created would be done with the
purpose of decreasing the number of intergenerational child abuse referrals that come into
Yuba County CPS, thus decreasing the money needed for foster care.
Theoretical Framework
The transmission of intergenerational child abuse can be explained by several
theories including ecological or multi-factor approach, social learning theory, attachment
theory, and psychoanalytic theory (Renner & Slack, 2006; Dunlap, Golub, Johnson &
Wesley, 2002). Due to the complexity of the issue it is important that workers take an
eclectic approach to better understand and address the issue.
It is important to understand how the abuse has disrupted the thought processes
associated with psychological needs, including safety, trust and dependency, esteem,
intimacy, and control. Disruption in this thought process can result in fear of others,
anger, insecurity, an inability to trust their perceptions of others, indiscriminate
attachment to others, and interrupted formation of interpersonal relationships (Whiting,
6
Simmons, Haven, Smith & Oka, 2009). Psychoanalysis emphasizes the interaction
between drives and impulses and the requirements of society towards conformity and
moral conduct, causing a lack of trust in humanity and create an inability to develop close
and trusting relationships. Constant judging and devaluing by parents can negatively
impact ego development and neglect may be worse abuse because it fails to provide a
structure for the successful development of self (Dunlap et al., 2002).
One common theory used in explaining intergenerational violence is social
learning theory. Children learn how to parent by watching their parents and they use
learned violent behaviors when parenting their children (Renner & Slack, 2006; Whiting
et al., 2009). An important role in the internalization of parenting behavior is modeling
and reinforcement play (Newcomb & Locke, 2001). As adults, they replicate these
behavioral norms, teaching these behaviors to the next generation (Dunlap et al., 2002).
One cannot see their social identity, except through society’s reaction. In this way an
individual’s identity or self is socially constructed. In the process, the reflection of a
person’s identity is subjected to distortions causing them to hold a distorted sense of self.
The attachment one has with their caregiver may influence the attachment one has with
their children (Newcomb & Locke, 2001; Dixon et al., 2005). According to Dixon et al
(2005), based on prior experiences with caregivers, children develop expectations about
future interactions with others. This early representation of relationships is said to guide
future relationships.
7
According to abused children they often feel unworthy and unable to obtain the
appropriate attention and care, which teaches them that caregivers are unresponsive,
rejecting and unavailable. These children often have problems developing an
autonomous self and forming interpersonal relations with their peers. Individuals who
have a history of abuse are at risk of becoming parents who abuse because they did not
develop skills to maintain healthy relationships. They often have problems forming
attachments with their children or with romantic partners (Dixon et al., 2005; Leifer,
Kilbane, Jacobsen & Grossman, 2004).
Definition of Terms
Intergenerational transmission of child abuse – child abuse that has been transferred from
one generation to another (from grandparents, to parents, to child).
Child abuse/maltreatment – physical or psychological/emotional mistreatment of
children, including physical abuse, sexual abuse, neglect, medical neglect and educational
neglect.
Physical abuse – physical aggression directed at a child by an adult, involving but not
limited to: striking, burning, choking, shaking, biting, slapping, punching, threatening
and throwing objects.
Sexual abuse – a form of child abuse where an adult or older adolescent abuses a child
for sexual stimulation. This includes but is not limited to: pressuring a child for sex
(whether or not it happens), indecent exposure of the genitals to a child, displaying
8
pornography to a child, sexual contact against a child, physical contact or viewing of a
child’s genitals, or creating pornography using a child.
Neglect – where the responsible adult fails to provide adequately for various needs
including but not limited to physical (food, water, clothing, hygiene), emotional (failure
to provide nurturing or affection), educational (failure to enroll a child in school or make
sure they attend and do their school work), medical (failure to obtain necessary medical
attention or providing needed medication).
Interventions – actions taken to improve a situation
Assumptions
The assumptions to be considered in this study include: 1) families with
intergenerational child abuse will continue to be referred to CPS; 2) CPS social workers
will continue to work with families struggling with intergenerational child abuse and the
factors involved in this abuse; 3) families involved with CPS receive the necessary
services needed; 4) CPS social workers continue to face barriers when working with
families with intergenerational child abuse and the factors involved with this abuse; 5)
parents struggling with intergenerational child abuse and the factors involved in this
abuse have a greater risk of re-abusing their children; 6) children who are maltreated are
at greater risk of becoming a parent who abuses their children; and 7) when they grow up,
children who are maltreated are at greater risk of having children in the child welfare
system.
9
Justification
According to the National Association of Social Workers Code of Ethics (2011)
social workers’ primary goal is to help people in need and to address social problems.
Inter-generational child abuse has become a prevalent concern not only in Yuba County
but also to alarming numbers of families in the United States today. There have been
many studies and literature published regarding inter-generational child abuse and its
effects on families, children and the child welfare system. However, we lack the
knowledge regarding the barriers that many social workers face when serving this
population with in the CPS agencies. This knowledge is important for the profession of
Social Work because it will create more effective social work practice, when addressing
the barriers that families and children face with inter-generational child abuse.
Limitations
This researcher will focus on the effects of intergenerational child abuse on
families involved in CPS through evaluating case records and through the experiences
and opinions of social workers. This researcher will be examining the factors involved in
thirty cases as well as the opinion and experiences of social workers when addressing the
problem of inter-generational child abuse with in the past and current caseloads in Yuba
County.
The social workers will explore their own barriers and limitations with working
with families with inter-generational child abuse during the family’s interaction with
CPS. The results of this study are biased to the experiences, opinions and beliefs of ten
10
CPS social workers in Yuba County California. The result of the study cannot be
representative since the sample size is small and does not include social workers from
other counties.
Summary
Chapter one includes the introduction, a background of the problem, a statement
of the problem, the purpose of the study and the theoretical framework. Chapter one also
contains definitions of relevant terms and a section that describes the limitations of the
study. Chapter two is a review of related literature with sections covering a description
of risk factors associated with child abuse; effects of child abuse on individuals; effects
child abuse has on Child Protective Services (CPS) social workers; re-referral and foster
care re-entry risks; intergenerational transmission of child abuse; parental protective
factors and interventions. Chapter three is a description of the methodology. In chapter
four, the data for this study is examined. In chapter five, a summary of the findings is
presented. Recommendations and implications for social work practice are also
discussed.
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Chapter 2
LITERATURE REVIEW
This literature review is organized in the following seven sections. The first
section will introduce risk factors associated with child abuse, while the second section
will discuss the effects of child abuse on individuals, both physical and psychological,
caused by child abuse. The third section will explore the effects child abuse has on Child
Protective Services (CPS) social workers. The forth section discusses re-referral and
foster care re-entry risks. The fifth section explores intergenerational transmission of
child abuse. The sixth section explores parental protective factors. The seventh section
discusses interventions for both parents and children to help break this cycle. The final
section addresses the gaps in the literature.
Child Abuse Risk Factors
Abused and neglected children often experience name calling, humiliation,
nakedness, mutilation of the body, are deprived of personal affects, share personal space,
dirty beds, fear for their personal safety, endure violent trauma, authoritarian control and
neglect (Whiting et al., 2009). There are many risk factors associated to child abuse.
There are family factors as well as personal factors (both parental and child) that can
facilitate child abuse.
Child abuse is likely to occur in families experiencing intimate partner violence,
maternal distress (depression and physical symptoms), poverty, family stress, social
isolation, and parental history of physical abuse as a child (Little & Kantor, 2002; Hazen,
12
Connelly, Kelleher, Landsverk & Barth, 2004; Pears & Capalidi, 2001). Violence
between adults can lead to child neglect because of parenting and mental health
problems, such as depression or substance abuse, associated with an adult caregiver’s
victimization, or through the abusive partner’s own neglectful care giving practices.
Another factor associated with risk of becoming an abuser is the severity and frequency
of abuse received as a child and how much the child identifies with their abuser (Renner
& Slack, 2006).
When parents experience anxiety, depression, poor self-esteem emotional
problems, substance abuse, mental illness, antisocial, delinquent behaviors and poor
interpersonal skills (Dixon et al., 2005; Pears & Capalidi, 2001) as well as young
maternal age, low educational achievement, and infant prematurity (Wu et al., 2004;
Pears & Capalidi, 2001) they are more likely to become abusive parents. According to
Whiting et al. (2009), posttraumatic stress disorder along with abuse experienced by the
parents, their consistency with discipline and depression (Pears & Capalidi, 2001) are
factors in parents abusing their children.
A lot of the literature agrees that parents with a history of childhood abuse are at
increased risk of becoming abusive to their own children (Dixon et al., 2005; Renner &
Slack, 2006; Milner et al., 2010). Parents with histories of multiple acts of abuse and
have at least one physical impact are more likely to become abusive than other parents
(Pears & Capalidi, 2001). It is not uncommon for abused children to have families with
criminal or substance abuse problems, receive welfare, and have several children; which
13
may lead to inadequate parenting practices and promote dysfunctional parenting practices
(Newcomb & Locke, 2001). Repeaters of abuse are less likely to have had at least one
loving and supportive parent during childhood, had more stressful life events and were
less likely to be in supportive adult partner relationships than non-repeaters (Renner &
Slack, 2006).
Many of the risk factors stated above facilitate other risk factors; such as the
abuse caused in childhood can cause mental illnesses such as antisocial behavior,
depression and posttraumatic stress disorder. These disorders can cause an adult to be
unable to concentrate on school and later make it difficult to obtain and keep a job; thus
causing them to have little to no income; this causes stress on the family unit. This
coupled with family modeling the behavior they learned as children parents become
abusive (Pears & Capalidi, 2001; Wilson & Horner, 2005).
Effects of Child Abuse on Individuals
Child abuse victims endure higher risk for a variety of emotional, behavioral,
psychological, and relational problems (Whiting et al., 2009); which have devastating
long- and short-term effects on children (Harder, 2005; Milner et al., 2010; Hildyard &
Wolfe, 2002). Children who are abused have higher risks of emotional problems such as
low self-esteem and limited emotional functioning; behavioral problems such as:
internalizing and externalizing behaviors, non-compliance, and aggression;
psychological/mental health problems such as: depression, anxiety, trauma symptoms
(post traumatic stress disorder), sleep disturbances, eating disorders, personality disorders
14
(borderline personality disorder and antisocial personality disorder), substance abuse
problems, and relational problems (problems with attachment) (Whiting et al., 2009;
Avery, Hutchinson & Whitaker, 2002). Some effects are physical while others are not.
Some physical effects are brain injury (which may or may not be healed), fractures,
burns, and blindness. Other effects are: learning and cognitive impairments, low selfesteem, aggressive and withdrawal behaviors such as antisocial attitudes and conduct
problems, self-harm, and poor physical health (Harder, 2005; Whiting et al., 2009; Pears
& Capalidi, 2001; Dixon et al., 2008; Dunlap et al., 2002; Wu et al., 2004; Mullen,
Martin, Anderson, Romans & Herbison, 1996).
Mental health of abused children is a big concern. Childhood victimization has
been associated with the development of attachment problems, depression, anxiety, and
low self-esteem to personality disorder, somatization, sexual action out, sexual
dysfunction, and revictimization, (Avery, Hutchinson & Whitaker, 2002; Mullen et al.,
1996) posttraumatic stress disorder substance abuse (Dixon, Browne & HamiltonGiachristsis, 2008) and bi-polar disorder features (Allen, 2008). Adolescents and adults
with a history of maltreatment are three to four times more likely to have depression than
youth with no history and are at higher risk for suicide attempts (Pears & Capalidi, 2001).
Abused children, and adults, who endured childhood trauma experience feelings
of shame, fear of abandonment, neuroticism, and become dependent on others. They
disregard their self worth. They internalize this view leading to the transmission of
violence to others (Whiting et al., 2009). Childhood abuse leads to a pattern of adult
15
victimization, addiction and criminality (Warren, Hurt, Loper, Bale, Friend & Chauhan,
2002). Childhood abuse and high rates of low self-esteem with antisocial personality
disorder and substance abuse in adulthood are shown to increase the likelihood of parents
being abusive (Whiting et al., 2009; Pears & Capalidi, 2001; Dunlap et al., 2002).
It is clear that victimization as children causes metal health and substance abuse
problems as well as personality disorders. Children are unable to build secure
attachments (Dixon et al., 2005) and as adults they have poor parenting skills, leading to
extremes stress coupled with their mental illness and substance abuse issues, thus leaving
a vicious cycle that needs to be broken to decrease the instances of child abuse.
Effects of Child Abuse on Child Protective Services Social Workers
Social workers need to be aware of the risks involved in child abuse so they can
further investigate other areas not related the referral. For example, women who have
trauma from past abuse, facilitates the relationship between child maltreatment and dating
violence for women (Milner et al., 2010). Thus when interviewing a family with
domestic violence it would be important to learn about her past experience with abuse
and evaluate for any current child abuse with in the family. Although emotional abuse
can cause emotional distress, learning disabilities, and cognitive impairment; workers
tend to not pursue this form of child maltreatment because they have to defend their
professional assessment and opinion in criminal court (Glaser, 2002).
Social workers may face hostility when working with those who were abused as
children (Parish-Plass, 2008). These children tend to distrust relationships and adults
16
because of the experiences they have had with adults in their family. Social workers also
need to be aware that there may be delinquent behavior in boys and decreased school
performance with boys and girls (Anctil, McCubbin, O’Brien & Pecora, 2007) and help
foster parents deal with these issues either through counseling or through the use of other
services. It is important that the social worker has regular communication between youth
in care, foster parents, mental health treatment, and also understand the child’s perception
of the foster parents’ helpfulness (Anctil et al., 2007).
Child Protective Services (CPS) needs to ensure that there is adequate training
and support for foster parents that will help them establish, maintain, and enhance
positive relationships with their foster children; especially since children in foster care
tend to have mental health issues causing foster home instability causing frequent foster
home changes (Anctil et al., 2007).
When social workers suspect emotional abuse they need to complete an assessment
that helps to identify the nature of the abuse or neglectful interaction. If caught early the
social worker can provide therapeutic interventions without removing the child, the
difficult part is that emotional abuse and neglect do not cause physical harm to the child
(Glaser, 2002).
Social workers need to be aware of poor families, since, families who have low
socioeconomic status and live in low-income neighborhoods are more likely to be
reported to child protective services and to have children in foster care (Berger, 2004). A
major risk factor for the perpetration of maltreatment is low socioeconomic status among
17
parents and has a potential mechanism in the transmission of child abuse (Zielinski,
2009).
It is important that all the work with child maltreatment be based on
contemporary and well-researched evidence (Sidebotham & Golding, 2001). Social
workers need to try and engage fathers more in treatment and resources (Guerrero, 2009).
Motivational interviewing is evidence-based form of intervention that social workers
should use. Motivational interviewing assists clients to become more aware of the
implications of change and/or of not changing through a nonjudgmental interview in
which clients do most of the talking (Lundahl, Kunz, Brownell, Tollefson, & Burke,
2010). It is difficult for social workers because most services for families are for families
who have involvement with Child Protective Services (CPS). There are very few
services for families engaged in less serious child maltreatment cases or who do not have
involvement with CPS (Berger, 2004).
Re-Referral and Foster Care Re-entry Risks
It is common that CPS works with many children who are subjects of repeated
referrals as victims of alleged neglect, physical and sexual abuse or other forms of child
abuse. Children from families with multiple stressors (e.g., low socio economic status
(SES), substance abuse and child disability) have increased rates of re-referral to CPS
(Connell, Bergeron, Katz, Saunders & Tebes, 2007). Not only is re-referral and issue, but
so is foster care re-entry.
Family characteristics related to increased re-entry into foster care include poverty;
18
substance abuse; parents’ history of childhood abuse or dependency; parental uncertainty
about parenting; and other parent characteristics such as lack of parenting skills, lack of
social support, and other problems. Risk factors for re-entry into foster care that are
significant includes maternal substance abuse and/or criminal activity associated with
substance abuse and neglected children (Kimberlin, Anthony & Austin, 2009).
Intergenerational Transmission of Child Abuse
There are many factors involved in the transmission of child abuse between
generations. According to Wilson and Horner (2005) intergenerational transmission of
child abuse is often associated with chronic abuse, entrenched families, and high poverty
neighborhoods. Having been mistreated as a child, parents are significantly more likely
to abuse their own children (Renner & Slack, 2006; Pears & Capalidi, 2001; Newcomb &
Locke, 2001; Dixon et al., 2005; Liefer et al., 2004; Langeland & Dijkstra, 1995;
Postmus & Ortega, 2005).
Poor parenting – the inability to effectively discipline (Pears & Capalidi, 2001;
Dixon et al., 2005); growing up with parents who had harsh parenting practices (Renner
& Slack, 2006; Pears & Capalidi, 2001; Newcomb & Locke, 2001); no parent provided
love or support during childhood (Renner & Slack, 2006; Liefer et al., 2004);
experiencing multiple forms of abuse with multiple injures (Pears & Capalidi, 2001;
Liefer et al., 2004); and more severe and frequent abuse as a child and identifying with
the aggressor (Renner & Slack, 2006; Pears & Capalidi, 2001; Liefer et al., 2004) are
factors in intergenerational transmission of child abuse. Other factors are having
19
witnessed domestic violence, being involved in domestic violence and being involved in
unsupportive partner relationships (Renner & Slack, 2006; Langeland & Dijkstra, 1995).
Insecure attachments, depression, post-traumatic stress disorder (PTSD),
substance abuse, and antisocial and delinquent behaviors left untreated from childhood
abuse influence the transmission of child abuse (Wilson & Horner, 2001; Pears &
Capalidi, 2001). While Newcomb & Locke (2001) explored impaired interpersonal and
social competence, problems with aggression, affect regulation and lack of empathy as
signs of intergenerational transmission of child abuse. Mothers who were sexually
abused were more aggressive and fathers who were sexually abused were neglectful
(Newcomb & Locke, 2001).
Protective Factors
Protective factors help to explain why some parents who experienced abuse as a
child do not grow up to abuse their own children. Some of these factors include but are
not limited to: social support, positive relationships, types and severity of abuse,
rejection of their parent’s values and attitudes, acceptance of the abuse as well as other
factors such as a learned positive self image. According to Langeland and Dijkstra
(1995), it is as important to identify the factors that keep individuals from engaging in
abusive behavior, as it is to learn about what causes the transmission of abuse to occur.
Social support and positive relationships are important in mitigating the risk
factors of intergenerational child abuse. Many of those who do not go on to abuse have a
natural predisposition for resiliency (Renner & Slack, 2006) as well as financial support
20
and social support (even perceived support is effective) (Dixon et al., 2008); which
buffers the effects of being abused (Pears & Capalidi, 2001) and stress (Dixon et al.,
2005). Having positive relationships with their mothers (Newcomb & Locke, 2001),
foster parent or relative, a supportive spouse (Langeland & Diijkstra, 1995), an intimate
long-term stable relationship and having a secure home environment with greater
emotional stability (Dixon et al., 2008) decreases the risk of transmission. Psychotherapy
(Dixon et al., 2008) as well as supportive religious affiliation, having few stressful life
events, and positive school experiences as a child affects quality of parenting later
(Langeland & Dijkstra, 1995). Children having developed secure attachments either with
one parent or a member in the community are more to be securely attached to their
infants and thus less likely to abuse them (Newcomb & Locke, 2001).
It is easier to break cycle when there was only one abusive parent rather than two
and non-repeaters also experienced less severe and less persistent forms of abuse.
Breaking the cycle of abuse requires an awareness of past abuse and an evaluation (or
rejection) of the attitudes and values of the parents, thus it is not surprising that
counseling and therapeutic intervention can also produce protective effects (Langeland &
Dijkstra, 1995).
According to Langeland and Dijkstra (1995), other protective factors are a high
IQ, exceptional talents, physical attractiveness and poise. A parent that has some
successes or accomplishments, like having special talents, has increased self-esteem and
competence allowing them to deal with the hazards and challenges of everyday life. An
21
optimistic attitude, the ability to solve problems, and a sense of hopefulness for a better
future seems to be factors that decrease the likelihood of the occurrence of abuse.
Interventions
If the cycle of abuse can be broken (Langeland & Dijkstra, 1995), the breaking of
this cycle could lead to substantial government savings (Wu et al., 2004). There are three
levels of prevention services: primary, secondary and tertiary. Primary prevention
services are offered to any family, regardless of risk level. Secondary prevention services
target those who are perceived to have a higher risk. Prevention/Intervention services for
child abuse and neglect at the tertiary level target client groups who have already
maltreated their children, as defined by a substantiated case with Child Protective
Services. Many child abuse and neglect prevention programs target clients at both the
secondary and tertiary levels (Harder, 2005).
When looking at intergenerational child abuse, workers need to address learned
behaviors or the beliefs associated with continued or future victimization (Renner &
Slack, 2006) with parents as well as their children (or future children). Parents with low
self-esteem, PTSD, or substance abuse should be assessed for abuse in either past or
present relationships (Whiting et al., 2009; Dixon et al., 2008; Newcomb & Locke, 2001)
and vice versa (Whiting et al., 2009).
Victims often benefit from training and education in establishing relationships,
social or behavioral adjustment skills, assertiveness skills, reframing skills and everyday
living skills as well as making sense out of past abuse and strengthening self-concepts
22
(Renner & Slack, 2006; Avery et al, 2002; Whiting et al., 2009). The goal is to stop the
cycle of abuse in which abused children may grow up to become abusing parents.
Trauma during the preverbal stage makes therapy with abused children difficult because
they distrust adults and they have difficulty with symbolization (Parish-Plass, 2008). But
unfortunately, approximately 76% of youth in need of mental health treatment go
untreated. (Burns et al., 2004).
Poor parenting is precursor to child maltreatment (Dixon et al., 2008). Parents
who have a history of poor parenting are likely to have been maltreated as children, thus
it would be important to assess these parents for issues regarding past abuse including but
not limited to posttraumatic stress disorder (Newcom & Locke, 2001). Parents who have
a history of being abused and who also have poor discipline and parenting skills serve as
a red flag for parents at risk of abusing their children (Pears & Capalidi, 2001). Financial
difficulties and lack of social support are associated with child abuse and neglect, thus
positive parenting programs could help by increasing current levels of social support and
reducing feelings of isolation (Dixon et al., 2008) and their improved discipline skills
may reduce aversive exchanges between themselves and their children (Pears & Capalidi,
2001). Workers should assess for protective factors (Dixon et al., 2008).
Attention should be given to environmental factors. For mothers who have
experienced abuse, it would be important to provide pre and postnatal education to help
them interact with their children positively and to help stop the intergenerational
transmission of child abuse. To improve neglectful mothers own personal wellbeing,
23
interventions should target how they interact with their environment (Sylvestre &
Mérette, 2010).
Treatment to break the cycle for youth who experienced abuse or violence should
focus on concrete events, exploring effects of subtle or overt abuse, and encouraging
responsibility of choices and appraisals (Whiting et al, 2009). Eighty percent of youths
involved with child welfare agencies have emotional or behavioral disorders,
developmental delays, or other issues and are in need of mental health interventions
(Burns et al., 2004). By de-identifying with the abuse and feeling more in control of their
lives one can avoid violent behavior and violent relationships. The focus needs to be on
prevention of substance abuse disorders and bundled with mental health services
(Whiting et al., 2009). A priority for youths early in their child welfare experiences
should include an assessment for mental health needs, access to mental health
professionals for evaluation and treatment. Trauma Focused Cognitive Behavioral
Therapy, Abuse Focused Cognitive Behavioral Therapy and Parent-Child Interaction
Therapy are thought to be effective treatments for youth and families involved in the
child welfare system (Burns et al., 2004).
Gaps in Literature
An extensive investigation of the relevant literature on this subject was
performed. The literature is well documented as to the effects and risks that
intergenerational child abuse has on families and the difficulties of breaking the cycle.
24
This researcher learned that a lot of this information was not included in national data and
surveys and agencies.
Reviews of the current literature on intergenerational child abuse revealed that
they were mostly focused on risk factors of intergenerational child abuse. Although
knowing risk factors is important there was a big lag in other areas pertaining to
intergenerational abuse such as treatment and protective factors specific for this
population.
This researcher discovered that there are no special interventions or treatments for
families with histories of intergenerational child abuse. Treatments seem to be the same
for those who have never been in the child welfare system. Literatures seem to be
showing that there is a cookie cutter approach to treatment to individuals within the child
welfare system.
The literature focused mostly on single parent homes. There was also a huge
discrepancy in the gender that was focused on within the literature. Most of the literature
focused on mothers as apposed to fathers as head of household. This demonstrates a bias
in the literature.
This researcher also found limited literature on social work perspectives on
interventions, treatments, and barriers with working with families who have histories in
intergenerational child abuse. This researcher seeks to address this gap by conducting
face-to-face interviews with social workers within Yuba County child protective services.
25
This researcher will attempt to acquire CPS social workers’ knowledge on their
experiences and challenges when working with this population.
Summary
In this chapter, the literature relevant to this study was reviewed. Some of the
topics discussed in this chapter included risk factors associated with child abuse; effects
of child abuse on individuals; effects child abuse has on Child Protective Services (CPS)
social workers; re-referral and foster care re-entry risks; intergenerational transmission of
child abuse; parental protective factors and interventions. In the next chapter, the
methods used to conduct the study are described.
26
Chapter 3
METHODOLOGY
The study subjects are cases from the Yuba County Child Protective Services
(CPS) Child Welfare System/Case Management System (CWS/CMS) that had histories
of intergenerational child abuse and were open between 1999 and 2010. Also included in
the study are social workers in Yuba County CPS. This project studies the factors
involve in intergenerational child abuse and the services families received and identifies
the best practices when working with this population.
Study Design
The project explores common factors that might relate to intergenerational child
abuse in Yuba County. In addition, the project explores the services needed to break the
cycle. This researcher obtained approval by the Human Subjects Review Committee at
California State University, Sacramento (CSUS) through the submission of a Human
Subjects Review application. Research findings help the design of services that could
interrupt this abusive cycle.
Among the major research questions for this study are the prevalence of
intergenerational child abuse and services that could address this issue. Do services to
the family help? What services, outreach programs or prevention programs need to be
created?
To study the issues involved in intergenerational child abuse, this project analyzed
secondary data from Yuba County CPS Child Welfare System/Case Management System
27
(CWS/CMS). Secondary data was obtained from client records that fit the criteria of
being involved in inter-generational child abuse. This researcher kept all identifying
information confidential and only obtained demographics and the factors involved in the
abuse; such as alcohol and drug abuse, domestic violence, the type of child abuse, jail
time, probation or parole and the services they received. Qualitative data is obtained
through interviews designed to identify best practices, challenges, and recommendations.
Workers among Yuba County CPS participated in a 10-minute interview. The interview
was conducted with eligible participants in the two CPS units: Emergency Response (ER)
and Ongoing – Family Reunification (FR) and Permanent Placement (PP) for
convenience purposes. The candidates agreed to participate in the interview upon
reading, understanding and signing the informed consent. This researcher screened each
candidate to ensure they fulfill the criteria for this study.
Sampling Procedures
Secondary data was retrieved from CWS/CMS. The criteria for inclusion of this
sample are clients who have a history of being in the child welfare system as children and
then having a child enter the child welfare system, between 1999 and 2010. With
cooperation from the county agency, office staff identified records of eligible research
subjects for this study. First we identified eligible cases to develop the sampling frame
for the systematic sampling. Then, with the intention of having a sample of 30, we used
3 as the interval for case selection. After that, a random number between 1 and 50 was
28
selected and became the first case. The first case ended up to be case number 10, the
second thirteen, the third sixteen and so on until all thirty cases were chosen.
To complement the data from the CPS clients, a convenient sample of ten frontline
social workers from Yuba County CPS ER and Ongoing –FR and PP and participated in
an interview. The criteria for the inclusion of this sample are social workers currently
employed at Yuba County CPS who hold a bachelor’s degree or master’s degree in any
field. The researcher secured ten participants among social workers in the two programs
using convenient and purposive sampling strategies. This researcher personally invited
the participants through email and personal contact.
Data Collection Procedures
County Staff generated a list of clients according to the inclusion criteria using the
CMS/CWS. This database includes demographics and family records on all cases and
referrals in the system. A systematic sampling method was used to gather a sample of
thirty. This researcher reviewed and collected appropriate data from the sampled cases.
Information from these cases was organized and recorded using the Yuba County
Intergenerational Child Abuse Data Collection Form (See Appendix A). The form was
developed specifically for this research project. During this researchers internship for
Yuba County CPS this worker had access to the computer system CWS/CMS. This
researcher was trained on confidentiality and had regular access to the records. The
agency gave this researcher authorization to access this information for this project (See
Appendix D). During this researcher’s down time this researcher used the database to
29
review the cases for intergenerational child abuse patterns. For the key informant
interview interviews were conducted with social workers working in Yuba County CPS.
The interview was a series of open-ended questions.
Instruments Used
The data collection instruments used was the Yuba County CPS Intergenerational
Child Abuse Data Collection Form and the Yuba County CPS Intergenerational Child
Abuse Interview Guide (See Appendix B). The data collection form is used to extract
data from client records. A case number is assigned to each record and no personal
identifiers are included. This form collects data regarding client demographics and their
history in the child welfare system such as type of child abuse, drug abuse, and treatment
received. Each interviewee signed an informed consent (See Appendix C). The project’s
interview consists of eight open-ended questions, which are included in the Yuba County
CPS Interview Guide. The interview assesses the following: 1) services available, 2)
what works with this population, 3) what does not work 4) challenges and 5) what is
needed. Comparing the services currently available and the needs of the population will
be important in this project.
Data Analysis Approach
Appropriate descriptive and inferential statistics were used to analyze the
quantitative data. These include the presentation of data and analysis of association and
differences. Some of the test used includes X2 and t-test. Qualitative data from the
interviews are analyzed identifying theses, trends and patterns. Content analysis methods
30
are also used. This researcher evaluated the interview responses to find commonalities
with the respondent’s responses.
Human Subjects Review
The Human Subjects Review Committee of Division of Social Work, California
State University, Sacramento approved this study as a minimal risk study. This
researcher met with the agency administration and discussed this project and received
their support. The intention of this project is to review and better understand the client
and better serve the population. Secondary data was used and no identifying information
was kept from the data obtained. Only demographic information (age, ethnicity, and
sex), type of child abuse, domestic violence, jail time, parole or probation, and type of
treatment received is collected and quantified. Participations in the interviews are
voluntary and the study of the survey focuses on workers’ perspectives and values.
Although this researcher will know the interviewees this researcher will not include the
name of the interviewee with the notes that are taken from the interview. No identifying
information will be kept with the notes from the interviews. Therefore, the personal
nature of the questions carries minimal risk of causing the subjects any emotional
discomfort.
31
Chapter 4
DATA ANALYSIS AND STUDY FINDINGS
The previous chapter discussed the design, subjects and data gathering procedures
of this study. The purpose for this chapter is to present the results of the analyzed
quantitative and qualitative data collected.
The secondary data was analyzed to determine the actual percentage of
intergenerational transmission of child abuse within Yuba County. It also included the
percentage of those families who suffer from mental illnesses and substance abuse issues.
The interview information was organized to reflect the past interventions and their
validity as well as the interventions that are perceived as being needed.
In the findings section, this researcher will provide information on the
overarching themes and suggestions shared by the participants and outline in detail the
secondary data that was collected. The secondary data was examined according to the
following topics: 1) Demographics, 2) parent(s) and grandparent(s) drug abuse, 3) the
type of abuse the grandparent(s) or parent(s) inflicted, 4) services parent(s) and
grandparent(s) received, 5) removal of children from grandparent(s) and parent(s), and 6)
whether the children were returned to the grandparent(s) or parent(s).
Findings from Secondary Data
Demographics.
This researcher collected secondary data on 30 parents who had voluntary or court
cases with Yuba County Child Protective Services (CPS) as adults and had experienced
32
abuse as children. Of the 1451 cases Yuba County CPS had between 2001 and 2010, 218
were evaluated for intergenerational child abuse. The 218 were cases with parents who
were born in 1980 or later. These were parents who were in the system as children as
well as having children of their own in the system.
Of the 218 cases, 30% (n=66) were identified has having intergenerational
patterns of abuse. Of those parents 23% were male (n=7) and 77% were female (n=23).
They range in age of 18-29. Fifty-seven percent were white (n=17), 10% were Mexican
(n=3), 10% were Asian (n=3), 17% were Native American (n=5) and 6% were white and
Native American (n=2).
There were 30 grandparents who were involved in child abuse with these parents.
Of the grandparents 32% were male (n=13) and 68% were female (n=27). The age range
is 26-55 with 12.5% or n=5 with an unknown age. Fifty-five percent were white (n=22),
8% were Mexican (n=3), 15% were Asian (n=6), 15% were Native American (n=6) and
7% were white and Native American (n-=3).
There were 63 children involved in child abuse with the parents in the study. Of
the children 46% were male (n=29) and 54% were female (n=34). The children ranged in
age of one to seven with 46% being under the age of one (n=29). Fifty-two percent were
white (n=33), 8% were Mexican (n=5), 5% were Asian (n=3), 16% were Native
American (n=10), 11% are white and Asian (n=7) and 8% were white and Native
American (n=5).
33
Parents drug use vs. grandparent drug use.
Of the grandparents who used drugs and had CPS involvement, 60% (n=18) had
children who became parents and also used drugs and had CPS involvement. Seven
percent (n=2) of grandparents had CPS involvement and a drug history that had children
who had CPS involvement with history of drug abuse (See Table 1). Grandparents with
CPS involvement and abused drugs were more likely to have children who grew up to
use drugs and have CPS involvement. Chi square analysis indicated that there is a
statistically significant relationship between grandparent’s use of drugs and their children
growing up to become drug abusers (X2=3.75, df=1, p=.053).
Of the grandparents who had CPS involvement and did not have a drug history
there were 20% (n=6) who had children who had CPS involvement and a drug history.
Thirteen percent (n=4) of grandparents who had CPS involvement and no drug history
had children who became parents who had CPS involvement and no drug history.
Table 1
Parent Drug Use vs. Grandparent Drug Use
Grandparent Drug Use
Yes
No
Total
Parent Drug Use
Yes
No
18
2
6
24
4
6
Total
20
10
30
34
Parent drug use vs. parent maltreatment type.
Of parents with intergenerational patterns of child abuse in Yuba County, 70%
(n=21) use drugs and neglect their children. Ten percent (n=3) use drugs and are
physically abusive and neglectful. Of the parents who do not use drugs, 17% (n=5) are
neglectful, 3% (n=1) are physically and emotionally abusive and are neglectful (See
Table 2). Parents who use drugs are more likely to be neglectful to their children.
Further examining this relation found that there is a statistically significant relationship
between parents drug use and they type of maltreatment they participate in (X2=4.760,
df=2, p=0.093).
Table 2
Parent Drug Use vs. Parent Maltreatment Type
Parent Drug Use
Total
Yes
No
Parent Maltreatment Type
Physical Abuse,
Physical Abuse Emotional Abuse
Neglect
and Neglect
and Neglect
21
3
0
5
0
1
26
3
1
Total
24
6
30
Grandparent child removed vs. grandparent received services.
Grandparents who did not have children removed (10%, n=3) received services,
(20%, n=6) did not receive services. Of the parents who were removed from the
grandparents 37% (n=11) received services and 33% (n=10) did not receive services (See
Table 3). Seven percent (n-=2) of parents removed from grandparents were placed in a
35
kin placement and none of the grandparents received services. Forty-seven percent
(n=14) of parents removed from grandparents were placed in a foster family home.
Twenty-seven percent (n=8) of the grandparents received services and 20% (n=6) did not
receive services. Ten percent (n=3) of parents removed from grandparents were placed in
a group home with all 10% of the grandparents received services. Seven percent (n=2) of
the parents removed from grandparents were placed with kin and in a foster family, none
of the grandparents received services. Forty-seven percent (n=14) of grandparents
received services while 53% (n=16) did not receive services (See Table 4). Grandparents
who had children removed from their care were not guaranteed to receive services. In
fact it is approximately 50/50 between receiving services and not receiving services.
Statistical significant relationship existed between grandparents having their children
removed and if they received services (X2=8.189, df=4, p=0.085).
Table 3
Grandparent Child Removed vs. Grandparent Received Services
Grandparents Received
Services
Total
Grandparents
Child Removed
Total
No
Yes
3
No
6
9
Yes
11
10
21
14
16
30
36
Table 4
Grandparents Child Placement vs. Grandparent Received Services
Grandparents Received
Services
Total
Grandparents
Child Placement
Total
Not Removed
Kin Placement
Foster Family
Group Home
Kin and Foster
Family
Yes
3
0
8
3
0
No
6
2
6
0
2
9
2
14
3
2
14
16
30
Parent child removed vs. parent received services.
Thirty-three percent (n=10) of parents did not have children removed, 23% (n=7)
received services and 10% (n=3) did not receive services. Sixty-seven percent (n=20)
had their children removed, 60% (n=18) received services and 7% (n=2) did not receive
services (See Table 5). Of those removed 17% (n=5) were placed with kin; 10% (n=3)
received services and 7% (n=2) did not receive services. It appears that parents who had
a case with CPS were more likely than not to receive services. Fifty percent (n=15) of
the children were removed from their parents and placed with a foster family. All of
those parents received services. Eighty-three percent (n=25) of parents with cases
received services while 17% (n=5) did not receive any services (See Table 6). A
37
statistical significant relationship existed between children being removed from their
parents and if the parents received services (X2=6.240, df=2, p=0.044).
Table 5
Parent Child Removed vs. Parent Received Services
Parents Received Services
Total
Parent
Child Removed
Total
No
Yes
Yes
7
18
25
No
3
2
5
10
20
30
Table 6
Parents Child Placement vs. Parent Received Services
Parents Received Services
Total
Parent
Child Removed
Total
Not Removed
Kin Placement
Foster Family
Yes
7
3
15
No
3
2
0
10
5
15
25
5
30
Grandparent child removed vs. parent child removed.
Seven percent (n=2) of parents and grandparents did not have any children
removed. Forty-three percent (n=13) parents and grandparents had their children
removed. Twenty-seven percent (n=8) grandparents had children removed, but parents
did not have children removed. Twenty-three percent (n=7) grandparents did not have
38
children removed, but parents did have their children removed (See Table 7).
Grandparents who had children removed are more likely to have children who end up
having their children removed. There is no statistical significance between grandparents
having their children removed and parents having their children removed (X2=0.714,
df=1, p=0.398).
Table 7
Grandparent Child Removed vs. Parent Child Removed
Grandparent Child Removed
Total
No
Yes
Parent Child Removed
No
Yes
2
7
8
13
10
20
Total
9
21
30
Grandparent received services vs. grandparents child returned home.
Forty-seven percent (n=14) of grandparents received services with 10% (n=3)
were not removed, 3% (n=1) had their children returned and 33% (n=10) did not have
their children returned home. Fifty percent (n=15) grandparents did not receive services
with 20% (n=6) did not have children removed, 3% (n=1) children were returned home
and 27% (n=8) children were not returned home (See Table 8). Grandparents who had
children removed and received services did not have their children returned home and
grandparents who had children removed and they did not receive services also did not
have their children returned home. Grandparents who had children removed were not
likely to have their children returned to their care. There is no statistical significance
39
between grandparent’s children being returned home and if the grandparents received
services (X2=1.189, df=2, p=0.552).
Table 8
Grandparent Received Services vs. Grandparents Child Returned Home
Grandparent Received
Services
Total
Grandparents Child Returned Home
Not Removed
Yes
No
Yes
3
1
10
No
6
1
8
9
2
18
Total
14
15
29
Parent received services vs. parents child returned home.
Thirty-three percent (n=10) did not have children removed, 37% (n=11) had their
children returned home and 30% (n=9) did not have their children removed. Eight-three
percent (n=25) of the parents received services; 23% (n=7) did not have children
removed, 37% (n=11) had their children returned home and 23% (n=7) did not have their
children returned home. Of the 17% (n=5) of parents who did not receive services, 10%
(n=3) did not have children removed and 7% (n=2) did not have children retuned home
(See Table 9). For parents who had their children removed, they are more likely to have
their children returned to their care if they received services. If the parents did not
receive services then they are less likely to have their children returned to their care.
There is a statistical significance between if the parents’ children are being returned and
if the parents received services. (X2=3.680, df=2, p=0.159).
40
Table 9
Parent Received Services vs. Parents Child Returned Home
Parents Child Returned Home
Not Removed
Yes
No
Parent Received Services
Yes
7
11
7
No
3
0
2
Total
10
11
9
Statistical significance.
Total
25
5
30
There is statistical evidence that shows that drug abuse patterns passed down
through generations, at least with families who have patterns of intergenerational child
abuse. There is also statistical evidence that shows there is a link between parent drug
use and parent maltreatment type. The major link is between drug use and neglect.
There is statistical significance between grandparents having their children removed and
receiving services. If parents had their children removed were more likely to receive
services. There is not any statistical significance between grandparents having their
children removed and parents having their children removed. Nor is there statistical
significance between grandparents receiving services and the return of their children.
Parents are more likely to receive services and have their children returned to their care
(See Table 10).
41
Table 10
Statistical Significance
Parent and Grandparent Variable
Parent Drug Use vs. Grandparent Drug Use Child Parent
Drug Use vs. Parent Maltreatment Type
Grandparent Child Removed vs. Grandparent Received
Services
Parent Child Removed vs. Parent Received Services
Grandparent Child Removed vs. Parent Child Removed
Grandparent Received Services vs. Grandparents Child
Returned Home
Parent Received Services vs. Parents Child Returned
Home
*=statistically significant
p-value
X2
3.750
4.760
8.189
df
1
2
4
.053*
.093*
.085*
6.240
0.714
1.189
2
1
2
.044*
.398
.552
3.680
2
.159*
Summary of Analysis of Secondary Data
The data shows that families in Yuba County who have patterns of
intergenerational child abuse and use drugs are more likely to pass this behavior down to
future generations. It also shows that parents who used drugs are more likely to be
neglectful to their children than any other form of abuse. Grandparents and parents who
had their children removed are more likely to receive services than those who do not have
their children removed. Parent received services even if they did not have their children
removed; where grandparents were less likely to receive services if they did not have
their children removed. There was no statistical relationship between grandparents who
had their children removed and the parents having their children removed; which means
that just because the parents were removed from the grandparents as children, the parents
42
did not necessarily have their children removed from their care. There is also no
statistical significance between grandparents receiving services and having their children
returned home. So, grandparents who had children removed and received services did
not have children returned home. Parents who had their children removed and received
services were more likely to have their children return to their care.
Findings from Interviews
This researcher interviewed six participants out of eleven line social workers at
Yuba County Child Protective Services (CPS). Of the six participants one was male and
five were female. They all received a masters in social work and have been working with
CPS ever since. The years of experience ranges from 10-18 years. One worker is a
supervisor, three are emergency response workers and two are ongoing social workers.
There was difficulty-getting involvement from the social workers due to the increased
workload. Throughout the interviews this researcher discovered that there is no protocol
or a standard of care when working with this population they receive the same services
and treatment that all other clients receive.
Social workers realize that there needs to be
other services and a different way of working with this population.
The areas discussed with the participants with regard to families with
intergenerational child abuse patterns were 1) challenges when working with the
population, 2) strategies used, 3) successes and challenges they have had with this
population, 4) mental health services that are needed, 5) what is unique to the population,
and 6) the million dollar question-if money was not an issue what would they do to help
43
these families. Throughout the interview process there were similar themes that this
researcher heard when discussing families with intergenerational child abuse patterns.
All six of the participants discussed how drug abuse and mental illness was a common
factor with this population. The participants also expressed how these factors are also
passed down through generations.
When working with this population five of six of the participants stated that there
was no appropriate role modeling. These parents saw from their parents how to parent
and are turning around and doing the same thing. They do not see anything being wrong.
The other participant stated deciphering the issue at hand was the challenge when
working with this population.
The respondents stated the strategies that worked best with this population was to
build good relationships with this population and to find out what they need to make their
situation better. While the workers build good healthy relationships with these clients,
they can help the clients open up to be able to discuss that there are changes that need to
be made and what the clients think is needed to make these changes. Building this
relationship can help show these clients what a healthy relationship looks like and can
help discover how to end unhealthy relationships and find good social support.
Some of the successes that the respondents had with this population are a few
clients have had long term success of breaking the abuse pattern and these clients calling
workers to update on how they are doing and also to ask for help if they are having
problems. Some of the things that help the long-term success are finding a job that has to
44
do with the issues they have been dealing with (i.e. working with others who have drug
and alcohol abuse issues) and staying connected to support systems (i.e. foster parents
who cared for the clients children). Some challenges are the lack of services available
and when the clients chose to stay in contact with friends and family who have the same
or similar issues.
According to the respondents, there is a lack of mental health services available to
clients who have histories of intergenerational child abuse. In most cases, medication is
dispensed without treatment such as counseling or therapy. The respondents think it
would be beneficial for children and families to obtain counseling and therapy instead of
going directly to medication. Group counseling would be beneficial to these families.
These respondents felt that this population is unique because they are savvy to the
system. They have been through the system at least one time, if not more, as a child, so
when they come into the system as adults, they know how to navigate it to get the
workers out of their lives. Often times once the workers are out of their lives, they return
to the system for the same issues. They are also unique because the families do not see
that what is going on in the home as a problem. They survived it so their children will be
fine is a commonality with these families.
When these respondents were asked if money was not an issue what they would
do to help break this cycle the responses were very similar. The thought was if there was
a community or a long-term transitional living facility that these families could stay in for
a long time they would have the support of the workers and other families with similar
45
issues. There would be work or chores for each person to participate in to keep them
busy and to help build self-esteem. There was also the idea of a “catch all” provider.
This is a place where this population could go to receive mental health treatment, alcohol
and drug treatment, parenting classes, and other services in one place instead of having to
go to more that one place for treatment and instead of a cookie cutter approach to
treatment. Each person would have an individualized treatment plan that they participate
in creating so they get the treatment that will work best for them. There was also
discussions about the computer systems to all the providers being linked so each provider
can see what is going on with the client at each place so all parties working with the
client will know what is happening with the family and will be less likely to have
miscommunication or lack of communication between social workers, court, probation,
and treatment providers.
Summary of Interview Findings
Families with patterns of intergenerational child abuse have histories of drug
abuse and mental illness. They receive the same treatment as any other group that does
not address their unique issues of passing on drug abuse patterns and child abuse patterns.
Families who have these patterns have no healthy source for role modeling appropriate
parenting practices or behaviors. Social workers in the field believe it is important to
build good trusting relationships with these clients so they can see healthy relationships
modeled and so they feel comfortable to come back for help when times get hard. They
also believe that there is a lack of services available to this population. This population
46
also has a hard time getting to the services due to transportation and childcare issues.
There is also a lack of good positive support with families who have intergeneration child
abuse patterns. This population tends to stay involved with others who have the same or
similar issues.
Conclusion
The secondary data and the interviews compliment each other. The data shows
issues that the families have with regard to drug abuse issues, removal and return of
children, and services. The data shows that services have been helpful with families
being able to keep the children in their home as well as the children being returned to the
home. The interviews show that there is a lack of services and ability to get to or stick
with services. The interviews show that there is a need that is not being fulfilled with this
population. Interviews with social workers show that there needs to be a change or
addition of services including counseling for all family members both individual and
family counseling as well as group counseling for social support. The two can be used to
together to create a plan for intervention with these families that will better suit their
needs.
47
Chapter 5
CONCLUSIONS, SUMMARY, AND RECOMMENDATIONS
Based on personal experience in the field and the perception of professionals in
the field there is a need for specialized treatment for families with histories of
intergenerational child abuse. With intergenerational child abuse behaviors and parenting
practices or lack there of, are passed down from generation to generation. Evidence
suggests that without treatment for these children and families these children are more
likely to grow up with mental illnesses making it difficult for them to concentrate,
causing them to drop out of school and being unable to hold a job, causing family stress
coupled with the parenting patterns they learned the too become abusive (Pears &
Capalidi, 2001; Wilson & Horner, 2005).
With the data collected and through out the interview process there were certain
recurring themes. One of the recurring themes is that there are inadequate services for
this population. One study shows that protective factors involved in lessening the
transmission of child abuse from one generation to the next is positive social support,
positive relationships, rejection of the parents’ values and attitudes, acceptance of the
abuse and learned positive self-image (Langeland & Dijkstra, 1995). Services that help
facilitate these protective factors would be useful when working with families who
experience intergenerational child abuse. Many of the social workers interviewed for this
project felt that there are many gaps in services and that specialized services needed to be
created for this population.
48
Recommendations
Having worked in the CPS for two years, this researcher saw first hand how this
population enters and re-enters the system, the lack in services and no services given to
the children unless there are major behavioral issues. There is limited research on the
treatment that is necessary for this population to help break the cycle of abuse. It is
recommended by this researcher that specialized services be created to treat this
population. If treatment for this population is not changed or enhanced, the cycle of
abuse will continue for generations to come.
Findings from this study indicate the needs for services for the families in the
following areas: individual therapy (for each family member over age 7), family therapy,
parent child interaction therapy, group therapy (for each family member over the age of
7), mental health treatment, job training, alcohol and drug abuse treatment, parenting
classes, and anger management. Many of these services are already available to adults or
severely emotionally disturbed children; however, they are scattered across the county.
Access to services, specifically transportation, is a major concern. Having the
services scattered makes it difficult for these families to get to the services especially if
the children remain in their care. There is also an issue with childcare. It would be
beneficial to have a program that is located in or close to clients’ community such as a
drug treatment program where the clients could stay with their children while receiving
treatment.
49
Often times the services are ordered by the worker without involving the client.
Yuba County has been slowing moving toward involving the client more with the
services that are needed for the client, by asking them what they think they need rather
than prescribing services. There will be times when services will be required that the
client does not think they need.
Review of Findings and Relevance
Findings of this research show that there are gaps in services available to families
with histories of intergenerational child abuse. The current idea of treating families with
intergenerational child abuse is treat the parents for mental illness with medication, drug
abuse through a treatment program and give them parenting classes at the Child
Protective Services (CPS) office. Children are not treated unless there are severe
behavioral issues. The research also shows that drug use and child neglect plays a part in
intergenerational child abuse.
The data in this research shows that if grandparents abused drugs and neglected
their children (parents), then parents are more likely to abuse drugs and neglect their
children also. It also shows that services play a large role in the return of children to their
parents.
According to the interviews, even though the families may come into the system
and receive services and either gets to keep their children in their care of have their
children returned to their care, they will most likely return several times for the same
issues. There is an understanding that when working with this population there needs to
50
be individualized treatment for these families rather than a cookie cutter approach. The
social workers interviewed also stated that transportation and childcare is an added
challenge for access to care for families in poverty. Centralized and coordinated services
in a one-stop location and possibly with designated transportation services would greatly
increase these families participation. There were also concerns of lack of appropriate role
modeling and social support for these families.
Consequences of unacknowledged and unresolved issues pertaining to
intergenerational child abuse persist through out CPS. This research is relevant to the
field of social work by identifying lacks in services and educating professionals on
research on the topic of intergenerational child abuse and the best practices when
working with this population. The end goal of this project is to educate professionals and
encourage others to apply for grants to enhance services for families who suffer from
intergenerational child abuse.
Implications for Social Work
The implications for the field of Child Protective Services (CPS) social work are
many. It is also important that social workers in the field of CPS in Yuba County are
educated in this research and are aware of the unique needs of families with histories of
intergenerational child abuse. The hope of this researcher is social workers working in
the field of CPS will write a grant to obtain funds to create intensive services for families
with histories of intergenerational child abuse in Yuba County. These services can help
social workers provide the services that are so desperately needed for this population.
51
Evaluation
The most significant limitation of this study is that it is generalized to Yuba
County. It cannot be generalized or used for other counties. Most of the workers have
worked in CPS for five or more years and are aware of the struggles and barriers faced in
the county with families who experience intergenerational child abuse, but these struggles
and barriers may not be the same in other counties across California. Furthermore, the
data that was collected was also just for Yuba County, thus cannot be generalized for
other counties. Do other counties have the same problem of intergenerational child
abuse? And if so, are the issues with the families the same as those faced in Yuba
County?
Recommendations for Further Research
The research does provide for substantial support on the need for specialized and
centralized services for clients who have histories of intergenerational child abuse.
Centralized services for clients will allow families the ability to continue treatment with
ease instead of having to travel to several different locations.
Based on the findings of this research, it appears that there is a plethora of
research on intergenerational child abuse and the effects on the family, parents, children
and even the economy and community; however, the research on treating individuals
with intergenerational child abuse is limited. Although the research shows that those
with protective factors are less likely to become abusers (Langeland & Dijkstra, 1995). It
would be beneficial for future researchers to evaluate these protective factors and how to
52
facilitate them within parents who have been abused and their children. The research
also shows that Trauma Focused Cognitive Behavioral Therapy, Abuse Focused
Cognitive Behavioral Therapy and Parent-Child Interaction Therapy are thought to be
effective treatments for youth and families involved in the child welfare system (Burns et
al., 2004), yet studies also show that youth tend to not receive the services that are needed
for them. Further research should be done to evaluate how these therapy modalities work
with families who have histories of intergenerational child abuse.
Summary
When a child experience abuse or neglect they are being shaped for a future of the
same problems and issues. They do not know any other way to be and think that life, as
they know it, is all they know. This way of life is normal for them. Unless these children
receive treatment and support they will grow up using drugs and being abusive or
neglectful to their own children. Because intergenerational child abuse is so predictable,
CPS needs to be treating the children as well as the parents to help stop the cycle from
continuing on. The primary purpose of this study was to show that there is a specific
need for these families to help them break this vicious cycle and to encourage social
workers to write a proposal for specialized treatment program for these families and
children. The secondary purpose of this project was to enhance the research on the topic
of intergenerational child abuse and the services and treatments that are needed. The
findings of this study suggest that treatment for intergenerational child abuse needs to
53
involve the entire family and not just the parents. It also suggests that intensive treatment
at a community level such as those for drug treatment would be beneficial.
54
APPENDIX A
Yuba County Intergenerational Child Abuse Data Collection Form
55
56
APPENDIX B
Interview Guide
Overview:
I am studying intergenerational child abuse in Yuba County. I will be looking at the ratio
of cases involved intergenerational child abuse and the factors involved in the abuse, i.e.
drug abuse, homelessness, lack of parenting skills and the type of abuse involved – just to
name a few.
This interview will help me to learn about what works, what does not
work, the challenges faced and what is needed when working with this population. In the
end, more appropriate services may be identified for the target population. You are asked
to participate in this study because of your expert knowledge on the subject matter. Your
participation is much appreciated.
Semi Structure Interview Questions:
1) What are the common challenges you face with working with families with a
history of inter-generational child abuse?
2) What are some specific strategies have you employed to working with this
population?
3) What are the challenges and the successes you have had with this population?
4) What types of psycho emotional or mental health services would be helpful and
needed for this population?
57
5) If you had a million dollars available to help break this cycle, what would you do?
6) What is so unique about this group?
7) Other comments/availability/accessibility?
58
APPENDIX C
Informed Consent
INFORMED CONSENT TO PARTICIPATE IN A RESEARCH STUDY
TITLE: Intergenerational Child Abuse: Best Practices
INVESTIGATOR: Adrienne Buhacoff, MSW candidate at California State University,
Sacramento (CSUS).
PURPOSE:
This study is being carried out in partial fulfillment of the requirements for a
Master’s Degree in Social Work for the researcher. The study investigates cases of
intergenerational child abuse (adults who were in the child welfare system as children
and now have children in the child welfare system). It will investigate the issues that put
them in the child welfare system and the issues that placed their children in the child
welfare system. In addition to analysis of current service data, this research intends to
interview 10 social workers working in Yuba County Child Protective Services in Yuba
County, to learn about the challenges facing social workers with this population and what
services they believe are needed.
PROCEDURE:
59
Should you agree to participate in this study, you will be asked to participate in an
interview that will take approximately 30 minutes of your time. The interview is
composed of open ended questions. The interview has a total of 8 questions that cover
such areas as services available, what works, what does not work, what are the challenges
and the needs of the population.
RISKS:
The researchers believe that there is no risk to you by participating in this research
study. You are, however, encouraged to stop the survey if you experience excessive
discomfort while completing it, and you may contact EAP program at 1-800-342-8111 for
assistance.
BENEFITS:
There is no direct benefit to you by participating in this study. However, the
findings of this study may help in the development of best practices when working with
families who have patterns of intergenerational abuse.
CONFIDENTIALITY:
Confidentiality will be maintained to the extent possible. The interview will take
place outside of the work place during personal time. The interviewer will not keep
names of the interviewee with the responses given. Interview data will be kept in a
60
secure, locked, location that is only accessible by the researcher. All research data will be
destroyed after the completion of the research project (no later than June 2011). No
individually identifying data will be included in any papers or publications that result
from this study. Complete confidentiality cannot be guaranteed because research records
may be subpoenaed by the federal DHHS for the purpose of ensuring the protection of
participants in research.
ALTERNATIVES/RIGHT TO REFUSE OR WITHDRAW:
Participation is voluntary, and you are able to discontinue your participation or
drop from the study at any time without explanation. You may decline to participate now
or at any time in the future without any risks or consequences to job performance, current
or future employment with DHHS.
QUESTIONS:
If you have any questions or comment in regard to this study, please feel free to contact
Adrienne Buhacoff at Adrienne@buhacoff.net or (916) 402-3450. Or you can contact my
thesis advisor, Dr. Francis Yuen at fyuen@csus.edu or (916) 278-7182.
61
Research Study Participant’s Bill of Right
1) To be told what the study is trying to find out
2) To be told what will happen to you and whether any of the procedures,
drugs or devices is different from what would be used in standard practice.
3) To be told about the frequent and/or important risks, side effects or
discomforts of the things that will happen to you for research purposes.
4) To be told if you can expect any benefit from participating and, if so, what
the benefit might be.
5) To be told the other choices you have and how they may be better or
worse than being in the study.
6) To be allowed to ask questions concerning the study, both before agreeing
to be involved and during the course of the study.
7) To be told what sort of medical treatment is available if any
complications arise.
8) To refuse to participate or to change your mind about participating after
the study is started. This decision will not affect your right to receive the
care you would receive if you were not in the study.
9) To receive a copy of the signed and dated consent form
10) To be free of pressure when considering whether to be in the study.
62
CONSENT: I have read and understand this consent form and the Bill of Rights for
Experimental Subjects. I have had a chance to ask questions about this research study. I
also understand that when I sign my name below, I am agreeing to volunteer for this
research study. I have signed this informed consent prior to any and all study-related
procedures being performed. I have received my own copy of this form.
____________________________________
___________________________
Signature of Participant
Date
____________________________________
Participant’s Name (Please print)
Please return this informed consent form into the box marked “Informed Consent”.
63
APPENDIX D
Support Letter
Yuba County Child Protective Services
5730 Packard Ave, Suite 100
Marysville, CA 95901
September 19, 2010
Committee for the Protection of Human Subjects
California State University, Sacramento
6000 J Street
Sacramento, California 95819
Dear Committee for the Protection of Human Subjects,
Yuba County Child Protective Services would like to cooperate with Adrienne
Buhacoff’s research by allowing her access to records on intergenerational abuse and to
Social Workers who work in the field. We understand the purpose of the study is to learn
about the best practices when working with families who have intergenerational abuse.
64
In order to support Adrienne Buhacoff, we will allow her access to computer records and
files of families who have histories of intergenerational abuse. We will also send a memo
to Social Workers working in Yuba County Child Protective Services about the project
and stating that their jobs will not be affected by whether they volunteer or not volunteer.
We understand that the information obtained by Adrienne Buhacoff through interviews is
confidential and that only she will have access to any identifiable information. We also
understand that all identifying information obtained by Adrienne Buhacoff from the
database and/or files will be kept confidential and will not be included in her project.
We will look forward to receiving the results of the study.
Sincerely,
Tony Roach, LCSW
Program Manager
65
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