Child Abuse and Neglect

Child Abuse and Neglect

TREATMENT OF PHYSICALLY ABUSIVE FAMILIES

Cognitive behavioral therapy is typically the recommended course of therapy for physically abusive families. Children who reside in such families often experience PTSD as a result of their experiences, and CBT focuses on "re-exposure interventions, education about violence and cognitive restructuring, processing of emotional cues, social problem-solving skills, and parenting interventions" (Vickerman & Margolin 2007). In groups or individually, children are encouraged to re-visit traumatic experiences, talk about them, and to find alternative coping mechanisms to deal with negative emotions. Depending on the nature of the family relationship, family members may also be involved and subjected to individual or family counseling, to enable them to find alternative ways to deal with anger, other than lashing out at other family members.

CBT involves the restructuring of responses, and encouraging those who are aided to think: "I am not responsible for my parents' frightening behaviors" versus lashing out with anger (Vickerman & Margolin 2007). Parents are taught about alternative discipline strategies and to change their method of thinking about how they cope with their children (which was likely learned when they were children). "As part of ongoing safety assessments, the therapist must be alert for changes in the family situation that could elevate chronic states of tension and stress to a crisis level with the potential of serious injury to the youth or another family member" (Vickerman & Margolin 2007).

TREATMENT OF NEGLECTFUL FAMILIES

Neglectful families are particularly difficult to treat, because the parents often are psychologically immature and need help as much as their offspring. The equilibrium that they have reached as an adult does not acknowledge the needs of others, often because their own needs have never been met. "Most neglectful parents want to be good parents, but lack the personal, financial, and/or supportive resources. Professional helpers must assume that parents want to improve the quality of care for their children. Interventions must be developed with that assumption.... Neglectful parents are typically psychologically immature, usually as a result of their own lack of nurturing as children" (Gaudin 1993). Interventions must often begin by 'parenting the parent' and require the social worker to treat the parent with sensitivity while still demanding that the parent assume adult responsibilities in relation to his or her children. This goes beyond teaching the parent new coping mechanisms and requires the social worker to strive to change the adult's as well as the child's 'way of being in the world,' rather than merely change the adult's violent methods of reaction to negative events.

TREATMENT OF SIBLINGS

Even if the child is not physically or emotionally abused, witnessing the abuse of a sibling is itself traumatic. Siblings may have guilt that they were not abused, or feel anger that the victim is given more attention than they receive, even if the attention is for a negative reason. Siblings may also exhibit anger and self-directed rage. They can also benefit from CBT, to deal with depression or inhibition of social relationships that have been generated as the result of growing up in an abusive household. Siblings may not wish to be associated with the abuse and wish to emphasize the normal aspects of their lives. However, they may be dealing with interpersonal difficulties that, while not directly related to the abuse, can be alleviated by partaking in the family treatment process. The counselor must stress the benefits to the sibling as well as to the other family members that are gained by participating in the therapy.

TREATMENT OF SEXUAL OFFENDERS

Treating sex offenders usually combines group and individual therapy and monitoring. "The goals of therapy include identification of his chain and cycle of offending, reduce denial, working toward taking full responsibility, recognizing impact on victims and victim empathy, recognizing impact of victimization on family members and friends, plan for regaining trust from family members, self-management of deviant sexual arousal, and working toward implementing an effective relapse prevention plan" (Relapse prevention model, 2012, Therapy corner). Treatment is usually considered a lifelong process also involves physically keeping the offender 'away from temptation' (i.e. children). Limiting access to children, such as the distance the offender can live from a school or playground is just as vital a component of therapy as the 'talk process.'