Project SafeCare: Improving Health, Safety, and Parenting Skills in Families Reported for, and At-Risk for Child Maltreatment

Project SafeCare was a 4-year, in-home, research and intervention program that provided parent training to families of children at-risk for maltreatment, and families of children who were victims of maltreatment. Parents were trained in treating children's illnesses and maximizing their own health-care skills (Health), positive and effective parent–child interaction skills (Parenting), and maintaining low hazard homes (Safety). The effectiveness of these training components was evaluated as the change in the parents' scores on roleplay situations for child health problems, hazards present in the home, and the frequency and quality of parent–child interactions during activities of daily living. Statistically significant improvements were seen in child health care, home safety, and parent–child interactions.     

The Relationship of Reflective Functioning to Parent Child Interactions in a Sample of Fathers with Concurrent Intimate Partner Violence Perpetration and Substance Abuse Problems

This study is the first to examine reflective functioning (RF) and direct parent–child interactions of fathers with concurrent intimate partner violence (IPV) perpetration and substance abuse (SA) problems. Twenty-four fathers, with children between the age of one and seven, completed a structured interview to assess RF, self-report measures of hostile-aggressive parenting behaviors, IPV perpetration severity, SA severity, and a coded play session with their children. Results of three simultaneous multiple regressions revealed that RF in fathers was not associated significantly with observed parenting behaviors. However, fathers’ SA severity emerged as a significant predictor for child avoidant behavior and dyadic tension, and fathers’ IPV perpetration severity contributed unique variance to child avoidant behavior and dyadic constriction. These results suggest that fathers’ SA severity and IPV perpetration behaviors may be more salient factors in predicting their father-child interactions than paternal RF.     

Child abuse potential and parenting stress within maltreating families

This study examined the relationship between child abuse potential and parenting stress in mothers and fathers receiving services for child maltreatment. Significant differences were found between perpetrating and nonperpetrating parents. Nonperpetrating parents reported more problems with family, greater total parenting stress and child-related stress, and greater stress from child demandingness, adaptability, acceptability, and distractibility. No significant gender differences in child abuse potential and parenting stress were found. Aspects of parent related stress moderated the relationship between child related stress and abuse potential. Perceived stress from parenting sense of competence was isolated as a variable that significantly increased abuse potential at medium and high levels of child-related stress.     

Consumer Evaluation of an Ecobehavioral Program for Prevention and Intervention of Child Maltreatment

This study was conducted to evaluate parental satisfaction and acceptability of Project SafeCare, an intensive parent training program to prevent and treat child abuse and neglect with a focus on three areas of intervention: (1) home safety, (2) infant and child health care, and (3) bonding and stimulation. Social validation questionnaires were employed to evaluate the acceptability, the effectiveness, and the outcome of treatments based on parents' perspectives. The questionnaires were divided into four categories: outcome measures, process and procedures, staff performance, and training modes. Overall, Project SafeCare was reported to be very successful and parents reported high satisfaction with all three training programs. Parents rated the procedures, staff, and outcomes very positively. Although parents liked the videos and rated them positively, they seemed to prefer training by counselors to training by video. Data were collected on 45 families and the training was conducted over 15 weeks.     

Parenting interventions for incarcerated parents to improve parenting knowledge and skills,parent well-being,and quality of the parent–child relationship: A systematic review and meta-analysis

Objectives

To systematically review and quantitatively synthesize the evidence for the impact of parenting interventions for incarcerated parents on parenting knowledge and skills, parent well-being, and quality of the parent–child relationship.

Methods

A systematic search of 19 published and unpublished literature sources was conducted between June and July 2015 (with no date, language, document type, or geographical restrictions). Studies were included if they: (a) utilized a sample of parents who completed a parenting intervention in an incarceration setting; (b) measured parenting knowledge and skills, parent well-being, or quality of the parent–child relationship as outcome measures; and (c) employed a randomized controlled trial or quasi-experimental design with no treatment, waitlist control, or treatment-as-usual as the comparison condition. Two review authors independently determined study eligibility and extracted data from eligible studies, which included rating the risk of bias for each eligible study. Meta-analysis was used to synthesize standardized effect sizes, and subgroup analyses were used to examine the moderating effect of parent gender, level of child involvement, and research design.

Results

Twenty-two studies were eligible for inclusion in the review; however, only 16 studies (N = 2292) reported sufficient data for inclusion in the meta-analyses. Parenting interventions were more effective at post-intervention for improving parenting knowledge and skills than no treatment, waitlist control, or treatment-as-usual [standardized mean difference (SMD) = 0.68, 95% confidence interval (CI) 0.28, 1.06] and quality of the parent–child relationship (SMD = 0.27, 95% CI 0.02, 0.51), but not for improving parent well-being (SMD = 0.14, 95% CI ?0.03, 0.30). There was significant heterogeneity across effect sizes for both parenting knowledge and skills and quality of the parent–child relationship outcome domains. There were no statistically significant differences between subgroups, and the effectiveness of parenting interventions was not maintained at follow-up time-points.

Conclusions

Existing evidence suggests small to moderate effectiveness for parenting interventions during incarceration at close to intervention completion. Further methodologically robust research is required to more confidently establish the effectiveness of parenting programs both in the short-term and in the post-release period.

     

Predictors of Child Abuse Potential Among Military Parents: Comparing Mothers and Fathers

The present study examines the predictors of child abuse potential for at-risk fathers and mothers serving as active duty Army members and their spouses. Although fathers are perpetrators of child physical abuse and neglect in a substantial portion of reported cases, what is known about factors associated with child maltreatment comes almost exclusively from studies of perpetrating mothers. Thus, the inclusion of a large sample of fathers in the present study makes a significant contribution to the extant literature. Participants were 175 fathers (93% active-duty) and 590 mothers (16% active duty) of young children enrolled in an Army-sponsored home visitation program. Regression analyses indicated that there were both common and unique predictors of child abuse potential for mothers and fathers. Common predictors included depression, parental distress, and family conflict. Low family expressiveness was predictive only for fathers, whereas marital dissatisfaction, low social support, and low family cohesion were predictive only for mothers. Possible reasons for these gender differences and the implications of these results for child maltreatment interventions are discussed.     

A Feasibility Pilot Intervention Program to Teach Parenting Skills to Mothers of Poly-Victimized Children

The Parceria (Partnership) Project is a Brazilian intervention program designed for mothers with an intimate partner violence (IPV) history. Its short term goal is to teach parenting skills to abused women, and in the long term, to prevent behavioral problems in their children. The objective of this pilot study was to evaluate the feasibility of the Parceria Project with mothers of children who had experienced multiple forms of maltreatment (poly-victimization), as it was expected that most of the mothers would also have a history of IPV. Seventeen Brazilian mothers took part in this intervention. They completed several types of evaluation. The intervention program using a cognitive-behavioral model took place in each family’s home. All mothers completed the intervention and evaluated the project positively. The study showed that it is feasible to conduct interventions with families who face severe psychosocial risk such as family violence.     

THE KIDS' TURN PROGRAM EVALUATION: PROBING CHANGE WITHIN A COMMUNITY‐BASED INTERVENTION FOR SEPARATING FAMILIES

We provide evaluation results for Kids' Turn, a community‐based divorcing parent education program. Based on pre‐ and post‐test results from 61 parents, we found that parents reported improvements over time in interparental conflict, the number of topics parents argue about, parental alienation behaviors, parent anxiety and depression, and children's internalizing behaviors. These changes over time remained after we accounted for child sex, parent and child age, and time since separation. However, we did not observe any change in parenting behaviors. We discuss these results in light of factors influencing the ability of community‐based programs to affect change in families after divorce.     

How the Framework of Implementation Science Guided an Evidence‐Based Dependency Parenting Program Initiative in Florida

In Florida, like most states, many of the parenting programs that are being utilized with families in the dependency system are non‐evidence based, and fail to provide quantifiable data on parent progress during and after completion of the programs. Providing pertinent information in court on parents’ progress in a parenting program, as opposed to simply monitoring attendance, is a growing need voiced by dependency judges and child welfare case management professionals. Clear, reliable information related to parenting skills acquisition and insight can help to ensure that families involved in the child welfare system have access to quality services that improve outcomes for their children. The purpose of this paper is to detail how a statewide initiative to increase the number of Florida circuits providing evidence‐based parenting programs to their clients utilized implementation science to guide their process, and the degree to which the participating circuits achieved full implementation of evidence‐based parenting programs.     

Consideration of Risk and Protective Factors for Families at Risk for Child Maltreatment: An Intervention Approach

Child maltreatment is associated with a complex interplay of risk and protective factors. Intervention service decisions for child maltreatment need an empirically-supported approach integrating targeted risk and protective factors. A literature review led to the proposed approach to address the interplay between risk (intimate partner violence; IPV and depression) and protective factors (social support and family resources) to help guide decision-making in home-based prevention services for vulnerable families. This approach suggests that social support and family resources are two pivotal protective factors in buffering against child maltreatment potential, while addressing core risk factors. This approach is consistent with research suggesting that home-based parenting programs should target central risk and protective factors in child maltreatment. Application of this approach can guide training of providers delivering home-based services and support decision-making. Future research is warranted to test this approach in empirically-supported interventions.     

The Co-occurrence of Child and Intimate Partner Maltreatment in the Family: Characteristics of the Violent Perpetrators

This study considers the characteristics associated with mothers and fathers who maltreat their child and each other in comparison to parents who only maltreat their child. One hundred and sixty-two parents who had allegations of child maltreatment made against them were considered. The sample consisted of 43 fathers (Paternal Family—PF) and 23 mothers (Maternal Family—MF) who perpetrated both partner and child maltreatment, together with 23 fathers (Paternal Child—PC) and 26 mothers (Maternal Child—MC) who perpetrated child maltreatment only. In addition, 2 fathers (Paternal Victim—PV) and 23 mothers (Maternal Victim—MV) were victims of intimate partner maltreatment and perpetrators of child maltreatment and 7 fathers (Paternal Non-abusive Carer—PNC) and 15 mothers (Maternal Non-abusive Carer—MNC) did not maltreat the child but lived with an individual who did. Within their family unit, 40.7% of parents perpetrated both intimate partner and child maltreatment. However, fathers were significantly more likely to maltreat both their partner and child than mothers and mothers were significantly more likely to be victims of intimate partner violence than fathers. PF fathers conducted the highest amount of physical and/or sexual child maltreatment while MC and MV mothers perpetrated the highest amount of child neglect. Few significant differences between mothers were found. PF fathers had significantly more factors associated with development of a criminogenic lifestyle than PC fathers. Marked sex differences were demonstrated with PF fathers demonstrating significantly more antisocial characteristics, less mental health problems and fewer feelings of isolation than MF mothers. MC mothers had significantly more childhood abuse, mental health problems, parenting risk factors and were significantly more likely to be biologically related to the child than PC fathers. This study suggests that violent families should be assessed and treated in a holistic manner, considering the effects of partner violence upon all family members, rather than exclusively intervening with the violent man. Requests for reprints should be sent to Louise Dixon, Center for Forensic and Family Psychology, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom.     

Harsh Discipline and Child Problem Behaviors: The Roles of Positive Parenting and Gender

This study examined harsh verbal and physical discipline and child problem behaviors in a community sample of 2,582 parents and their fifth and sixth grade children. Participants were recruited from pediatric practices, and both parents and children completed questionnaire packets. The findings indicated that boys received more harsh verbal and physical discipline than girls, with fathers utilizing more harsh physical discipline with boys than did mothers. Both types of harsh discipline were associated with child behavior problems uniquely after positive parenting was taken into account. Child gender did not moderate the findings, but one dimension of positive parenting (i.e., parental warmth) served to buffer children from the detrimental influences of harsh physical discipline. The implications of the findings for intervention programs are discussed. This research was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism.     

Using iPhones? to Enhance and Reduce Face-to-face Home Safety Sessions within SafeCare?: An Evidence-based Child Maltreatment Prevention Program

Innovative handheld technologies are changing the possibilities for public health interventions. The present research describes a preliminary examination of the iPhone? when used as an assessment tool and an enhancement to an evidence-based, in-home child safety intervention. Three families with young children received an augmented version of the Safety module of SafeCare, a home-visiting child maltreatment prevention program. Specifically, parents were trained to use an iPhone to video rooms in their homes, as well as communicate feedback, logistics, and safety content between the home visitor and parent. The effectiveness of iPhone and video was examined using a multiple baseline design across in-home settings replicated across families. Home hazards were reduced dramatically across rooms and across participants. Face-to-face time of the home visitor was progressively reduced and replaced by video data collection. These data suggest smartphones are promising for data collection and for augmenting face-to-face interactions. Implications for reducing costs as smartphones become increasingly ubiquitous and for engaging and retaining participants are discussed.     

Emotional Dysregulation and Negative Affect Mediate the Relationship Between Maternal History of Child Maltreatment and Maternal Child Abuse Potential

Risk for committing child abuse is frequently attributed to an intergenerational “cycle of violence” through which abuse as a child increases risk for committing abuse as a parent. While this hypothesis has support, more research is needed to understand the factors that account for this pattern of risk. Given literature suggesting that adults with a history of child maltreatment have increased risk for a wide range of psychopathology, this study examined the role of two behavioral endophenotypes, emotional dysregulation and negative affect, in the association between maternal experiences of childhood maltreatment and maternal child abuse potential among 83 low-income, primarily African-American mothers of elementary school age children. Results indicate that a mother’s experience of abuse as a child predicts later risk for abusive parenting as measured by child abuse potential scores. However, our data also indicate that the relationship between maternal experience of child abuse and later child abuse potential is mediated by maternal emotional dysregulation and negative affect.     

Ecological correlates of neglect in infants and toddlers

Infants and toddlers are more likely to be victims of neglect than any other form of maltreatment. Infants and toddlers are at highest risk of fatality because of maltreatment and experience behavioral, social, academic, medical, and cognitive consequences of neglect during their most formative years. Within an ecological framework, this study examines the correlates of the substantiation of neglect in children 0 to 36 months of age. Using an ex post facto design and a random sample of 148 child protective services cases, bivariate analysis revealed significant differences in families who were substantiated for neglect in the areas of child characteristics, home environment, social environment, caregiver, and maltreatment situations. Multivariate analysis found children who were substantiated for neglect were exposed to greater environmental dangers and had caregivers who had poor parenting skills. Implications for practice and future research are discussed.     

DO PARENT EDUCATION PROGRAMS PROMOTE HEALTHY POSTDIVORCE PARENTING? CRITICAL DISTINCTIONS AND A REVIEW OF THE EVIDENCE

Most parent education programs are designed to improve child well-being following divorce by changing some aspect of parenting. However, there has been relatively little discussion of what aspects of parenting are most critical and the effectiveness of programs to change different aspects of parenting. This paper addresses these issues by: 1. Distinguishing three aspects of post-divorce parenting that have been targeted in parent education programs; 2. Reviewing evidence of the relations between each aspect of parenting and the well-being of children and; 3. Critically reviewing evidence that parent education programs have been successful in changing each aspect of post-divorce parenting.     

Practice tips for managing challenges in parenting capacity assessments in child protection court

Courts frequently rely on parenting capacity assessments to make decisions about visitation and case progress in child protection court. Although these evaluations can provide valuable information to courts, they often involve assessing areas of human behavior that are not clearly defined in the literature. For example, mental health professionals are often tasked with identifying risk and protective factors for child maltreatment while identifying factors that can impede progress towards reunification. Although some of these factors may be easy to identify and assess (e.g., symptoms of mental illness or substance abuse), others may be more challenging. For example, factors such as denial and minimization about risk factors and maltreatment, a parent(s)’ ability to protect their child(ren) from future incidents of maltreatment, the parent(s)’ potential for change, and the consideration of what is in the best interest of the child are hard to assess. This article will provide a summary of the research in these areas, provide tips for managing these areas, and highlight directions for future investigation that will help inform parenting capacity assessments in child protection court.     

The impact of stress on cognitive components of child abuse potential

The purpose of the present research was to test the effects of situational stress on the components of the cognitive behavioral model, including expectations, interpretations, and behavioral responses to child behaviors (Twentyman et al., 1985). It was predicted that parental abuse potential would be positively related to inappropriate expectations, to negative and internally caused interpretations of child behavior, and to negative parental responses. Second, it was expected that interpretations and responses would be more negative as child abuse potential increased. Sixteen mothers from a child abuse prevention and treatment program completed the Child Abuse Potential Inventory (Milner and Wimberly, 1980) and provided interpretations, evaluations, and responses to a set of vignettes depicting normal child behaviors. The data supported the hypotheses. As abuse potential increased, parent responses were judged as more controlling, punishing, rejecting, and aroused. High stress strengthened the magnitude of these responses. These findings were interpreted within the context of a cognitive behavioral model.     

Comparison of Parent and Child Reports on Child Maltreatment in a Representative Household Sample in Hong Kong

This study investigated and compared the rates of child maltreatment as reported by parents and children. Self-reports of 1,093 children aged 12 to 18, which were matched with both parents’ records, were compared and analyzed in the study. The levels of agreement between parent and child reporting of various kinds of parental child maltreatment were low to moderate. Factors affecting the disagreement in reports were also investigated. Social desirability and violence approval were the common predictors of disagreement in father-child and mother-child reports, respectively. The low agreement between parent–child reports found in the present study highlights the need for the inclusion of both parent and child reports on maltreatment in future clinical screening and intervention programs.