Social-cognitive skills training with a sexually abused and abusive child psychiatric inpatient: Training,generalization, and follow-up

This paper describes the clinical application of a social-cognitive skills training program for an 11 1/2-year-old child psychiatric inpatient with a history of sexual abuse and neglect who was referred for hospitalization after sexually molesting a neighborhood girl. The content and procedures of the program are outlined in detail to facilitate replication. Results indicated that improvements were found on analogue role-play scenarios administered during training-which then generalized to several specific and general measures of social adjustment/competence on the inpatient unit. A 1-year follow-up assessment revealed the maintenance of these therapeutic gains. The implications of this therapeutic approach with maltreated children and need for more rigorous empirical outcome studies are discussed.     

Traumatized Youth in Residential Treatment Settings: Prevalence, Clinical Presentation, Treatment, and Policy Implications

Children and adolescents with histories of traumatic exposure comprise a substantial portion of youth in residential treatment programs. However, until recently, little has been known about this specific population. Given the well-documented unique treatment considerations for traumatized youth, it is important to understand how the distinct needs of this population factor into the particular residential treatment setting approach. This paper presents a comprehensive overview of the current understanding of this vulnerable youth population, the impact trauma exposure can have on their clinical presentation and response to treatment, and the available empirical research regarding effective intervention strategies. In addition, policy implications specific to traumatized youth receiving treatment in residential settings are discussed.     

Using recidivism data to evaluate project 12-ways: An ecobehavioral approach to the treatment and prevention of child abuse and neglect

Many programs and projects have been remiss at looking at outcome variables such as recidivistic child abuse and neglect. Presented here are program evaluation data which examine recidivism data over 5 years across more than 700 families. Families receiving services from Project 12-Ways, a multifaceted in-home ecobehavioral approach, were compared with families indicated in the same region who received child protective services other than those offered by Project 12-Ways. Families who receive services from Project 12-Ways are less likely to reinjure or neglect their children again.     

Cognitive problem-solving training to improve the child-care judgment of child neglectful parents

Child neglect, the failure to adequately meet a youngster's care needs, is the most frequent form of child maltreatment reported to welfare authorities. However, there have been few empirical reports of treatment outcomes for adjudicated, child neglectful parents. In the current study, an initial assessment of three neglectful parents revealed substantial deficits in cognitive problem-solving skills related to child care judgment. Treatment, consisting of modeling, shaping, practice, and feedback was used to improve each parent's child care problem-solving skills in a multiple baseline design. Skill enhancement was also found for untrained (generalization) problem situations, and independent caseworker ratings of each family's functioning provided external validation of the intervention's clinical impact.     

HOW EFFECTIVE ARE COURT‐AFFILIATED DIVORCING PARENTS EDUCATION PROGRAMS? A META‐ANALYTIC STUDY

In this meta‐analytic study, we looked at all empirical studies that examined the effectiveness of court‐affiliated divorcing parents education programs (DPEs). Overall, we found that DPEs were generally effective. Nineteen studies with a DPE treatment group and no‐treatment control group had an overall significant moderate positive effect (d= .39); those who participated in DPEs were about 50% better off in terms of program outcomes compared to those who did not participate. The studies examined five specific outcomes: co‐parenting conflict, parent‐child relationships, child well‐being, parent well‐being, and relitigation; with most of these specific outcomes we found significant moderate effects ranging from d= .19–.61. However, there were important methodological limitations in this body of research, which are discussed. While more research is needed to confirm the positive potential of DPEs, we probably know enough to justify continuing and even increasing support for this recent social policy innovation.     

A COMPELLING NEED FOR MANDATED USE OF SUPERVISED VISITATION PROGRAMS

Courts are frequently confronted by circumstances that do not justify termination of all contact with a parent, yet present legitimate concerns regarding the physical, emotional, or mental health of the child. Supervised visitation programs afford such parents and their children the opportunity to preserve the emotionally vital parent-child relationship while protecting the child, and sometimes the other parent, from harm. As the number of children deemed to be at risk continues to rise, demand for supervised visitation services steadily exceeds supply. This article proposes that all states should make supervised visitation programs universally available by enacting legislation that provides for their creation, regulation, and funding, together with clearly defined guidelines that mandate participation in supervised visitation programs whenever specific risk factors are present.     

Exposure to Maternal- and Paternal-Perpetrated Intimate Partner Violence, Emotion Regulation, and Child Outcomes

The current study examined the relationship of maternal- and paternal-perpetrated intimate partner violence (IPV) to children’s internalizing and externalizing symptomatology. Mother-child dyads (N?=?53; child ages 8–11) reported maternal- and paternal-perpetrated IPV exposure and measures of child symptomatology. Results demonstrated that: (a) maternal- and paternal-perpetrated IPV have similar but not identical relations with child outcomes, (b) mothers’ and children’s reports of paternal-perpetrated IPV were positively related, (c) mother and child report of maternal- and paternal-perpetrated IPV related to child emotional and behavior problems, and (d) emotion dysregulation mediated the link between IPV exposure and child outcomes. Notably, findings differed by reporters. Results support emotion dysregulation as one mechanism through which IPV exposure may lead to child behavior problems, with implications for clinical intervention.     

Incorporating a Healthy Living Curriculum within Family Behavior Therapy: A Clinical Case Example in a Woman with a History of Domestic Violence,Child Neglect,Drug Abuse,and Obesity

Women reported to child protective service agencies frequently report problems that significantly interfere with the health and well-being of their children and themselves. Behavioral treatment programs appear to be effective in managing these co-existing problems, such as domestic violence and substance abuse. However, evidence-supported interventions are rarely exemplified in complicated clinical cases, especially within child welfare settings. Therefore, in this case example, we describe the process of adapting an evidence-supported treatment to assist in managing significant co-existing health-related problems in a mother who was referred due to child neglect and drug abuse. At the conclusion of therapy, the participant reported improvements in perceived family relationships, illicit drug use, child maltreatment potential, whereas other health-related outcomes were mixed. Most improvements were maintained at 4-month follow-up. Issues relevant to implementing evidence-based treatments within community contexts are discussed, including methods of increasing the likelihood of valid outcome assessment, managing treatment integrity, and adjusting standardized treatments to accommodate co-occurring problems.     

Social problem-solving correlates of sexual deviancy and aggression among adult child molesters

Cognitive-behavioral treatment programs for adult sex offenders often include training geared to improve a perpetrator's social problem-solving skills. However, little empirical evidence exists to date that documents the relationship between problem-solving and deviant sexual interest or behavior among child molesters. As such, this study investigated the association between problem-solving and two aspects of sexual offending—self-reported sexual deviancy and clinician-rated sexual aggression among a recruited sample of incarcerated child molesters. To minimize the potential for biased self-reports, criterion scores on a lie scale were employed to exclude individuals who might be prone to misrepresent their responses. Results indicated this sample to be characterized by significant deficits on all measures of social problem-solving as compared to the general population. In addition, a series of correlational analyses indicated that an avoidant problem-solving style was significantly associated with past sexual aggression, whereas a negative problem orientation and an impulsive/careless problem-solving style were significantly related to a measure of current sexual deviancy. Of particular interest is the finding that a rational problem-solving style (i.e., the constructive style that involves the systematic application of specific problem-solving skills geared toward identifying an effective solution) was not significantly related to either sexual offending measure. The implications of these collective results are discussed.     

Innovative Programs in Israel for Prevention & Responding to Parental Alienation: Education,Early Identification and Timely,Effective Intervention

There is substantial research and documentation showing that behavior of a parent which alienates a child against the other parent (PA) and other family members may cause serious, and sometimes permanent, damage to the child. Building on the work that defines maladaptive parental gatekeeping (MG) and PA, and on identifying typologies of behavior, and their effects on the alienated child, the need for prevention of children in these cases is well established. This paper describes programs and responses in Israel, some already in place and others under development, almost all of which require multidisciplinary collaboration between professionals. The programs include: primary prevention; early identification, so as to allow prompt secondary intervention by advice and treatment of parents and child; and immediate tertiary intervention when alienation has led to contact failure or is about to do so. Prevention and early intervention can reduce the need for the massive investment of resources needed for attempts to restore contact, and also for treatment of those affected by PA.     

Management of donated foods in child nutrition programs, the Nutrition Services Incentive Program, and charitable institutions. Final rule

This final rule revises and clarifies requirements for the management, distribution, and use of donated foods in the National School Lunch Program and other child nutrition programs, in the Nutrition Services Incentive Program, and by charitable institutions. In response to an audit by the USDA Office of Inspector General, the rule establishes specific requirements to ensure that recipient agencies in child nutrition programs receive the benefit and value of all donated foods received and provided to food service management companies to conduct the food service. The rule also incorporates legislative changes affecting the distribution of donated foods in the Nutrition Services Incentive Program, and reduces reporting and administrative requirements for donated foods provided to charitable institutions. Lastly, the rule restructures and revises regulatory provisions in a plain language format to make them easier to read and understand.     

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.     

Medical Evidence and Expert Testimony in Child Sexual Abuse

Expert medical testimony in child sexual abuse cases can be critical to the outcome of a legal case. This article will review the development of the medical knowledge and clinical expertise in child sexual abuse. Since the passage of mandatory child abuse reporting laws, the forensic medical examination of a child for evidence of sexual abuse has become standard. Until recently, many myths regarding female genital anatomy existed but were based primarily on dogma and lack of empirical research. Over the past 25 years, many research studies and accumulating clinical evidence have expanded medical knowledge and debunked old myths. Physical evidence, even in cases of alleged genital or anal penetration is rare. Sexually transmitted infections are also uncommon and often require medical interpretation as to their significance in a prepubertal child. Specialized medical knowledge, training, and clinical expertise have developed in order to evaluate children presenting with allegations of sexual abuse. Such medical expertise provides invaluable service to courts. We review criteria for evaluating such expertise in light of current medical practice.     

Wife assault theory,research, and treatment: A literature review

Treatments for wife assaulters and their victims have been based on a variety of psychological and sociological theories. Tests of theory based on investigation of assailant and victim characteristics as well as evaluation of treatment effects based on empirical outcome studies have yielded diverse results. In reviewing the literature it appears that development of assailant typologies based on extent of psychopathology, severity of violence, and context of violence has potential utility in guiding future treatment decisions for assaulters. Further development of similar typologies for classifying responses of assaulted women could yield similar results. Population screening and matching programs to individual characteristics could be expected to improve clinical outcomes.     

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.     

Parental problem-solving skills and child behavior problems: A comparison of physically abusive,neglectful, clinic,and community families

Failure to solve problems related to parenting and other aspects of daily living is hypothesized to result in frustration or inability to cope, and lead to deviant parental behavior such as aggression or neglect. The present investigation provided support for a procedure for measuring parental problem-solving skill and compared the problem-solving abilities and child behavior problems of maltreating and nonmaltreating parents. Subjects were 40 parents with at least one child between the ages of three and twelve. Subjects were assigned to one of four groups: (a) physically abusive parents (n = 9); (b) neglectful parents (n = 9); (c) nonmaltreating clinic parents seeking help for child behavior problems (n = 11); and (d) nonmaltreating, non-help-seeking community parents (n = 11). Abusive and neglectful parents were deficient in problem-solving skill as compared to clinic and community parents, yet there were many similarities in parental reports of child behavior problems for maltreating and nonmaltreating parents. Parental problem-solving skill did not correlate significantly with parental ratings of child behavior problems.     

Modeling Facts,Culture, and Cognition in the Gun Debate

Can empirical data generate consensus about how to regulate firearms? If so, under what conditions? Previously, we presented evidence that individuals' cultural worldviews explain their positions on gun control more powerfully than any other fact about them, including their race or gender, the type of community or region of the country they live in, and even their political ideology or party affiliation. On this basis, we inferred that culture is prior to facts in the gun debate: empirical data can be expected to persaude individuals to change their view on gun policies only after those individuals come to see those policies as compatible with their core cultural commitments. We now respond to critics. Canvassing the psychological literature, we identify the mechanisms that systematically induce individuals to conform their factual beliefs about guns to their culturally grounded moral evaluations of them. To illustrate the strength and practical implications of these dynamics, we develop a series of computer simulations, which show why public beliefs about the efficacy of gun control can be expected to remain highly polarized even in the face of compelling empirical evidence. Finally, we show that the contribution culture makes to cognition could potentially be harnessed to generate broad, cross-cultural consensus: if gun policies can be framed in terms that are expressively compatible with diverse cultural worldviews, the motivation to resist compelling empirical evidence will dissipate, and individuals of diverse cultural persuasions can be expected rapidly to converge in their beliefs about what policies are best. Constructing a new, expressively pluralistic idiom of gun control should therefore be the first priority of policy-makers and -analysts interested in promoting the adoption of sound gun policies.     

Familial Sex Trafficking of Minors: Trafficking Conditions,Clinical Presentation,and System Involvement

It is well documented in the literature that child sex trafficking can be perpetrated by family members, though limited research has focused on describing this type of sexual exploitation. This pilot study addresses this gap by providing an analysis of familial sex trafficking considering trafficking dynamics, and rurality. Using a sample of 31 child welfare-involved children referred for behavioral health assessment and treatment, this mixed methods study explores: (1) victim and trafficker characteristics, the trafficking situation, law enforcement classifications of trafficking, clinical profiles of victims, and system involvement of children and youth involved in familial sex trafficking; (2) gender differences in clinical outcomes in sex-trafficked children; and (3) geographical differences in severity of the victimization experience. Major findings document high rates of family members trafficking children for illicit drugs; high severity of abuse as measured with the Sexual Abuse Severity Score, with higher severity of abuse for children living in rural communities; clinical threshold level scores on the Child Behavior Checklist (CBCL), and the Trauma Symptom Checklist for Children (TSCC-A). Boys and girls had similar clinical profiles except boys had higher CBCL externalizing scores, and females had higher TSCC depression scores. Additionally, more than half of the children in this sample had attempted suicide in their lifetime. This formative study sheds light on the phenomenon of familial sex trafficking, thereby creating the context for further investigations. Implications for identification and effective responses to familial sex trafficking, with specific attention to gender and geography are discussed.