Child Abuse and Neglect CrisisInterventionAlicia SolizWestern New Mexico University AbstractFor this paper I have chosen to identify achild abuse and neglect crisis intervention.
This intervention focuses onhelping children who suffer from abuse and neglect and how we as social workerscan intervene in the lives of troubled families. The specific intervention Ihave chosen to base my paper on is, CrisisIntervention in Child Abuse and Neglect. This intervention was conducted bythe U.S. Department of Health and Human Services, Administration for Childrenand Families, Administration on Children, Youth and Families, and the NationalCenter on Child Abuse and Neglect.
This paper will discuss the specificevidence, fidelity and logic of the intervention for the client, with theclients being the families in crisis. A child abuse and neglect crisisintervention is a logical fit discussing cultural sensitivity andappropriateness because it has become widely known since the 1970s when theChild Abuse Prevention and Treatment Act was signed. According to Crisis Intervention in Child Abuse andNeglect, “Since that time, the Federal Government has served as a catalystto mobilize society’s social service, mental health, medical, educational,legal and law enforcement resources to address the challenges in the preventionand treatment of child abuse and neglect.” In 1971, twenty-one manuals werecreated by the National Center on Child Abuse and Neglect (NCCAN), in order toprovide professional guidance to those involved in the child protection systemand to help enhance the collaboration of the community and the quality ofservices being provided to troubled children and families. The manualsdescribed a number of things including, “each professional’s roles andresponsibilities in the prevention, identification, and treatment of childmaltreatment.” (Crisis Intervention inChild Abuse and Neglect, 1994.)Since the manuals have been developed, our understanding of the intensity ofchild abuse and neglect has dramatically increased.
With our increasedunderstanding, we have a better grasp on what we can do to help prevent childabuse and neglect. InterventionPlan In the case of this intervention, theclient would be the children who suffer from abuse and neglect along with thetroubled families who are a part of it. The evidence based practice comes froman intervention that was already conducted in 1994. This intervention isdescribed in the manual CrisisIntervention in Child Abuse and Neglect. Informed consent was acknowledgedand practiced with this information considering it involved real clients andcase workers. This intervention plan demonstratesmany ethics and values throughout this process. For example, in section 1.01 ofthe NASW Code of Ethics it states “Social workers’ primary responsibility is topromote the well-being of clients,” and the entire purpose of this interventionis to do just that.
The intervention also goes alone with sections 1.03 and1.07 of the NASW Code of Ethics, with section 1.03 involving informed consentand section 1.07 involving privacy and confidentiality. This crisisintervention also demonstrates various different type of values. This interventionincludes, the scope and goals of the crisis intervention, six goals of crisistreatment, a nine-step crisis intervention model and examples of crisisintervention teams.
Throughout the intervention plan, an assessment is alsogiven that describes the process to help the clients get through the crisis.The steps in the assessment include making the initial contact, identifying theprecipitating event, observing family interaction and conditions, anddetermining the family’s needs.Instruments For this type of intervention,various types of screening instruments are given to clients in order to conducttreatment evaluations. In any type of risk-assessment protocol, great cautionand professional judgement must be warranted. A constellation of risk factorsmust also be taken into determination in order to suggest if a child isconsidered not safe in a home and that careful monitoring is advised. The typeof screening instrument is usually based upon the specific case and training isrequired for some specific instruments.
IRBProcessDuring this intervention, the IRB processis taken heavily into consideration before any screening of instruments areused. The primary purpose of the IRB process is to help protect the rights andwelfare of clients participating in research activities. The IRB process istaken into consideration during this intervention when special training isrequired for different screening instruments. Training for certain screeninginstruments is required in order to insure that no misinterpretations occur.Design For this intervention, an ABA designwas established in order to work with the children and families that sufferfrom abuse and neglect. An ABA design is when a baseline condition is firstestablished, this being the “A” phase. A treatment or intervention is thenintroduced to see if it can effect some sort of change, this being the “B”phase. After this, the treatment is then removed to see if it returns to thebaseline or phase “A.
” In this case, the children and families in crisis wouldbe considered the baseline condition. The intervention is then introduced tothe families to see if good changes come from it. The intervention is thenremoved when the families enter back into their normal lives and they see ifthey are still considered to be in crisis. Single study case design is anothermethod of design used in this intervention. Single study case design is alsoknown as single subject design. This evaluation method is used to test thesuccess of an intervention or treatment on a particular case.
This design alsoprovides conformation about the productiveness of the intervention usingcompact sample sizes. In this case, the intervention would include thedifferent types of approaches used to help treat the client, being the childrenwho suffer from abuse and neglect. Methods The Crisis Intervention in Child Abuse and Neglect uses variousapproaches in order to help families accomplish their goals. Throughout theintervention plan, all types of these approaches are named and described. A “Community Systems” and “Use ofCommunity Resources” approach is used when total family involvement is the mainimportance of the crisis intervention. This type of approach finds that”coordination and involvement of all available community agencies and resourcesare of paramount importance to successful resolution of most crises.” (Crisis Intervention in Child Abuse andNeglect, 1994.) When addressing the needs of families in crisis,cooperation within the community is needed in order to assure maximum benefitfrom the use of the resources.
With lack of communication and coordinatedefforts between community resources, it creates extreme frustration for thefamilies involved in the case. In order for a worker to help provide stabilityand support for the family in crisis, they must guide them to appropriateorganizations and services throughout the community. The crisis worker shouldbe able to provide specific names of services and organizations, accompany theclients to appointments and always be available through phone or e-mail.
Another approach used for thisintervention is the Multiple Impact or Multimodal Approach. This type ofapproach includes the use of many crisis workers rather than just one. Multiplecrisis workers are used for this approach in order to deal with family andcommunity-wide dysfunction.
Each crisis worker on the team has specializedtraining in something different. For example, some workers specialize in childdevelopment, sexual abuse assessment or behavioral management, while othermembers are usually trained in a broad variety of things. In Multiple ImpactTherapy, therapists, students or volunteers are assigned to work with eachfamily member for about an hour. During this hour, an assessment is conductedand individual time is spent with specific family members.
The client will thenbe asked to observe while each therapist role plays another family member. Whilerole playing, the therapist will say what the other family member feels andwants from the members of the family. The therapist also uses “I” messages inorder to express how certain things look from that particular family member’sperspective. This process usually takes up to several hours since all familymembers are encouraged to express themselves. After the first couple of days,only one crisis worker stays assigned to the family unless more are necessary.Even with only one crisis worker assigned to the family from that point on,there is still an abundance of consultants who are familiar with and able toexperience the family firsthand. Cognitive Behavioral Approach isanother approach used when working with crisis intervention that involves childrenwho suffer from abuse and neglect.
In this approach, “cognitive behavioraltherapy assumes that clients have irrational, maladaptive beliefs that requirecognitive restructuring.” (CrisisIntervention in Child Abuse and Neglect, 1994.) Cognitive behavioraltherapy is designed to identify particularly unwanted targets behaviors. Inorder to do this, listening to the opinions of the other family members and thefamily as a whole is required. The listener begins by attempting to identifywhat set of the undesirable behavior.
After this, a new behavior is introducedby another family member in order to replace the antecedent. Desirableresponses are then agreed upon by the family members and either reinforcementsor consequences are provided depending on if they agreed or disagreed on adesirable response. Consistency and follow us are important for the success ofcognitive behavioral therapy. Crisis Intervention in Child Abuse and Neglectalso uses Task-Centered Approach when working with their clients. Task-centeredmethods of treatment combine both crisis intervention theory and researchpractice that indicates the effectiveness of the methods used with a broadrange of clients. The task-centered approach also includes both uncontrolledand controlled studies. Controlled studies usually take place in a schoolsetting and psychiatric clinics, while uncontrolled studies focus on the productivenessthat has been conducted in medical, family, child guidance, psychiatric,school, corrections and public welfare settings.
Another type of approach used is theFamily Treatment Approach. When using this approach, therapists developsituations in order to demonstrate how the family will react to it. Thetherapist then tries to engage the family members to assure their involvementis active in the ongoing treatment. In this approach the major focus is on thefamily system rather than just one individual, but the therapist stillacknowledges that each member of the family is assigned a specific role. Thisapproach also focuses on family secrets, myths, dyads, etc. that possibly givesclues as to why the family has become so dysfunctional and if it’s somethingdeeper rather than just what’s on the surface. The family treatment approachhas also shown to be the most effective type of treatment for children andfamilies because it helps them focus on family preservation being moreimportant than separation.
The last approach that the Crisis Intervention in Child Abuse andNeglect gives is an example of is the Eclectic Team Approach. In anEclectic Team Approach, team members work together to use their differentknowledge and expertise to manage the presenting crisis. While using theirdifferent perspectives, the team members work with the family to create atreatment plan. When one member of the team comes in direct contact with thefamily in crisis, he or she then consults back to the rest of the group to fillthem in. Intervention teams do notnecessarily work “for” the clients, instead the eclectic knowledge is sharedwith them. This enables them to “choose problem-solving strategies that restoretheir sense of well-being and ability to cope.” (Crisis Intervention in Child Abuse and Neglect, 1994.) DataCollection The data collection method used forthis crisis intervention is done using a Family Assessment Form, otherwiseknown as a FAF.
An FAF is designed to assist workers from the help and helpdetermine what kind of intervention for the family is needed. To measure riskvariables in the home, a Family Risk Scale is used. A Family Risk Scaleconsists of “26 scales with sub-variables, and ’emphasize parentalcharacteristic and family conditions that are believed to be predictors orprecursors of child maltreatment or other harm to children.'” (Crisis Intervention in Child Abuse andNeglect, 1994.) This assessment also includes six of the Child Well-Beingscales. These scales are believed to be the most useful for risk assessment.
Checklists are another form of datacollection while dealing with crisis intervention in child abuse and neglect.General risk-assessment checklists are used with great caution and they tend toidentify weaknesses in the family at crisis. Although these checklists tend toidentify weaknesses as the main point, they still focus on finding strengths tobuild upon. While using checklists, crisis workers turn family weaknesses aspotential goals or action steps in reverse.
Conclusion The best service delivery outcome toultimately evaluate the intervention would be the Eclectic Team Approach. TheEclectic Team Approach combines workers of all different skill types, alongwith the best approaches that fit the crisis situation. All approaches arecarefully considered by the crisis workers and one is then chosen based on howwell it’s going to work to help the family in crisis. This information will help utilizeto improve/service delivery to children that suffer from child abuse andneglect because it gives different methods that crisis workers can use to helpfamilies get through it. Throughout this intervention, different types ofmethods and techniques are named that help treat families in this type ofcrisis. These methods range from using only one crisis worker, to using a teamof crisis workers, to using the entire community as resources. Although, themain purpose of all these techniques and methods is to instill hope into thefamilies in crisis. Crisis workers work on keeping their promises to thefamilies and sure enough the clients begin to trust and believe in change.
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