D Glaser

Defining the Task of Parenting

Fulfillment of the needs of dependent, developing/changing children:

• Basic needs provision: food, stable shelter, healthcare
• Protection including from abuse
• Response to attachment needs
• Ensuring family tasks and functioning

Family Tasks and Functioning

Consistent and Age-appropriate:

• Caring, nurturing, and stimulating
• Setting of boundaries
• Clear communication and affective expression
• Hierarchies and inter-generational boundaries
• Intra-generational alliances
• Balance between family cohesiveness and connectedness with outside world
• Models of non-violent conflict resolution

What is Child Abuse and Neglect

• (Wo)man-made and potentially avoidable harm to children
• Different forms may exist discreetly or co-exist
• All forms of CAN involve psychological harm
• Omission & commission forms of CAN:
  • neglect
  • physical abuse/non-accidental injury
  • sexual abuse
  • emotional abuse and neglect
  • factitious illness

Emotional Abuse and Neglect Refers to:

• Parent-child RELATIONSHIP (not event or single interaction)
• Characterises the relationship
• Heterogeneous collection of different forms of interaction
• Both omission and commission
• Physical contact not required
• Actually or potentially harmful to the child

Abuse threshold reached when the viability of the relationship is questionable without some intervention.

Thresholds

Definitions are culturally relative. In the UK, threshold criterion is Significant Harm Ill Treatment physical, mental or sexual AND/OR impairment of the child's physical or mental health, or physical, intellectual, emotional or behavioural development, attributable to the care given or likely to be given.

Impairments of Child's Health and Development by Emotional abuse and Neglect

Ranked in Decreasing Order of Frequency

• Emotional state
• Developmental/educational attainment/poor late school attendance
• Behaviour
• Peer relationships
• Physical symptoms/poor growth

American Professional Society on the Abuse of Children

• Spurning
• Terrorizing
• Exploiting/corrupting
• Isolating
• Denying emotional responsiveness
• Mental, health, medical and educational neglect

The Child's Needs which are Violated by Emotional Abuse & Neglect

• The child as a person who EXISTS
• THIS child
• Child as a developing CHILD
• The child as an INDIVIDUAL
• The child as a SOCIAL BEING

Categories of Emotional Abuse and Neglect

I. Emotional unavailability, unresponsiveness and neglect

II. Hostility, harsh punishment denigration and rejection of a child

Child perceived as deserving these based on persistent negative beliefs about, attributions or misattributions to the person of the child.

III. Developmentally Inappropriate or In-consistent

• Developmentally inappropriate or inconsistent expectations of, impositions on, and interactions with the child.
• Exposure to confusing or traumatic experiences.
• Failure to provide adequate cognitive stimulation and/or opportunities for experiential learning.

IV. Failure to recognise or acknowledge the Child's Individuality and Psychological Boundary

• Inability to distinguish between the child's reality and the adult's belief.
• Using the child for the gratification of the parents' emotional needs.

V. Mis-socialisation of the child within the child's context by failing to promote the child's social adaptation (including isolating) or actively promoting mis-socialisation (corrupting)

Impeding the Appropriate Socialisation of the Child within the Child's Context

• Active corruption
• Failing to promote socialisation

Two Questions to Ask of the Classification

I. First question to ask of a classification: What holds the classification together?

In EA/N:

(i) Does not require physical contact.

(ii) It takes into account the essence of childhood dependency and development.

II. Second question to ask of a classification: What keeps the categories apart? i.e. the categories must be discrete.

(i) Different aspects of the child's needs.

(ii) Different motivations in the carer.

(iii) Different treatment approaches for the interaction/relationship.

(iv) We hypothesis, different harmful consequence for the child.

Can We Ask Children to Describe Emotional Abuse?

"Biting the hand that feeds you"

• Emotional abuse not recognised/defined by society
• Abuser = primary carer
• Child loyal to/dare not upset primary carer
• Difficult to acknowledge awfulness of being rejected, unloved, exploited
• Threat to own survival and self worth
• Cannot reflect on it or describe abuse (procedural memory)
• Abuse rationalised by self-blame, denied, re-framed

Reasons for Registration

3 tiers of concern

1. Parental attributes or risk factors

2. Categories of ill treatment or mediating mechanisms

3. Impairment of child's development or evidence of harm to child

Child Protection

Implies the cessation of danger to the child which can only be achieved by:

• Ensuring the perpetrator(s) of abuse/neglect, or their circumstances, have changed sufficiently to no longer pose a risk to the child or
• Effectively supervising all contact between the child
• & perpetrator(s) of abuse/neglect ("supervisor" must believe in abuse) or
• Separating child from perpetrator(s) of abuse or neglect

Process of Professional Involvement in Emotional Abuse and Neglect: Working Towards Protection

Assessment

I. Child

Developmental profile of child-physical, emotional, cognitive, behavioural, social.

II. Parents & Family

1. Family's concerns about child and explanations

2. What ''remedies'' have been tried

3. Nature of help requested by family

4. Account of salient family history

5. Parents' mental health including alcohol/drug misuse

6. Inter-parental violence

7. Strengths and protective factors

III. Family's Capacity for Change

In parental risk factors and relevant category(ies) of ill-treatment, by means of a time-limited trial of intervention.

Therapy

• Individual work with the child
• Parent-child and family work
• Individual work with parents

Process of Professional Involvement in Emotional Abuse and Neglect: Working Towards Protection

Therapeutic Interventions in Emotional Abuse

Category 1: Emotional Unavailability

• If no associated Category 2, explore underlying cause(s) and address those
• If associated Category 2, approach as Category 2

Category 2: Negative Attributions

• Explore with carer(s) what child's view of him/herself might be and how to alter it

Category 3: Developmental

• Parenting management

Category 4: Psychological Boundaries

• Explore with parent what child's perceptions
• Look for ghosts from the past
• Look for maintaining factors for parent

Category 5: Impeding Socialisation

• Explore with parent, child's experience in her/his environment

Treatment for the Emotionally Abused Child

Child's Status:

• Protected within family after sufficient change in parent interaction with the child
• Protected by move to another carer or family
• Not protected, but less detrimental to remain at home than to move

In therapy for child, now possible to talk about the abuse.If abuse continues, therapy can help child with coping.

Protective Factors

• Child's innate resilience (including good ability)
• Brief duration of abuse (early successful intervention)
• Late onset - earlier "good" experiences
• Other significant non-abusive relationships

Note

1. Article has been revised by author on 22 March 2001.