Disclosure of sexual abuse among youth in residential treatment care: a multiple informant comparison

A Treatment-To-Prison-Pipeline? Scoping Review and Multimethod Examination of Legal Consequences of Residential Treatment Among Adolescents

OBJECTIVE

Toward the overall goal of interrogating systems that contribute to racial inequity in child and adolescent psychology, we examine the role and function of Residential Treatment Centers (RTCs) in creating or exacerbating race and gender inequities using the language of mental health and the logic that treatment intentions justify children's confinement.

METHODS

In Study 1, we conduct a scoping review to investigate the legal consequences of RTC placement, attending to race and gender in 18 peer-reviewed articles, encompassing data for 27,947 youth. In Study 2, we use a multimethod design focusing on RTCs in one large mixed-geographic county to examine which youth are formally charged with a crime while in RTCs, and the circumstances under which these charges occur, attending to race and gender (N = 318, 95% Black, Latine, Indigenous youth, mean age = 14, range = 8-16).

RESULTS

Across studies, we find evidence for a potential treatment-to-prison pipeline through which youth in RTCs incur new arrests and are charged with crimes during and following treatment. This pattern is pronounced for Black and Latine youth and especially girls, for whom use of physical restraint and boundary violations are recurring challenges.

CONCLUSIONS

We argue that the role and function of RTCs via the alliance between mental health and juvenile legal systems, however passive or unintentional, provides a critical exemplar of structural racism; and thus invite a different approach that implicates our field to publicly advocate to end violent policies and practices and recommend actions to address these inequities.

Being silenced, loneliness and being heard: understanding pathways to intimate partner violence & abuse in young adults. a mixed-methods study

BACKGROUND

International research shows the significance and impact of intimate partner violence and abuse (IPVA) as a public health issue for young adults. There is a lack of qualitative research exploring pathways to IPVA.

METHODS

The current mixed-methods study used qualitative interviews and analysis of longitudinal cohort data, to explore experiences of pathways to IPVA. Semi-structured Interviews alongside Life History Calendars were undertaken to explore 17 young women's (19-25 years) experiences and perceptions of pathways to IPVA in their relationships. Thematic analysis was undertaken. Based on themes identified in the qualitative analysis, quantitative analysis was conducted in data from 2127 female and 1145 male participants of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort study. We fitted regression models to assess the association of child maltreatment, parental domestic violence, and peer-to-peer victimisation, by age 12, with loneliness during adolescence (ages 13-14), and the association of loneliness during adolescence with IPVA (age 18-21). Mediation analysis estimated the direct effects of maltreatment on IPVA, and indirect effects through loneliness.

FINDINGS

All women interviewed experienced at least one type of maltreatment, parental domestic violence, or bullying during childhood. Nearly all experienced IPVA and most had been multi-victimised. Findings indicated a circular pathway: early trauma led to isolation and loneliness, negative labelling and being silenced through negative responses to help seeking, leading to increased experiences of loneliness and intensifying vulnerability to further violence and abuse in young adulthood. The pathway was compounded by intersectionality. Potential ways to break this cycle of loneliness included being heard and supported, especially by teachers. Quantitative analysis confirmed an association between child maltreatment and loneliness in adolescence, and an association between loneliness in adolescence and experience of IPVA in young adult relationships.

CONCLUSION

It is likely that negative labelling and loneliness mediate pathways to IPVA, especially among more disadvantaged young women. The impact of early maltreatment on young people's wellbeing and own relationships is compounded by disadvantage, disability and ethnicity. Participants' resilience was enabled by support in the community.

Informant Discrepancies in Child Maltreatment Reporting: A Systematic Review

Potential informants on child maltreatment include the youth who has experienced the alleged maltreatment, and the youth's caregivers, social workers and case files. When multiple informants are compared, they often disagree about whether or not a youth has experienced maltreatment. Such determinations are critical as endorsement-or lack of endorsement-of maltreatment can have significant consequences on the child's safety, future living arrangements and referral for treatment and services. The current study provides a systematic review of the literature on informant discrepancies in child maltreatment. Three databases-PsychINFO, Web of Science, and PubMed-were used to identify studies for the review and 13 articles met inclusion criteria. Results showed that more youth tend to report physical, sexual and emotional abuse than seen in case files. By contrast, more case files include neglect than reported by youth. Implications and future directions are discussed.

Diverse trauma profiles of youth in group care settings: A cluster analysis

BACKGROUND

Many adolescents in group care have experienced higher rates of traumatic event exposure, behavior problems, and severe trauma sequelae compared to those outside of group care. Yet, little research has examined from a person-centered perspective their diverse trauma profiles and corresponding service needs.

OBJECTIVE

This exploratory study aimed to examine the heterogeneity of trauma-related profiles among youth in group care to highlight potential distinct service needs among subgroups.

METHOD

Data from the Maltreatment and Adolescent Pathways Study identified 96 randomly selected youth (14-17 years) in Canadian group care settings who completed a battery of self-report measures. Cluster analysis was employed to reveal common patterns of maltreatment and trauma symptoms among subgroups, further described and validated by externalizing behaviors (substance use, risky sexual behavior), internalizing symptoms (global mental health, anger), and personal/parental demographic factors.

RESULTS

Four distinct clusters emerged: (1) no/low maltreatment, low trauma; (2) moderate physical and emotional abuse, moderate trauma; (3) moderate-severe maltreatment, low trauma; and (4) severe maltreatment, high trauma. Clusters 1, 2, and 4 reflected 'dose-response' relationships between maltreatment and trauma symptoms; Cluster 3 was characterized as 'resilient'. Females were highly over-represented in Cluster 4, echoing previous research.

CONCLUSIONS

Findings align with previous research confirming high incidence of maltreatment, internalizing, and externalizing problems among youth in group care, but extends to emphasize the importance of providing trauma-informed services tailored to their variable, complex presentations. Limitations and suggestions for group care settings to provide this wide range of services at program and individual levels are discussed.

Young People's Perceptions of Sexual Assault in Residential Care: "It Does Happen a Lot"

The Australian Royal Commission into Institutional Responses to Child Sexual Abuse (the Royal Commission) examined child sexual abuse within a wide range of institutions that provide services to children, this included residential facilities. The current study (funded by the Royal Commission) considers young people's perception of safety in residential care; specifically, the current study attended to the voices of young people who spoke about sexual harassment and assault in qualitative interviews. Interviews were conducted with young people aged between 13 and 21 years who were or had recently been in residential care. Participants were asked for their perceptions of situations in a series of vignettes describing various levels and types of sexual assault and harassment. During these interviews, the young people in this study voluntarily reported known incidences of sexual assault and harassment in varying levels, perpetrated by workers, individuals outside of residential care, and peers within residential care. Sexual assault and harassment was discussed in heteronormative and gendered ways with young men seen as perpetrators and protectors, and young women seen as being vulnerable. Further, it was evident from this study, that there were varying responses to these situations from workers within the residential care facilities.

Screening for Child Sexual Exploitation in Online Sexual Health Services: An Exploratory Study of Expert Views

BACKGROUND

Sexual health services routinely screen for child sexual exploitation (CSE). Although sexual health services are increasingly provided online, there has been no research on the translation of the safeguarding function to online services. We studied expert practitioner views on safeguarding in this context.

OBJECTIVE

The aim was to document expert practitioner views on safeguarding in the context of an online sexual health service.

METHODS

We conducted semistructured interviews with lead professionals purposively sampled from local, regional, or national organizations with a direct influence over CSE protocols, child protection policies, and sexual health services. Interviews were analyzed by three researchers using a matrix-based analytic method.

RESULTS

Our respondents described two different approaches to safeguarding. The "information-providing" approach considers that young people experiencing CSE will ask for help when they are ready from someone they trust. The primary function of the service is to provide information, provoke reflection, generate trust, and respond reliably to disclosure. The approach values online services as an anonymous space to test out disclosure without commitment. The "information-gathering" approach considers that young people may withhold information about exploitation. Therefore, services should seek out information to assess risk and initiate disclosure. This approach values face-to-face opportunities for individualized questioning and immediate referral.

CONCLUSIONS

The information-providing approach is associated with confidential telephone support lines and the information-gathering approach with clinical services. The approach adopted online will depend on ethos and the range of services provided. Effective transition from online to clinic services after disclosure is an essential element of this process and further research is needed to understand and support this transition.