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Han H, Koziol-McLain J, Morse Z, Lees AB. Current approaches addressing oral health practitioners' responsiveness to child abuse and neglect: A scoping review protocol. PLoS One 2024; 19:e0296650. [PMID: 38330062 PMCID: PMC10852231 DOI: 10.1371/journal.pone.0296650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 12/18/2023] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION Child abuse and neglect (CAN) poses significant risks, causing severe and long-lasting effects on a child's well-being, including physical and mental health and learning and socializing capabilities. Oral health practitioners (OHPs) uniquely position themselves to identify signs of maltreatment in the orofacial area, offer appropriate support, and collaborate with a multidisciplinary team. The literature has shown that OHPs under-report child protection concerns to a statutory child protection agency. Responding to CAN is often hindered by various factors, such as the fear of making false accusations and insufficient knowledge to detect and report potential cases. However, the literature lacks a comprehensive understanding of the strategies and interventions that can address the responsiveness of OHPs and other professionals to child protection issues. This scoping review aims to provide a broad overview and map the literature on the existing approaches to enhance the responsiveness of OHPs in child protection. MATERIALS AND METHODS The proposed scoping review will be conducted following the JBI methodology for scoping reviews guideline and reported using the PRISMA-ScR guideline. The first exploratory search is conducted to refine the search strategy and inclusion and exclusion criteria. The second search will include MEDLINE (EBSCO), CINAHL (EBSCO), Dentistry & Oral Science Source (EBSCO), Cochrane Library, and Scopus, with a date range from January 2000 to March 2023. The third search will involve reference list searching and gray literature searching in Google and Google Scholar. Government and international health organizations' websites will be searched for policies and guidelines. The review will consider studies that report the current approaches to address OHPs' responsiveness to CAN in any setting. Two reviewers will independently select sources and extract data. Any disagreements will be resolved by consensus of the research team. The extracted data will be presented in a tabulated chart with a narrative summary.
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Affiliation(s)
- Heuiwon Han
- Department of Oral Health, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Jane Koziol-McLain
- Centre for Interdisciplinary Trauma Research, Auckland University of Technology, Auckland, New Zealand
| | - Zac Morse
- Department of Oral Health, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Amanda B. Lees
- School of Public Health and Interdisciplinary Studies, Auckland University of Technology, Auckland, New Zealand
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McGuier EA, Rothenberger SD, Campbell KA, Keeshin B, Weingart LR, Kolko DJ. Team Functioning and Performance in Child Advocacy Center Multidisciplinary Teams. CHILD MALTREATMENT 2024; 29:106-116. [PMID: 35943489 PMCID: PMC9908768 DOI: 10.1177/10775595221118933] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The quality of teamwork in Child Advocacy Center (CAC) multidisciplinary teams is likely to affect the extent to which the CAC model improves outcomes for children and families. This study examines associations between team functioning and performance in a statewide sample of CAC teams. Multidisciplinary team members (N = 433) from 21 CACs completed measures of affective, behavioral, and cognitive team functioning. Team performance was assessed with three measures: team member ratings of overall performance, ratings of mental health screening/referral frequency, and caregiver satisfaction surveys. Linear mixed models and regression analyses tested associations between team functioning and performance. Affective team functioning (i.e., liking, trust, and respect; psychological safety) and cognitive team functioning (i.e., clear direction) were significantly associated with team members' ratings of overall performance. Behavioral team functioning (i.e., coordination) and cognitive team functioning were significantly associated with mental health screening/referral frequency. Team functioning was not associated with caregiver satisfaction with CAC services. Aspects of team functioning were associated with team members' perceptions of overall performance and mental health screening/referral frequency, but not caregiver satisfaction. Understanding associations between team functioning and performance in multidisciplinary teams can inform efforts to improve service quality in CACs and other team-based service settings.
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Affiliation(s)
- Elizabeth A. McGuier
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Kristine A. Campbell
- Center for Safe and Healthy Families, Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Brooks Keeshin
- Center for Safe and Healthy Families, Department of Pediatrics, University of Utah, Salt Lake City, UT
| | | | - David J. Kolko
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Kletečka-Pulker M, Doppler K, Völkl-Kernstock S, Fischer L, Eitenberger M, Mussner M, Klomfar S, Mora-Theuer EA, Grylli C, Atanasov AG, Greber-Platzer S. Influence of various factors on the legal outcome of cases of child abuse-experiences gathered at an interdisciplinary forensic examination center in Vienna, Austria. Int J Legal Med 2024; 138:3-14. [PMID: 37828300 PMCID: PMC10772007 DOI: 10.1007/s00414-023-03094-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 09/14/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND AND OBJECTIVE To improve the currently low conviction rate in cases of child abuse a forensic examination center for children and adolescents (FOKUS) was established in Vienna, Austria. Besides a state of the art treatment combined with forensic documentation, one of FOKUS' key goals is to identify potential areas for improvements within the process legal proceedings in cases of child abuse through constant scientific monitoring. The accompanying study at hand includes all patients referred to FOKUS within a two year timeframe (n = 233), monitoring their progression from first contact with the medical professionals from FOKUS to the end of criminal proceedings. A detailed analysis of case files was performed in those cases that were reported to the legal authorities by the clinicians of FOKUS (n = 87). Aim of the study is to investigate which factors contribute to the initiation of legal proceedings and a successful conviction. RESULTS Multivariate logistic regression analyses showed that main proceedings were opened more often in cases where the offender was an adult (p < 0.001) or admitted his guilt (p < 0.001) and if digital traces were available (p = 0.001) or trial support (p = 0.024) present. Furthermore, the combined occurrence of medical documentation and victim disclosure was related to a higher probability of opening main trials. CONCLUSION These findings underline how challenging the successful persecution of an offender in cases of child abuse is.
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Affiliation(s)
- Maria Kletečka-Pulker
- Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBI-DHPS), Ludwig Boltzmann Gesellschaft, Währinger Straße 104/10, 1180, Vienna, Austria
- Institute for Ethics and Law in Medicine, University of Vienna, Spitalgasse 2-4, 1090, Vienna, Austria
| | - Klara Doppler
- Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBI-DHPS), Ludwig Boltzmann Gesellschaft, Währinger Straße 104/10, 1180, Vienna, Austria
- Institute for Ethics and Law in Medicine, University of Vienna, Spitalgasse 2-4, 1090, Vienna, Austria
| | - Sabine Völkl-Kernstock
- Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBI-DHPS), Ludwig Boltzmann Gesellschaft, Währinger Straße 104/10, 1180, Vienna, Austria
- Department of Children and Adolescent Psychiatry, Medical University Vienna, 1090, Vienna, Austria
| | - Laura Fischer
- Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBI-DHPS), Ludwig Boltzmann Gesellschaft, Währinger Straße 104/10, 1180, Vienna, Austria
| | - Magdalena Eitenberger
- Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBI-DHPS), Ludwig Boltzmann Gesellschaft, Währinger Straße 104/10, 1180, Vienna, Austria
| | - Mark Mussner
- Institute for Ethics and Law in Medicine, University of Vienna, Spitalgasse 2-4, 1090, Vienna, Austria
| | - Sophie Klomfar
- Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBI-DHPS), Ludwig Boltzmann Gesellschaft, Währinger Straße 104/10, 1180, Vienna, Austria
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University Vienna, 1090, Vienna, Austria
| | - Eva Anna Mora-Theuer
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University Vienna, 1090, Vienna, Austria
| | - Chryssa Grylli
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University Vienna, 1090, Vienna, Austria
| | - Atanas G Atanasov
- Ludwig Boltzmann Institute for Digital Health and Patient Safety (LBI-DHPS), Ludwig Boltzmann Gesellschaft, Währinger Straße 104/10, 1180, Vienna, Austria
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Polish Academy of Sciences, Jastrzebiec, 05-552, Magdalenka, Poland
| | - Susanne Greber-Platzer
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University Vienna, 1090, Vienna, Austria.
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McGuier EA, Campbell KA, Byrne KA, Shepard LD, Keeshin BR. Traumatic stress symptoms and PTSD risk in children served by Children's Advocacy Centers. Front Psychiatry 2023; 14:1202085. [PMID: 37457766 PMCID: PMC10346839 DOI: 10.3389/fpsyt.2023.1202085] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Purpose Children who experience maltreatment are at high risk for posttraumatic stress disorder (PTSD). Children's Advocacy Centers (CACs) can facilitate access to treatment following maltreatment allegations. We describe PTSD symptoms and intervention decision-making for children served by CACs. Methods Children served by CACs in a single state were screened for PTSD symptoms using a structured mental health screening/referral protocol. CAC staff used an electronic form that provided guidance for decision-making. We examined descriptive statistics for PTSD symptoms and risk and tested associations between child characteristics and symptoms. We described CAC staff's delivery of brief interventions and referral decisions and tested associations with child characteristics and symptoms. Results Two thousand and three hundred fifty children completed screening between 2018 and 2020. Almost half (45.5%) exhibited traumatic stress symptoms suggesting high probability of PTSD at the time of their CAC visit. Children who identified as female or transgender male and older children were more likely to be at high risk for PTSD. Brief interventions were delivered to 66% of children, and most were referred to evidence-based trauma treatment (53.1%) or community mental health services (39.0%). Categorization as moderate or high PTSD risk was associated with a higher likelihood of brief intervention delivery and referral to trauma treatment. Conclusion Many children served by CACs are likely to meet criteria for PTSD at their initial visit. CAC staff demonstrated the ability to deliver brief interventions and make referrals to mental health treatment. Use of structured screening/referral protocols may improve early identification and treatment access for children experiencing PTSD symptoms.
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Affiliation(s)
- Elizabeth A. McGuier
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Kristine A. Campbell
- Department of Pediatrics, Center for Safe and Healthy Families, University of Utah, Salt Lake City, UT, United States
| | - Kara A. Byrne
- Department of Pediatrics, Center for Safe and Healthy Families, University of Utah, Salt Lake City, UT, United States
| | - Lindsay D. Shepard
- Department of Pediatrics, Center for Safe and Healthy Families, University of Utah, Salt Lake City, UT, United States
| | - Brooks R. Keeshin
- Department of Pediatrics, Center for Safe and Healthy Families, University of Utah, Salt Lake City, UT, United States
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Jablonka O, Palusci VJ. Role of Psychologists in Child Abuse Pediatrics. Pediatr Clin North Am 2022; 69:879-893. [PMID: 36207099 DOI: 10.1016/j.pcl.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This article describes the extent of the problem and the medical evaluation of child maltreatment, focusing on the outpatient interdisciplinary assessment of suspected child physical and sexual abuse. Separate from their role as clinicians, the roles of the child psychologist before, during, and after the medical assessment are highlighted. The child psychologist is an important member of the interdisciplinary team who helps the team prepare for the evaluation (before), assists in screening and determining immediate psychological safety during the medical evaluation (during), and communicating the need for further treatment and follow-up (after).
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Affiliation(s)
- Olga Jablonka
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, 462 First Avenue, GC-65, New York, NY 10016, USA.
| | - Vincent J Palusci
- Department of Pediatrics, NYU Grossman School of Medicine, 462 First Avenue, GC-65, New York, NY 10016, USA
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Byrne KA, McGuier EA, Campbell KA, Shepard LD, Kolko DJ, Thorn B, Keeshin B. Implementation of A Care Process Model for Pediatric Traumatic Stress in Child Advocacy Centers: A Mixed Methods Study. JOURNAL OF CHILD SEXUAL ABUSE 2022; 31:761-781. [PMID: 36242552 PMCID: PMC9743153 DOI: 10.1080/10538712.2022.2133759] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/25/2022] [Accepted: 07/03/2022] [Indexed: 06/01/2023]
Abstract
Child Advocacy Centers (CACs) are well-positioned to identify children with mental health needs and facilitate access to evidence-based treatment. However, use of evidence-based screening tools and referral protocols varies across CACs. Understanding barriers and facilitators can inform efforts to implement mental health screening and referral protocols in CACs. We describe statewide efforts implementing a standardized screening and referral protocol, the Care Process Model for Pediatric Traumatic Stress (CPM-PTS), in CACs. Twenty-three CACs were invited to implement the CPM-PTS. We used mixed methods to evaluate the first two years of implementation. We quantitatively assessed adoption, reach, and acceptability; qualitatively assessed facilitators and barriers; and integrated quantitative and qualitative data to understand implementation of mental health screening in CACs. Eighteen CACs adopted the CPM-PTS. Across CACs, screening rates ranged from 10% to 100%. Caregiver ratings indicated high acceptability. Facilitators and barriers were identified within domains of the Consolidated Framework for Implementation Research. Qualitative findings provided insight into adoption, reach, and caregivers' responses. Our findings suggest screening for traumatic stress and suicidality in CACs is valued, acceptable, and feasible. Implementation of mental health screening and referral protocols in CACs may improve identification of children with mental health needs and support treatment engagement.
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Zumbach J, Brubacher SP, Davis F, de Ruiter C, Ireland JL, McNamara K, October M, Saini M, Volbert R, Laajasalo T. International perspective on guidelines and policies for child custody and child maltreatment risk evaluations: A preliminary comparative analysis across selected countries in Europe and North America. Front Psychol 2022; 13:900058. [PMID: 36275299 PMCID: PMC9586013 DOI: 10.3389/fpsyg.2022.900058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 07/26/2022] [Indexed: 11/04/2022] Open
Abstract
Little knowledge exists on how evaluators in child custody and child maltreatment cases are informed by guidelines, the kinds of qualifications required and the types of training provided in different countries. The purpose of this paper is to provide an international preliminary comparison on how child custody and child maltreatment risk assessments are conducted in selected Western countries, and how the assessments are informed by best practice guidelines. Another aim is to increase knowledge on how the guidelines and best-practice standards could be developed further to reflect recent research findings. A total number of 18 guidelines were included in the analyses: four from Canada, five from the United States, three from the United Kingdom, three from the Netherlands, two from Finland, and one from Germany. We conducted a content analysis of the included guidelines in the database, focusing on how the guidelines address the best interest of the child criteria, guidelines for conducting the assessments, considerations for evaluative criteria, and specific guidance for conducting specific assessment procedures (e.g., interviews and observations). Findings show that the qualifications of and training provided to evaluators in child custody and child maltreatment risk evaluations are largely heterogeneous across the countries represented. Guidelines differ in whether and how they highlight the importance of evidence-based practices and scientifically validated assessment measures. Implications are drawn from the review and contextualized by international expert authors in the fields of forensic psychology, and family law. After the content analysis, discussion sessions within the expert group were held. The authors provide both commentaries and suggestions to improve the development of standard methods for conducting both child custody and child maltreatment risk evaluations and to consider a more transparent and judicious use of social science research to guide methods and the recommendations offered within these assessments.
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Affiliation(s)
- Jelena Zumbach
- Psychologische Hochschule Berlin, Berlin, Germany,*Correspondence: Jelena Zumbach,
| | - Sonja P. Brubacher
- Centre for Investigative Interviewing, Griffith Criminology Institute, Griffith University, Brisbane, QLD, Australia
| | - Frank Davis
- Association of Family and Conciliation Courts California Chapter, Oakland, CA, United States
| | - Corine de Ruiter
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | | | | | - Martta October
- Special Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Michael Saini
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Renate Volbert
- Psychologische Hochschule Berlin, Berlin, Germany,Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Forensic Psychiatry, Berlin, Germany
| | - Taina Laajasalo
- Special Services, National Institute for Health and Welfare, Helsinki, Finland,Department of Psychology, University of Helsinki, Helsinki, Finland
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Westphaln KK, Manges KA, Regoeczi WC, Johnson J, Ronis SD, Spilsbury JC. Facilitators and barriers to Children's Advocacy Center-based multidisciplinary teamwork. CHILD ABUSE & NEGLECT 2022; 131:105710. [PMID: 35728288 DOI: 10.1016/j.chiabu.2022.105710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/09/2022] [Accepted: 06/08/2022] [Indexed: 05/22/2023]
Abstract
BACKGROUND Children's Advocacy Centers (CACs) use a multidisciplinary team (MDT) approach to initiate, coordinate, and provide essential multisector services for children and families who experience child abuse. Despite rapid dissemination of the CAC model across the world, little is known about characteristics associated with CAC-based teamwork. OBJECTIVE Given that teamwork characteristics may impact the outcomes of child and families who interact with CACs, the purpose of this qualitative study was to explore experiences, facilitators, and barriers to CAC-based multidisciplinary teamwork. PARTICIPANTS, SETTING, & METHODS We conducted semi-structured interviews with members of a MDT at a Midwestern CAC. RESULTS Findings suggest that MDT teamwork was fostered by clear communication, responsiveness, commitment, openness, and appropriate resources whereas MDT teamwork was hindered by role confusion, conflicting perspectives, poor communication, low staffing, complex politics, and structural barriers. CONCLUSIONS Characteristics of CAC-based teamwork may vary from the teamwork of other types of child protection teams. Interventions that enhance CAC-based teamwork may optimize the function of CAC MDTs and improve outcomes for children and families who engage with CACs.
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Affiliation(s)
- Kristi K Westphaln
- University of California Los Angeles, School of Nursing, Los Angeles, CA 90095, USA; University Hospitals Center for Child Health and Policy, Cleveland, OH, USA.
| | - Kirstin A Manges
- National Clinician Scholars Program, University of Pennsylvania, Philadelphia, PA, USA; Center for Health Equity Promotion and Research, Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA.
| | - Wendy C Regoeczi
- Cleveland State University, Department of Criminology, Anthropology, and Sociology, Cleveland, OH, USA.
| | | | - Sarah D Ronis
- University Hospitals Center for Child Health and Policy, Cleveland, OH, USA; Case Western Reserve University, School of Medicine, Department of Pediatrics, Cleveland, OH, USA.
| | - James C Spilsbury
- Case Western Reserve University, School of Medicine, Department of Population and Quantitative Health Sciences, Cleveland, OH, USA.
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Mortier P, Alonso J, Auerbach RP, Bantjes J, Benjet C, Bruffaerts R, Cuijpers P, Ebert DD, Green JG, Hasking P, Karyotaki E, Kiekens G, Mak A, Nock MK, O'Neill S, Pinder-Amaker S, Sampson NA, Stein DJ, Vilagut G, Wilks C, Zaslavsky AM, Mair P, Kessler RC. Childhood adversities and suicidal thoughts and behaviors among first-year college students: results from the WMH-ICS initiative. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1591-1601. [PMID: 34424350 PMCID: PMC8878415 DOI: 10.1007/s00127-021-02151-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 07/30/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the associations of childhood adversities (CAs) with lifetime onset and transitions across suicidal thoughts and behaviors (STB) among incoming college students. METHODS Web-based self-report surveys administered to 20,842 incoming college students from nine countries (response rate 45.6%) assessed lifetime suicidal ideation, plans and attempts along with seven CAs: parental psychopathology, three types of abuse (emotional, physical, sexual), neglect, bully victimization, and dating violence. Logistic regression estimated individual- and population-level associations using CA operationalizations for type, number, severity, and frequency. RESULTS Associations of CAs with lifetime ideation and the transition from ideation to plan were best explained by the exact number of CA types (OR range 1.32-52.30 for exactly two to seven CAs). Associations of CAs with a transition to attempts were best explained by the frequency of specific CA types (scaled 0-4). Attempts among ideators with a plan were significantly associated with all seven CAs (OR range 1.16-1.59) and associations remained significant in adjusted analyses with the frequency of sexual abuse (OR = 1.42), dating violence (OR = 1.29), physical abuse (OR = 1.17) and bully victimization (OR = 1.17). Attempts among ideators without plan were significantly associated with frequency of emotional abuse (OR = 1.29) and bully victimization (OR = 1.36), in both unadjusted and adjusted analyses. Population attributable risk simulations found 63% of ideation and 30-47% of STB transitions associated with CAs. CONCLUSION Early-life adversities represent a potentially important driver in explaining lifetime STB among incoming college students. Comprehensive intervention strategies that prevent or reduce the negative effects of CAs may reduce subsequent onset of STB.
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Affiliation(s)
- Philippe Mortier
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Dr. Aiguader, 88, 08003, Barcelona, Spain.
- CIBER en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain.
- Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium.
| | - Jordi Alonso
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Dr. Aiguader, 88, 08003, Barcelona, Spain
- CIBER en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Pompeu Fabra University (UPF), Barcelona, Spain
| | | | - Jason Bantjes
- Department of Global Health, Faculty of Medicine and Health Sciences, Institute for Life Course Health Research, Stellenbosch University, Stellenbosch, South Africa
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de La Fuente Muñiz, Mexico City, Mexico
| | - Ronny Bruffaerts
- Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium
- Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, MI, USA
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - David D Ebert
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jennifer Greif Green
- Wheelock College of Education and Human Development, Boston University, Boston, USA
| | - Penelope Hasking
- School of Population Health, Curtin University, Perth, Australia
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Glenn Kiekens
- Department of Neurosciences, Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium
- Faculty of Psychology and Educational Sciences, Clinical Psychology, KU Leuven, Leuven, Belgium
- Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Arthur Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, People's Republic of China
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Siobhan O'Neill
- School of Psychology, Ulster University, Derry-Londonderry, Northern Ireland
| | - Stephanie Pinder-Amaker
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Dan J Stein
- Department of Psychiatry and Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, Republic of South Africa
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Dr. Aiguader, 88, 08003, Barcelona, Spain
- CIBER en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
| | - Chelsey Wilks
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Alan M Zaslavsky
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Patrick Mair
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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Carbone JT, Kremer KP, Holzer KJ, Kondis JS, Vaughn MG. Emergency Department Admissions for Physical Child Abuse: Evidence from the 2006-2017 Nationwide Emergency Department Sample. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP12768-NP12793. [PMID: 33715483 DOI: 10.1177/08862605211001479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Physical child abuse continues to be a serious public health issue in the United States. This study expands on previous research by exploring trends in physical child abuse diagnoses among children admitted to emergency departments (EDs) across the United States. The analysis aimed to explicate the association between physical child abuse and both sociodemographic and behavioral health covariates to better inform and identify risk factors associated with ED admissions for abuse. The study also explicated differences between confirmed and suspected physical child abuse cases. The study utilized a nationally representative sample of hospital-owned EDs that included 319,676,625 ED admissions between 2006 and 2017 for children under 18-years-old. The analysis included a trend analysis, bivariate descriptive statistics, and multivariate logistic regression models were employed. Children with a physical child abuse diagnosis were less likely to be from higher income communities (aOR = 0.61, 95% CI [0.53, 0.71]), less likely to be female (aOR = 0.93, 95% CI [0.90, 0.96]), and more likely to be uninsured (aOR = 1.65, 95% CI [1.48, 1.84]). Children with attention-deficit hyperactivity disorder (aOR = 1.36, 95% CI [1.14, 1.62]) and a conduct disorder (aOR = 1.28, 95% CI [1.04, 1.58]) were more likely to have a physical abuse diagnosis. The sex-stratified analyses found that the higher rates of physical abuse among children with attention-deficit hyperactivity disorder were driven by the male subsample, while higher rates of abuse for those with conduct disorders were the result of the female subsample. A supplemental analysis of suspected versus confirmed physical child abuse for the fourth quarter of 2015 through 2017 also revealed sociodemographic and behavioral health differences. This study supports the need to consider sociodemographic and behavioral risk factors associated with physical child abuse to inform treatment and potential reoccurrence of abuse.
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Affiliation(s)
| | | | | | - Jamie S Kondis
- Washington University School of Medicine, St. Louis, MO, USA
| | - Michael G Vaughn
- Saint Louis University, St. Louis, MO, USA
- Yonsei University, Seodaemun-gu, Seoul, South Korea
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Lindenbach D, Dimitropoulos G, Bhattarai A, Cullen O, Perry R, Arnold PD, Patten SB. Confidence, Training and Challenges for Canadian Child Advocacy Center Staff When Working with Cases of Online and In-person Child Sexual Exploitation. JOURNAL OF CHILD SEXUAL ABUSE 2022; 31:297-315. [PMID: 35156898 DOI: 10.1080/10538712.2022.2037803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/24/2021] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Abstract
Child Advocacy Centers are interdisciplinary hubs that play a vital role in responding to child maltreatment, especially sexual abuse. Sexual abuse cases increasingly involve an online component, but no studies have examined the experience of Child Advocacy Center staff in dealing with online sexual exploiftation. This study surveyed 37 staff at five Child Advocacy Centers in Alberta, Canada to understand their ability to recognize and respond to concerns about online and in-person sexual exploitation of their clients. The majority of respondents (54%) dealt with cases that involved grooming, luring, sexual abuse and child sexual abuse imagery (also known as child pornography) in the last year. Staff were equally confident in their ability to recognize and respond to grooming, luring, sexual abuse and child sexual abuse imagery. However, staff were more likely to have formal training in identifying sexual abuse and less likely to encounter difficulties in responding to sexual abuse relative to grooming, luring or child sexual abuse imagery. Clinicians used similar therapies when working with youth impacted by sexual abuse versus child sexual abuse imagery. Given that most Child Advocacy Center staff in our sample dealt with online child sexual exploitation, additional training in this area may be warranted.
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12
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Giles S, Alison L, Christiansen P, Humann M, Alison E, Tejeiro R. An Economic Evaluation of the Impact of Using Rapport-Based Interviewing Approaches With Child Sexual Abuse Suspects. Front Psychol 2021; 12:778970. [PMID: 34955997 PMCID: PMC8696026 DOI: 10.3389/fpsyg.2021.778970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
Two studies examined whether rapport-based interviewing with child sexual abuse (CSA) suspects provides greater interview yield that could result in overall cost-savings to the investigation. First, multi-level modelling was applied to 35 naturalistic CSA suspect interviews to establish whether rapport-based interviewing techniques increase “yield” – defined as information of investigative value. The Observing Rapport Based Interviewing Technique (ORBIT coding manual was used to code interviews; it includes an assessment of both interpersonal adaptive and maladaptive rapport-based interviewer engagement as well as motivational interviewing (MI) strategies. The impact of these two strands (interpersonal and MI) on extracting information of investigative value (including strengthening a case for court and safeguarding) were examined. Adaptive interpersonal strategies increased case strengthening and safeguarding yield, with motivational interviewing having the largest impact on safeguarding yield. Both strategies increase the likelihood of gaining additional types of economic yield. Maladaptive interviewer strategies reduced case strengthening and different types of economic yield. In study two, literature-based economic estimates were applied to establish the potential cost benefits from following national ORBIT rapport training. Further training in adaptive and motivational interviewing could contribute cost savings between £19 and £78 million (annual unit costs) increasing to £238–£972 million (lifetime costs) for online CSA across England and Wales; and £157–£639 million (annual unit costs) increasing to £2–£8 billion (lifetime costs) for all CSA. Failure to commit training resource to this, or an alternative strategy, could mean the cost burden attributable to maladaptive interviewing (between £1 and £6 million for online CSA and £12 and £48 million for all CSA) is not successfully averted.
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Affiliation(s)
- Susan Giles
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Laurence Alison
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Paul Christiansen
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Michael Humann
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Emily Alison
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Ricardo Tejeiro
- Department of Psychology, University of Liverpool, Liverpool, United Kingdom
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13
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Alazri ZN, Eisenhauer C, Hanna KM. Female teachers' child abuse reporting role in Oman: Results from focus groups. CHILD ABUSE & NEGLECT 2021; 122:105342. [PMID: 34600276 DOI: 10.1016/j.chiabu.2021.105342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 09/10/2021] [Accepted: 09/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Schoolteachers are in a good position to identify and report suspected child abuse and neglect cases; however, they still fail to report all the cases. Recently, the Sultanate of Oman, which is a collectivistic culture, mandated schoolteachers to report any suspected case. However, there is a lack of evidence known to us about the factors associated with Omani teachers' reporting behavior. Such evidence is needed to inform the interventions that are designed to enhance teachers' reporting behavior. OBJECTIVE The current study was designed to address this gap by exploring the factors that affect Omani schoolteachers reporting behavior of suspected child abuse and neglect cases. PARTICIPANTS AND SETTING A total of 26 participants were recruited from five basic education schools in the Muscat governorate in Oman. METHODS This is a descriptive qualitative study. Five focus group discussions were conducted. Thematic coding was used for data analysis. RESULTS Three themes were discerned from the data analysis. The factors that affect Omani schoolteachers as described by the participants were: 1) reporting within an environment of educational resource scarcity; 2) reporting within an environment of competing female social roles and their professional reporting role; and 3) reporting within an environment of complex and diverse abuse and neglect cases. CONCLUSIONS Our findings highlight the role of culture in reporting behavior. Implications for research and practice are discussed.
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Affiliation(s)
- Zeinab Nasser Alazri
- University of Nebraska Medical Center, College of Nursing, Sultan Qaboos University, P.O. Box 66, Al-Khod 123, Oman.
| | - Christine Eisenhauer
- University of Nebraska Medical Center, 801 E. Benjamin Avenue, Norfolk, NE 68701-0469, United States of America.
| | - Kathleen M Hanna
- College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE 68198-5330, United States of America
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14
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Zafar N, Naeem M, Zehra A. Professional team response to violence against children: From experts to teamwork. CHILD ABUSE & NEGLECT 2021; 119:104777. [PMID: 33139069 DOI: 10.1016/j.chiabu.2020.104777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Prevention and management of violence against children requires a multidisciplinary approach. Countries and regions tackle this problem according to their understanding and capacity, and therefore these teams work differently in different countries and regions. OBJECTIVES Current study is a bird's eye view looking at the response to violence against children through exploring multidisciplinary approaches and challenges in child protection in high, upper-middle, and lower-middle-income countries. PARTICIPANTS Participants for this study were selected through purposive sampling from eleven countries, one key informant from each country (N = 11). METHODS Current study is qualitative in nature and phenomenological design was used. Key informants were approached through email, and semi-structured online interviews were conducted. Thematic analysis was used to analyze the data and several themes emerged. RESULTS Capacity building systems are established in upper-middle and high-income countries, whereas lower-income countries are struggling with these systems, the Philippines having a better structured system. The process of child protection services is mostly similar except the availability of multidisciplinary teams, which lacks in lower-middle and even in upper-middle-income countries. These teams function relatively well in high-income countries although the lead role in these teams differs from country to country. There are many challenges in managing these teams in low-middle income countries. Child protection systems are also reasonably well established in upper and upper-middle-income countries whereas gaps are visible between policies and implementation in lower-middle-income countries. CONCLUSION It is the responsibility of each country to protect children as per their commitment to SDGs. Although the functioning of multidisciplinary teams seems better in high and upper-middle countries, the low-middle income countries are trying to combat violence against children according to their priorities, some are doing better than others.
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Affiliation(s)
- Naeem Zafar
- Protection and Help of Children Against Abuse and Neglect (PAHCHAAN), Pakistan; Child Rights Department, The University of Lahore, Pakistan.
| | - Mehek Naeem
- Protection and Help of Children Against Abuse and Neglect (PAHCHAAN), Pakistan; Child Rights Department, The University of Lahore, Pakistan.
| | - Andleeb Zehra
- Child Rights Department, The University of Lahore, Pakistan.
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15
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Kimber M, McTavish JR, Vanstone M, Stewart DE, MacMillan HL. Child maltreatment online education for healthcare and social service providers: Implications for the COVID-19 context and beyond. CHILD ABUSE & NEGLECT 2021; 116:104743. [PMID: 32980151 PMCID: PMC7513691 DOI: 10.1016/j.chiabu.2020.104743] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/10/2020] [Accepted: 09/13/2020] [Indexed: 05/12/2023]
Abstract
Evidence indicates that healthcare and social service providers (HSSPs) receive inadequate education related to recognizing and responding to child maltreatment. This is despite the fact HSSPs are identified as an important factor in the primary, secondary, and tertiary prevention of this childhood exposure. The need for online education for HSSPs' is highlighted during the COVID-19 pandemic restrictions and will continue to be relevant afterward. The objective of this commentary is to provide an overview of: (a) educational interventions for HSSPs' related to recognizing and responding to child maltreatment; (b) the development of VEGA (Violence, Evidence, Guidance, Action), which is an online platform of educational resources to support HSSPs to recognize and respond to child maltreatment; and (c) the RISE (Researching the Impact of Service provider Education) project, which is an ongoing multi-province evaluation of VEGA in Canada. It is important to consider ongoing ways that HSSPs can receive education related to recognizing and responding to child maltreatment. The virtual implementation of VEGA and the RISE Project provide a necessary opportunity to continue to increase the capacity of Canada's HSSPs to adequately and safely recognize and respond to child maltreatment, while simultaneously advancing education scholarship for the field of child maltreatment and which will have relevance for the COVID-19 context and beyond.
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Affiliation(s)
- Melissa Kimber
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada.
| | - Jill R McTavish
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, MIP Suite 201A, Hamilton, ON, L8S 4K1, Canada
| | - Meredith Vanstone
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, 1280 Main Street West, DBHSC 5003E, Hamilton, ON, L8S 4K1, Canada
| | - Donna E Stewart
- Centre for Mental Health, University of Toronto and University Health Network, 200 Elizabeth Street, EN-7-229, Toronto, ON, M5G 2C4, Canada
| | - Harriet L MacMillan
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, and Department of Pediatrics, McMaster University, 1280 Main Street West, MIP 201A, Hamilton, ON, L8S 4K1, Canada
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16
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Herbert J, Ghan N, Salveron M, Walsh W. Possible Factors Supporting Cross-Agency Collaboration in Child Abuse Cases: A Scoping Review. JOURNAL OF CHILD SEXUAL ABUSE 2021; 30:167-191. [PMID: 33317439 DOI: 10.1080/10538712.2020.1856994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/01/2020] [Accepted: 11/13/2020] [Indexed: 06/12/2023]
Abstract
Cross-agency collaboration for responding to child abuse cases is critical for the safety and wellbeing of children. However, working effectively across organizational boundaries can be difficult, especially where there are considerable disciplinary differences. Accordingly, many jurisdictions have put in place policies and processes to support cross-agency collaboration across groups responding to severe child abuse. The aim of this scoping review was to highlight key factors that may influence the quality of cross-agency collaboration in severe child abuse cases. A systematic search comprising 57 empirical studies examining the facilitators and/or barriers to cross-agency collaboration in child abuse cases was undertaken identifying eleven factors. This review found the most commonly cited factor was the need to reconcile the different roles/mandates of workers with their roles in a cross-agency response. A clear cross-agency protocol that establishes agreed procedures was also a commonly cited factor, along with cross-agency training, and communication and information sharing practices. This scoping review highlighted the lack of high-quality evidence that could be used to assess the effectiveness of policies and processes to support cross-agency collaboration for child abuse cases, and targeted areas for future research to enhance the quality of evidence for this common type of program/intervention.
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Affiliation(s)
| | | | | | - Wendy Walsh
- University of New Hampshire, Durham, NC, USA
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17
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Herbert JL, Bromfield LM. A quasi-experimental study of the Multi-Agency Investigation & Support Team (MIST): A collaborative response to child sexual abuse. CHILD ABUSE & NEGLECT 2021; 111:104827. [PMID: 33250277 DOI: 10.1016/j.chiabu.2020.104827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 11/15/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
To improve the holistic response to child sexual abuse in Perth, Western Australia, a group consisting of government and community support agencies developed a new co-located approach that combined support services with investigations, called the Multi-agency Investigation & Support Team (MIST). The model was comparable to the prominent Children's Advocacy Centre approach, with adaptations for Australian conditions. This study evaluated the fidelity with which this new program was delivered and examined whether it resulted in improved criminal justice, child protection, and service outcomes compared to existing practice. Drawing on service data linked across participating agencies the study found MIST was delivered with reasonable fidelity to its planned procedure, but with some challenges for delivery of the program due to the relative workload for staff in the MIST condition. The service demonstrated high levels of caregiver satisfaction with the response and high rates of children's engagement with therapy. A quasi-experimental comparison between MIST (n = 126) and Practice as Usual (n = 276) found MIST was significantly faster throughout the criminal justice and child protection processes, but the conditions did not differ in the rate of arrest or child protection actions. While embedding support services within the investigation process may not have a dramatic influence on criminal justice and child protection outcomes, the high rates of uptake of therapeutic services and parental satisfaction suggest other benefits that require future exploration.
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Affiliation(s)
- James Leslie Herbert
- Australian Centre for Child Protection, University of South Australia, Australia.
| | - Leah Marie Bromfield
- Australian Centre for Child Protection, University of South Australia, Australia
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18
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The Integration of People Convicted of a Sexual Offence Into the Community and Their (Risk) Management. Curr Psychiatry Rep 2021; 23:52. [PMID: 34196851 PMCID: PMC8249282 DOI: 10.1007/s11920-021-01258-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 10/25/2022]
Abstract
PURPOSE OF REVIEW We are reviewing recent research into the community integration of men convicted of a sexual offence and their (risk) management. This is a high-profile political issue that binds together research in psychology, criminology, politics, health, public health, and policy studies. The review will demonstrate that a multi-disciplinary, life course, EpiCrim-oriented approach is the most effective way of reducing re-offending and promoting desistance in this population. RECENT FINDINGS Research demonstrates that life course development, especially from psychology and criminology, has an impact on whether people sexually offend or not. Therefore, to understand sexual offending behaviour, we need to look at the aetiology of said behaviour from a nature and a nurture perspective. Therefore, we need to use an Epidemiological Criminology (a marriage of Public Health and criminology) approach that works at all four stages of the Socio-Ecological Model (SEM) (individual, interrelationship, community, and societal). The research encourages a person first approach, that we look at Adverse Childhood Experiences and past trauma in the lives of men who sexually offend and use this, in conjunction with strength-based approaches, to inclusively integrate them into society. The prevention of sexual offending, both first time offending, and relapse prevention require a multi-level, multi-disciplinary approach. Successful desistance from sexual offending is as much about the community and society as it is about the individual.
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Farr J, Edbrooke-Childs J, Town R, Pietkiewicz D, Young I, Stapley E. Counseling for Young People and Families Affected by Child Sexual Exploitation and Abuse: A Qualitative Investigation of the Perspective of Young People, Parents, and Professionals. JOURNAL OF CHILD SEXUAL ABUSE 2021; 30:102-123. [PMID: 33427106 DOI: 10.1080/10538712.2020.1848959] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 10/24/2020] [Accepted: 10/31/2020] [Indexed: 06/12/2023]
Abstract
Despite growing awareness of the negative impact of child sexual exploitation on young people's psychological, emotional and relational lives, little is known about how counseling can support young people and their families. The aim of this study was to explore the experience of counseling for young people and parents affected by child sexual exploitation and abuse, with a view to examining what facilitates progress, from the perspective of young people, parents and professionals. In-depth semi-structured interviews were conducted with 10 young people, 8 parents and 7 professionals and were analyzed using thematic analysis. Findings suggest that through counseling, young people experienced affective and relational improvements that were attributed to the process. Characteristics of the counseling relationship that facilitated progress included being able to talk openly in a caring, non-judgmental and unpressurized environment, as well as receiving advice, techniques or solutions within a holistic approach. Facets of service delivery were also highlighted, including the provision of confidentiality, flexibility and consistency, along with a multi-agency approach that promoted engagement. Perceived obstacles to progress included resistance at the outset and service location issues.
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Affiliation(s)
- Joanna Farr
- Anna Freud National Centre for Children and Families and University College London, London, UK
| | - Julian Edbrooke-Childs
- Anna Freud National Centre for Children and Families and University College London, London, UK
| | - Rosa Town
- Anna Freud National Centre for Children and Families and University College London, London, UK
| | | | | | - Emily Stapley
- Anna Freud National Centre for Children and Families and University College London, London, UK
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20
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Keen J, Abdulwahid M, King N, Wright J, Randell R, Gardner P, Waring J, Longo R, Nikolova S, Sloan C, Greenhalgh J. The effects of interoperable information technology networks on patient safety: a realist synthesis. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [DOI: 10.3310/hsdr08400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Interoperable networks connect information technology systems of different organisations, allowing professionals in one organisation to access patient data held in another one. Health policy-makers in many countries believe that they will improve the co-ordination of services and, hence, the quality of services and patient safety. To the best of our knowledge, there have not been any previous systematic reviews of the effects of these networks on patient safety.
Objectives
The aim of the study was to establish how, why and in what circumstances interoperable information technology networks improved patient safety, failed to do so or increased safety risks. The objectives of the study were to (1) identify programme theories and prioritise theories to review; (2) search systematically for evidence to test the theories; (3) undertake quality appraisal, and use included texts to support, refine or reject programme theories; (4) synthesise the findings; and (5) disseminate the findings to a range of audiences.
Design
Realist synthesis, including consultation with stakeholders in nominal groups and semistructured interviews.
Settings and participants
Following a stakeholder prioritisation process, several domains were reviewed: older people living at home requiring co-ordinated care, at-risk children living at home and medicines reconciliation services for any patients living at home. The effects of networks on services in health economies were also investigated.
Intervention
An interoperable network that linked at least two organisations, including a maximum of one hospital, in a city or region.
Outcomes
Increase, reduction or no change in patients’ risks, such as a change in the risk of taking an inappropriate medication.
Results
We did not find any detailed accounts of the ways in which interoperable networks are intended to work and improve patient safety. Theory fragments were identified and used to develop programme and mid-range theories. There is good evidence that there are problems with the co-ordination of services in each of the domains studied. The implicit hypothesis about interoperable networks is that they help to solve co-ordination problems, but evidence across the domains showed that professionals found interoperable networks difficult to use. There is insufficient evidence about the effectiveness of interoperable networks to allow us to establish how and why they affect patient safety.
Limitations
The lack of evidence about patient-specific measures of effectiveness meant that we were not able to determine ‘what works’, nor any variations in what works, when interoperable networks are deployed and used by health and social care professionals.
Conclusions
There is a dearth of evidence about the effects of interoperable networks on patient safety. It is not clear if the networks are associated with safer treatment and care, have no effects or increase clinical risks.
Future work
Possible future research includes primary studies of the effectiveness of interoperable networks, of economies of scope and scale and, more generally, on the value of information infrastructures.
Study registration
This study is registered as PROSPERO CRD42017073004.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 40. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Justin Keen
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Natalie King
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Peter Gardner
- School of Psychology, University of Leeds, Leeds, UK
| | - Justin Waring
- Health Services Management Centre, University of Birmingham, Birmingham, UK
| | - Roberta Longo
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Claire Sloan
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Joanne Greenhalgh
- School of Sociology and Social Policy, University of Leeds, Leeds, UK
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Herbert JL, Bromfield L. Worker Perceptions of the Multi-Agency Investigation & Support Team (MIST): A Process Evaluation of a Cross-Agency Response to Severe Child Abuse. JOURNAL OF CHILD SEXUAL ABUSE 2020; 29:638-658. [PMID: 32045339 DOI: 10.1080/10538712.2019.1709241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/22/2019] [Accepted: 12/08/2019] [Indexed: 06/10/2023]
Abstract
The Multi-agency Investigation & Support Team (MIST) was a new approach to abuse investigations that aimed to minimize the distress and uncertainty experienced by children and non-abusive caregivers in dealing with the many agencies typically involved in a case post-disclosure, while also attempting to improve the accessibility of supportive and therapeutic services. As part of a broader evaluation, this study examined worker perceptions early in the implementation of this new approach. Thirty-three (33) interviews were conducted with workers affected by this new pilot. The interviews identified almost exclusively positive perceptions of the changes relative to practice as usual, particularly in terms of improvements to collaboration and communication across agencies, and the benefits of providing support alongside the investigation process. Some areas of difficulty and areas for improvement were identified, particularly the need for stronger governance of the cross-agency protocol and improved connection to some of the groups involved in the response that were not co-located. The study suggests professionals working in the MIST model consider the model beneficial to the quality of the response to severe child abuse while highlighting that the process of change into this new way of working was challenging at times.
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Affiliation(s)
- James Leslie Herbert
- Australian Centre for Child Protection, University of South Australia , Adelaide, Australia
| | - Leah Bromfield
- Australian Centre for Child Protection, University of South Australia , Adelaide, Australia
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