Child Protection and Practice最新文献

Background

Parental substance use is a substantial public health and safeguarding concern. Research examining the impact of parental substance use upon children is well-established, but there is a lack of research examining how parents/caregivers cope with their parenting role within the context of another parent's substance use, or how best to support these parents/caregivers.

Objective

This paper examines the experiences and support needs of parents/caregivers impacted by another parent's substance use.

Participants

Nineteen parents/caregivers from substance exposed families via local community-based voluntary sector support organizations, in urban and rural settings in northeast England.

Methods

Qualitative, in-depth interviews with caregivers (mothers, fathers, grandparents, aunts, uncles, siblings, aged 25 to 65+ years) of dependent aged children (aged 4 to17 years) in substance exposed families. Thematic analysis explored their experiences and support needs.

Results

Cumulative stress impacted parents/caregivers in their parenting role, creating further challenges in caring for children impacted by another parent's substance use. Parents/caregivers felt their needs went unrecognized by support services, and interactions with statutory services frequently exacerbated their stress. Parents/caregivers worried about what to disclose to children about substance use and how and when to do this.

Conclusion

Parents/caregivers attempted to mitigate the risk of another parent's substance use upon the children in their care. They often perceived lack of appropriate support specifically for parents/caregivers, particularly considering the extra challenges they faced caring for children in the context of parental substance use. Resources to support parents/caregivers in talking with children about these issues may offer guidance and reassurance to caregivers to alleviate some of their stress.

Background

Childhood violence and mental health remain concerning public health issues globally yet there is limited evidence on the associations between experiences of such violence and mental health in refugee settings.

Objective

To assess the association between experiences of childhood violence (sexual, physical, and emotional violence) and mental health (severe mental distress, self-harm, suicidal ideation and/or attempted suicide) in refugee settings in Uganda.

Data and methods

Data are from the 2022 Uganda Humanitarian Violence against Children and Youth Survey (HVACS) conducted among 1338 females and 927 males aged 13–24 years between March and April 2022. Cross-tabulation with chi-square tests and multivariate logistic regression analysis were used to assess the association between experiencing childhood violence and mental health.

Results

The results show a high prevalence of experiencing childhood violence (females 40.8% vs males 55.2%) and mental distress (45% for both males and females). Females who experienced childhood sexual violence had significantly higher odds of reporting severe mental distress (aOR = 1.989; CI = 1.216–3.255), suicidal ideation and/or attempted suicide (aOR = 4.119; CI = 2.157–7.864) and self-harm (aOR = 3.734; CI = 1.619–8.609) compared to those who did not experience such violence. Experiencing childhood physical or emotional violence was also significantly associated with increased odds of reporting suicidal ideation and/or attempts and self-harm among females. Among males, childhood emotional violence was significantly associated with increased odds of reporting suicidal ideation and/or attempts (aOR = 9.233; CI = 2.293–37.177) or severe mental distress (aOR = 2.823; CI = 1.115–7.148).

Conclusion

Childhood exposure to violence was associated with poor mental health, with a higher risk observed among females. The findings of this paper provide critical insights to facilitate the development or strengthening of violence prevention and response interventions on violence against children in refugee settings.

Despite increasing recognition of children's right to have a say about matters that affect them (Article 12, United Nations Convention on the Rights of the Child), this right is often denied in the context of child abuse research. This article explores the ways in which ethical decision-making can contribute to the denial of this right and the negative implications of this at both an individual and societal level.

Ethical decision-making that stymies the conduct of abuse-focused research with children is usually justified with reference to protecting participants from risk of harm. Whilst in no way suggesting that this is not a critical consideration, the authors question the simplistic and deterministic ways in which this can be understood within ethical decision-making, and the unnecessarily risk-averse decisions that can ensue.

Sharing examples from their cumulative 30 years' experience of engaging children and young people in abuse-focused research, the authors stress the need for a more holistic, nuanced and dynamic approach to assessing and managing risk of harm. This would consider risks of both inclusion and exclusion. Understanding that risk and harm are neither static nor universally experienced concepts, it would recognise the implausibility of the ‘do no harm’ guarantees often expected of social researchers. Instead, informed by rights-respecting and trauma-informed perspectives, it would focus on holistically promoting participant wellbeing in, and through, research. Key to this is permitting, and supporting, researchers to exercise contextually-informed, collaborative decision-making in the field; something the authors share their emerging practice framework for.

Children are disproportionately impacted by humanitarian disasters, which cause toxic stress. When a crisis overwhelms the capacity of health and social systems to meet the needs of a population, external crisis response teams working in a range of sectors may offer support to save lives and meet the affected populations' basic needs. Gaps have been identified in health sector interventions for children in humanitarian contexts, including lack of routine interventions to protect and promote early child development (ECD). To address this gap and improve the quality of humanitarian responses for girls and boys, the Global Health Cluster, Child Health Task Force, and the Inter-Agency Network for Education in Emergencies held a webinar series on Strengthening Nurturing Care in Humanitarian Response. It concluded that incorporating interventions to support nurturing care for ECD into health responses in acute phase emergencies is lifesaving. In crisis contexts, even simple interventions can be the difference between life and death, and when systematically applied, they can dramatically improve a child's life opportunities as well as national recovery and economic growth.

Background

To optimize PCIT treatment with children exposed to abuse and neglect, PCIT with Trauma-Directed Interaction (PCIT with TDI) was created.

Objective

The current study was a quasi-experimental cohort study (PCIT and PCIT with TDI treatment groups) with pre/post-treatment comparisons. The study was conducted in a statutory child protection agency and was a naturalistic evaluation of the outcomes achieved by this service. The outcomes under investigation included caregiver and child posttraumatic stress symptoms, child behavior problems, parenting stress, caregiver mental health, child protection notifications, and placement permanency goals.

Participants and setting

Children were included in the study if they were aged between 2 and 7 years, had behavioral difficulties or trauma symptoms and/or their caregivers were experiencing parenting stress.

Methods

Families were allocated to treatment group by clinician availability/preference (i.e., preference allocation). Caregivers were asked to report on child posttraumatic symptoms and behavioral issues; and to self-report on posttraumatic stress, general stress, parenting stress, and depression and anxiety at prescribed points in treatment.

Findings

Sixty-eight children and their caregivers were treated with either PCIT (n = 22) or PCIT with TDI (n = 46). Statistically significant changes were observed for both treatment conditions for some of the outcomes of interest for both children (i.e., child behavioral problems, posttraumatic stress) and their caregivers (i.e., general stress, posttraumatic stress). There was no significant main effect of treatment on any of the outcomes of interest.

Conclusion

Future research should include a randomized controlled trial to adequately determine the efficacy of PCIT versus PCIT with TDI with this population.

Background and purpose

Preventing child sexual abuse is a health and medical priority in many countries. The risk of sexual abuse can be markedly reduced through education, awareness, and skill-building for children. The purpose of this study was to train and evaluate a robot-based psychological intervention program for preventing child sexual abuse.

Methods

This study had a semiexperimental design that included pre- and posttests as well as a control group. A stratified random sample of 80 individuals was drawn from the population of eight-to ten-year-old children in Ghaen, Iran, in 2018. Subsequently, the sample was randomly divided into two experimental groups and two control groups. The experimental group participated in a robot-based psychological intervention program, for a total of 10 sessions. The control group received no intervention. The tool used to measure children's knowledge and awareness of sexual abuse was a custom-designed questionnaire developed by Tahan (Tahan, 2023). Participants completed the questionnaire in the pretest, posttest, and follow-up stages. The collected data were analyzed using repeated measures ANCOVA in SPSS (v.25).

Results

The findings demonstrated that educating children about sexual abuse was effective in enhancing their knowledge of appropriate and inappropriate touching (p < 0.01). Furthermore, the robot-based cognitive-behavioral intervention program for the prevention of child sexual abuse was effective (p < 0.01).

Conclusion

The psychological intervention program increased children's knowledge and awareness concerning the prevention of sexual abuse and associated coping skills. Furthermore, psychological intervention programs were effective in preventing child sexual abuse.

This study examined the mediating role of job satisfaction in the associations among workplace support, job autonomy, and turnover intention among child welfare workers in China. The differential effects of several sources of workplace support (coworkers, supervisors, and organization leaders) on worker turnover intention were also examined. Using data drawn from the Chinese Social Work Longitudinal survey 2019, a series of path analyses were conducted. The results indicated that job satisfaction partially mediated the effects of workplace support and job autonomy on turnover intention. When the effects of workplace support from different sources were examined, the mediating effect of job satisfaction was significant only for the association between support from organization leaders and turnover intention. Greater workplace support from organization leaders and supervisors directly predicted lower turnover intention, while workplace support from coworkers was not significantly associated with turnover intention. The findings suggest that policies and programs that promote workplace support from organization leaders and supervisors and enhance job autonomy and satisfaction may be critical to address high turnover rates among child welfare workers.

UNICEF policies, plans, and strategies increasingly demonstrate that gender equality and the empowerment of girls are central to the organization's mandate to advance child rights. In its newest frameworks, UNICEF has pledged to practice gender transformative approaches to achieve progress toward advancing adolescent girls' wellbeing and agency, as well as a more gender equal world. Employing such approaches requires shifting power and resources to adolescent girls and girl-led organizations and networks. This means deliberate support for girls' capacities as leaders and changemakers; understanding and confronting the gendered and age-related power dynamics and norms that impede gender equality at all levels of society and stages of life; and working with girls and their communities to create more gender equitable environments for girls' rights (Rumble et al., 2022).

UNICEF has seen some early successes, but also encountered challenges in applying these approaches. Gaps in expertise, restricted funding, and political sensitivities are just a few impediments to ensuring transformative action at scale. Yet, the potential impacts are enormous.

In this Practice Perspective Article, we share our reflections on principles UNICEF is applying, implementation challenges it is encountering, early outcomes it is capturing, and lessons it is learning in its work to employ gender-transformative approaches to further adolescent girls’ rights.

Background

Homelessness during pregnancy and early childhood is associated with poorer social welfare outcomes for birth parents and their children. For these clients, contact with the child protection system is common. In some cases, children are removed.

Objective

To systematically review published literature investigating the impact of housing support during pregnancy and early childhood on child protection outcomes.

Participants

and setting: Provision of housing support for clients experiencing homelessness while pregnant or parenting young children (0–7 years) in high-income countries.

Methods

A systematic search of databases CINAHL and SocIndex for peer reviewed studies, with independent double-screening of retrieved studies and full-text review of eligible studies.

Findings

Of 793 screens and 37 studies with full-text review, two were eligible. Both were small, without a control group, and one was qualitative. There was no convincing evidence for impacts, and meta-analysis was not possible. In post-hoc reviews, five additional studies met all criteria except child protection outcomes. These studies’ findings suggested that, compared with controls, housing interventions led to faster initial improvements in housing status and decreased alcohol use, as well as decreases in child internalising and externalising behaviours.

Conclusions

There are promising indications that housing interventions generate benefits for clients experiencing homelessness while pregnant or parenting young children. However, high-quality longitudinal studies with robust intervention designs are lacking, likely due to the challenges inherent in embedding research to evaluate such programs. Given the importance of pregnancy and early childhood on children's development, existing housing support and policy implementation evaluations should be prioritised.

Background

During the COVID-19 pandemic, it was hypothesized that stay-at-home policies would impact cases of violence, abuse, and neglect among children and youth due to increased familial stressors.

Objective

We examined the effect of the implementation of pandemic policies on violence-related emergency department (ED) visits and hospitalizations among youth.

Participants

Violence-related ED visits and hospitalizations among children and youth ages 0–19 in Ontario, Canada were obtained from April 2015 until the most recent available date, March 31, 2022.

Methods

We used an interrupted time series design to model the change in monthly violence-related ED visits and hospitalizations before and during the pandemic. We used negative binomial models to estimate the immediate effect of the policy and the change in the number of injuries during the pandemic.

Results

After adjusting for seasonality and population changes over our study period, we observed a 56% decrease in violence-related ED visits (RR: 0.44, 95%CI: 0.38, 0.50) and a 35% decrease in hospitalizations (RR: 0.65, 95%CI: 0.52, 0.82) immediately after the implementation of the pandemic policy, followed by moderate increasing trends. We observed no difference in the effect of the pandemic policies on the rate of violence-related ED visits and hospitalizations by sex, age or material deprivation; however, males aged 10–19 years and those in higher quintiles of material deprivation had higher average rates of injuries compared to females, those in younger age groups and lower quintiles of deprivation over the study period.

Conclusions

We observed an abrupt decrease in the rate of violence-related ED visits and hospitalizations immediately after the onset of pandemic policies in Ontario. Following this, violence-related injuries increased, approaching pre-pandemic levels.