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Journal Issue: Preventing Child Maltreatment Volume 19 Number 2 Fall 2009

Progress toward a Prevention Perspective
Authors: Matthew W. Stagner Jiffy Lansing

Possible Approaches to Preventing Child Maltreatment

In the following section we briefly describe various types of interventions and the risk and protective factors they aim to influence. We provide a quick overview to suggest the range of approaches and the trade-offs within each. We also align the interventions with Daro’s four theoretical perspectives outlined above. In the remainder of the volume, contributors examine these and other interventions in greater detail.

Education (Learning Theory)
Distributing educational materials to a family when a baby is born is one effective way to teach new parents about healthy parent-child interaction and child care practices. In a randomized trial using culturally sensitive videotapes that illustrated both successful and unsuccessful strategies for feeding infants, parental attitudes and parent-child interactions during feedings significantly improved among first-time African American teen mothers in the intervention compared with those in the control group.71

Support Groups (Learning, Environmental, and Ecological Theories)
Support groups provide formal peer support facilitated by a trained professional. They also encourage participants to create their own informal support networks. Most support group models seek to enhance protective factors such as improved parent-child interaction and communication as well as to reduce negative behaviors.72 When support groups are offered through public education systems, early education programs such as Head Start, or child care centers, they often include opportunities for parent-child interactions and early childhood education interventions aimed at children.73

Daro and McCurdy’s analysis of parent education and support groups shows promising positive effects on parental attitudes, knowledge, and behaviors.74 And Abt Associates’ national evaluation of family support services found that group-based parenting education and support produced larger positive effects on children’s cognitive and socio-emotional development than did home-visiting services.75

Home Visitation (Learning, Environmental, and Ecological Theories)
A promising means of delivering targeted services to individual families is home visitation. Because very young children can suffer from especially high rates of maltreatment, the most promising programs appear to be those that focus on early intervention. Having a trained professional or para-

professional deliver services in the home rather than in a professional office or community center makes it possible to tailor services to each family’s needs. Home visitors can also assess environmental factors that influence the family’s child-rearing practices. Because such services can initially be provided to all families identified by demographic or geographic risk factors, they also function as an assessment for further services. Studies evaluating home-visiting programs show some positive results, but at the same time they make clear that a program’s services must be appropriately configured and delivered to be effective.76

Community Programs and Broad Public Policies (Environmental and Ecological Theories)
Community-based programs address socioeconomic risk factors by providing access to services and financial support. By linking parents to local support networks (both formal and informal), they also address risk factors associated with social isolation and community context. Families facing limited access to child care or reliable transportation are often unable to sustain involvement in structured groups.77 Strategic placement of programs within the local community may increase the likelihood of participation, facilitate support networks, and provide information. Such programs can include voluntary home-visiting programs, parent support groups, and family support center programs.

Public policies that provide maternity and paternity leave, as well as child care subsidies, can also be seen as community-level supports. Paid maternity leave promotes parent-child attachment in the crucial early months of life and alleviates the financial stress of loss of income. Free or subsidized child care promotes work by easing the burden of child care costs. Both maternity and paternity leave and child care policies can promote child and family well-being, enhance the quality of family and community life, and promote self-sufficiency. Moreover, such policies enhance the business community’s perception of the value of child rearing and its commitment to promoting healthy families.

Individual or Family Therapy (Psychodynamic Theory)
Most often provided after maltreatment has occurred, these therapeutic approaches are sometimes part of the service plan requirements for children returning from substitute care to their parents. Psychotherapy presumes that maltreatment occurs because of the parent’s maladaption to earlier-in-life experiences and is the result of unconscious unresolved conflict being acted out in the family context. The psychodynamic therapist helps the client acknowledge the existence and consequences of the maladaption, while working with the client to develop strategies for change, including competencies associated with identifying, establishing, and maintaining supportive social networks.78 Family therapy provides a professionally guided exploration of family roles and dynamics that aims to improve family and individual functioning.79

Psychiatrists often use play therapy to help young children express and understand past events in order to increase the likelihood of resilience and decrease the likelihood of their developing maladaptive coping techniques.80 There is very little systematic evaluation of these types of interventions, which are as yet provided only to families already in the child welfare system. The individualized and long-term nature of this treatment makes it a costly intervention, even if successful at preventing future maltreatment. Perhaps the greatest potential benefit is for society. By fostering resilience and adaptability in victims of maltreatment, successful psychodynamic therapy could preclude their future involvement in the child welfare system as parents.