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Prevention of child abuse: the empowerment of parents

Abstract     This article focuses on the level of child abuse in the UK, and the burdens which this places not only on the traumatized victims but also on the social, health and other services. Some of the possible causes of child abuse will be studied in more detail, looking at both individual and societal factors. Different approaches to prevention will be discussed, including in particular the modern concept of screening and prediction, used to justify a greatly increased selective input by the services into families thought to be 'at risk'. The alternative of supporting instead all parents - especially those living in more stressed residential areas - will be examined. The possibility of involving local communities in controlling abuse will be suggested as another possible way forward for society.

Daunting evidence from the NSPCC

The most important UK organisation concerned with campaigning against child abuse, researching the extent and consequences of abuse, and involving itself with child care policy and practice, is the National Society for the Prevention of Cruelty to Children (NSPCC). Its website, www.nspcc.org.uk , presents a picture of the general situation in the UK as reported and updated regularly. The quality of its statistics on the abuse and mishandling of children is better than ever, and it is only sexual abuse that is still likely to be underestimated because of its largely hidden nature.

At the end of March 2006 some 32,000 children were on the Child Protection Register (CPR), although in the whole of the preceding year altogether 38,000 were added to the register. The numerical difference is due to the fact that placements are cancelled when this is considered safe. One estimate is that about ten times that number of children are brought to the notice of the statutory agencies each year because of concern over their well-being.

A separate statistic on ‘children in care’ showed that In 2006 there were 60,000 children in local council care - an increase of 5,000 over the previous five years. A significant minority of these would be children on the CPR; others would be children taken into care at the request of parents, or because the parents were seen to have difficulty in coping with the rearing of their children. The total cost of this care is £1.65 billion annually.

A study of the reasons for placement on the CPR showed that 45% of the children were there because of neglect, 12% because of physical abuse, 7% because of sexual abuse and 25% because of emotional abuse. The remaining percentage of children were there for more than one reason. Of the total on the CPR, 13% of children were under one year, 30% were between one and four years, 27% between 5 and 9 years, and 30% ten years and older.

Looking at the population as a whole, an estimated 7% have experienced serious physical abuse during childhood, with about 35 children a year being killed as a result of abuse.

The figures for children’s experience of sexual abuse have been divided to highlight family relationships. Only 1 per cent have been abused by parents or carers; 3% by another relative; and 11% by people known to the child but not related. By comparison well under half that proportion - just 5% - have been sexually abused by adult strangers. As is now well recognized, the obsessive warnings of ‘stranger danger’ ignore the fact that the biggest risk of sexual abuse comes within the home or from known friends.

One of the saddest abuse statistics is the finding (in the USA but likely to be similar in other developed countries) that disabled children are three to four times more likely than non-disabled children to be physically, sexually or emotionally abused, or neglected.

Vast amount of child suffering;   services find it hard to cope

However these figures are interpreted, they are evidence of a vast amount of child suffering. While there is general agreement on the extent of physical abuse and neglect, estimates about sexual abuse are confounded by arguments about how widespread it is and what are the implications not only for society but also for parent-child relations within the family setting. The effects of this form of abuse are often lifelong for many of the children who are its victims.

All the services - social, community health, educational and medical - face a growing burden as a result of the increased reporting of child abuse. There have been numerous complaints about children on the protection register for whom a case worker cannot be allocated - or who do not receive home visits because of the large numbers of more serious cases needing attention. Social service work for mentally ill and elderly people has also suffered as a result. Health visitors are often asked to step in by making increased visits to families of children on the register, but they too are finding it impossible to meet all the demands. Case conferences (to consider reports of suspected abuse or neglect, and to decide on remedial action) take a large block of both social service and health visiting time.

There are some professional doubts as to how much of this work can or should be taken over from social workers. In an early study Taylor and Tilley1 examined the conflict faced by health visitors and the ethical dilemma of whether they should remain in a relationship of trust with their clients, which would only be breached in exceptional circumstances, or whether they should become more of a child abuse inspection service. They could not be expected to operate in both ways. This dilemma is still faced by that profession today.

To date the research on success in treatment is sparse, partly because of the need for long-term follow up to assess the effects of that treatment and partly because there is limited evidence of any particularly successful approach.

An important conclusion from this very brief review is that there is a disturbingly high and possibly increasing level of child abuse, but that the professional resources available to deal with it are insufficient and likely to remain so even with a considerable growth in those resources.

Complex causes of child abuse   -   individual, family and society

It would be a bold person who could offer any final conclusions on the many possible causes of child abuse. As with various human problems, the aetiology is complex and multi-faceted. There are two particular approaches to explanation, with a wide area of overlap.

The first is to see the problem as inherent within the individuals and family constellation, with shortcomings in the personalities of those individuals, or problems of mismatch in the dyadic or triadic relationships. This explanation takes in the possibility that in a minority of cases there may be features in the characteristics of the child which in some way 'invite’ or ‘prompt' the brutality, neglect or sexual exploitation. This of course is a dangerous argument if used in any but a few extreme cases, and it can never justify the abuse.

The second approach is to argue that societal factors play a prominent part in the development of abuse situations. The NSPCC's research has noted that many of the children registered in 1989 came from the most socially disadvantaged families, with only 15% of the mothers and 39% of the fathers having jobs. Creighton2, a senior researcher for the NSPCC, has pointed out that the parents of the physically abused children on the CPR were distinguished from parents nationally by their youth, low socio-economic status, high unemployment and high criminality; the author also pointed out that marital problems were thought to be the most significant stress factor which may have led to the abuse.

A 2002 study3, based on the large ALSPAC regional cohort, showed that levels of deprivation were strongly related to placement on the CPR, with odds ratios of 2.33 for paternal unemployment and 2.16 for overcrowding. A second analysis model showed that high mobility (more than three house moves in the previous five years) and a poor social network were also indicative.

An unusual early study by V.Yule4 described her observations on 85 parent-child pairs in the streets, shops and buses of a provincial city. Each observation lasted three minutes and was carried out at a time when the parent was not busy hurrying or dodging the traffic. She found a very high level of brusque and often physically aggressive behaviour by the parents towards their infants or young children, with children frequently scolded or shouted at for innocent behaviours which did not apparently conform to what the mothers expected.

Yule compared the stresses faced by so many parents in this country with the pleasure that adults in other cultures still have in dealing with their children. "The martyrdom of young mothers (here) comes partly from feelings of low social status.... How does a young mother with toddlers, parcels and push-chair feel as she struggles unaided on to a bus, without a courteous hand or smile from anyone?....

"The martyrdom comes also through incompetence. You hate doing what you know you are doing badly.... Mother-with-toddler groups proliferate, to share 'problems'; but young parents have little social communication with older parents who may have 'solutions'."

The parents’ use or misuse of power a critical factor

From a different point of view there are theoretical grounds for arguing that the abuse of a child, whether physical or sexual, has a strong link with the exercise of power by the parent. All parents exercise some form of power over their children's development; no child could grow within a power vacuum. Power is also exercised, instinctively, by a young child who learns that its cries or gestures will usually have the power to achieve certain felt needs.

It is when the parents' exercise of power becomes unreasonable or authoritarian that there is the potential for abuse - insisting for example that a young child's feeding or sleeping patterns should meet some imposed criteria, or refusing to explore cries or other 'unreasonable' demands from the child on the grounds that the child's needs have already been met. Sometimes these issues lead to insensate rage in parents whose lack of self-esteem means that they cannot tolerate child behaviours which they do not understand.

Because most parents have learned self-control and are able to rely on verbal rather than physical strategies to get their way - and coupled with moderate self-esteem - they do not resort to abuse, however frustrated, angered or despairing they may be over a child’s behaviours. Of course some of them may still practice more subtle forms of emotional blackmail or cruelty which do not show up as weals, burns or other visible evidence of abuse.

While abuse stretches across all the social classes, the effect of low self-esteem is a central factor in many of the situations leading up to abuse. Parents who find themselves to be failures in most areas of life, who enjoy little esteem from others, who may not have jobs or whose jobs may be unrewarding, and who have faced a lifetime of economic and 'social' struggle, tend to have very limited self-esteem. They are more likely to abuse when pressured than are 'successful', advantaged parents with reserves of high self-esteem.

There is a different and more complex genre of feelings and emotions in the exercise of power through sexual abuse; here the abuse is in one sense more subtle because it does not usually involve violent assertion. It is instead a power relationship in which the child's human dignity and integrity are ignored in order to obtain from her or him sexual pleasure. The parent or other adult assumes the situation to be non-threatening for a compliant if bewildered child, who it is assumed does not need to be fully informed or aware of the awful reality of what is being done to her or him.

Understandably, research studies confirm that the exercise of power by abusing parents generally goes hand in hand with their lack of self-esteem. Two studies reflect this position. Court 5, writing as head of what was then the Battered Child Research Department of the NSPCC, stated that "feelings of worthlessness and powerlessness are closely linked with the battering parents' lack of self-esteem and basic trust". Court considered that the damaging childhood experiences of many battering parents were of central importance in this situation, crippling their ability to 'mother' children when they in turn became parents.

Lack of parental self-esteem contributes to abuse

Stratton and Swaffer6 provide confirmation for the theory that the beliefs that abusive parents hold about their children are an important factor in determining whether, and in what way, a child will be abused. Their study compared three groups of parents, mothers of physically abused children, a non-abusing control group, and mothers of handicapped children (to provide stressed but coping controls). The authors showed that the abusive parents, when interviewed, tended to ascribe a good deal less control to themselves (in interactions with their children) than did the other parents.

It is interesting to note Stratton and Swaffer's finding that the abusive parents attributed a very high level of control to their children in those same interactions - much above the levels attributed by the mothers in the other groups to their children.

Such findings imply that parents who see themselves as having only minimal control over interactions with their children, while believing that their children exercise twice as much control as they really do (in the quoted study), are likely to feel frustrated and angered over their relative inability to influence their children's behaviours.

For parents with only limited verbal ability this means a considerable temptation to resort to violence as a way of re-establishing some measure of control, however temporary.

One of the most profound studies in this field is that of Burgess and Garbarino 7, who present an evolutionary perspective on child abuse. They identify social isolation of the family, particularly the mother-infant relationship, as being perhaps the most significant way in which modern cultural evolution is at odds with our evolutionary past. They cite an earlier cross-cultural study which identifies isolation of the mother-child relationship (in the modern Western, isolated nuclear family) as a universal threat which increases the risk of rejection for those involved, leading to unprecedented stress in the lives of young mothers.

Limited success of most approaches to prevention

If prevention is to be successful it needs to home in on the presumed causes of child abuse and either provide anticipatory support in advance of any possible abuse, or set up formal systems to deal with abuse situations in such a way as to prevent a repetition. For many reasons, humane and practical, it is preferable to try to create a situation in which support for the parents prevents abuse from starting.

One widely-known approach to prevention is that of screening, in which assessment instruments are used to judge the likelihood or 'risk' of the parents becoming abusers. Browne8 has suggested a three-stage screening in the first nine months of a child's life: first looking at a broad checklist of social factors, then examining the parents' perceptions of their child and family stress, and finally studying the infant's behaviour and attachment. He presents a statistical framework, but recognises that many of those screened as potential abusers would not in fact become abusers, since the predictive instruments are not infallible.

Browne argues that objective means of assessment are better than subjective opinions about the potential for abuse within a family. One has to question this judgment, given the doubts described below about the high number of false positives thrown up by screening.

The basic approach of screening to identify parents 'at risk' of becoming abusers, an approach which is shared by many within the psychology, health and social work professions, raises major ethical and practical questions. This approach has been questioned by Barker9, who points out that even a sensitive screening instrument can label 35 innocent families for every one abusing family identified. The more serious objection is that labeling is done in advance of any abuse having occurred. This cannot be justified ethically.

An increasing number of the families placed on child protection registers are put there not because of abuse having occurred or having been strongly suspected, but because it is the kind of totally disorganised family situation which is regarded as bordering on abuse. One can ask whether the negative dynamics which this action creates between the professionals and the labeled families does not in fact precipitate rather than prevent the descent into actual abuse?

Certainly parents will become aware that they are being subjected to an unusual degree of scrutiny, with the inevitable rise of parental aggression towards authority and often towards their child who is seen to be the 'cause' of the added attention from professionals.

A second form of prevention is closely allied with the labeling process. This involves the prescription of ever more elaborate and costly controls so that everything possible is done to forestall abuse or to act with speed the moment it is positively identified. No one can question the need for rigorous procedures to protect infants and children. Almost every inquiry into the deaths which do occur finds that various professionals had a part of the whole picture but not sufficient to prompt immediate action; lack of adequate communication and unawareness are generally blamed rather than actual staff negligence.

Risk of ‘games-playing’ on both sides

The fundamental difficulty with this form of 'prevention', when some abuse has occurred or is suspected - and before more formal measures are taken - is that it can degenerate into a kind of games-playing, with both sides trying to anticipate what the other might do. Instead of parents feeling that they have a source of potentially strong support in trying to overcome what most parents recognise to be fundamentally wrong and cruel, they concentrate on how they can avoid detection, prosecution or having the child taken into care.

This is not to suggest that there are any easy solutions to situations which cause much study, review and heart-searching for committed social workers and other professionals.

The most drastic form of intervention in situations of child abuse - taking the child into care - is very expensive. Various studies have counted the dozens of different professionals who have been involved in dealing with the situation caused by the serious abuse and taking into care of a single child. Less expensive intervention strategies cover a wide range of alternatives, including compulsory attendance at family centres, group therapy and home visiting; in some cases two or more of these approaches may be used in combination.

The choices faced by child protection teams and casework conferences when they decide to take a child into care can be finely balanced between the probable continuation of the abuse and the damage which is likely to be caused to the child, or alternatively the trauma for the child when he or she is suddenly taken into care 'for his or her own good', without sufficient regard for whether the child wants this, or could survive at home with reasonable supervision. This, the most drastic form of prevention, nearly always involves critical and sometimes agonising decisions, especially as the alternative of not taking the child into care can lead to situations in which professionals may be blamed for acting too slowly when a child is injured or killed.

An Australian study is one of the few to offer a more encouraging perspective. Lines10 describes a carefully monitored experimental study in which volunteers were recruited to work as parent aides in support of families where abuse had already occurred. A fairly intensive support programme was offered, totaling 20 hours per month per client. The cost-benefit ratio of the programme was low - a highly positive finding - compared to the cost of putting an abused child in the medical centre to which they were customarily brought (for six days on average). The limitation of this study are its intensity and its small size, with 12 parent aides visiting a total of 36 abusing mothers for some part of the five-year period examined in the study. There was only one case of re-abuse - thus a rate of 3% - compared with the normal rate of 8% re-abuse for the total metropolitan area during the same five-year period.

In the literature in general there is a wealth of descriptive research on every kind of programme to prevent or overcome abuse, but a paucity of studies on the degree of success achieved by most of these initiatives.

The conclusion from this brief examination of a variety of approaches is that prevention in the sense of anticipating and preventing abuse has not up to now been very effective. It is more difficult to comment on the success of treatment in preventing further abuse, since it requires long-term follow up of 'treated' families and comparing it with a similar group of abusing families which have not been treated. Such studies would however raise serious ethical and conceptual difficulties.

Empowerment as the preferred approach to prevention?

Given that child abuse is in most cases linked to a fundamental abuse of power by the parents, it may seem strange to suggest that such parents should be 'empowered' in order to help avoid the possibility of abuse, or to put an end to the abuse if this behaviour has already begun.

As pointed out earlier, the dynamics of power are not straightforward. Many parents who feel disempowered in their life situation and in relation to society, to professionals and even to those closest to them, may understandably seek to exercise power in the one remaining area (in their child-rearing) where it can be imposed.

The goal of genuine and ethical empowerment should thus aim at encouraging parents to achieve disciplined and sensitive control over various aspects of their lives and their interaction with others, including their children. Such empowerment can never be absolute; it will always end up as a balance of powers.

The Child Development Programme, a large-scale home visiting programme based on specially trained health workers, is oriented strongly towards this concept of empowerment. It is its most important feature, and is more relevant to its success than are any other aspects of the programme such as its structuring or its use of illustrated 'cartoons'.

It uses relatively simple methods to encourage the development of parental control. Currently it is focused mainly on regular (usually monthly) home visits to first-time parents who, by definition, are non-abusers. But it also involves visiting selected parents with two or more children, especially where there are parenting problems. The programme is wide-ranging and comprehensive, endeavouring to deal with all the major areas of a child's development, health and nutrition; it is also concerned with the health and well-being of the mother. Among its many goals it aims to keep to a minimum the level of abuse arising in programme families. Parents are also provided with non-didactic pictorial and verbal information, in an attractive and easily understood format.

Parents are encouraged to realise the positive control that they already have or can achieve over their lives and their child-rearing. The significance of empowerment in this context is that the programme helps parents to understand how they can influence the child sensitively, how they can cope with its crying, its sleeplessness, its seemingly unreasonable behaviour. They learn thus an enlightened use of power, in a constructive and positive way, because the parents are learning through their own efforts (rather than being taught, as occurs in most intervention programmes) how to understand the competing power needs of the child and of themselves. Because these insights enable the parents to achieve more success, they become more confident and more accepting of the child's uniqueness, and more able to cope with its seemingly awkward behaviours and demands.

From a different perspective, a parent who becomes deeply and consciously involved with and attuned to the well-being of a child can achieve a consensus of action with that child which replaces the kind of power struggle that so easily arises when there is an inadequate parental grasp of the child's perspective.

CDP methods encourage parents to develop coping skills

For understandable reasons the Child Development Programme, in its work with parents, does not draw specific attention to the possibility of child abuse (unless there is clear evidence of a parent’s harsh or neglectful responses to the child). The programme visitor is concerned to provide positive information to the parents about the problems of child-rearing, and to encourage the parents to find their own solutions to their problems as far as that is possible, rather than the visitor offering or prescribing solutions. This, and the focus on building self-esteem, is the key to the empowerment of parents.

Thus parents learn how to deal with the kinds of problems which most parents face, and often fail to solve. A great many potential abuse situations have undoubtedly been overcome by programme parents developing the skills of coping with their children, while also coming to understand them better.

This process has another important effect on the parents. Parents who find themselves now succeeding for much of the time in their child-rearing, even if they are still achieving little in other spheres of life, gain considerably in self-esteem.. That, again, is the reverse of what occurs with the parent who starts to abuse and, in doing so, loses even more of his or her limited self-esteem.

The Child Development Programme does not claim to be a panacea for all the ills of parenthood. But it does offer struggling parents a way forward that respects their dignity, increases their self-esteem, and as a direct consequence improves the development and health of their children. It does not offer dramatic overnight change, but a slow and steady improvement over the months or years that the programme continues. Wherever it has been introduced, its low cost and considerable effectiveness make it an important service to parents.

An early version of this programme was evaluated in a large scale research study of 1,031 families between 1980 and 1984. The results of that randomly controlled study were reported11 in 1988 and showed significant effects of the programme on improving not only a variety of home environmental variables, such as the language and cognitive environments and the nutrition of the intervention children, but also in improving their overall development, compared to the control sample. More recent research has shown the positive effects of the programme on improving the self-esteem of mothers involved in the programme, compared to control mothers.

Other evidence has continued to confirm the success of this programme, not only in achieving very high levels of immunisation and improved nutrition - notoriously problematical issues in more disadvantaged areas - but also in reducing the levels of both child abuse and cot deaths, compared to the levels in the surrounding community where the programme has not been introduced.

One of the most significant field studies undertaken within the Child Development Programme followed 31,000 children whose parents had taken part in this programme12 in 24 different health authorities. Information was obtained on the subsequent progress of these children over periods of one to several years since the programme had ended. The number and proportion of these children who were physically abused or who were placed on the CPR was recorded and those proportions were compared with the levels of physical abuse and CPR placement of the entire young child population in each of the surrounding 24 health authorities.

Given that the areas chosen for the programme were always selected from the most socially stressed and disadvantaged in each authority, it could have been assumed that the programme children’s levels would have been higher. In fact the levels of physical abuse were 50% lower and placement on the CPR was reduced by 40% in the programme children, compared with the figures for all young children in those authorities.

Training community workers to work with abusing parents?

Given the strength of feeling about child abuse, it may seem that any community would reject totally the idea that it should agree to become involved with tackling child abuse in its midst, other than to notify the agencies concerned when situations of abuse arise.

Yet, at root, child abuse is a problem not only of the wider society but also of the community within which it occurs. The more that a community can come to understand the nature of this problem and help to deal with it, the more likely it is that the present social 'epidemic' of abuse can be contained and ultimately reduced.

Abuse is so much a part of the social fabric of families within their wider community that it is unlikely it can ever be dealt with effectively outside of that community fabric.

Society's present approach to abuse is to employ professionals from a highly educated and usually more privileged stratum of society, to deal with this disturbing problem. However well-intentioned, an outside body and outside agents cannot offer a long-term resolution to a community problem as serious as that of abuse; but nor can a community itself succeed in resolving that problem on its own. It is only when a community is willing to take on the awesome responsibility of starting to deal with the situation, backed up by empathetic professional support and guidance, that a long-term resolution or at least a lessening of the abuse problem is likely to occur.

This is a much wider version of the concept of empowerment, but it is equally relevant to the concept of empowering individuals and families. Child abuse is a social ill in the body politic; it is not usually brought in from outside but rather arises mainly from cultural 'life styles' and assumptions about child-rearing within the community itself. Given the right level of understanding, and backed by training and support from experienced social workers and others with professional insights into this problem, salaried workers selected from these communities and given the needed training might in time be able to do a more successful job in working with the troubled parents than could most professionals, because the latter will always be seen as outsiders, however well-meaning and however skilled.

Aiming at family and community regeneration?

It is in this light that a family regeneration programme, modeled on the empowerment ethos and using many of the principles and strategies of the Child Development Programmes, could some day be set up to tackle this challenge at the community level. It would be a daunting task, dealing with parents who have, for whatever reasons, come to rely on the abuse of power. To help such parents learn to cope sensitively with their children, while also learning a new and deeper sense of the meaning and limits of power, would be particularly difficult. The salaried workers for such programmes would need to be carefully chosen from the communities where the home visiting was to be done.

Understandably, such community empowerment would need careful monitoring to avoid breaches of confidentiality, kangaroo court judgments and the persecution of abusing families. It would also need a certain toughness of approach to avoid its becoming a soft and ineffective alternative to more conventional approaches, which in most cases are found to have very limited results.

Other programmes which focus on working with abusing parents usually try to help them recognise and come to terms with what they have done, persuading them to re-examine their own childhood and showing them how to cope with their children in a non-abusing way. Encouraging such self-examination is a direct and upfront approach, but not necessarily the best means of bringing about the resolution of a problem that is so intricately involved with power relationships and cultural assumptions about child-rearing.

The approach of the suggested family regeneration programme would be rather different. Given that low self-esteem plays such a large part in the aetiology of abuse, the main focus of the programme would be on encouraging such parents to contribute to working out their own solutions - with the support and encouragement of the specially trained workers who would be visiting regularly, but not so frequently that the visits become counter-productive.

Finding ways to cope with own impatience, anger and violence?

Many of the principles and practices of such a programme would mirror and be built upon those of the Child Development Programme. The parents would be praised for any small successes in achieving basic developmental tasks with their children, and receive particular praise if they can find ways to curb their own impatience, anger and violence when their children do not conform to what the parents expect. In doing so they would not only be learning how to cope better and more tolerantly with their children, but would also gain steadily in self-esteem because the successes (and often the ideas too) would come mainly from themselves.

It would be a genuine family regeneration in which the parent(s) would be the main builders, although the role and insights of the regeneration worker would be even more profound and require great integrity, because she would have to work on the basis that if the parents proved incapable of moving forward in any meaningful and long-term way, it could be her responsibility (and not that of a committee) to decide when to end that family’s involvement in the programme and arrange for social services to take care and control of the children away from the parents.

For the majority of the previously abusing parents the new found structure of growing self-confidence and coping with most of their child's behaviours would be a fragile edifice in the early months of programme visiting. It would need constant reinforcement, with successes counteracting the failures that would also occur at times. The profound awareness, support and encouragement of an empathetic and mature regeneration worker would be central to this approach, together with the other strategies which form part of that programme, such as presenting and discussing informal illustrated information leaflets, the structuring of the visits and the parent(s) deciding on each visit on her (or his) own behavioural change targets for the period before the next visit.

Inevitably there would be failures with such an approach. For some parents the level of self-esteem is so poor, the inhibitions against violence or sexual exploitation so minimal, and the frustration or temptation of the situations they face so great, that they cannot control their impulses to violence or other abuse of the child. Indeed a very small minority of parents have personalities that are so disturbed that their children need to be removed, perhaps permanently.

There is not the space to go into detail as to how such a programme could operate. The social workers who would become trainers for this programme would need to learn and apply the programme strategies and philosophy which they would impart to the regeneration workers. The choice of the community workers - women, or occasionally men to work with some of the abusing fathers - would be critical; they would in most cases be people who have reared their own children with reasonable success, and who are strong internally but preferably not dominant community leaders; the latter might find it difficult to empower others who have little or no self-esteem.

The need for legal and other constraints, to ensure confidentiality and integrity in such a programme, will inevitably (and rightly) be required as they are today for anyone involved in sensitive work with families. Experience over many years with other community-based home visiting programmes has not shown serious breaches of confidentiality nor any of the other dangers which it was thought might arise from using women from the same community as those they were visiting. Instead these other programmes have had a considerable effect in cementing communities together, in situations where there is normally widespread mistrust of others within the same community.

Whatever the challenges of this kind of family regeneration programme, carrying out a programme of supportive home visits to families with children already on the CPR (or where there is a likelihood of such placement), will be moving into uncharted waters. The strongest arguments for trying it out are that existing methods of dealing with abuse have had only limited success and are moreover extremely costly. The fact that extremely firm methods of dealing with abuse can in many cases reduce or prevent further abuse, does not mean that the quality of child-rearing is necessarily any more caring and constructive.

The idea of putting much of the onus for dealing with the problems of child maltreatment back into the hands of the community, by employing women from the same community to provide family support and encourage self-regeneration, may be the best alternative waiting to be attempted.

Conclusions

This paper has endeavoured to show an awareness of the enormous difficulty of preventing child abuse, either before it has arisen or once it has occurred. There is still only limited understanding of why abuse occurs, and little or no certainty about any of the methods used to contain or deal with it when it has arisen.

Given that the professional solutions have been only marginally successful, perhaps we should return the problem to the communities within which most abuse arises, whatever their level of disadvantage or advantage - and see whether the talents, street wisdom and insights of selected and specially trained people from the same communities can be utilised in combination with the insights and skills of professionals working in the area of child protection.

Empowerment is a challenging concept. It threatens a secure world of hierarchy and order. It suggests that ordinary people have within themselves the resources and depth to deal with some of society's most agonising human problems. Beyond that, it suggests that ultimately communities will have to be given the responsibility and resources for dealing humanely with their own social ills, and in doing so will grow to be stronger and more confident.

This will not be done in isolation. As communities become more confident they will learn that there is much support and many insights they can gain from others, particularly from professionals who have great knowledge on particular issues. But it will be the communities who will ask for that support and make good use of it. Such support cannot be imposed.

Walter Barker, B.Sc., M.A., Ph.D.

Director, Parent and Child Empowerment Organisation

(formerly the Early Child Developoment Centre)

Acknowledgement.   This paper is an updated version of a talk given at a seminar held in Leeds in 1990 to discuss the challenge of dealing effectively with child abuse. At that time the research division of the National Society for the Prevention of Cruelty to Children (NSPCC) kindly assisted by providing much of the factual information on the extent of abuse in society. Recent statistics, for the years 2006/2007, have been drawn from the NSPCC’s website, www.nspcc.org.uk .

References

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2. Creighton, Susan (2002)   Physical abuse    NSPCC Website   www.nspcc.org.uk>

3. Sidebotham, P. et al (2002)   Child maltreatment in the “Children of the Nineties”: deprivation, class and social networks in a UK sample    Child Abuse and Neglect 26   12 1243-1259>

4. Yule, V. (1985)   Why are parents tough on children?    New Society   27 September 444-446

5. Court, J. (1970)   Psycho-social factors in child battering    Journal of the Medical Women's Federation 52   99-104>

6. Stratton, P. and Swaffer, R. (1988)   Maternal causal beliefs for abused and handicapped children    Journal of Reproductive and Infant Psychology 6    201-216>

7. Burgess, R.L. and Garbarino, J. (1983)        Doing what comes naturally? An evolutionary perspective on child abuse. IN Finkelhor, D., Gelles, R.J., Hotaling, G.T. and Straus, M.A. The dark side of families: current family violence research  London: Sage

8. Browne, K. (1989)   The health visitor's role in screening for child abuse    Health Visitor 62  September 275-277

9. Barker, W. (1990)   Practical and ethical doubts about screening for child abuse    Health Visitor 63  January 14-17

10. Lines, D. (1987) nbsp; The effectiveness of parent aides in the tertiary prevention of child abuse in South Australia    Child Abuse and Neglect 11   507-512

11. Barker, W. and Anderson, R. (1988)   The Child Development Programme: an evaluation of process and outcomes Early Childhood Development Centre Bristol

12. Barker, W., Anderson, R. and Chalmers, C. (1992)   Child protection: the impact of the Child Development Programme Early Childhood Development Centre Bristol

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