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Sunday, June 2, 2013

Do interventions reduce recidivism in child protection?

The idea of writing about the impact of therapy in child protection cases seems somewhat mundane. However, a recently published study by Soloman and Asberg (2012) looked at the issues of child protection interventions and recidivism, or the revolving door. The reality is that there is not a significant research base on this topic. Thus, the contributions from these authors is welcome.



There were a couple of areas that particularly struck me. Past research tells us that isolation is a risk factor in child protection cases. These authors tells us that the creation of social support networks can help to reduce recidivism. Giving parents therapy to help them address such things as mental health, emotional issues, trauma and substance abuse also helps to reduce recidivism. While this might make intuitive sense, it is nice that research is quantifying the impact.

A major finding is seen on p. 2316:

Overall, findings suggest that cases with at least one minority caregiver and cases in which caregiver(s) have received therapy are less likely to involve abuse or neglect recidivism, while cases in which children were temporarily taken from their caregivers' custody
are nearly nine times more likely to involve abuse or neglect recidivism. Although some studies found that neglect cases have higher recidivism rates (e.g., Hindley et al., 2006), this association was not found in the current study.

While this study has a skewed sample, it does tell us that some of the assumptions that have been held as true, may not be universally so. There may be sub samples where the assumptions prove untrue, as the above quote suggests

The point here is that each case must be considered on its own merits. It also tells us that each case should have a unique case management plan that reflects what might be done to assist families. This study does affirm that therapy is a worthwhile endeavour. The reason might well be that it helps parents deal with stress which is strongly related to the frequency of abuse. Parents who are unable to manage stress that pushes them towards their coping limits are more prone to abuse. This includes rates of neglect. Therapy can increase the coping skills which then reduces risk.  Consider what the authors states on p. 2312:

It has been found that 30% of investigated child maltreatment cases involve at least one
instance of recidivism within 3 years from the original index event (Connell et al., 2009), and these rates of re-referral to CPS seem to continue to climb as more time passes, with life-time re-referral rates upward of 40% (Connell et al., 2007; Drake, Jonson-Reid, Way,
& Chung, 2003) or 50% (English, Marshall, Brummel, &; Orme, 1999).
If therapy can reduce these recidivistic patterns, it is worth continuing to try. Children who are subject to repeated apprehensions and placement into foster care do worse. Can therapy help, this study suggests possibly so.


Reference

Soloman, D. & Asberg, K. (2012). Effectiveness of child protective services interventions as indicated by rates of recidivism. Children and Youth Services Review, 34, 2311-2318 http://dx.doi.org/10.1016/j.childyouth.2012.08.014







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