Psychoeducational Strategies for Addressing Child Abuse Risk

PSYCHOEDUCATIONAL INTERVENTION Andrea J. Kennedy PNC-360 Christin Emberlin

THE DEFINITION CHILD ABUSE AND NEGLECT • Having numerous kinds of neglect and abuse the signs might differ depending on the kid. How Child Welfare Information Gateway having a sheet that is supposed to aid them (U.S. Department of Health and Human Services, n.d.). • The definition of Neglect and child abuse means that parents and individuals that are their caregivers. A kid is considered to under the age of 18 or not being emancipated kid (U.S. Department of Health and Human Services, n.d.). • With every failure to act or every new act of a parents or custodian and their position that may be sexual exploitation or sexual abuse significant physical or emotional injury, ending in death failure to act or an act that exhibits impending danger that cause grave injury (U.S. Department of Health and Human Services, n.d.).

STATE LAW DEFINITIONS OF CHILD ABUSE AND NEGLECT • With the Federal legislation setting the minimum ethics for those states who accepting funds from the Federal legislation. On the federal level, they leave it for each state to define the laws for child maltreatment. To find the states definitions on child neglect and abuse they are in two positions in the states statutory code (Child Welfare Information Gateway, n.d). • Numerous states have acknowledged four major kinds that are consider maltreatment, they define them as emotional neglect or abuse, physical, sexual abuse, and neglect (Child Welfare Information Gateway, n.d). • Criminal statutes: outlining the forms that are considered child maltreatment may be specialty to the criminal, they will get arrested and arraigned in the court (Child Welfare Information Gateway, n.d). • Civil statutes: outlining the definition of what the child maltreatment is, is executive individuals that are authorized to be able to be recognized and they report what they believe to be child abuse, while conclude the foundations for intervention from the States child protection agencies (CPS) and the courts. To find each states detentions go to State Statues Search through the info Gateway website (Child Welfare Information Gateway, n.d).

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CHILD RISK FACTORS: Necessity for Continuous Care- babies and little kids Mental Health, Emotional Health Physical Health Size Age Early Development Status Social Development (CASA, 2023). This Photo by Unknown Author is licensed under CC BY

SINGLE AND GROUP Teen Parents: Studies have shown that physical abuse states that there are greater for child abuse when the parents are younger (CASA, 2023). Individual Characteristics: The risk factors involve a history of trauma, mental health matters, and adverse reaction to stress (CASA, 2023). Substance Abuse: It has been found that about two-thirds of cases of child maltreatment include a level of substance abuse (CASA, 2023). Additional factor may include levels of high stress, lower socioeconomic status, and absence of social assistance (CASA, 2023). PARENT OR CAREGIVER RISK FACTORS

C OMM U NI T Y AN D E N V I R O NM E N TAL RI S K FA C T OR S Poverty, social isolation, substance abuse, and depression (CASA, 2023). Community circumstances and violence, personalities of the kids, their family, and their parents (CASA, 2023). Community circumstances, social mindsets, low socioeconomic status, and violence within the area the kids live in, and this puts the kids in more danger (CASA, 2023). With child abuse not seeing a child’s insufficient parenting abilities, race, isolation of family, gender, family stress or crisis, ethnic group, unemployment, economic or social status, age group, mental illness or physical, and history of neglect or abuse (CASA, 2023). Kids that are abused may show signs of bewilderment, guilt, and disgrace. If the abuse is caused by family friend, parents, and family member. They may be scared to tell anyone due to the relationship to their abuser. Being aware for the red flags is vital to keeping the kids safe (CASA, 2023).

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CONTROL AND INTIMIDATING CHILDREN • Taunting or cat and mouse games: Putting strict or impractical expectations on the kids that are complemented by stark intimidations if the child fails to finish the tasks (Keep Your Child safe.org, 2023) • Occupying a kid’s body space whilst discipling or talking to them, grabbing their chin while yelling in their face (Keep Your Child safe.org, 2023). • Intentionally Scaring the kids: using the kids specific phobias/fears by means of control or indirect threat. Making statement that are meant to scare the kids (Keep Your Child safe.org, 2023).. • Swaggering and self-importance, they generate the same result, by entering the kids body space, whilst the parent pillars over the kid, this is a threating body langue (Keep Your Child safe.org, 2023). • Threatening: Threating the kids by using bodily harm, threaten to destroy something the kid loves like a favorite toy, kill a pet, threat suicide, threaten to hurt the other parent, and hurting siblings (Keep Your Child safe.org, 2023). • Exhibitions of anger: kicking stuff, screaming, throwing articles throughout the room, shrieking, and punching walls (Keep Your Child safe.org, 2023).

HOW SUBSTANCE ABUSE AFFECTS CHILD ABUSE Parents that have substance abuse issues have a foremost influence on their kid’s welfare. It is said that every one in eight kids within the U.S. are living in a home with at least one parent abuses substances. The kids that have parents with substance abuse will go through trauma, they go through strains with learning and concertation, have issues regulatory physical and emotional reactions to stress and have issues trusting connections (Kaliszewski, M. 2022). It has been stated that kids who grew up with parents with substance abuse issues may grow up to abuse substance as well, and if they were abused as kids, they may turn to substance to help them cope in life (Kaliszewski, M. 2022)Those who are using substance find it difficult to properly function as a parent, as they have physical and mental impairment due to their substance abuse. They find it difficult to be able to control their anger, emotions, and they are impulsivity, spending money on their substances and not the household necessities, spending time away from the kids due to incarceration, or time away for looking for substance, or even making the substance, here are some risk factors of child abuse due to substance abuse:  Neglect  Physical  Emotional  Sexual (Kaliszewski, M. 2022)

SIGNS & SYMPTOMS OF ABUSE/NEGLECT Behavioral clues: • excessively obedient, particularly with problematic or tender parts of the exam (Stanford Medicine, 2023 • babies excessive crying or developmental delay • depression, inactiveness • social withdrawal • signs of PTSD • nightmares, sleeping problems • substance abuse • poor attentiveness/distractibility • reverting behavior for age • extraction to touch, frightened of exam • habitual school absence • fear, anxiety, clinging • sexualized behavior • amplified verbal abuse or physically violent conduct with others • phobias • evading of unclothing • appears scared of parent • bed wetting • eating problems • hyperactivity • self-harm such as cutting • language disorders • destroys or hurts items

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SIGNS & SYMPTOMS OF ABUSE/NEGLECT CONTINUED Symptom clues: • vomiting, touchiness or irregular breathing might signify head trauma (Stanford Medicine, 2023) • headaches • unwillingness to use an extremity • unclear somatic complaints, frequently chronic • unsolved symptoms - look for poisoning, forced ingestion of water, salt (Munchausen by proxy) • severe – blunt trauma might not display exterior marks – look for distention, soreness, inattentive bowel noises • recurrent, baffling sore throat • genital discomfort or painful urination or defecation • unclear somatic complaints, frequently chronic • trouble walking or sitting • abdominal pain, chronic • abnormal weight gain or loss • deteriorating medical issues, such as asthma

SIGNS & SYMPTOMS OF ABUSE/NEGLECT CONTINUED Physical clues (most common manifestations of abuse are found from skin, bone, or CNS): • diagnosed STD or pregnancy (Stanford Medicine, 2023). • lack of care of medical needs; wound care, medication • facial injuries without good explanation • bites - human bites are more superficial than animal, and show up better 2-3 days later • intra-abdominal trauma, usually to multiple organs • signs of restraints on axilla or extremities • bruising, tearing, bleeding, discharge from genital or rectal area • failure to flourish, poor weight gain, malnutrition • burns – (in 6-20% of abused children) cigarette, rope, immersion, or shape of hot object • immersion burns have sharp line of demarcation without drip or splash marks • is the severity of the burn consistent with length of contact by history? • stun gun burns occur in pairs, 0.5cm diameter and 5cm apart • cigarette burns circular, 8-10mm deep, heaped margin - may be confused with impetigo or moxibustion • poor hygiene • subdural hematoma • clothed inappropriately for weather • head injury, mental status change • trauma to ear • Lacerations • fractures • Dislocations • traumatic hair loss • bruising • retinal hemorrhage • defensive injuries on forearms • oral/dental injuries, such as torn or bruised frenulum, lips, teeth, palate, tongue or oral mucosa • oral injuries/STDs from forced oral sex • injuries from non-ambulatory child may be "bottle jamming" • scarring/bruising at corners of mouth from being gagged • lacerations or tissue damage to oral structures may come from eating utensils, scalding or caustic liquids

CHARACTERISTIC S OF A PERPETRATOR: With socialization factors that involve a history of childhood abuse and demographics. What the biological that influences that relate to abusive behavior being, physical issues, neuropsychological and neurological characteristics, physiological reactivity (Milner, J.S. & Chilamukurti, C., 1991) How the behavioral personalities of a perpetrators include abuse of substances, parental punishment approaches, parent- child connections, and social isolation (Milner, J.S. & Chilamukurti, C., 1991). There are seven affective and cognitive aspects: depression, other character issues, self-esteem, suffering and strain in life, ego- strength, assessments of child conduct, awareness, anticipations of child conduct, position of control, and attributions ( Milner, J.S. & Chilamukurti, C., 1991) This Photo by Unknown Author is licensed under CC BY

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ASSESSMENT Screening Children It is vital to look at the complete picture from many bases and not just one. It is vital to interview parent and kids together, but keep in mind if there is thought of abuse ask the parent to talk to the kids alone. If the parent says no, then it is a good sign of child abuse (Stanford Medicine, 2023) • Asking parents  As parents to the feel that their kids are safe at their babysitters, school, or daycare  Have the observed, or has their kids had any concerning compiling, have they noticed any new physical indications recently  Are their kids recently acting differently that may be worrying them (Stanford Medicine, 2023). Pre-verbal/pre-school children Take notice of any symptoms and signs, pay aition to how the kids are acting while they are playing, and what they are drawing. While they play are they do they physically harm the materials, toys like dolls, do they take the toys like action figures and have them hurt one another, do they have the dolls act sexually, how do the parents and kids act with each other (Stanford Medicine, 2023). et mad  Does anyone scare them (Stanford Medicine, 2023).

ASSESSMENT CONTINUED Verbal children - asking questions Do your best not to do any leading when questioning, if sexual abuse is suspected, leave that line of questing for the professionals when they interview. Focuses on general conversations, having the child discloses spontaneously, pay attention to changes in kids voice, eye contact, breathing patterns, changing the topic when they are telling them about individual and circumstances. Make certain to limit the questions to just the essential for sensible thought on creating the report, so the kids are not going through extensive interviews (Stanford Medicine, 2023).  Anybody touched them in any way they did not like  Assessing if neglect, have the kid tell you about a normal day, like what they eat, who id cooking the food, or where they get it at, when they play were is it at, who is coming and going and the times, do they have water electricity and everything they may need  Do individual ever hit them, who is getting hit, what do they use to hit with, how much does it happen, does it scare them  What occurs at what time they do something their parents do not like  What goes on during bath time  Do they hurt anywhere on their body  Do they have a bed room, is that where they sleep, if not where do they sleep\  What goes on at school, daycare, babysitters, and home when individual g Verbal children – discussing domestic abuse Kids might have a assortment of replies concerning domestic abuse, like terror, remorse, rage, sorrow, and powerlessness. If they use pretend to getaway, talk to toys, hide, become restless, watchful, and much more (Stanford Medicine, 2023).  Know that you are not responsible to solve the issues, do not say to the kids that you are going to work with their parents and make all better  What do they concern about the fighting at the house  Saying you are concerned with the safety at the house, and let them know you are happy they told you about it  Let the kids know it is not their job to prevent the fighting in the house, ask if they have a safe place to go, do they know how to call 911 for aid, as long as it is age apposite  What do they do when there is fighting going on  Let the kids know that it is not their fault to what is happing in the house (Stanford Medicine, 2023).

TREATMENT INTERVENTIONS AND RESOURCES COULD HELP A FAMILY WITH THIS TYPE OF ABUSE? Being able to recognize neglect and abuse, it may be challenging. It requires to be cautious while assessments of what might be going on, involving examining for behavioral and physical indications (National Research Council, 1993). When it is possible, talking with the kids Issues that might be deliberated in when deciding child abuse may involve Getting data that concerns the medical and developing history of the kids Teaching the kids to learn how to have healthy relationships and having conduct Witnessing communication s amongst the kids, parents, and caregivers Physical examination that involves assessing what injuries that may be, and indications of assumed neglect and abuse Deliberations with the caregivers and parents Teaching the kids improvement of self-confidence and to learn conflict management Aiding the kids that have been abused to learn how to trust others Tests that consist of X- rays, lab test, ultra sounds and any type of test that may be needed (National Research Council, 1993).

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CLIENT'S TREATMENT PL AN Practicing self-care: Additional significant thing to recall while aiding a victim is in an abusive relationship that one needs to take care of oneself. What the emotional toll that comes with assisting a victim may be extremely demanding Keep in mind that it is alright to take a step back, and center on your own requirements, keep in mind that you cannot force somebody leave the abusive relationship. Keep in mind that you may need to have your own outlet and talk to someone as well when you need too (Strachan, Marilyn et alt., 1993). Getting educated on abusive associations is tremendously complicated, that it normally has numerous methods of abuse that is going on inside of them. Being able to learn about the dissimilar kinds of abuse and what the caution signs for all of them as well as the crescendos of the control and power, that can aid you to understand what a victim of abuse is going through. Likewise aiding the victim to feel safe, feel understood, while they are talking about their connection (Strachan, Marilyn et alt., 1993). Being patient, it is hard enough to leave a relationship that is not abusive, it is even harder to leave an abusive one. It might take a long time to get the power, to acquire a secure plan, and have the essential assistance in place of leaving. It might be a extremely lingering extremely frightening method for somebody that has been intimidated and has made to feel insignificant. Keep in mind that foe some to be able to have the power to even talk about their abusive association is a big move (Strachan, Marilyn et alt., 1993). Try and think about how the victim is an expert, it does not matter how much you may know about what the victims is going through, they ultimately understand what is conceivable and what their abuser is proficient of doing. Challenges, pressure for them to leave even trying to influence them to do approximately that they are not prepared to do, by trying to do this it may make it worse and additional unsafe and drive them away. While speaking about their association ask about, what makes them feel secure, what kind of assistance do they requisite, having them let you know what they are able to do, and what is required at the minute (Strachan, Marilyn et alt., 1993). A safety plan is vital, for and individual can have with aiding a victim. With the safety plan being tailored foe every victim while concentrating on safety though assisting them in avoiding unsafe circumstances and devising a response plan if the condition intensifies. When making a safety plan, it is vital to have the victim’s contribution. Working with them to have the escape plan, generating a list of who musts to be called once they leave, recognize what the safe places are if it intensifies. The safety plan musts to be unassuming, simple for the victim to recall when in a emergency (Strachan, Marilyn et alt., 1993).

REFERENCE CASA Court Appointed Special Advocates for Children, (2023). Risk Factors for Child Abuse and Neglect. https://casaspeaks4kids.com/risk-factors-child-abuse-neglect/#:~:text=Child%20abuse%20isn%27t%20limited,isolation%2C%20and% 20inadequate%20parenting%20skills Child Welfare Information Gateway, (n.d). Definitions of Child Abuse and Neglect. https://www.childwelfare.gov/topics/can/defining/ Kaliszewski, Michael, (2022, September 9). The Link Between Child Abuse and Substance Abuse. American Addiction Centers. https://americanaddictioncenters.org/blog/the-link-between-child-abuse-and-substance-abuse Keep Your Child Safe.Org, (2023). Intimidating Children. https://keepyourchildsafe.org/child-abuse/verbal-abuse/intimidation/ Milner, J.S. & Chilamukurti, C. (1991 September). Physical Child Abuse Perpetrator Characteristics: A Review of the Literature U.S. Department of Justice Programs. Journal of Interpersonal Violence Volume: 6 Issue:3. https://www.ojp.gov/ncjrs/virtual-library/abstracts/physical-child-abuse-perpetrator-characteristics-review-literature National Research Council. 1993. Understanding Child Abuse and Neglect. Washington, DC: The National Academies Press. :"7 NTERVENTIONS AND TREATMENT." doi: 10.17226/2117. National Academies of Sciences, Engineering, and Medicine. 1993. Understanding Child Abuse and Neglect. Washington, DC: The National Academies Press. https://doi.org/10.17226/2117 . Stanford Medicine, (2023). Child Abuse. Screening Children. https://childabuse.stanford.edu/screening/children.html Stanford Medicine, (2023). Signs & Symptoms of Abuse/Neglect. https://childabuse.stanford.edu/screening/signs.html Strachan, Marilyn, Anthony, Peterson, & Urquiza J., (1993).. The Role of Mental Health Professionals in the Prevention and Treatment of Child Abuse and Neglect. https://www.childwelfare.gov/pubPDFs/mentlhlth.pdf U.S. Department of Health and Human Services, (n.d). What is Child Abuse or Neglect? What is the Definition of Child Abuse and Neglect? https://www.hhs.gov/answers/programs-for-families-and-children/what-is-child-abuse/index.html#:~:text=Child%20Abuse%20and%20 Neglect%20Definition&text=%22Any%20recent%20act%20or%20failure,imminent%20risk%20of%20serious%20harm.%22 This Photo by Unknown Author is licensed under CC BY-S

Psychoeducational Intervention

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