Early Interventions with Abusive Families
Interventions with abusive families should begin as soon as abuse is known and be compassionate in nature. This is because of the profound effects of early abuse on children. Serious effects like brain damage are more common than most of us would like to know, and even neglect alone has been correlated with significantly reduced IQ scores. Gross physical differences in height and weight have been observed between abused children and normal comparisons (Kent, 1976). Other effects on cognitive social information processing biases and psychological sequelae are likely to start at a very young age.
An important locus of intervention is the emerging violent parent. Cognitive behavioral therapies are the favored approach today for violent persons. These therapies have helped reduce recidivism, violent behavior, domestic violence, and have also proven to be cost effective (e.g., Kettlewell & Kausch, 1983; Lipsey & Wilson, 1993; Robertson, Grimes, & Rogers, 2001). Bennett et al. (2005) highlight the fact that, in a review of rehabilitation programs for offenders, three-quarters of successful rehabilitation programs included a cognitive skills training component, while none of the unsuccessful ones had done so.
In child abuse cases, most practitioners agree that the whole family system should be involved. Farrington and Welsh (2007) deem an early intervention program combining child social skills training and parent training (employed in the Montreal Longitudinal-Experimental Study) to be “one of the most successful” of this type of program (p. 114). In this intervention, the children received training in social skills and self-control using coaching, modeling, role playing and reinforcement. The parents received parent management training, which taught them to provide positive reinforcement for desirable behavior, consistent but nonpunitive discipline for bad behavior, as well as “crisis management” techniques. The “incredible years” parent training program, which has had a beneficial impact on harsh discipline and physical punishment (Letarte, Normandeau, & Allard, 2010). Multisystemic Therapy (MST) is also favored in the “evidence-based” literature. (We will discuss MST in more detail below.)
One of the fortunate things about a mandatory educational system for children is that school agents can witness possible abuse and report it. This provides opportunities for early intervention. School programs can be used to teach children to identify their own victimization and to provide services to help children cope with exposed to abuse or trauma (e.g., Coleman, 1996). There are tremendous disincentives for teachers to report suspected abuse because of the perceived punitive nature of the system, the hassles, and the stress involved in the process. Thus, more regular “check-ins” with high-risk families from a friendly support worker are likely to work better than waiting for evidence of abuse in the form of broken bones, burns, and bruises.