Commentary: Umbrella synthesis of meta‐analyses on child maltreatment antecedents and interventions – a commentary on van IJzendoorn and colleagues (2020)

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154443/1/jcpp13175_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154443/2/jcpp13175.pd

Direct and Indirect Effects of Child Abuse and Environmental Stress: A Lifecourse Perspective on Adversity and Depressive Symptoms

There is a great deal of evidence about the mental health implications of physical child abuse and environmental stressors, or hardships that people experience at the household and neighborhood level (e.g., neighborhood violence; economic hardship, substance abuse, or conflict among family members). Yet, studies often focus on either abuse or environmental stress, not both, or examine abuse and environmental stressors as a combined set of experiences. Less is known, therefore, about how child abuse and environmental stress might work as either distinct or interrelated risks to diminish mental health over time. In this longitudinal study, we used path analyses to examine the cumulative effects of physical child abuse and environmental stressors on adult depressive symptoms among a sample of children followed into adulthood (N = 356). The goal was to assess whether chronic physical child abuse remains an independent predictor of adult outcomes once we accounted for the cumulative effects of household and neighborhood stressors across the lifecourse. Cumulative measures of physical child abuse and environmental stress each independently predicted a higher likelihood of adult depressive symptoms (ß = .122, p \u3c .01 and ß = .283, p \u3c .001, respectively). After accounting for adolescent depressive symptoms, only cumulative environmental stressors independently predicted depressive symptoms (ß = .202, p \u3c .001). Tests of the indirect effect of cumulative environmental stress on the relationship between cumulative physical abuse and adult depressive symptoms were marginally statistically significant. Results add to literature that examines child abuse, adversity, and lifecourse perspectives on health. (PsycINFO Database Record (c) 2018 APA, all rights reserved

Direct and Indirect Effects of Child Abuse and Environmental Stress: A Lifecourse Perspective on Adversity and Depressive Symptoms

There is a great deal of evidence about the mental health implications of physical child abuse and environmental stressors, or hardships that people experience at the household and neighborhood level (e.g., neighborhood violence; economic hardship, substance abuse, or conflict among family members). Yet, studies often focus on either abuse or environmental stress, not both, or examine abuse and environmental stressors as a combined set of experiences. Less is known, therefore, about how child abuse and environmental stress might work as either distinct or interrelated risks to diminish mental health over time. In this longitudinal study, we used path analyses to examine the cumulative effects of physical child abuse and environmental stressors on adult depressive symptoms among a sample of children followed into adulthood (N = 356). The goal was to assess whether chronic physical child abuse remains an independent predictor of adult outcomes once we accounted for the cumulative effects of household and neighborhood stressors across the lifecourse. Cumulative measures of physical child abuse and environmental stress each independently predicted a higher likelihood of adult depressive symptoms (ß = .122, p \u3c .01 and ß = .283, p \u3c .001, respectively). After accounting for adolescent depressive symptoms, only cumulative environmental stressors independently predicted depressive symptoms (ß = .202, p \u3c .001). Tests of the indirect effect of cumulative environmental stress on the relationship between cumulative physical abuse and adult depressive symptoms were marginally statistically significant. Results add to literature that examines child abuse, adversity, and lifecourse perspectives on health. (PsycINFO Database Record (c) 2018 APA, all rights reserved

Trauma‐Informed Programs Based in Schools: Linking Concepts to Practices and Assessing the Evidence

When children experience stress and adversity in their homes and communities, schools become a critically important setting in which to intervene and foster their resilience. Changing practices within schools so that vulnerable and traumatized children are better understood and more compassionately served is a goal shared by many school professionals, yet schools remain poorly equipped to address the needs of these children. Any number of school‐based programs have the potential to benefit children with an elevated risk for academic difficulties and mental health disorders, although questions remain as to which programs are most promising, effective, and sustainable. Questions also remain about which programs best serve diverse populations and which have potential to reach the largest number of children, including those who do not outwardly manifest behaviors consistent with an underlying disorder but nonetheless require support. In this review, we take stock of existing programs used in schools to address the social, emotional, and academic needs of children with trauma histories. We summarize components of a various trauma‐focused programs, categorized as: (a) individual and group‐based approaches, (b) classroom‐based approaches, and (c) school‐wide approaches. For each category, we review and comment on the state and quality of research findings and provide illustrative examples from the literature to show how programs address trauma in the school context. Findings of the review suggest that empirical evidence currently favors individual and group‐based approaches, although classroom‐based and school‐wide programs may be better positioned for integration, access to services, and sustainability. Implications and recommendations center on future research, practice, and policy.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153239/1/ajcp12362_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153239/2/ajcp12362.pd

Applied and Translational Research on Trauma‐Responsive Programs and Policy: Introduction to a Special Issue of the American Journal of Community Psychology

The special issue highlights work across systems that include child welfare, education, juvenile justice and health, as well as agencies serving adults who are at‐risk for high levels of childhood and adult trauma exposure. While articles appearing in the special issue are not divided equally across these systems, they cover important and overlapping concepts within each. Some articles span more than a single system or domain of research, whereas others fit primarily within single area or domain. Articles provide new insights from research on practices, programs, and policies that help to transform systems so they are increasingly more responsive to the needs of vulnerable populations.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152826/1/ajcp12402.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/152826/2/ajcp12402_am.pd

Reconstructing the workforce within public health protective systems : Improving resilience, retention, service responsiveness and outcomes

Background Unacceptably high staff turnover has plagued traditional approaches to child protection, seemingly forever. Around the globe, numerous studies, reports and inquiries have highlighted how statutory agencies, focusing on risk-oriented investigations of suspected maltreatment, experience significant issues with worker stress and its occupational and organisational consequences. Yet, promoting staff resilience within child protection agencies’ workforces has proved to be quite elusive at a systems level. While concern about child protection services often centers on the children and families agencies they intend to assist, the experiences of workers within the system provide further evidence that the system is itself failing. As a result, governments around the world are increasingly embracing system reforms that promote public health approaches focusing on early intervention and prevention to build child, family and neighbourhood support capacity and resilience and thereby reduce child maltreatment. Objective We review the workforce issues affecting traditional child protection approaches and its impacts. In light of this, we examine the knowledge to be applied in the development of public health approaches that embrace integrated and coordinated systems of community care. Such reforms, with altered organisational remits that are far broader than narrow tertiary responses of investigation and removal, utilize evidence-based interventions targeted at differentiated risk and service user needs to provide effective supports and reduce maltreatment. This article unpacks the strategies needed to build and properly prepare a re-tooled workforce capable of implementing a public health model of preventive interventions. Participants and setting Not applicable. Methods Current public health reforms are examined through the lens of their potential impacts upon contemporary workforce issues. Focusing upon building a stable, resilient and appropriately skilled workforce for a public health model, we examine the implications for key stakeholders including workers, program and organisational leaders, educators, researchers, academics and community members, especially children and vulnerable families. Results and conclusions Public health approaches to protecting children seek to provide effective supports and services in timely ways in order to prevent unnecessary statutory interventions, which affect those from cultural and poor communities disproportionately. But remodelling systems to embrace these approaches entails complex practice, program, policy and legislative changes, using evidence to intervene in ways that are primarily voluntary rather than coercive. In doing so they provide potential to recast the basis of the helping relationship to attend better to the relational aspects of changed behaviour. Embedding workforce resilience strategies in reformed systems is necessary to address retention and ensure service effectiveness and responsiveness to the diversity of needs of struggling families and impoverished communities. Thereby, public health approaches are well placed to achieve their true potential

Re-Visioning Public Health Approaches for Protecting Children

This volume provides readers around the globe with a focused and comprehensive examination of how to prevent and respond to child maltreatment using evidence-informed public health approaches and programs that meet the needs of vulnerable children, and struggling families and communities. It outlines the system failures of contemporary forensically-driven child protection practice. Detailed guidance is provided about how to re-think earlier intervention strategies, and establish stronger and more effective programs and services that prevent maltreatment at the population level. Service user and stakeholder perspectives, particularly from marginalized groups including Indigenous peoples, highlight how public health approaches can better support families and keep children safe. Case studies from different countries grapple with the fraught nature of large system change and the various strategies needed to effect multi-level reforms. Presenting the reader with an array of innovative services used in different institutional and community context, this volume confronts the complex challenges found in implementing successful prevention programs that are aligned with diverse cultural and political environments and community expectations

Tests of the mitigating effects of caring and supportive relationships in the study of abusive disciplining over two generations

To examine evidence of the continuity in abusive discipline across two generations (G1 and G2) and the role of safe, stable, and nurturing relationships (SSNRs) as protective factors. Data are from the Lehigh Longitudinal Study, a prospective investigation of the causes and consequences child maltreatment that began in the 1970s with a sample of 457 children and their parents. Data were most recently collected in 2008-2010 from 80% of the original child sample (N = 357) when they were adults age 36 years on average. Of those assessed as adults, 268 participants (G2s) were parenting children and thus comprise the analysis sample. Analyses examined the association between harsh physical discipline practices by G1 parents and G2's reports of similarly severe discipline practices used in parenting their own children. Analyses also investigated the direct and interactive (protective) effects of SSNR variables that pertain to the care, warmth, and support children received from their mothers, fathers, and siblings over their lifetimes. A measure of an adult partner's warmth and support was also included. A case-level examination of G2 harsh discipliners was included to investigate other forms of past and more recent forms of abuse exposure. Results show a significant predictive association between physical discipline by G1 and G2 parents (β = .30; p < .05; odds ratio, 1.14; confidence interval, 1.04-1.26), after accounting for childhood socioeconomic status and gender. Whereas being harshly disciplined as a child was inversely related to reports of having had a caring relationship with one's mother (r = -.25; p < .01), only care and support from one's father predicted a lower risk of harsh physical discipline by G2s (β = -.24; p < .05; odds ratio, .74; confidence interval, .59-.92). None of the SSNR variables moderated the effect of G1 discipline on G2 discipline. A case-level examination of the abusive histories of G2 harsh discipliners found they had in some instances been exposed to physical and emotional abuse by multiple caregivers and by adult partners. There is continuity in physical disciplining over two generations. SSNRs measured in this study did not mediate or moderate the effect of G1 on G2 harsh physical discipline, although care and support from fathers was inversely related to the likelihood of G2 harsh physical discipline. This relationship is independent of abuse in childhood. Research is needed to identify factors that interrupt the intergenerational continuity of harsh physical (abusive) disciplining so that promising interventions can be developed and implemented

The Personal Security of Children Demands Bold System Reform

In this article, we argue for a new approach to child welfare—one that replaces existing child protection systems beset by scandals and tragedies with broad-scale system re-alignment that places public health prevention and early intervention at the forefront of efforts to engage, support, and empower families. We explain that the ‘rescue and removal’ orientation that drives policies and practices in contemporary child welfare and child protection systems is deeply flawed in its orientation, lacking in its evidence of effectiveness, and fiscally unsustainable. We point to differential response as one attempt to reform child welfare systems from within, but note that the changes DR brings, while promising, are insufficient to achieve what is required to eradicate child maltreatment and bring about a more just and sustainable practice of promoting the welfare of children. Here, we also share some emerging and encouraging initiatives from around the globe to illustrate the promise of prevention and early intervention approaches—what we call beacons of hope. For the sake of all children, it is time think boldly about the potential that exists in broad-scale, systemic and cross-sectoral reform that fully and unabashedly embraces universal and primary prevention as a means to ensure children’s right to personal security