Intervening in severe physical child abuse cases: Mental health, legal, and social services

Objective: To examine the child protection process in cases of severe physi cal abuse, to compare characteristics of the families with risk factors pre viously reported in the published literature, and to develop recommendation s about the use of mental health professionals in such cases. Method: Reviewers examined 30 case records of severely physically abused ch ildren under age 5, nominated by child protection workers and mental health providers. The reviewers recorded demographic. clinical, and case process information such as mental health and other referrals, reunification status , and frequency of criminal prosecution. A case study was described. Results: The parents displayed a range of psychological characteristics (e. g., depression, anxiety, personality disorders) and life problems (e.g., do mestic violence, substance abuse, abused as child). The majority of parents denied the abuse. The children were very young (more than half under 6 mon ths old) and many had difficult births or medical problems prior to the abu se. The most common services offered were individual psychotherapy and pare nting classes. More than half of the children reunified with at least one p arent within 1 year. Forty percent of the cases involved criminal prosecuti on. Conclusions: Reunification occurred more quickly and more often than expect ed based on the severity of the injuries. The system often relies on psycho therapy to correct the abusive behavior, even when the perpetrator remains unknown and specific risks such as substance abuse or domestic violence are present. The authors advise utilizing multidisciplinary teams for recommen dations regarding reunification. (C) 1999 Elsevier Science Ltd.