| Summary: | This thesis provides an investigation into Care Proceedings and potential treatment interventions to address the risk factors associated with child abuse and/or neglect. After an introduction to child abuse and neglect in chapter one, chapter two focuses on the first systematic review of a NICE recommended intervention, Multisystemic Therapy for Child Abuse and Neglect (MST CAN). This review highlights that there is emerging evidence that the intervention can reduce the risk of further child maltreatment by addressing risk factors identified at referral. However, there are limited high quality studies evidencing this and those that exist are predominantly from the USA.
An empirical study follows (chapter 3) looking at the similarities and differences between family profiles of real-life Care Proceedings whereby at the end of the process children either remained within their family on a Supervision Order or removed on a Care Order. The results of this study indicated that there are very few statistically significant differences between the two groups, providing evidence of the challenges faced by social workers to identify which cases may be appropriate to divert from court in the first place. The differences that were found highlighted that removal from parental care during proceedings was significantly associated with removal being the final outcome at the end of Care Proceedings. Perceived parental engagement was also identified as being significantly correlated with Care Proceedings outcome, those parents that were perceived to engage with services and children’s Social Care were more likely to have their children remain at home at the end of proceedings. Highlighting engagement as a key factor for decision making in Care Proceedings.
Chapter 4 provides a case study of a family engaged in Multisystemic Therapy for Child Abuse and Neglect (MST CAN). The chapter demonstrates how MST CAN is an effective intervention in addressing the associated risk factors for child abuse and neglect. Specifically, parental mental health, parental alcohol and substance use, parenting practice and family communication.
The penultimate chapter provides a critique of the University of Rhode Island Change Assessment (URICA) used with adults who misuse alcohol and/or substances. The review of the URICA is due to it being an assessment of motivation to change which is linked to engagement and also substance use and/or alcohol use is a key risk factor identified during Care Proceedings. The review suggests that the URICA is a useful tool in measuring current stage of change and could help to inform treatment. However, it should not be used as a prediction of treatment outcome. Lastly, chapter 6 brings together the findings and implications for real world practice in the area of assessing and treating the risk factors associated with child abuse and neglect.
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