The pictures in our heads part two: the child protection reforms and the causes of child abuse

In my first ‘pictures in our heads’ post, I noted that assumptions about how problems and their solutions are to be understood are implicit in policies of all kinds. These assumptions influence how we frame the key issues. Therefore, the changes proposed by the Vulnerable Children’s Act and Children’s Action Plan contain assumptions that shape the way we think about the causes of, and solutions to, child abuse.

Those pictures are inferred by what these reforms set out to address and what they do not. They suggest, for example, that the risk of child abuse is associated with people in professional contact with children (otherwise why emphasise the safety checking of people who work with children?). They also imply that professionals in contact with children are not capable of correctly identifying child abuse, or don’t report it to the appropriate authorities when they do (otherwise why the attention on child abuse policies that emphasise training to recognise abuse and ensure reporting policies?).

These latter assumptions, in turn rest on the premise that abuse is easily recognised by those with the correct expertise, and that the proper way of responding to it is by referral to a statutory agency. It is also implied that child protection is hampered by poor communication and lack of collaboration between professionals, by an inability to share relevant information, or identify who is at-risk (addressed by the creation of Children’s teams, the vulnerable kids information system data base, information sharing agreements that lower the threshold for information sharing, and the creation of predictive risk modelling).

How do these policy assumptions, these pictures in our heads, shape up when held up to evidence and ethics?  When I look at this list of the child protection reforms, I find myself thinking “Yes, but where’s the prevention?”. Of course there needs to be attention to ensuring people working with children are ‘safe’, (although most children are abused by someone in their family). Of course we need professionals to collaborate and share information (but who is collaborating with the family and working on a relationship with them to make sure the information gathered is in depth enough to make a solid decision?) Of course we need good education on the signs of abuse (but the research highlights time and again that the bulk of notifications are in that ‘grey’ area, the social malleability of abuse definitions, the lack of social consensus on an agreed minimum parenting standard, and the diversity of ‘signs’ in children).  And finally, when I get to the end, I’m left thinking these are all in some way valuable contributions but where is the direct prevention of causes?

In any system aimed at child abuse prevention and intervention, the emphasis must be on ameliorating the factors that are known to actually contribute to child abuse, otherwise the system can become very good at methods of surveillance, information sharing and legal intervention, without actually preventing abuse occurring, or responding to it in ways that are effective in reducing ongoing harm when it does. The international research on the ‘causes’ of child abuse is immense, with many showing ecological associations only, or small effect sizes. Broadly, the conclusion that can be drawn from this body of work is that child abuse is associated with multiple, complex factors that range on a continuum from cases where causation is wholly based on individual factors, to cases where causation is almost entirely environmental, with many, many permutations in between.

What do I mean by this? Well, at one end of the causation continuum, there are those for whom the combination of environmental stressors is so great that parenting in a positive and caring manner is almost impossible. Nearly anyone can be abusive, given the right conditions. Other social situations are coded as abuse in order to legitimate the state assuming responsibility for children: the children with both parents in jail; the child with a seriously disabled solo mother with no support; the child living in a car. At this end of the ‘causation continuum’ the right combination of factors – poverty, discrimination, a stressful neighbourhood (high transience, high crime rates, and a high child: adult ratio), low social supports, sub-standard housing, many children with small age gaps and cultural acceptance of violence – is a recipe for disaster for almost anyone.

Coming along to the mid section of the continuum, people with some environmental and some personal or family level factors (such as mental illness, substance abuse or a history of abuse) might also struggle to parent adequately. Finally, there are a few people at the individual causation end, for whom whatever their social environment, they are likely to become abusive, usually due to a combination of extreme early trauma and pathological tendencies (references available on request). Their abuse is likely to be severe. They may also be living in poverty but that is not likely to be the main cause of their abusive behaviour. These are often the headline hitters.

When we use this sliding continuum of social, family and personal contributors to examine the population coming to the attention of child protection services (not an accurate tally of abuse but the best we have in this country) what does this tell us? Firstly, that the vast majority of people coming to the attention of CYF are at the first end and the middle of the continuum. Of the, roughly, 150,000 notifications CYF receive each year, only about 20,000 cases are substantiated because many of them are families with immense social needs and minor levels of abuse or none at all. A majority of the substantiated findings are for emotional abuse and neglect, both types of abuse with substantial environmental impacts. Thus the overwhelming majority of people coming to the attention of CYF have an array of stressful social conditions and some family level risk factors. Responding adequately to these social and familial factors will, for the vast majority of people, have preventive effects. There are, of course, always a few cases where individual sources of risk prove to be intractable, and where children are best protected by removal from the situation. However, using these exceptional cases to drive policy change, loading the system to focus resources on ‘hard end’ perpetrators, will inevitably mean abandoning the majority of poor and vulnerable families to inequitable social and economic conditions.

Prevention therefore requires direct attention to the social and family level causes of abuse. The first requires significant investment in poverty reduction and access to universal services, and the latter requires a focus on those services that work with families directly in supportive, therapeutic and educational ways.

Why do the government reforms focus so much on the extreme end of the continuum? Macdonald and Macdonald (2010) explain that extremely risk averse systems are enacted by organisations as an attempt to lessen low-probability, high-cost outcomes, that is, they protect against “extreme bads” (p. 1174) (in this case, child deaths). Paradoxically, they emphasise that a focus on extreme bads only “…detracts from a focus on those aspects of social phenomena that might prove more effective in safeguarding children from significant harm” (Macdonald & Macdonald, 2010, p. 1180). The system gets caught up in surveillance to catch out the high end perpetrators without attending to the vast array of social factors that contribute to the bulk of less serious abuse that can be a prelude to the slide into more abusive behaviour.

If the pictures in our heads suggested by the current reforms are not in line with current evidence, what is informing them? Where are these pictures coming from? One source is the political project of the moment, neoliberalism. Neoliberalism, assumes that individuals are primarily responsible for their own behaviour and that the job of government is to promote freedom and enable choice. If people ‘choose’ to use their freedom to harm others, then it is the job of the state to intervene and to require sanctions and control. This is Loic Wacquant’s (2009) ‘liberal paternalism’ where institutions are employed to manage the populations most affected by the removal of earlier social and economic protections with increasingly punitive social and penal policies. Under liberal paternalism the state abandons its role and responsibility to promote community and social wellbeing, and there is a gradual reduction in the range and level of primary and secondary services. Yet in other areas, the state is much more ready to intervene with ‘the full weight of the law behind it’ (Parton, 2014, p. 11). Poverty and inequality increases, there is a growth of the private sector in providing social services, and the state is more commercially oriented, and residual (Parton again). This kind of political framing is having a significant impact on the shape of child protection reforms, and increasingly driving divergence from best evidence and ethics in child protection systems design. Prevention is never a simple task, but these kinds of pictures do not serve a prevention agenda well.

Emily Keddell, Senior Lecturer in Social Work, University of Otago.

(The opinions expressed in this post are my own and do not represent the views of my employer, or any association to which I belong.)

References

Macdonald, G., & Macdonald, K. (2010). Safeguarding: A case for intelligent risk management. British Journal of Social Work, 40, 1174 – 1191.

Parton, N. (2014). Social work, child protection and politics: Some critical and constructive reflections. British Journal of Social Work. doi: 10.1093/bjsw/bcu091

Waquant, L. (2009). Prisons of poverty. Minneapolis: University of Minnesota Press.