Throughout this work I will relate to a case study. I will provide a definition of abuse using both sociological and psychological perspectives to contribute to our understanding of the causes of abuse. I will define the types, indicators, signs and symptoms of abuse and its impact on families and individuals, identifying factors relevant to the case study, recognising and explaining current legislation making reference to Government reports/inquiries and research into failures to protect from harm and abuse. I will consider the policies and procedures that my work place use and I will identify some statutory and voluntary agencies and their roles in supporting those affected by abuse, relating specifically to the abuse of children. My understanding is abuse is an unpleasant and harmful treatment of an individual, which can effects physical and psychological welfare and may affect future development. Abuse can cause an individual a great deal of distress and fear, as well as physical injury and may affect their emotional development. “Child maltreatment is the abuse and neglect that occurs to children under 18 years of age.
It includes all types of physical and/or emotional ill-treatment, sexual abuse, neglect, negligence and commercial or other exploitation, which results in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power. Exposure to intimate partner violence is also sometimes included as a form of child maltreatment” (WHO) A Psychological & Sociological Perspective into the Causes of Abuse Psychological theory focuses on the instinctive and psychological qualities of those who abuse. Believing it’s the abusers abnormalities that are responsible for abuse, abusive parents may have been abused in childhood. Psychodynamic theory claims abuse and neglect are a bi-product of maternal deprivation. The mother has suffered abuse herself, displays a lack of empathy, sensitivity and responses to her child. Mother and child relationships are the focus with the mothers’ psychological make-up key.
Psychodynamic psychologists say we are born with drives which need satisfying and if not satisfied one can be psychologically stuck at a certain stage Erikson’s “lifespan” theory saw that universally people face conflict throughout stages of life, he said people faced conflicts influenced by social relationships, rather than their own psycho-sexual development. At each stage of life Erikson believed was: a conflict to resolve and a balance to achieve between the two with a possible positive outcome, creating a ‘virtue’ or ‘ego strength’ allowing competency in all other areas of life or if not resolved a negative ‘maladjustment’ causing disadvantage in the succeeding stage. For example at Stage 1 – Infancy, conflict – trust versus mistrust. A baby learns from attentive care to trust, or through neglect, mistrust in the world. Good resolution of this stage leads to the ego strength of hope about the world. The maladjustment can be either mistrust or insecurity.
Erikson believes people who’ve had problems in life haven’t resolved conflict beforehand and as each stage is programmed the individual cannot relive a stage however work can be done to resolve some of the issues. “Hope is both the earliest and the most indispensable virtue inherent in the state of being alive. If life has to be sustained hope must remain, even when confidence is wounded, trust impaired” Erikson, 1950. (Bingham et al. p78) Sociological theory emphasise social and political conditions as most important reason for child abuse, examining social conditions that create the climate for abuse, not individual factors. Feminist theory sees abuse as longstanding male power over women and children, believing men abuse to exert power.
Brownmiller 1975, revealed sexual abuse is more than an action committed by one man against one woman; it is a imposing tool of male control over women, an exercise of power with a philosophy to instruct women to fear male violence. “A sexual invasion of the body by force, an incursion into the private, personal inner space without consent. . . . constitutes a deliberate violation of emotional, physical and rational integrity and is a hostile, degrading act of violence that deserves the name of rape” (Brownmiller, S p377) The five most common social service workers will likely see are: Physical Abuse, Emotional Abuse, Sexual Abuse, Neglect and Financial Abuse.
Physical abuse is causing bodily harm it may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning or suffocating or excessive discipline or family violence, use of restraints or imprisonment, denial or misuse of medication, physical aids and adaptations or when the carer feigns ill-health of a child. Some signs and indicators may be physical (several injuries in various stages of healing, repeated injuries or accidents over a period of time, injuries that form a shape like the object used to injure (buckle, hand, iron, teeth, cigarette burns), or death. Behavioural indicators include (negative self-image, deserving punishment, no recall how injuries occurred, offer inconsistent explanations, wary of others and reluctance to go home) Physical abuse can be seen in relation to John Burn (60). He claimed no recollection to a black-eye and urged for his son not to be informed, although it is important not to cast assumptions.
Emotional abuse is persistent neglect with severe effects on a child’s emotional development. Can involve conveying worthlessness, detested, inadequate or valued only to meet the needs of another. It may involve the imposition of age- or developmentally-inappropriate expectations on a child or causing children fear or danger, or exploiting or corrupting them. Some level of emotional abuse is persistent in all ill treatment. Both physical (Bed-wetting/soiling without medical cause, prolonged vomiting/diarrhoea, not attained developmental milestones) and behavioural (play models negative behaviour/language, depression, anxiety, withdrawal or aggression) signs may be indicators. John Burn did not want his son to be told anymore of his black-eye as he would be annoyed, Ann reported Peter gets loud and aggressive at night and appeared apprehensive during social work visit as Peter did not want interference.
Sexual abuse includes acts or behaviours where a more powerful person uses another for a sexual purpose. It may involve a stranger, however most sexual abuse is by someone known and trusted. It includes touching, fondling, sexual intercourse, exposure of private parts, or seeking to be touch for sexual gratification. Also voyeurism, pornographic photographing or involvement of children, prostitution or using internet/phone for sexual conversations with children. Indicators can be: physical: bruises, swelling or bleeding in genital/vaginal/anal area, torn, stained or bloody underclothing, and STI’s. Behavioural – cringing/flinching if touched; caregiver constantly calling ‘stupid’ or ‘dumb’ and can be displayed by child or abuser. Scottish Government acknowledges “not every case of sexual activity in under-16s has child protection concerns, but some may need support in relation to their sexual development and relationships” (fpa.org.uk).
Ann (17) has learning difficulties and would have been under 16 during her first pregnancy. Due to her age and vulnerability Child Protection issues should have been raised as Peter is almost double Ann’s age and the Sexual Offences (Scotland) Act 2009 states “sexual activity between an adult and someone under 16 is a criminal offence” Neglect – failure to meet basic physical and/or psychological needs, likely to result in the serious impairment of health or development, involving failure to provide food, shelter and clothing, or to protect from physical harm/danger, or failure to obtain medical care/treatment, failure to respond to basic emotional needs. Possible physical indicators may be: Inappropriately dress for weather, dirty, unkempt, lengths of time unsupervised, malnourished, severe nappy rash or persistent skin disorders from lack of care and hygiene.
Both children in the case study are neglected they have unsatisfactory medical attendance with George (1) suffering nappy rash, inflamed skin and missed inoculations since birth. Kyle (2) has missed medicals which could’ve addressed his development needs. Financial abuse includes stealing money or property, fraud, pressure in connection with savings, wills, inheritance or personal financial transactions, embezzlement, pensions or benefits. Possible signs and indicators of this abuse: unusual & unexplained activity in bank accounts, embezzlement or unpaid bills. John Burn may have been financially abused, he has no recollection of missing money and is unable to manage without it, and again does not want his son to know.
The impact and effects of the above abuse within the case study is apparent as Peter Burns has traded a dependency on heroin for alcohol which sees him sleep all day, neglecting his role within the family and becomes loudly aggressive at night, this would cause fear in the rest of the household.
Protection means recognising concerns and understanding how to share concerns, investigate, assess and the steps required to ensure safety and well-being. Legislation places a variety of duties and responsibilities on services and organisations. Neglectful indicators seen in both infants within the study, social work may say that the parents breach ‘Section 5 of The Children (Scotland) Act 1995’ which states “a parent has in relation to his child the responsibility to safeguard and promote the child’s health, development and welfare”. (www.scotland.gov.uk) “State Parties shall take all appropriate legislative, administrative, social and educational measures to protect the child from all forms of………abuse, while in the care of parent(s), legal guardian(s) or any other person who has the care of the child.” (Article 19’ UNCRC) This places responsibility on the social worker and health professionals in case study.
Legislation is often formed as a response to public inquiries, highlighting poor practice/abuse that takes place with authority or private providers, government investigations highlight failures and make recommendations to prevent future incidents. Summary of Fatal Accident Inquiry Determination: The Deaths on Erskine Bridge Niamh and Georgia died below Erskine Bridge, 4/10/2009, by suicides. Having walked from the Good Shepherd Open Unit, stopping at the centre of the Bridge, both girls died on impact with the water. The Inquiry lasted 65 days and it ruled deaths avoidable had reasonable precautions been taken: ‘Staff members on duty at the Unit been higher. Had Niamh & Georgia risk assessment needs assessed and accommodated at a different location within the Unit’. Several recommendations were made following relating to: security, supervision, management, lack of information, risk/psychological assessments missing, better communication system and accurate recording/time keeping amongst others.
Professor S Platt of Health Policy Research at University of Edinburgh made three recommendations which are reflected in residential policies now. 1. Local authorities to commission guidelines for staff on recognising and mitigating suicide risk in this client group. These guidelines should include the requirement to develop a detailed management protocol. 2. The management protocol should set out the procedures to be implemented when a looked after and accommodation child is considered to be at risk of self-harm or suicide e.g. by making suicide ‘threats’, by expressing suicidal thoughts or by making preparations for suicide. The protocol should cover inter alia the allocation of duties and responsibilities. 3. Professionals working with looked after and accommodated children, either directly or indirectly should have a sound understanding self-harm and suicide among their clients and of appropriate interventions to mitigate that risk. Provision of appropriate training on start of employment and regularly thereafter (as part professional development). (Scotland-judiciary.com)
Results of recommendations mean frequent suicide prevention training is mandatory, new traffic light system of reporting absconders/missing people, created in partnership with Strathclyde Police and Local Authorities reflecting individual risk assessments, allowing staff to identify and prevent risks of self harm or suicide and report efficiently should they suspect an absconder is at risk. My workplace lengthy child protection policy, provides guidelines for all eventualities. In the case of a disclosure the child/young person would be informed that information would be passed on if it related to their wellbeing being harmed, allowing them to speak without interruption, listen to-do not coheres, don’t make judgement, positive praise for sharing with you and inform them that you will do all in your power to support them. It must then be reported to the child protection officer who would deal with the formal reporting if it were deemed necessary.
I could be asked to help assess the child or provide statements to police. In the case of the abuser staff working in safeguarding children has a responsibility to ensure children are adequately protected and a responsibility to share information about individuals where a risk of child abuse is suspected with Social Care Service Managers. Legislation, National Care Standards and SSSC Codes of Practice contribute to the protection of children and vulnerable adults. In NCS’s for school care accommodation services standard 3.3 looks at care and protection states that workers are aware of child protection policies and procedures. Standard 3.7 ensures protection issues are dealt with using policies and procedures. The SSSC codes of practice contribute to protection code 3.2 states we must carry out the correct processes and procedures to challenge and report dangerous, abusive, discriminatory or exploitive behaviour and practice. code 3.7 states we must support service users/carers to make complaints, taking complaints seriously, responding to or passing to appropriate person. Code 2.7 states to respect confidential information.
For child protection, no Schedule One offence is ever ‘spent’ in terms of Rehabilitation of Offenders Act 1974. The Sexual Offences Act 2003 has sections relevant to care workers and committed against service users such as; Section 39 Care workers: causing or inciting sexual activity, Section 40 Care workers: sexual activity in the presence of a person with a mental disorder & Section 41 Care workers: causing a person with a mental disorder to watch a sexual act. The support, therapy and treatment of those affected by abuse is an important factor in ensuring wellbeing and safety. Statutory, voluntary and private/independent organisations provide diverse services some of which may overlap. Set up through government remit such as SurvivorScotland, social service and education departments, CAMHS are part of the NHS who support young people and their families with emotional, behavioral and mental health difficulties. A single shared assessment from a multi-agency partnership of professionals not only protect but prevent with early intervention.
Many voluntary agencies/charities focus on helping children such as, Barnardos, Womens Aid and the NSPCC (National Society for Prevention of Cruelty to Children) who work at national, regional and local level, some of their services include Childline as well as advise lines like the CTAC (Child Trafficking Advice Centre). Private services are profit driven, including home care providers and respite services. Instances of disclosure in various aspects which must be always dealt with professionally no matter how distressing. Workers/carers are offered support in the form of counselling through BACP (The British Association for Counselling and Psychotherapy) or services such as mind, Re-think or Samaritans who’ll listen to, provide support, advice, signposts or referrals to other agencies. There will be instances where workers will support the ‘abused’ however may find themselves supporting an ‘abuser’ or ‘someone at risk of abusing’.
Police, Prison Services, Local Authorities, and Social Services work closely to minimise risk and supervise offenders in the community. It is crucial not to allow personal feelings/values to conflict with professionalism. The Human Rights Act, Article 8: Right to privacy, highlights the importance of confidentiality in this line of work, however this right can be limited if it is necessary to protect public safety which Police and Social Work would determine through on-going reviews of risk level each offender poses, reducing the likelihood of further offending by providing sex offender group-work through social work services. Not all sex offenders are alike, some people have deep regrets and go on to be law-abiding whereas others have deep-rooted psychological problems requiring intensive support to manage behaviour. Workers should bear in mind that a significant proportion of sexual crimes go unreported and there are a number of sex-offenders not known to the authorities and need to take sensible safety precautions if you should suspect such individuals. Workers will have supervision with managers where issues are highlighted or access to counselling.
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