Tracking the Impact of Early Abuse and Neglect

Children who experience abuse and neglect early in life are more likely to have problems in social relationships and underachieve academically as adults.

Maltreatment experienced before age 5 can have negative effects that continue to be seen nearly three decades later, according to a new study led by Lee Raby, an assistant professor of psychology at the University of Utah.

“It is not a controversial statement to say abuse and neglect can have harmful consequences,” Raby said. “This study adds to that by showing that these effects are long term and don’t weaken with time. They persist from childhood across adolescence and into adulthood.”

The journal Child Development published the study. Co-authors are: Glenn I. Roisman and Madelyn H. Labella, Institute of Child Development, University of Minnesota; Jodi Martin, Department of Psychology, York University; R. Chris Fraley, Department of Psychology, University of Illinois at Urbana-Champaign; and Jeffry A. Simpson, Department of Psychology, University of Minnesota.

Raby said his team wanted to know two things: Does maltreatment early in life have long-term associations that extend into adulthood and do those effects remain stable or weaken over time?

The researchers used data from the Minnesota Longitudinal Study of Risk and Adaptation, which has followed participants since their births in the mid-1970s. The U study looked at data on 267 individuals who had reached ages between 32 and 34.

Information about the participants’ exposure to physical abuse, sexual abuse and neglect was gathered from multiple sources during two age periods: 0-5 years and 6-17.5 years. Throughout childhood and adolescence, teachers reported on the children’s functioning with peers. The children also completed standardized tests on academic achievement. The participants were interviewed again during their 20s and 30s, during which they discussed romantic experiences and educational attainment.

Unlike studies based on adults’ retrospective accounts of their childhood experiences, the data used here were collected in real-time. In addition, because data on the participants has been collected throughout their lifetimes, the researchers were able to disentangle the effects of maltreatment that occurred in their early years from experiences of abuse and neglect during later childhood.

“The design allows us to ask our two questions in a way no other study has before,” Raby said.

Raby said the findings showed those who experienced abuse or neglect early in life consistently were less successful in their social relationships and academic performance during childhood, adolescence and even during adulthood. The effects of maltreatment did not weaken as the participants got older.

“The harmful effect of early abuse and neglect was just as important when we were looking at outcomes at age 32 years as when we looked at outcomes at age 5,” he said.

The researchers found abuse and neglect in later childhood also impacted these competencies in adulthood, but that later maltreatment did not fully account for persistent and long-term influences attributed to abuse and neglect experienced in early childhood. They also found long-term difficulties with social functioning — but not academic achievement — occurred independent of such factors as gender, ethnicity and early socioeconomic status.

“These findings add more evidence for the importance of identifying high-risk families and attempting to intervene before experiences of abuse and neglect occur,” Raby said.

Trauma Informed Practice: Better Late Than Never

I was 21 years old, fresh out of University and had taken a position as a Child and Youth Worker at a boys group home. After my first day on the job, my roommates were shocked to hear that I had spent the better part of my day protecting myself from being stabbed with a protractor and dodging flying bricks from a wildly out of control 13 year old. I had physically restrained him over a dozen times and at the end of the day, I left exhausted and doubtful that I had a future in this field.

The training I had received focused on behavioral management techniques as many group homes at that time operated as token economies. In reality, this meant that a great deal of focus from staff was connected to the behaviors that the children/adolescents exhibited. If they presented with positive, desirable behaviors, they would be rewarded by moving up a level, or receiving some form of token reinforcement. In turn, if they exhibited undesirable or negative behaviors, they would lose tokens, privileges, control, and status.

It wasn’t until several years later that I began to understand the shortcomings of this model when used in isolation. I was working in the Yukon Territory in a similar setting but had now been trained in ‘Trauma Informed Care’. The children/adolescents in both settings had many similarities despite ethnic, geographical and social differences. They presented with a pervasive pattern of emotional dysregulation, they had problems with attention, concentration, and impulse control, and for the most part, they struggled with getting along with themselves and others.

Most importantly, they were all survivors of some form of childhood trauma. As brain science and studies such the ACE study from the Centers for Disease Control and Prevention are showing, childhood abuse and neglect is the most costly public health issue to date. One look at the Adverse Childhood Experiences (ACE) study and you can see that traumatic life experiences such as physical, emotional or sexual abuse, neglect, and other household issues during childhood/adolescents leads to an increased likelihood of developing mental health disorders, addictions, learning & behavioral problems as well as coming in contact with the criminal justice system, along with countless other social issues.

This study and others have also connected early trauma to workplace absenteeism, financial problems, drug use, unintended pregnancies, prescription painkiller use and even a higher chance of developing COPD, heart disease, liver disease and cancer due to the ongoing stress in the body. Despite this study and countless others, we live in a health care system that often ignores trauma and it’s impact on brain and body development.

In some cases, the ongoing practices and policies even further traumatized and victimize those who touch foot into the system. For those that have worked in agencies and organizations that aren’t ‘trauma informed’, you are not alone, and it is not too late. As I reflect back on the shift to becoming ‘trauma-informed’, I began seeing that the client’s behaviors were really a unique language that provided a glimpse into how childhood abuse, neglect and adverse experiences had impacted their physical, emotional, social and mental well-being.

Providing trauma-informed practice means that creating a safe and non-judgmental environment is one of the most important aspects of working with vulnerable populations. As such, building relationships with our clients are the entry point into their healing, and ruptures in relationships (i.e. being attacked with a protractor) can be opportunities to teach emotional regulation, demonstrate how to repair relationships and develop meaningful connections.

As a result, clients begin to feel more empowered, have more control, and have more predictability in their environment. For staff, this means less energy is spent on managing behaviors and more focus is on creating an environment where clients have a chance to heal their broken attachment systems and learn how to calm their physiological responses that were so prone to living in fear and danger. Trauma informed practice is strengths based. It means safety and trust over obedience. For clients, it means that having an emotional or aggressive episode is met by support,

For clients, it means that having an emotional or aggressive episode is met by support, comfort, and learning rather than fewer privileges, shame, and isolation. As health care professionals, we have to turn our focus to the early attachment issues and traumatic experiences that many of our clients have faced.

We have to view behaviors as a language and not as the root problem. We have to become trauma-informed to truly create a safer, healthier and balanced society for future generations to come.

To Counter Child Abuse, Administrators and Case Workers Need Support to Implement Evidence-Based Improvements

In 2015, more than 425,000 children were placed in foster care due to incidents of abuse and neglect. But many unsubstantiated cases under investigation divert time and resources from handling cases that warrant close monitoring and attention. According to recent statistics, more than two million reports of child abuse and neglect were accepted for investigation in 2015 – with more than 700,000 of them eventually substantiated as cases of child abuse or neglect.

Imperfect Responses to Harmful Abuse and Neglect

Caseworkers often report that negotiating the multiple demands of their jobs puts them under constant stress. The sheer volume of Child Protective Services reports and investigations, the number of youth in foster care that need to be looked after, and the piles of paperwork that must be filled out to track decision-making – all of these burdens are overwhelming under the best of circumstances.

Faced with such workloads, agencies and caseworkers are ill-equipped to deliver services based on evidence of what works for youth and parents in the foster care system. The current standard of practice, however, leads agencies and caseworkers to engage in practices not supported by research-based evidence. Poorly conceived and delivered services cause considerable harm by failing to limit the incidence and after-effects of abuse and neglect.

Victims of child abuse and neglect are nine times more likely to become involved in crime and 25% more likely to experience teen pregnancy. Such victims also face increased risks of smoking, early-age drinking, suicidal ideation, inter-personal violence, and sexual risk-taking. The sad results become obvious in later years. Two-thirds of adults under treatment for drug abuse report that they were maltreated as children. And similar reports of childhood abuse come from 14% of men in prison along with 36% of incarcerated women. Four-fifths of 21-year-olds who were abused as children show evidence of at least one mental health disorder. And saddest of all, about 30% of child abuse victims will later abuse their own kids.

What Could be Done?

Several steps can be taken to improve responses to child abuse and neglect:

  • Improved, ongoing training and job support for caseworkers and supervisors could ensure that they know the characteristics of the populations they serve and are aware of effective anti-abuse practices and know how to deliver them or help clients find others in the community who can provide optimal help. Front-line workers also need training to monitor client progress and detect when a case warrants more intensive intervention.
  • Enhanced preventive efforts could save lives and money. Research shows that the total cost of new U.S. cases of fatal and nonfatal child maltreatment was approximately $124 billion in 2008. The estimated cost per victim of nonfatal child maltreatment was $210,012 in 2010, including the costs for health care, productivity losses, child welfare services, criminal justice procedures, and special education. In fatal cases, the figure rises to an astonishing $1,272, 900 per death.
  • Resources should be reallocated to areas of greatest need. In addition to redistributing available funding to hire more staff to manage high caseloads, innovative and effective programs and services must be delivered to prevent child maltreatment and fatalities. States should take advantage of funds offered by the federal government to expand evidence-based child welfare interventions that may have previously been underfunded.

Lessons from Philadelphia

A promising model comes from the state of Pennsylvania, which has participated in a federally funded project that allows child welfare agencies to use Title IV-E funds for evidence-based reforms. Philadelphia’s child welfare system has been at the forefront of adopting three evidence-based treatments for children and families that the city was previously unable to implement due to lack of funding. Waiver funds have made it possible to enhance preparation for child welfare caseworkers, develop databases to track outcomes for children and families, and train staff to identify and implement further improvements.

With flexible authority over spending, two child welfare agencies in Philadelphia decided to implement the Positive Parenting Program, an evidence-based approach to preventing child abuse. Although some reallocated resources have been used to train staff, additional funding is needed to discover barriers to effective program implementation and to implement additional steps known to be cost-effective – such as holding weekly consultations and boosting training for current and replacement leaders and caseworkers involved in the new program.

Research could pinpoint which approaches do best at giving various parents and youth access to the positive parenting program. And as parents and their offspring complete the program, further research would ideally track results in areas such as safety, reductions in abuse incidents, and improved parent-child relationships.

Next Steps

The Title IV-E Waiver Demonstration Project was a provision in the U.S. Child and Family Services Improvement and Innovation Act, which Congress reauthorized for five years in 2011. Now that the act is again up for reauthorization, Congress has the ability to implement changes to the way child welfare federal funds are allocated. Advocates for children have an opportunity to contact representatives and senators in Congress to propose that this program should expand to give more states the chance to reallocate funds and improve child safety.

Much remains to be learned about what it takes to carry out evidence-based interventions in the child welfare system, which provides vital help to many endangered children, youth, and families, disproportionately minorities. The federal Waiver Project provides a unique opportunity to observe what happens when system leaders, community partners, and providers mobilize to prevent childhood trauma. Lessons learned will help provide ongoing guidance to federal and state administrators and welfare leaders as they look for the most effective, empirically proven ways to protect children and families under their supervision.

Best Practices for Grief: Foster Care


Often, helping professionals in the lives of foster care youth struggle to understand the magnitude of losing a child or teen in the foster care system has experienced.  Abuse and neglect, loss of innocence, trauma, separation from parents, loss of security, and multiple placements are all factors affecting the wellness of children placed in the foster care system.

These heavy experiences not only impact children and teens in our foster care population short term, but they are also far reaching.  The long term impacts of these experiences of foster care youth are evidenced by the staggering statistics of foster care alumni such as homelessness, prison, unemployment, mental health concerns, and lack of education.

In order to effectively serve this underserved population, it’s time for us to acknowledge how much we really don’t know about foster care youth in the United States today.  It’s time to create more conversation about the needs of children and teens in foster care placement and the realities of their experiences.  It’s time we meet them where they’re at in their grief.

Foster care alumni abandoned by the educational system often become the inmates at youth detention centers and adult prisons across the country. They are the experts on what needs to change in order to create more equitable outcomes and opportunities for vulnerable populations. These orphaned inmates are the ones who could drive the creation of new methodologies, curriculum and policies to decrease risks while increasing protective factors. – Foster Care Alum Veola Green

Below is the first video in our series highlighting best practices for teachers and other key players impacting the lives of grieving foster care youth today.  In this video, I interview Evangelina Reina, LCSW, Assistant Regional Administrator for DCFS – Los Angeles and Adjunct Assistant Professor for The University of Southern California.

Reina offers her insight into best practices when working with children and teens in foster care placement as well as her expertise on what sets foster care youth apart from youth impacted by the other experiences of death, divorce, parental incarceration, and parental deployment.

Changing Hearts, Changing Lives: How 5 Social Initiatives in Chicago Are Making a Difference


Home to 9.5 million people, Chicago is the third-largest city in the United States and internationally recognized for its contributions to finance, transportation, commerce and culture. In the 2014 Global Cities Index, Chicago earned its fourth-consecutive top 10 ranking for its impact in business, information exchange, cultural experience and political dialogue. But despite all that Chicago is doing right, for some, life in the Windy City still presents challenges. Vulnerable populations, including children and adults, need the help of professionals.

Poverty affects 33 percent of children in Chicago, according to ThinkProgress, compared to 20 percent for all children in Illinois. And All Chicago, a nonprofit organization, reports that approximately half of all renters and homeowners arecost burdened, paying more than 30 percent of their income toward housing costs. Poverty has led to high figures for homelessness and hunger:

  • 138,575 Chicago residents were homeless in the 2013-14 school year, a 19.4 percent increase from the previous year (Chicago Coalition for the Homeless)
  • One in six (812,100) in Cook County receives food from a member agency grocery or meal program (Greater Chicago Food Depository)

And although Chicago has seen an overall improvement in violent crime, it has increased in certain areas of the city. “In the early 1990s, the most dangerous third of the city saw about six times more murders than the safest third,” Chicago writer Daniel Kay Hertz reports. “Over the last several years, the most dangerous third has seen between 12 and 16 times more homicides.”

Social workers are answering the call for help. By teaming up with initiatives and organizations, led by community leaders and professionals in education, psychology and more, social workers are truly making a difference for those in need.

Social workers are educated professionals trained to help at-risk populations. They can work in community centers, agencies, rehabilitation centers and other areas. A program such as the online Bachelor of Social Work from Aurora University gives those with a passion for changing lives the tools they need to succeed, including courses in how to work with groups, the special needs of children and adolescents, how to work with communities and groups, and more.

Val Starr, an Aurora University alumna who assisted homeless veterans as a social worker at Catholic Charities and now works for the Edward Hines Jr. VA Hospital, is just one example of how social workers are making a difference in Chicago.

“I have really found my passion working with this population and their unique needs,” Starr said. “It means so much to me to have the ability to help them.”

Education was the first step in Starr’s journey to change the lives of those who need help the most. “The education I received at AU was so beneficial to this position because it helped me understand and recognize mental health needs, taught me strategies for working with individuals from all walks of life and helping them cope with their daily struggles,” she said.

Learn how social workers like Val are making life in Chicago better, as we examine five initiatives that are helping make the city a safer, more accessible place to live.

1. Chicago Safe Start

Who it helps: According to the 2014 annual report for Safe From the Start (SFS), 4,350 children have sought treatment at the 11 Illinois sites since the program was launched, with a mean age of 4.7. Seventy-six percent of children had a single parent, while 58 percent of children came from families with annual household incomes of less than $15,000. On average, 22 percent of children were exposed to additional violence after services began.

In 1999, following the tragic deaths of 13 people at Columbine High School, President Bill Clinton called a national summit to address the subject of children and violence. The event included experts in childhood development and juvenile justice, and the findings shed light on the damage that exposure to violence can have on children.

The summit’s accompanying report said that “Being abused or neglected as a child increases the likelihood of arrest as a juvenile by 53 percent and of arrest for a violent crime as an adult by 38 percent.” Plus, there are long-term consequences for the child. Educational difficulties, alcohol and drug abuse, employment problems and mental health problems such as posttraumatic stress disorder (PTSD) were mentioned for children who were exposed to violence in some way.

As a result of the summit and national attention on childhood exposure to violence, 11 Safe From the Start demonstration sites launched in 2000, with Chicago Safe Start as one of the original locations. A program of the Chicago Department of Public Health, it provides therapy for children ages six and under who have been exposed to violence, either directly or as a witness in the home or in public. Its ultimate aim is to help prevent and reduce the negative impact that violence can have on young children.

Alongside social workers who intern in the program, therapists identify and approach any issues that the child may have, such as aggression, sleep difficulties or anxiety. Through mental health and family support services, such as child-parent psychotherapy, workers treat the trauma, which can include a parent or caregiver as well.

According to the report, the program has successfully helped children and caregivers. “The data to date indicates that families that participate in Safe From the Start Services experience a significant reduction in child symptoms and caregiver stress, and an improvement in child and caregiver functioning … examination of key outcome indicators over the last several years of the project suggests that sites are having an increasingly positive impact on families that they serve.”

The success of this program could ultimately be used to help even more children across the country. “As program development continues, Safe From the Start will likely serve as a model program nationally for efforts to address issues related to young children’s exposure to violence.”

2. Elev8 at Perspectives Academy

Who it helps: Since opening in 2008, Perspectives has helped more than 2,800 middle school students in one or more Elev8 programs. When the health center opened in May 2008, the immunization rate increased from 43 percent to 94 percent over the next 12 months. Also, since the health center opened, Perspectives has reached 100 percent compliance rates each year.

Taking place in more than a dozen schools across Baltimore, Oakland, New Mexico and Chicago, Elev8 brings together schools, families and community partners in low-income area middle schools to help students succeed in high school. Perspectives Middle Academy in Auburn Gresham is one of five public middle schools in the Chicago area, giving children access to a school-based health center and exciting possibilities in the cornerstone of the program, extended day opportunities.

These after school services help give students not only a safe space, but the skills needed to succeed in high school and beyond. “We really wanted to use the after school programs as a way to help students develop new skills, but also expose students to different areas of thinking about ‘What do I want to do when I grow up? Do I want to be a chef? Should I take culinary arts? What does that really look like?’” said Tenisha Jones, education director at Greater Auburn-Gresham Development Corporation. “So if you were in a culinary arts program, at the end of the eight weeks you’re able to get on a bus and go to a real culinary arts program to cook with a real cook in a real kitchen to really make the after school programs tie back into real world experiences for the students.”

One program geared toward STEM for girls has led one graduate to make a college decision to pursue forensic chemistry at Western Illinois University, reports Gordon Walek, writer for Local Initiatives Support Corporation (LISC). From STEM and the culinary arts to martial arts, students can find something they love and get a real glimpse into their future opportunities.

The extended day opportunities are offered from 3:45 to 6:30 p.m. Monday through Thursday, in addition to a four-week summer program that runs 8:00 a.m. to 3:00 p.m. Monday through Thursday. The school-based health center provides primary care such as immunizations and physicals, and mental health services are planned for the future.

For Jones, the success of Elev8 at Perspectives has meant a great deal. “I feel as though I have truly been blessed. It’s been a really special opportunity to be a part of having the resources to develop and implement a project of this nature with many moving pieces, and really looking at the theory behind why we need to do these things,” she said. “The results that I’ve seen because of this project have been phenomenal, really the crowning glory of my career at this point. I’ve seen kids go from sixth grade to 12th grade, and I’ve seen mentorship happen because after school providers take special interest in kids and wind up saving a kid from going off the wrong track.”

3. Chicago Neighborhood Initiatives

Who it helps: Low- and moderate-income communities such as West Garfield Park. According to analysis from the Social IMPACT Research Center, more than 40 percent of West Garfield Park households are below the poverty level, and 19.4 percent of households are in extreme poverty with incomes below 50 percent of the poverty line.

Chicago Neighborhood Initiatives (CNI) has announced plans for the world’s largest rooftop farm at the Method Home Products manufacturing facility. Designed, built and operated by Gotham Greens, the state-of-the-art agricultural greenhouse will produce up to 1 million pounds of fresh produce each year and bring nearly 150 jobs to Pullman. The food will then be distributed to local farmer’s markets, retailers, restaurants and community groups.

This is one of many accomplishments for CNI, a nonprofit community development organization that helps low- and moderate-income communities revitalize neighborhoods and improve economically. Since 2010, it has generated 12,000 jobs and 135 affordable housing units in Chicago neighborhoods located on the Far South Side and the West Side, such as those in Pullman, Englewood, West Garfield Park and Austin.

In February of 2015, CNI was recognized with the Community Strategy of the Year Award at the annual Chicago Neighborhood Development Awards by LISC. According to U.S. Bank, which funds and supports CNI, CNI has achieved a number of high-profile initiatives in 2014:

  • Completing the first phase of Pullman Park, bringing a Walmart, Planet Fitness and Ross Dress to an abandoned factory site.
  • Selling of 38 rehabbed homes to revitalize houses in local communities.
  • Launch of a microlending program, CNI Micro Finance Group. It has helped more than 40 businesses with $500,000 in microloans, 82 percent of loan recipients were firms owned by African-Americans and 52 percent went to small businesses owned by women.

As a result, CNI has helped strengthened in-need communities across the greater Chicagoland area.

4. Chicago Help Initiative

Who it helps: Since 2001, 157,000 meals have been served to Chicago-area people in need.

In 1999, commercial real estate broker Jacqueline C. Hayes came face-to-face with the homeless when trying to show a location, when a major street closed just off Michigan Avenue and Oak Street. “A lot of the homeless started coming and living in the doorways, and I had to ask them to move, in order to show spaces,” Hayes said. “I was so anxious that this is what tourists would see when they came to the city; then I reversed it, and I thought, ‘How awful that people felt safe living in doorways?’ And so I just wanted to do something about it, and I gathered various organizations together.”

This moment prompted Hayes to action. It began with handouts on how to help the homeless, and later became the Chicago Help Initiative (CHI), which provides meals to those in need and connects them to resources that can break the cycle of hunger.

Most of the guests are homeless. Many have mental issues. And about 20 percent are veterans. But every Wednesday, at the dining hall facilities provided by Catholic Charities, a distinguished meal is served for 135 people (and bag meals for another 70 to 90). Tablecloths and flowers are set, and food is provided by area restaurants, hotels, businesses and people in the community. It’s this approach that has made such an impact on guests; once, the InterContinental Chicago hotel catered in prime rib, a gesture that caused some guests to become emotional because they had never had it before.

The food is just a part of the experience. The Wednesday dinners often include birthday celebrations, and sometimes there is live entertainment or a game night. Often, guests hear a presentation on a certain topic that can help. For instance, the CHI has had the Safer Foundation discuss expunging one’s criminal record, the Lincoln Park Community Shelter present housing information and Streetwise speak on employment opportunities. Guests also have access to a jobs table and a resource table for housing and other needs. A nurse practitioner and other health representatives are on hand, and, according to Hayes, there are plans to provide dentistry and eye care support for guests.

This is all possible through volunteers that help during the weekly dinners and other events such as the literacy program and the bike fair. Interns in the CHI make phone calls to social workers to secure speakers for the dinners, and they get to interface with the guests. Donors and sponsors in the community also help the CHI reach guests.

“It’s been an amazing experience,” Hayes said. “It gives you a lot of contentment to know that I’m helping, and that’s true for each of the volunteers and the board members, that we know we’re doing something.”

5. Urban Initiatives

Who it helps: Beginning in 2003 with just 12 children and two teachers, Urban Initiatives now serves more than 16,000 children, a majority who are minorities and living in households that are at or below the poverty line.

Across 38 Chicago Public Schools, children from kindergarten through twelfth grade have access to programs that can improve their health and academic performance — and, perhaps most notably, their character.

This is all offered by Urban Initiatives, taking place in three sports-based youth development programs:

  • Work to Play is the flagship program from Urban Initiatives that allows children from kindergarten to fourth grade to participate on a soccer team. With two practices and one game each week, children must meet behavioral and academic standards to play. There are no skill level requirements for children to participate.
  • Take the Lead is a leadership development program for children from fifth to eighth grade who are alumni from the Work to Play program. These children serve as team captains on Work to Play teams, engaging with coaches to build leadership skills and focus on community service and academic goals.
  • Play with Potential is a recess program that is offered to all students in kindergarten through twelfth grade, focusing on teamwork and physical activity.

The programs have found success. According to Urban Initiatives, 96 percent of Work to Play participants play for at least 60 minutes, five days per week. One-hundred percent of Take the Lead captains are confident in their ability to lead younger teammates. And in the Play with Potential program, students are 45 percent more likely to perform moderate to vigorous physical activity than those at other schools.

A full staff of program associates and coordinators, in addition to volunteers and the management staff, works with the children to make the most of mentoring opportunities that take place in the programs.

For the mentors that make a difference in the lives of students, they are quick to acknowledge what they learn in the process. “It is the goal of Urban Initiatives coaches not just to be a mentor but to teach and train students to be mentors themselves, no matter how old they are and no matter the age of those they mentor,” Urban Initiatives program director Brendan McAlpine writes. “The Urban Initiatives team is proud and grateful to state that we have learned just as much from our students as we have taught them.”

Making Chicago a Better Place to Live

The aforementioned programs and initiatives embody the commitment that many have in helping those who are less fortunate or susceptible to certain social issues. Across crime, education, poverty and hunger, they are making a difference in Chicago communities where they serve.

One thing these initiatives have in common is the presence of social workers. These professionals organize programs, secure resources to help those in need and work alongside of other professionals to touch the lives of others. Hundreds of thousands of social workers can be found across America, changing the lives of those in need.

This article was written in conjunction with Aurora University Bachelor of Social Work Program.

Preserving the Therapeutic Relationship as a Mandated Reporter


If you find yourself a mandated reporter of child abuse and neglect and have ever had to report a client or patient with whom you have worked so hard to build rapport, the disruption of the therapeutic relationship probably appropriately concerns you. You know you have to call, and you can easily imagine that Jenga tower of rapport and trust you and your client built together toppling over completely.

Furthermore, you may already know that many cases of abuse and neglect do not spring from the woodwork, and there may be a complicated context. It may be important to you as a clinical practitioner to preserve the relationship if possible, so you can help your client and their family further.

HOWEVER: Not all is lost! In both the research, and this writer’s personal experience, The therapeutic relationship can be preserved, or the damage at least mitigated. Others have done it and you probably can too. After you accept that you need to/have to/are going to report (the definitions of abuse and neglect vary from state to state but generally follow the definitions in federal law) consider the following steps:

  • Be realistic and own your role. Be comfortable with the fact that you may damage or extinguish the therapeutic relationship. You are fulfilling your responsibilities as a mandated reporter and these responsibilities are in place to protect your client and their child. Plenty of data illustrates the importance of your mandated role. The CDC notes the stakes when they report that many incidences of abuse and neglect are not reported. In a nutshell, the importance of your therapeutic relationship does not outweigh the importance of reporting.
  • Be as honest as possible. Fulfill your responsibility to make the call, but also be responsible for informing your client, unless contraindicated. Give as much information as possible about the process, which can increase their sense of control over the process. It’s also extremely important to make sure they understand what caused the report, if you can safely do so.
  • Educate on the process. Be familiar with the process and give updates as you have them. Advise how they can advocate for themselves and use your local Child Protection agency as a resource. Provide your client information on advocating for themselves if they are concerned they will not be treated fairly.
  • Acknowledge feelings and emphasize your supportive role. You can be a mandated reporter and still available to be supportive to the client and family throughout the process. You can still listen to and reflect their frustration with the call and the process. Acknowledging feelings  is therapeutic in almost every situation. You can always acknowledge feelings without condoning specific actions.
  • Stick to your guns and do not waver on the report itself. You can acknowledge and validate frustration and still be comfortable with your call. Clarify what those criteria were that led to the call and how you can still be available to prevent them from resulting in a report in the future. The only thing more irritating than knowing someone reported you for suspected abuse or neglect may be the perception they reported you when they did not know it was required.
  • Diffuse some responsibility. If you made the call, own it but you can still spread the responsibility around. You can probably sincerely say:
    •  Law and probably agency policy requires you make the call given the previously discussed situation (what was said, what you observed)
    • Your supervisor advised you are required to make the call, if you consulted them first.
    • You consulted with other clinical team members as well, if you did so.
  • MIX AND MATCH FOR COMBO POINTS! As with many therapeutic techniques, you can use more than one of the above. Acknowledging feelings + being honest about the criteria that led to the report available for support + educating on the process = a sort of “gentle reality check”. It sounds like they are very angry about this situation, they are entitled to feel angry at you and/or the system, but the specific situation required this report.

Again, rest assured that any good faith report that you make of reasonable cause to suspect abuse or neglect always wins when compared to not reporting. You are mandated for a reason. Most reports of abuse or neglect were made by mandated reporters just like you and as noted above, the number of incidences of child abuse and neglect, and the resulting damage to those children and our society at large, already greatly outnumber the number of reports.

If the very real potential for the Child Protection System to be used as a tool of oppression concerns you, you have other options as a social worker, and these concerns should not impact your decision to make a report:

  • If prevention remains a possibility, or if you do not already reasonably suspect abuse or neglect, make sure your at-risk client is aware of the risks. A large part of this writer’s Pediatric Clinic role is advising families at risk of abusing or neglecting their children of the definitions of abuse and neglect, the mechanisms for reporting, interviewing them to identify the psychosocial context that they feel causes those risks, and connecting them with appropriate education and/or resources.
  • If you fear your client may be treated unfairly after the report, you can still be their advocate throughout the process. Share your knowledge of the process. Again, making sure they know you remain available is an important part of maintaining the therapeutic relationship.

SAFETY NOTE: Much of the above bears the assumption that you can safely discuss a report with your client. If you or your supervisor have any realistic concern about your safety, particularly if you work in the client’s home, it is okay to skip some of the above steps. While it may be better for the therapeutic relationship to be honest about making a report, since the client may be aware of you as the possible reporter from the context or reading of your non-verbal cues, as far as the therapeutic relationship goes, your safety outweighs the importance of that relationship in the same way a child’s safety does.

If you do not feel safe speaking honestly and sincerely with your client about concerns that you have for their safety or the safety of children in their care, you may not be the best therapist or social worker for them anyway. And there’s nothing wrong with that.

You can find more information child abuse and neglect, including the laws in your state, at

New Field Placement Model With Crittenton Earns Award from CSU Fullerton for its “Teaching and Mentorship” Culture


Fullerton, Calif. – Crittenton Services for Children and Families (CSCF) is proud to announce the agency’s nomination and selection as this year’s recipient of the Most Committed Partner award by both the CSUF Social Work Department and the CSUF Center for Internship & Community Engagement (CICE).

Each year CICE hosts its annual Community Engagement Awards as a way to highlight students, faculty and community partners in their efforts to strengthen the bonds of engagement that connect the University and the community. CICE’s main mission is to bring faculty, students, and community partners together to create high impact practices for student success.

“Our collaborative partnership with CSUF extends learning from the classroom to the community, giving students experiential learning opportunities that will build their skills, their resumes, and their ability to positively impact the world around them. It is truly a win-win,” said Joyce Capelle, Chief Executive Officer, CSCF, “We are honored to have worked alongside outstanding faculty and staff of CSUF for more than a decade, in order to provide students practical work experience while at the same time making a difference in the lives of the most vulnerable youth.”

Under the “Stellar Support of Students” category the CSUF Department of Social Work nominated Crittenton as an organization that has made a difference in the career trajectory of students via mentorship.  As part of the non-profit’s mission, Crittenton, has made it a part of its strategic plan to make the idea of a “teaching institution” a reality and part of the overall agency culture. For its efforts in guiding and mentoring students, Crittenton has been recognized for going above and beyond its duties as an experiential learning host site.

In addition, as of 2015 both Crittenton and CSUF celebrate a 10-year anniversary of working together to serve vulnerable children and their families curtail the effects of child abuse, neglect, and trauma.

Since the inception of this evidenced-based field placement opportunity for social services, human services, and social work students have been able to take ample opportunity to earn academic units, licensing requirements and gain valuable work experience at a nationally accredited agency.

In fact, throughout this 10-year partnership period, roughly 121 undergraduates and 35 graduate students from CSUF have been given the opportunity to take part of a non-profit’s mission with a connection to a proud national child welfare legacy that goes back to 1883. Nearly 30 CSUF students have been hired as Crittenton employees via this partnership.

At the helm of this internship program collaboration with CSUF is executive team member and CSUF Alumna, Denise Cunningham, Senior Vice President of Crittenton Services.

Cunningham has been a strong advocate of community partnerships between Crittenton and higher education institutions, and has also served in the capacity of a mentor. Her commitment to student success is such that as of this year the CSUF Social Work Department has appointed her Chairperson of the department’s advisory council.

To build tomorrow’s workforce in the human services fields it takes the acquisition of knowledge in the classroom in tandem with developing skill-sets in the community. Crittenton’s partnership with CSUF is an excellent example of this collaborative approach to developing effective practitioners and future change agents.

Confidentiality Policies that Hurt Children in Child Welfare Protection Cases

A news story regarding abuse animal recently resulted in thousands of dollars in donations. The community was appropriately outraged when pictures and details of the abuse were aired by local television stations. The community responded with donations and tips that led to the identification and arrest of the abuser. It was striking that the community immediately mobilized to provide care for the dog, supporting the local rescue organization, and law enforcement in their efforts. The response was immediate and generous.

For me, the more striking aspect of this story was something unrelated. A story on Page 6 of the local newspaper reported the same day that three children had been removed and placed in foster care. A two-year-old had tested positive for exposure to three different illegal drugs.  Their babysitter called authorities when they observed that the toddler was not acting normally. The story went on to state the children lived in deplorable conditions and two children were hospitalized, but there were no donations. If there was an arrest, it was not reported. Instead of support for the organization charged with providing emergency care for the children, there was criticism that the abuse was not identified earlier.

boy with dogThe contrast in the two stories was readily apparent. The community rallied to support the animal rescue organization, law enforcement, and the veterinary clinic providing medical care for the dog. There were donations of money and supplies, assistance to law enforcement, and offers of care for the dog. The animal rescue organization issued a statement saying they did not need a home for the dog 24 hours after the story was reported; they had more than enough donations and offers of assistance.

Meanwhile, the child welfare agency was criticized, the medical provider not identified, and the role of law enforcement was not acknowledged. I doubt the story of child abuse prompted many calls offering a home for the children. Generally only stories of abandoned or abused infants generates calls from potential new foster parents or inquiries about adoption.

Why was there such a difference in response? I believe that, in part, confidentiality played a role. The names and locations of the children were not included in the news story. Details of the care required for the dog were shared while the care of the children remained confidential. The names of the alleged perpetrators of the abuse of the dog were widely publicized, including their ‘mug shots’. The rescue organizations and other community support agencies were identified. Conversely, the names of alleged perpetrators of the abuse of the children were withheld. Rarely are details of child abuse shared with the public. When there are news stories, they tend to be only the horrific cases where a child has died, has been starved, or is severely abused, and the focus generally is on ‘system failures’. For the record, I would not advocate for publicizing ‘mug shots’ of abusers in most child abuse cases. I firmly believe in a strength-based approach to treating and ultimately ending child abuse.

I understand the interest in shielding vulnerable children from media coverage, and my intent is not to compare children to animals. It is worth noting, however, that child protection emerged as a field as a result of animal protection laws. I am not one of ‘those people’ who bemoan the support received by animal rights organizations.

However, maybe child welfare could learn something from animal protection efforts. Maybe the public reporting of child abuse should be accompanied by a request for support, a list of opportunities to help. Maybe child welfare should be more transparent about the important work they do every day so that the next time a child is abused finger-pointing is replaced by offers of support. I look forward to the day that shelter care facilities for abused children are obsolete because of the abundance of foster homes available. And perhaps one day child welfare will be able to turn away offers of support. Better yet, maybe one day communities will be so engaged in protecting children that abuse reports are a rarity and replaced with a ‘norm’ of citizens reaching out to ensure children are cared for and nurtured. Perhaps one day….

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