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C A S E M A N A G E M E N T A N D T R E A T M E N T O F P H Y S I C A L A B U S E A N D N E G L E C T

CHAPTER 13

CASE MANAGEMENT

• Case management: the ongoing work with families

to

• set & review goals/outcomes

• make plans to achieve those goals

• identify & select needed services

• collaborate with servicer providers

• monitor progress

• provide emotional support

• maintain records

• prepare documentation and reports

CAUTIONS FOR CASE WORKERS

• counter-transference: the worker’s reaction to the

client (feelings, attitudes, thoughts and behaviors),

which is brought about by the helper’s own past life

experiences

• must become aware of it so that helper’s own actions do

not negatively influence the service being provided.

• Confidentiality may need to be broken if the client

threatens or attempt suicide, threatens to kill

another, of abuse/neglect a child: must be

reported.

POTENTIAL TREATMENT SERVICES

• Therapy: art; cognitive processing; trauma-focused

play, integrative-eclectic, cognitive-behavioral;

parent-child interaction, & intensive family

preservation.

• Education: early childhood program, resilient peer

training intervention, parent-child education for

physically abusive parents

• Care: eye movement desensitization and

reprocessing (EMDR); therapeutic foster care;

parents anonymous, Inc.; family preservation

services

PROVIDING TREATMENT: CLIENT RESPONSE

• Engaging families in treatment can be difficult:

• showing difficulty in trusting others

• exhibit personality disorder, intolerant of a lengthy treatment

process

• have communication/cultural misunderstandings

• Treatment can provoke loyalty conflicts in children.

• Families are not always eligible for treatment by

appropriate agencies.

• Resources to treat may be limited.

WHO PROVIDES TREATMENT & HOW LONG?

• Family preservation agencies, often with the aid of

grans and independent of child protective services,

provide a full range of treatment services.

• The duration of treatment: specific guidelines

measure when families are ready for termination:

parents must demonstrate the following:

• be more aware of their own needs and how to get them

met

• be able to reach out for help in the future

• be able to communicate more effectively

• feel more positively toward their children

TREATMENT OF NEGLECTFUL FAMILIES

• Neglectful families may be especially resistant to treatment and necessitate family-centered services. • In-Home Family-Centered Services: intensive, short-term,

family-based services; voluntary, crisis prevention services to promote healthy functioning

• Shared Family Care: out-of-home care in which host caregivers and the parent(s) care for the children simultaneously; skills building model promotes parental responsibility and resource development

• The goal to help the family to function & improve their parenting skills so that the family can remain together.

TREATMENT OF PHYSICALLY ABUSIVE FAMILIES

• The primary goal of treatment with physically

abusive family is for the battering to cease and the

parents to develop coping skills for the future.

• Treatment for the child

• attending to the medical problem resulting from the abuse

• providing a safer environment

• attending to the psychological scars from the abuse.

• TF-CBT: trauma-focused cognitive behavioral therapy

TREATMENT FOR THE PHYSICALLY ABUSED CHILD

• Psychological Services:

• Trauma-focused cognitive behavioural therapy (TF-CBT)

• Therapies to help with self-concept & affect

• Remedial Services:

• Motor skills, cognitive development, & individualized

education plan (IEP)

• Socialization Services:

• Aggressiveness leads to cycle of poor peer relations

TREATMENT OF THE PARENTS & SIBLINGS

• Abusive parents also need to be treated for their

own traumatic pasts, in developing better

relationships with their children and in learning more

effective parenting skills, including appropriate

disciplinary techniques.

• Parent-child interaction therapy (PCIT)

• parent–child relationships

• parenting skills

• Alternatives for families cognitive-behavioral

therapy (AF-CBT)

• targets violent/abusive behaviors