Identifying and reducing the stressors that put a family at risk can be important opportunities to assist families in overcoming the abusive home environment.

While it has already been mentioned that the stressors of socio-economic status are a major underlying contributor in some families due to the added stresses of poverty, isolation and drug and alcohol abuse other individual factors can put individuals at risk. For example, inappropriate parenting skills, cause stress and fear when a baby cries and the parents do not know what to do to pacify the child.

Some babies can be irritable, unresponsive hence cry a lot. Parents who maybe young, and have come from a family as an only child or one or two older siblings have not had the opportunity to learn from younger siblings and experienced mothers. Undiagnosed psychological problems and not receiving the appropriate support or treatment is another contributing factor.

Case Study:

Josh, found himself inside for the third time since leaving school half way through year 8. He always thought education was a waste of time, and it certainly didn’t seem to help his family.

Looking back for as far as he could remember he’d been brought up on the sound of his father yelling and his mother in tears.

As he got older, however, the anger from his dad began being directed at him. Some nights, after a beating, he would cry himself to sleep because of the intensity of his pain. They all said it was to teach him a lesson, but Josh had no idea what he was supposed to learn. Sometimes he didn’t even say anything, he’d just be sitting there and find himself being belted across the head.

Teachers couldn’t hit him, he knew that. But Josh never respected a male teacher who wouldn’t stand his ground. His dad might have been aggressive, but he never took any crap from anyone. Josh believes you can’t respect a man who won’t fight and stand up for himself.

Growing up, no-one talked in Josh’s household. They either grunted, pointed, or yelled. He used to laugh and say that he had “a simple life”. But now he wondered if it was so simple. He thought back to his school years, and when he first settled disputes with a kick or a punch, no-one seemed to take it too seriously. He was even quite popular. He concluded that his popularity was a result of being the man to have around if a fight broke out.

But Josh knew that something changed when he went from primary school to secondary school. He met Lilly. He adored Lilly and would do almost anything for her.  She wanted him to give up punching and fighting. At first he thought it was a “girl thing” and she’d get over it, but he soon realised that she was serious. When he tried to change for her, it didn’t last. So she dumped him and started going out with Jonothan Corby.

Beating Jono into the ground made Josh feel good, he even told his dad about it that night and they laughed at Jono’s injuries. His mum didn’t laugh, but she was like that.

Later that night, however, the police called in to the house. Josh’s Dad gave him a beating because of this, stating that he had “brought shame on the house”.

Now in jail, Josh is looking at his life and wondering how he ended up there.

Tweet This Post Digg This Post Share on Facebook

Whatever the cause of the abuse and/or neglect, it can have long-standing consequences for the child. The younger the child, and the more vulnerable they are, the more serious the consequences are likely to be, however, with early intervention children can recover from abuse and neglect.

When the abuse is ongoing or long term it can result in the child becoming:

1. Withdrawn, living in their own world, and suffering low self-esteem.
2. Abused and neglected children are at greater risk of developing anxiety disorders; they become hypervigilent always alert possible danger.
3. Attachment disorders are not uncommon, along with learning disorders, including poor language and cognitive development.
4. Aggressive behaviours including other behavioural problems and developmental delay (which can include eating disorders and physical ailments).
5. Delinquency and criminal behaviour including violent and aggressive behaviours.

Case Study

Timmy is six years old. He enjoyed being at school and playing with all the other children at play time, but in class he was not able to follow the lessons like the other children. Some times he would find he would be daydreaming and would suddenly realise he was in class and would drag his mind back to whatever the teacher was saying.

He was not comfortable with the teacher walking around the classroom. Sometimes she would hover around the children watching their efforts at painting, offer some advice, and ask what certain aspects of the painting were. This always made Timmy shake. He felt afraid and he did not know why. The teacher was never angry at him and never yelled at him like his Dad did.

Sometimes when she would ask him a question, he would just nod his head. Even when he knew the answer he hardly spoke.

He knew he wasn’t as smart at the other kids, they knew the answers to lots of questions. They were also very eager to put their hand up or yell the answer out. They seemed so brave. Timmy wasn’t very brave.

Lately, when he would be playing with the ball in the playground he found himself punching some of the other boys, or kicking them, really, really hard. He had to go to the principal’s office once for hurting one of his friends. Timmy is not really sure why he got so angry and punched the boy so hard, he was quite shocked that he did it. He didn’t mean to hurt him.

Not all children deal with abuse through violence. Many simply withdraw into themselves, with serious trust issues making genuine relationships difficult.

Tweet This Post Digg This Post Share on Facebook

As stated in The Australian Institute of Family Studies, 2004 edition of Identifying and Responding to Child Abuse and Neglect, the sad facts are:

There are four recognised types of child abuse: physical abuse, sexual abuse, emotional/psychological abuse, and neglect. Children and young people are most often abused by a parent or a carer. The rates of substantiated abuse or neglect decreases as age increases, children under the age of one year old are the most likely to be subjected to a substantiated report of abuse, and children 15-16 years of age are the least likely.

There is no accurate statistical information on the prevalence of child abuse in Australia. The most accurate statistical information available is based on the number of reports of suspected child abuse made to the statutory child protection departments in each state. While these statistics give some indication of the extent of this problem in our society, it is well known that a large number of cases of child abuse go unreported. 

Difficulties arise in obtaining accurate statistics regarding child protection because in Australia state governments have the statutory responsibility for protecting children from abuse and neglect, however the definitions of what constitutes child abuse differs across the states and territories, and mandatory reporting requirements also differ between the states and territories. Thus it is difficult to obtain consistently comparable statistics to give a national indication.

However of the number of substantiated cases reported, 28% comprise of physical abuse, 10% sexual abuse, 34% emotional abuse and 28 % neglect.

Overly represented in child abuse substantiated cases are families with a complex range of socio-economic problems such as poor housing, poverty, unemployment, substance abuse, single parent families, social isolation, and family and domestic violence. Parents faced with these challenges often require additional support to care for their children, as abuse of a child seldom happens once; it is often a process that can persist over many years.

Aboriginal and Torres Strait Islander children and young people are eight times more likely to be reported in child protection statistics than non Aboriginal and Torres Straight Islander children. While children with disabilities especially those with chronic health problems or serious disabilities are more vulnerable to abuse or neglect as a result of stress that “around the clock” care can create for carers.

Adults who were abused as children are at greater risk of developing psychological and emotional problems later in life and of repeating the pattern of abuse with their own children.

In this Special Reports series, we will look at the issue of child abuse and neglect - and how counsellors can play a positive role in assisting children.

Follow-Up Posts:

1. The consequences of abuse and neglect for the child
2. How can we help?
3. Recognising when a child or young person is at risk
4. Assessment
5. Intervention
6. Case Planning and Review

Related Series: Communicating with Children, The Impact of Child Sexual Abuse, My Child Being Bullied

Tweet This Post Digg This Post Share on Facebook

Not every end is the goal. The end of a melody is not its goal, and yet if a melody has not reached its end, it has not reached its goal. A parable.” ~ Friedrich Nietzsche

It’s almost a paradox, but the goal of a successful counselling relationship is to, eventually, come to an end! Sometimes therapists and clients build a rewarding relationship and it may be difficult for both to formalise the end of that bond; but nevertheless, it is a vital step to effectively mark the success of the process and move forward.

Let’s overview the formal ending of the client-worker relationship. This formal ending usually falls into two categories: planned or unplanned.

1. Unplanned terminations

Either client or worker may initiate unplanned terminations. Client-initiated terminations may occur as a result of:

1. the client dropping out of treatment,
2. an adverse event that has rendered the client unavailable for service, or
3. the client behaving in a manner that is incompatible with service requirements and is thus withdrawn from the program.

Client-initiated terminations can leave both worker and client with residual feelings of rejection, relief, anger and/or shame due to lack of opportunity for discussion and defusing.

Unplanned worker-initiated terminations can occur as a result of:

1. an adverse event that has rendered the worker unavailable for service,
2. the worker being dismissed, or
3. the worker being laid-off or transferred.

Similar emotional reactions to those that may occur from client-initiated unplanned endings can also occur in response to worker-initiated endings, particularly if the ending is immediate. Some worker-initiated endings, however, whilst unplanned, can accommodate a final session for discussion and handover and this, of course, is best practice.

2. Planned terminations

Planned terminations can occur with two outcomes:

1. the unsuccessful achievement of service goals and
2. the successful achievement of service goals.

Planned Terminations with Unsuccessful Outcomes

Planned terminations with unsuccessful outcomes may occur when:

1. the worker or client is dissatisfied with the helping relationship,
2. the client is not progressing, despite continual attempts,
3. the worker is not competent in addressing the specific needs of the client or
4. the client does not comply with the requirements of intervention.

Hepworth, Rooney, Rooney, Strom-Gottfried & Larsen (2006) suggest that in situations such as these, the worker should discuss with their client (1) what factors prevented a more favourable result from being achieved and (2) the client’s feelings about seeking help in the future.

Such discussion needs to occur in an environment where the client feels safe and does not feel judged. Additionally, the worker needs to ensure that they do not respond in defence of themselves or the service. This will only serve to distance the client and may initiate a missed opportunity for genuine feedback.

Planned Terminations with Successful Outcomes

The aim of case management and other collaborative practice endeavours is to achieve the goals established with the client in the planning and contracting stage. The achievement of such goals, may not signal that the client won’t need the support of the worker in the future, but it does demonstrate that at this time the client can function sufficiently on his or her own.

It may therefore be beneficial in situations of planned terminations (with successful outcomes) that client and worker together discuss contingencies should future assistance be required. Additionally, successful outcomes may mark the client’s readiness for further growth and development, thus a referral to an appropriate service that would foster such development may be appropriate.

Tweet This Post Digg This Post Share on Facebook

You have been counselling a married couple for several weeks. The couple came to you because of problems they were having in their relationship. During the process you have seen the pair separately at which time you learnt that the husband is only staying with his wife because of their two children. The wife meanwhile has confided to you that her husband is not the biological father of one of the children.

If you were confronted with this dilemma how would you deal with this couple?

(click on the comments link below to view responses)

Related Dilemmas: A Multicultural Issue in Relationship Counselling, Family Therapy and Adolescent Counselling, A Family “Break-Up” Dilemma

Tweet This Post Digg This Post Share on Facebook