NCJ Number
107899
Journal
Child Abuse and Neglect Volume: 11 Issue: 3 Dated: (1987) Pages: 409-420
Date Published
1987
Length
12 pages
Annotation
This paper reviews studies of untreatable families, considers the potential benefit of further work, and briefly considers other fields of study which have a bearing on such families.
Abstract
An untreatable family is one in which the child is at too high a risk to remain in the home. In the case of physical abuse, 16-60 percent of parents reabuse their children after the initial incident. Sexual reabuse occurs in 16 percent of cases. Studies in physical abuse indicate that 20-87 percent of abusive parents are unchanged or worse at the end of treatment. In sexual abuse the equivalent figures are 16-38 percent. Parental factors associated with a poor outcome include parental history of severe childhood abuse, persistent denial of abusive behavior, refusal to accept help, severe personality disorder, mental handicap complicated by personality disorder, parental psychosis with delusions involving the child, and alcohol/drug abuse. Parents lack empathy for their child and fail to see the child's needs as separate from their own. Severe forms of abuse (fractures, burns, scalds, premeditated infliction of pain, vaginal intercourse, or sexual sadism) are more likely to prove untreatable. Munchausen by proxy, nonaccidental poisoning, and severe forms of nonorganic failure to thrive are similarly resistant. An early recognition of untreatability may help to reduce burnout by diverting resources from untreatable to treatable families. 3 tables and 48 references. (Author abstract modified)