Abuse and Neglect-BCCFinalAB

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Child Abuse, Neglect and Setting Professional Boundaries:

Child Abuse, Neglect and Setting Professional Boundaries

**Please Note**:

**Please Note** This training contains two videos . Please give the video a second to upload when you get to that slide. This training and material may have triggering content . You may click on the slide to move the presentation forward if you are unable to view the video Child Abuse and Neglect is a difficult topic please talk to someone after the training if further follow up is needed .

Learning Objectives::

Learning Objectives: To understand the definition of abuse and neglect. Identify the Types of Abuse and Neglect Although child abuse is a prevalent problem, we can work to prevent it! How to set and maintain professional boundaries

Learning Objectives::

Learning Objectives: To inform all employees of the code of Maryland requirements for reporting child abuse and/or neglect To increase awareness and to steps to protect children from maltreatment and assist their families with treatment services video

The Federal Child Abuse Prevention and Treatment Act (CAPTA):

The Federal Child Abuse Prevention and Treatment Act (CAPTA) Defines Child abuse and neglect as: Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or An act or failure to act which presents an imminent risk of serious harm.

Case of Mary Ellen::

Case of Mary Ellen: 1875 Abusive adoptive parents Church workers tried to get local authorities to take legal action---nothing was done Society for the Prevention of Cruelty to Animals Animals were protected, so she was removed from the home and adoptive parents went to prison In 1875---children at least reached status of animal

Case of Mary Ellen::

Case of Mary Ellen: Because of her case, NY Society for the Prevention of Cruelty to Children was established (other cities established similar societies) By 1968 ---all 50 states had enacted some sort of law regarding the reporting of child abuse By 1974 ---Child Abuse Prevention and Treatment Act (CAPTA) was signed into law, which created the National Center on Child Abuse and Neglect 1974 -Child Abuse Prevention and Treatment Act

Definitions::

Definitions: Abuse Caretaker Child Family Member Household Member Mental Injury Neglect Sexual Abuse Maryland Annotated Code, Family Law Section 07.02.07

Definitions::

Definitions: Abuse : physical injury, not necessarily visible, or mental injury of a child, under circumstances that indicate that the child’s health or welfare is harmed or at substantial risk of being harmed; sexual abuse of a child, regardless of whether the child has physical injuries Caretaker : an individual who has, or is known to the child through having had, permanent or temporary care, custody, or responsibility for the supervision of the child

Definitions::

Definitions: Child : an individual younger than 18 years old Family Member : a relative by blood, adoption, or marriage Household Member : an individual who lives in, or is regularly present in, a child’s household Mental Injury : observable, identifiable, and substantial impairment of a child’s mental or psychological ability to function

Definitions::

Definitions: Neglect : failure to provide proper care and attention to a child, including leaving a child unattended, under circumstances that indicate that the child’s health or welfare is harmed or placed at substantial risk for harm; metal injury or substantial risk of mental injury of a child that is caused by the failure to provide proper care and attention to a child

Types of Abuse::

Types of Abuse: Physical Abuse Sexual Abuse Emotional Abuse ( Mental Injury ) Neglect

Physical Abuse :

Physical Abuse Infliction of physical injury Moderate to severe Punching, beating, kicking, biting, shaking, throwing, stabbing, choking, hitting, burning, or otherwise harming a child Considered abuse even if caregiver did not intend to harm the child

Sexual abuse :

Sexual abuse Encompasses any and all sexual contact with a child by adults, adolescents or older children Children can be bribed or coerced into sexual situations

Sexual abuse:

Sexual abuse Can include but is not limited to: Indecent exposure Voyeurism Kissing Fondling (by child or of child) Penetration or attempted penetration Incest Rape Sodomy Exploitation (prostitution or pornographic materials)

Emotional Abuse (known as Mental Injury in MD) :

Emotional Abuse (known as Mental Injury in MD) Pattern of behavior that hinders a child’s emotional development & sense of self-worth Includes excessive, aggressive, or unreasonable demands that place expectations on child beyond his/her capacity Constant criticizing, belittling, insulting, rejecting and teasing

Emotional Abuse (known as Mental Injury in MD) :

Emotional Abuse (known as Mental Injury in MD) Also includes failure to provide psychological nurturing necessary for a child’s psychological growth and development Several types: Rejecting abusive expectations verbal assaults unpredictable responses Ignoring constant chaos Denying terrorizing Isolating dominating Corrupting emotional black mail

Neglect :

Neglect Most common for of child maltreatment Act of omission Caregiver does not provide proper care Can be physical, medical, educational, or emotional

Risk Factors::

Risk Factors: Child Gender Age Family or Parent Race Ethnicity Society Socioeconomic Status Disabilities Community

specific characteristics in the children they choose to abuse. :

specific characteristics in the children they choose to abuse. Passive, quiet, troubled, lonely children from single parent or broken homes . Perpetrators frequently seek out children who are particularly trusting (Conte et al., 1987) and work proactively to establish a trusting relationship before abusing them, this often extends to establishing a trusting relationship with the victim’s family as well.

Gender:

Gender Gender is also a major factor in sexual abuse. Females are 5 times more likely to be abused than males . The age of the male being abused also plays a part. 8% of victims age 12-17 are male. 26% of victims under the age of 12 are male.

family characteristics that heighten or lower risk of sexual abuse. :

family characteristics that heighten or lower risk of sexual abuse. Children who live with two married biological parents are at low risk for abuse. The risk increases when children live with step-parents or a single parent. Children living without either parent (foster children) are 10 times more likely to be sexually abused than children that live with both biological parents. Children who live with a single parent that has a live-in partner are at the highest risk: they are 20 times more likely to be victims of child sexual abuse

Age is a significant factor:

Age is a significant factor Age is a significant factor in sexual abuse. While there is risk for children of all ages, children are most vulnerable to abuse between the ages of 7 and 13 . The median age for reported abuse is 9 years old. However, more than 20% of children are sexually abused before the age of 8.

Race and ethnicity:

Race and ethnicity Race and ethnicity are factors in identified sexual abuse. African American children have almost twice the risk of sexual abuse than white children. Children of Hispanic ethnicity have a slightly greater risk than non-Hispanic white children.

Socioeconomic Status :

Socioeconomic Status The risk for sexual abuse is tripled for children whose parent(s) are not in the labor force.   Children in low socioeconomic status households are 3 times as likely to be identified as a victim of child abuse.  

disabilities:

disabilities Most studies have reported that children with disabilities are at greater risk for sexual abuse. The latest research identified incidents of child sexual abuse involving children with disabilities at only half the rate of their non-disabled peers.

Community :

Community Children who live in rural areas are almost 2 times more likely to be identified as victims of child sexual abuse. Children who witness or are the victim of other crimes are significantly more likely to be sexually abused.

Effects of Abuse::

Effects of Abuse: Physical Consequences Psychological Consequences Behavioral Consequences Societal Consequences

Physical Consequences :

Physical Consequences Physical effects of abuse or neglect can be relatively minor (bruises or cuts) or severe (broken bones, hemorrhage, or even death). Abusive head trauma, caused by shaking and blunt impact, is the most common cause of traumatic death for infants. Children who experienced neglect are at higher risk for diabetes and poorer lung functioning, while physical abuse was shown to increase the risk for diabetes and malnutrition.

Psychological Consequences :

Psychological Consequences emotional effects of abuse and neglect isolation, fear inability to trust low self-esteem depression relationship difficulties.

Offenders::

Offenders: Can be anyone! Family, friends, neighbors, or strangers 90% of child victims know their offender, with almost half of the offenders being a family member. Of sexual assaults against people age 12 and up, approximately 80% of the victims know the offender. Not only men abuse children and Youth

Statistics::

Statistics: 2011 NATIONAL ABUSE STATISTICS – Approximately 681,000 children were victims of maltreatment 46 states reported approximately 3.3 million children received preventative services from Child Protective Services agencies in the United States. In 2010, Maryland had 45,129 total referrals for child abuse and neglect. Of those, 26,294 reports were referred for investigation . In 2010, 24 children in Maryland died as a result of abuse or neglect.

Warning signs of emotional abuse in children:

Warning signs of emotional abuse in children Excessively withdrawn, fearful, or anxious about doing something wrong. Shows extremes in behavior (extremely compliant or extremely demanding; extremely passive or extremely aggressive). Doesn’t seem to be attached to the parent or caregiver. Acts either inappropriately adult (taking care of other children) or inappropriately infantile (rocking, thumb-sucking, throwing tantrums).

Warning signs of physical abuse in children:

Warning signs of physical abuse in children Frequent injuries or unexplained bruises, welts, or cuts. Is always watchful and “on alert,” as if waiting for something bad to happen. Injuries appear to have a pattern such as marks from a hand or belt. Shies away from touch, flinches at sudden movements, or seems afraid to go home. Wears inappropriate clothing to cover up injuries, such as long-sleeved shirts on hot days.

Warning signs of neglect in children:

Warning signs of neglect in children Clothes are ill-fitting, filthy, or inappropriate for the weather. Hygiene is consistently bad (unbathed, matted and unwashed hair, noticeable body odor). Untreated illnesses and physical injuries. Is frequently unsupervised or left alone or allowed to play in unsafe situations and environments. Is frequently late or missing from school.

Warning signs of sexual abuse in children:

Warning signs of sexual abuse in children Trouble walking or sitting. Displays knowledge or interest in sexual acts inappropriate to his or her age, or even seductive behavior. Makes strong efforts to avoid a specific person, without an obvious reason. Doesn’t want to change clothes in front of others or participate in physical activities. An STD or pregnancy, especially under the age of 14. Runs away from home.

Helping an abused or neglected child:

Helping an abused or neglected child What should you do if you suspect that a child has been abused? How do you approach him or her? Or what if a child comes to you? It’s normal to feel overwhelmed and confused in this situation. Child abuse is a difficult subject that can be hard to accept and even harder to talk about.

Helping an abused or neglected child:

Helping an abused or neglected child Just remember, you can make a tremendous difference in the life of an abused child, especially if you take steps to stop the abuse early. When talking with an abused child, the best thing you can provide is calm reassurance and unconditional support. Let your actions speak for you if you’re having trouble finding the words. Remember that talking about the abuse may be very difficult for the child. It’s your job to reassure the child and provide whatever help you can.

Mandated Reporters:

Mandated Reporters THAT’S YOU! Childcare professionals School personnel Health care professionals Social Workers Law enforcement officers Mental health professionals, and All persons Required by law to report, both orally and in writing, any suspected child abuse or neglect

Reporting::

Reporting: When? Verbal reports should be made immediately. Written reports must follow the verbal report before the end of a shift.

Board of Child Care’s Stand:

Board of Child Care’s Stand Board of Child Care Will support without judgment both the employee and the resident. Employee Proactively taking steps to avoid abuse/neglect situations and to report suspicions is every employees duty and responsibility Nothing is insignificant!

BOARD OF CHILD CARE PROGRAM DEPARTMENT POLICY & PROCEDURE MANUAL 200.4 – CHILD ABUSE AND NEGLECT POLICY :

BOARD OF CHILD CARE PROGRAM DEPARTMENT POLICY & PROCEDURE MANUAL 200.4 – CHILD ABUSE AND NEGLECT POLICY As a staff member of the Board of Child Care, you are mandated to report a source of child abuse and neglect by virtue of your employment in a child care facility. Procedure: Should you be a witness to, be involved in, or be aware of something that you feel constitutes abuse; you should contact the Campus Supervisor and/or Administrator-On-Call immediately. 1)After the Program Director/Administrator on Call is alerted by phone, a Serious Incident Report should be completed. The Serious Incident Report should be an objective factual account of the incident that you witnessed or were involved in or that was reported to you. 2)The Serious Incident Report should be given to the Program Director/AOC. They will notify the Assistant Executive Director. If it is a possible case of abuse and/or neglect, adhere the following guidelines.

Guidelines (under supervision, collaboration and Communication with the Administrator): :

Guidelines (under supervision, collaboration and Communication with the Administrator): 1)The safety of the child must be assured. An assessment will be made regarding a plan of action for safety . 2)A medical assessment should be completed by Board of Child Care Nurse, Physician or Emergency Room Physician if indicated. All medical tests and x-rays should be completed immediately to assess possible injury (if any ). 3)An interview and written statement will be taken from the alleged abuser, which will be signed and dated . 4)Once the Program Director processes the information it will be presented to the Assistant Executive Director. The Assistant Executive Director/designee will determine whether the report is a reportable. A report to the President and CEO/designee of status of report will be communicated.

Guidelines: (under supervision, collaboration and Communication with the Administrator): continued:

Guidelines: (under supervision, collaboration and Communication with the Administrator): continued 5) Once all preliminary documentation (i.e. Serious Incident Report, youth report, statements) has been gathered it must be reported to Child Protective Services (CPS) and/or local state governing agency. CPS will make a determination based on the information as to whether they will investigate the incident. It is good practice to consult with CPS when questions arise on questionable incidents to get their feedback and document any recommendations they may give. 6) Parents/Guardians of the resident are informed of the incident along with the placing agency, and the OLM , by the Assistant Executive Director/designee .

Mandated Reporters:

Mandated Reporters Maryland Law requires every health practitioner, educator, human service worker, or police officer to report suspected child abuse and neglect, it does NOT require PROOF that abuse or neglect has occurred before reporting.

Mandated Reporters:

Mandated Reporters Incidents are to be reported as soon as they are suspected. Waiting for proof may involve grave risk to the child and impede services to the family. Proof may be long in coming, witnesses to child abuse and neglect are rare, and the child’s testimony may be disbelieved or inadmissible.

Protection for Reporters::

Protection for Reporters: Confidentiality: Identity of reporter is kept confidential Direct any questions to local authorities conducting investigation Immunity: In MD, reporters have immunity from civil liability and criminal proceedings

PowerPoint Presentation:

Health practitioners and social workers, among others, who knowingly fail to report suspected abuse of a child may be subject to professional sanctions by their licensing boards. For those who do report, the law provides protection. Persons who make "good faith" reports are immune from civil liability and criminal penalty. Protection for Reporters:

Investigation Process::

Investigation Process: If allegation of abuse is accepted: Case is categorized and assigned to a social worker. Initial contact with the victim must be made within 24 hrs. in cases that involve serious physical or sexual abuse. Contact must be made within 5 days for cases of neglect. ***Police department is only involved in cases of serious physical abuse, sexual abuse, or criminal matters.

Professional Boundaries:

Professional Boundaries It is important for Child Care Workers to have defined boundaries. They exist for the protection of the workers and the residents.

Why Are Boundaries Necessary?:

Why Are Boundaries Necessary? Professional relationship Safe for the clients Allows us to be objective Teach the residents how to form appropriate relationships Help us focus on the needs of the resident, not our needs

Blurred Boundaries:

Blurred Boundaries Too much information about yourself Giving/receiving gifts Dual or overlapping relationships Becoming “friends ” Physical contact

DISRUPTIVE ROLES IN PROFESSIONA BOUNDARIES FOR CHILD WELFARE PROFESSIONALS :

DISRUPTIVE ROLES IN PROFESSIONA BOUNDARIES FOR CHILD WELFARE PROFESSIONALS The Over-Identifier = This Child Welfare Professional is overly enmeshed with the victim of abuse and has lost themselves by overly identifying with the child victim. The Rescuer =This Child Welfare Professional believes that they are the ONLY one that can help the child and that no one else can possibly save the child but them. They do not think that any other professionals can understand the child or can offer assistance to the child.

DISRUPTIVE ROLES IN PROFESSIONA BOUNDARIES FOR CHILD WELFARE PROFESSIONALS :

DISRUPTIVE ROLES IN PROFESSIONA BOUNDARIES FOR CHILD WELFARE PROFESSIONALS The Blamer = This Child Welfare Professional does not want to deal with the sensitive and emotional issue of child sexual abuse so they attempt to blame the child for the victimization, allowing the Child Welfare Professional to label the victim as “different” and blame him or her. This allows the worker to distance himself/herself from the child so that the issue of victimization does not hit too close to home.

DISRUPTIVE ROLES IN PROFESSIONA BOUNDARIES FOR CHILD WELFARE PROFESSIONALS :

DISRUPTIVE ROLES IN PROFESSIONA BOUNDARIES FOR CHILD WELFARE PROFESSIONALS The Distancer = This Child Welfare Professional believes that they cannot become involved with their clients or it will be too painful so they avoid dealing with the sensitive and emotional issues of child abuse. Thus, they avoid effectively dealing with the victim.

When Dealing with Professional Boundaries ASK FIRST :

When Dealing with Professional Boundaries ASK FIRST Remember it is always better to ask first, if you are unsure!

Questions to consider…:

Questions to consider… Is this in the resident’s best interest ? Whose needs are being served ? How would I feel telling a colleague about this ? Am I treating this client differently ? Does the action benefit me rather than the client?

Questions continued…:

Questions continued… Am I uncomfortable documenting this decision or behavior in the record ? Am I taking advantage of the client ? How would this read if reported in the newspaper?

Expectations Specific to BCC:

Expectations Specific to BCC No contact with residents or their families outside of the agency No acceptance of money or gifts Be careful of personal disclosure DO NOT discuss residents with other residents CONFIDENTIALITY ALWAYS!

Never Confuse a Job With Having a Life:

Never Confuse a Job With Having a Life Danger zones: being tired, being unprepared Know your signs for stress Accept that there are things you can’t fix Healthy choices Practice relaxation Humor Social Support

THANK YOU:

THANK YOU

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