by Anne P. DePrince & Julia Dmitrieva
Following child abuse and neglect allegations, investigations can involve multiple systems and people from child welfare, criminal justice, and health agencies. Complex multi-system investigations can leave caregivers confused, intimidated, or alienated, which can decrease their engagement with child welfare action plans (Staudt, 2007). Decreased caregiver engagement can negatively affect child outcomes, including increasing out-of-home placements (Dawson & Berry, 2002). Therefore, policy-makers and practitioners have called for multidisciplinary teams (MDTs) to work together across the investigation. As communities begin to establish or seek to improve MDTs, hearing directly from caregivers about their perceptions of investigations is important to ensuring practices support children and families. We set out to learn directly from caregivers about their views of child abuse and neglect investigations involving MDTs.
…policy-makers and practitioners have called for multidisciplinary teams (MDTs) to work together across the investigation.
Between January and June, our team interviewed 32 caregivers involved in child abuse and neglect investigations. Half of the caregivers interviewed indicated that they were the subject of the investigation; half were not. Caregivers were asked to share their perspectives on several topics. For example, what did they see as their role in the investigation? What did people involved in the investigation do to communicate support-validation-respect or lack of support-invalidation-disrespect?
We are learning several important things from caregivers. Here are our take-aways from preliminary analyses:
Caregivers Believe Coordination Matters. Caregivers frequently conveyed their beliefs that investigation outcomes depend on the coordination and communication of the MDT. Therefore, MDTs may want to take opportunities to clearly communicate to families who is on the team and how they work together, including how they communicate with one another. By emphasizing and explaining the collaboration, providers may be able to show their alignment with caregiver beliefs that coordination matters for outcomes. Providing information verbally and in writing about who their team members are from across the disciplines may support caregiver acquisition of that information during what can be a stressful time. Further, MDTs might consider how they communicate the caregiver’s role in the investigation and take steps to reinforce the messages given to caregivers.
Communication with Caregivers is Critically Important. Across interviews, we heard over and over about the importance of clear communication with families, during the initial days when the investigation begins as well as over time. Communication was central to caregiver perceptions of both support and respect when communication went well — and drove perceptions of lack of support and disrespect when communication faltered. Caregivers pointed to specific communication actions that made them feel supported and validated, such as returning phone class and providing regular and timely updates on the investigations. In addition, caregivers also felt supported when MDT members listened, explained steps in the investigation, answered questions, and conveyed belief (versus treating caregivers like “criminals”), empathy, and encouragement.
Though some caregiver concerns may fall outside the control of the MDT, clear communication with families may help nonetheless. For example, more than a third of participants expressed frustrations around issues related to the tensions between criminal and civil legal systems (e.g., protection orders), inaccessible language used in the investigations, and lack of offender accountability. While the MDT cannot control consequences for offenders, the team can play an active role in educating families about the criminal justice process, including terms used and timelines.
Keep the Brain in Mind. The majority of caregivers interviewed had their own histories of experiencing intimate violence by someone close, such as a caregiver or partner. Histories of intimate violence can make attention and memory as well as emotion regulation tasks difficult (e.g., Stein, Kennedy, & Twamley, 2002; Twamley et al., 2009). The onset of a child abuse and neglect investigation is stressful, whether an allegation is leveled against the caregiver or someone else. The multi-system response is confusing to understand. This context, combined with feedback from caregivers, suggests that teams responding to child abuse and neglect investigations should plan for challenges related to attention and memory, confusion about systems and roles, complex emotions, and prior experiences and expectations. MDTs might consider providing communications in multiples forms (for example, in writing and verbally) and plan to repeat communications.
Recognize the Unique Strengths and Challenges Facing Families. Half of participants described concerns about actions that were dismissive of the caregiver, and one in five described feeling as if the team was insensitive. This is consistent with other research on sexual assault survivors’ perceptions of victim services (including criminal justice) (Gagnon et al., 2018). In that work with sexual assault survivors, we learned that their perceptions of criminal justice and health-related services often started in the waiting room (Wright & DePrince, 2018). MDTs serving children may have similar opportunities to set the stage for the investigation in ways that emphasize family privacy in the waiting room (e.g., in how families sign-in) and center the child (e.g., in the degree to which the room is child-friendly).
Communities seeking to increase collaboration among agencies responding to child abuse and neglect allegations should prioritze:
- explaining how agencies will work together during the investigation;
- clear and regular communications with caregivers;
- strategies that convey support, such as listening and offering resources;
- recognize the unique strengths and challenges facing individual families.
This research was supported by the Colorado Evaluation and Action Lab of the University of Denver. The opinions expressed are those of the authors and do not represent the views of the Colorado Lab or the University of Denver. Thank you to our government partners as well as as members of the Traumatic Stress Studies Group, especially graduate student researchers Maria-Ernestina Christl, Julie Olomi, Adi Rosenthal, and Naomi Wright; and research assistants Margaret Port, Francesca Dino, Hannah Branit, Avery Stackle, Madison Hakey, Sandra Dominguez, Veronique Calmels, and Halley Pradell.
Dawson, K., & Berry, M. (2002). Engaging families in child welfare services: An evidence-based approach to best practice. Child Welfare, 81(2), 293-317.
Gagnon, K.L., Wright, N., Srinivas, T., & DePrince, A.P. (2018). Survivors’ Advice to Service Providers: How to Best Serve Survivors of Sexual Assault. Journal of Aggression, Maltreatment & Trauma, 27(10), 1125-1144. doi: 10.1080/10926771.2018.1426069
Staudt, M. (2007). Treatment engagement with caregivers of at-risk children: Gaps in research and conceptualization. Journal of Child and Family Studies, 16(2), 183-196.
Stein, M. B., Kennedy, C. M., & Twamley, E. W. (2002). Neuropsychological function in female victims of intimate partner violence with and without posttraumatic stress disorder. Biological Psychiatry, 52(11), 1079-1088.
Twamley, E. W., Allard, C. B., Thorp, S. R., Norman, S. B., Cissell, S. H., Berardi, K. H., … & Stein, M. B. (2009). Cognitive impairment and functioning in PTSD related to intimate partner violence. Journal of the International Neuropsychological Society, 15(6), 879-887.
Wright, N. & DePrince, A.P. (2018, December 10). Victim Services Start in the Waiting Room [Blog post]. Retrieved from //traumaresearchnotes.blog/2018/12/10/victim-services-start-in-the-waiting-room/