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Abstract
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This article addresses some of the common uncertainties and dilemmas encountered by both adult and child mental health workers in the course of their clinical practice when dealing with cases of suspected emotional abuse or neglect (EAN) of children. We suggest ways of dealing with these according to current best practice guidelines and our own clinical experience working in the field of child maltreatment.
Within the field of child maltreatment, emotional abuse and neglect (EAN) (psychological maltreatment) refers to caregiver behaviours towards or involving a child (excluding physical/sexual abuse and physical neglect) that cause or have a strong potential to cause serious harm to all aspects of a child's well-being or development. EAN could reflect repeated caregiver acts or omissions, or a single extreme behaviour. Caregiver refers to any adult responsible for caring for the child, usually parents.
This is a form of maltreatment with a high prevalence partly because it exists both on its own and in combination with other forms of abuse or neglect. And yet it is frequently under-recognised, including by clinicians working in child and adolescent mental health services (CAMHS) and adult mental health. Part of this may be due to ambiguity and lack of consensus over the definition, and the need to distinguish between parenting difficulty and actual EAN.
Risk factors for EAN include child factors (e.g. developmental disorder), caregiver factors (e.g. psychiatric disorder and substance misuse, which will be identified by adult mental health professionals, domestic violence, parental history of childhood maltreatment)1 and wider family factors (e.g. large number of children, poverty).2
Clinicians may observe worrying interactions between parents and children amounting to EAN, or come to recognise that a referred child's difficulties are associated with such parent-child interactions. These may be formulated as contributing to the child's mental health difficulties and be a focus of treatment.
Language: en |