Emotional abuse: The hidden form of maltreatment
Emotional abuse: The hidden form of maltreatment
Adam M. Tomison and Joe Tucci
- Broad Characteristics
- Defining Emotional Abuse
- Types of Emotional Abuse
- Witnessing Domestic Violence
- Redefining Physical Abuse as Emotional Abuse or Neglect
- Systems Abuse
- Future Research Directions
The foundations for good mental health are laid down in the emotional development that occurs in infancy and later childhood and appears to be dependent upon the quality and frequency of response to an infant or child from a parent or primary caregiver (O'Hagan 1993; Oates 1996). The parental response to the infant's emotions or expressive behaviours usually results in the formation of an attachment bond between the two. This bond develops in the early months and years of life, and is closely linked to the behavioural response of the parent and the ongoing cycle of parent-child interaction.
Bowlby (1969) proposed that for humans, and for infants in particular, survival depends to some extent on having access to such an attachment figure, usually a parent and most commonly the mother. Such attachment experiences have a profound influence on the development of other interpersonal relationships that form in later childhood or adult life, and have implications for the way in which adults subsequently relate to their own children (Oates 1996).
Where a child experiences a warm, intimate and continuous relationship with her or his mother or other care-giver, that child would thrive. Conversely, an unresponsive parent, or one who responds inappropriately to a child's needs, would increase the likelihood of the child becoming anxious and insecure in its attachment.
If a parent inadvertently or deliberately engages in a pattern of inappropriate emotional responses, the child can be said to have experienced emotional abuse (O'Hagan 1993). Emotional abuse is the least studied of all the forms of child maltreatment and its etiology (i.e. theories of causation) is less developed (National Research Council 1993).
Research into the impact and prevalence of emotional abuse has been plagued with disagreements about how to define it, measure it and treat it (Nesbit & Karagianis 1987; Giovannoni 1989; Claussen & Crittenden 1991; McGee & Wolfe 1991; O'Hagan 1993). The failure to overcome these issues has been taken as an explanation for the omission of emotional abuse from most policy agendas and research programs (Frost 1982, as cited in Daro 1988).
The precise relationship between emotional abuse and other forms of maltreatment is currently not known (National Research Council 1993). Emotional abuse may occur as a distinct form of abuse (e.g. verbal abuse, threats to abandon a child, witnessing domestic violence) (Navarre 1987), or in conjunction with other forms of maltreatment (Herrenkohl 1990). It is increasingly considered to be the core issue in all forms of child abuse and neglect (Hart, Germain & Brassard 1987; Navarre 1987; McGee & Wolfe 1991).
Not only does emotional abuse appear to be the most prevalent form of child maltreatment, but some professionals believe it to produce the most destructive consequences (Garbarino & Vondra 1987). The effects of emotional abuse may be manifested in the sense of helplessness and worthlessness often experienced by physically abused children (Hyman 1987), in the sense of violation and shame found in sexually abused children (Brassard & McNeil 1987), or in the lack of environmental stimulation and support for normal development found in neglected children (Schakel 1987).
O'Hagan (1993) has further argued that it is the emotional and psychological trauma associated with physical and sexual abuse that has the most detrimental impact on the development of children, a view supported by the United Kingdom's National Commission of Inquiry into the Prevention of Child Abuse (1996).
On the basis of a sub-sample of 721 letters submitted by adults who had been abused as children the National Commission determined that 80 per cent of respondents who had experienced sexual abuse in combination with physical and/or emotional abuse felt that the emotional abuse was most damaging in the long term.
Similar findings were confirmed by Briggs (1995) in interviews with men allegedly sexually, physically and emotionally abused by caregivers while in Christian Brothers boarding schools in Western Australia. Children may recover from physical pain and injuries, but may never recover from the terror, degradation, humiliation or breach of trust involved in sexual abuse (Briggs 1995; Briggs & Hawkins 1996).
However, unlike the more visible consequences of physical abuse or neglect, the consequences of emotional abuse have not been extensively investigated, because they are more elusive (Herrenkohl 1990). Most maltreatment typologies tend to use emotional abuse as a residual category, encapsulating the forms of maltreatment not captured by the categories of physical abuse, sexual abuse or neglect (Daro 1988).
Consequently, the effectiveness of the response to emotionally abused children has been questioned by a number of authors. Melton and Davidson (1987) have maintained that the concept of emotional abuse may be too imprecise for use as a basis for state intervention with families. Bourton and Burnham (1992) describe their experience of social workers visiting families without a clear agenda for intervention, at times manufacturing a crisis to resolve a chronic situation. Garbarino and Vondra (1987) have argued that children appear to suffer not only from the identified abuse, but also from the iatrogenic effects (where the treatment causes more damage than the illness itself) of the protective and therapeutic systems designed to assist them to recover from the experience - commonly known as 'systems abuse'.
This paper explores the range of controversies inherent in attempts to operationalise a definition of emotional abuse within legal, practice and research frameworks. The paper includes an overview of current research investigating aspects of emotional abuse: specifically, children's witnessing of spousal violence; the use of emotional abuse in the minimisation of abusive concerns; and emotional abuse in the context of systems abuse. A review of the short and long-term consequences of emotional abuse will be presented as part of a future Clearing House Issues Paper.
Briggs and Hawkins note that by 'the very nature of adult-child relationships and cultural influences, most adults will have inflicted emotional abuse on children, probably without realising it' (1996, p.21).
While behaviour may be emotionally damaging to a child, it may not necessarily be considered emotionally abusive by child protection or child welfare staff. Depending upon which of the many definitions is employed, emotional abuse may involve passive or neglectful acts, and/or the deliberate, cruel and active rejection of a child (Briggs & Hawkins 1996).
A common feature of most definitions, however, is the basic tenet that isolated instances of inappropriate responses do not constitute emotional abuse for the purposes of intervention. Unlike physical and sexual abuse, where a single incident may be considered abusive, emotional abuse is characterised by a climate or pattern of behaviour(s) occurring over time (O'Hagan 1993; McDowell 1995a, as cited in Woodham & Lapsley 1996). Thus, 'sustained' and 'repetitive' are the crucial components of any definition of emotional abuse (O'Hagan 1993).
It should also be noted that, like other forms of maltreatment, emotional abuse occurs in different forms and at different rates in different cultures. Every culture defines some form of behaviour as abusive, and has instances where people deviate from acceptable standards (Korbin 1991). Briggs and Hawkins (1996) cite the example of the industrial north of England, where traditional views emphasise the value of modesty and sincerity. The perception that conceit and dishonesty are the worst traits a child could develop has been linked with the accepted regional propensity of 'putting down' children.
Any definition of emotional abuse, then, should be 'reliant upon context, where each incident [behaviour] a child is subject to is seen to be part of an established pattern' (Woodham & Lapsley 1996, p.276) and dependent on the context of a child's living environment. For the purposes of this paper, emotional abuse is discussed in terms of the behaviours which may be considered abusive by professionals in the child protection and child welfare fields.
One of the main issues in defining emotional abuse is the search for agreement on the most accurate term to describe it. A variety of labels appear to be used interchangeably with emotional abuse: mental cruelty (Navarre 1987); psychological maltreatment (Hart, Germain & Brassard 1987); emotional neglect (Whiting 1976; Junewicz 1983); mental injury (Kavanagh 1982); psychological battering (Garbarino, Guttman & Seeley 1986); and coercive family processes (Patterson 1982). Each term appears to reflect an attempt to incorporate within it a resolution of issues related to the following.
First, whether the abuse is intentional. For example, emotional neglect reflects acts of omission, a failure to take action; that is, the caregiver may not be aware that her/his behaviour or attitude is abusive. In contrast, a key assumption of mental cruelty and psychological battering is the caregiver's intent to cause harm; in other words, an act of commission.
Second, whether there is a difference in the processes affected by this form of abuse. For example, psychological maltreatment focuses on the impact on the mental abilities of a child, such as intelligence, memory, recognition and attention. However, emotional abuse places a greater significance on the impact on a child's feelings and capacity to express emotion and develop relationships (O'Hagan 1993).
Third, 'goodness of fit' within a legislative framework requires differing standards of evidence to aid in decision making.
Fourth, the emphasis placed on patterns in family relationships (attachments) as a cause of children's distorted social learning processes (Patterson 1982).
Clearly there is a need to examine the terminology employed in the process of defining emotional abuse. In the following sections, the term 'emotional abuse' has been adopted to facilitate the writing process; it does not reflect a premature resolution of these issues.
Defining Emotional Abuse
The identification and professional recognition of the three major forms of child abuse - physical, sexual and emotional - has evolved over time (Browne 1988). Browne contends that, in each case, the type of abuse can be characterised in the same way and 'dichotimized into 'active' and 'passive' forms' (1988, p.15); that is, acts of commission and omission.
However, a large number of quite heterogeneous stratification systems have been developed in order to define emotional abuse. Some investigators (for example, Browne 1988), have distinguished between 'abusive' and 'neglectful' components of emotional abuse. For Whiting (1976), psychological abuse is present when parents cause a child to become emotionally disturbed, that is, via an act of commission. Psychological neglect occurs when parents refuse to allow an emotionally disturbed child to receive treatment, representing an act of omission. However, other investigators believe that any distinction between psychological abuse and neglect, the 'active' and the 'passive', is artificial (Garbarino, Guttman & Seeley 1986).
In what is widely regarded as the seminal work in the field of emotional abuse, James Garbarino and associates (Garbarino 1978; Garbarino, Guttman & Seeley 1986) have provided the basis for more recent attempts at defining what Garbarino terms 'psychological maltreatment' - 'a concerted attack by an adult on a child's development of self and social competence, a pattern of psychically destructive behaviour' (Garbarino, Guttman & Seeley 1986, p.8).
Under this definition, 'psychological maltreatment' is classified into five behavioural forms:
- rejecting: behaviours which communicate or constitute abandonment of the child, such as a refusal to show affection;
- isolating: preventing the child from participating in normal opportunities for social interaction;
- terrorising: threatening the child with severe or sinister punishment, or deliberately developing a climate of fear or threat;
- ignoring: where the caregiver is psychologically unavailable to the child and fails to respond to the child's behaviour;
- corrupting: caregiver behaviour which encourages the child to develop false social values that reinforce antisocial or deviant behavioural patterns, such as aggression, criminal acts or substance abuse.
Garbarino has also argued that each of these forms of psychological maltreatment has a differential effect on children depending on their passage through the four major developmental stages of infancy, early childhood, school age and adolescence (Garbarino, Guttman & Seeley 1986).
For example, rejection in infancy will result from a parent's refusal to accept and respond to a child's need for human contact and attachment. In early childhood, rejection is associated with a parent who actively excludes the child from family activities. At school age, rejection takes the form of a parent who consistently communicates a negative sense of identity to the child, and in adolescence, rejection is identified by a parent's refusal to acknowledge the young person's need for greater autonomy and self-determination (Garbarino, Guttman & Seeley 1986).
Hart and colleagues hosted a national conference in the United States in order to achieve a consensus among professionals on a working definition of psychological abuse. It was concluded that the psychological maltreatment of children and youth:
'... consists of acts of omission and commission which are judged on the basis of a combination of community standards and professional expertise to be psychologically damaging. Such acts are committed by individuals, singly or collectively, who by their characteristics (e.g. age, status, knowledge, organisational form) are in a position of power that renders a child vulnerable. Such acts damage immediately or ultimately the behavioural, affective, or physical functioning of the child' (1987, p.6).
The conceptualisation of emotional abuse has continued to expand through both research and clinical observation.
Hart, Germain and Brassard (1987) extended Garbarino's original typology of psychological maltreatment by including two other behaviours: the denial of emotional responsiveness; and acts or behaviours which degrade children.
Garbarino and Vondra (1987) included: stimulus deprivation; influence by negative or inhibiting role models; forcing children to live in dangerous and unstable environments (e.g. exposure to war, domestic violence or parental conflict); and the sexual exploitation of children by adults and parents who provide inadequate care while under the influence of drugs or alcohol.
McGee and Wolfe (1991) constructed an operational definition of psychological maltreatment for use in research, defining psychologically abusive acts in terms of parent-to-child communication. Utilising a developmental psychopathology perspective, they concluded that 'psychological maltreatment is any communication pattern that could undermine a child's resolution of important developmental tasks' (1991, p.14). Thus, it is the message conveyed to the child which is critical to the child's experience of the abuse. For example, destroying a child's toy communicates 'I hate what you value'.
However, McGee and Wolfe's model has been criticised on a number of grounds, in particular: the need for a greater level of accountability when making decisions about statutory intervention based on concepts such as potential harm rather than actual harm (Giovannoni 1991); the failure to incorporate active interpretations of societal standards in attempts to define maltreatment (Barnett, Manly & Cicchetti 1991); the lack of qualitative and quantitative research upon which to base the model (Egeland 1991); the lack of attention paid to the cultural and historical context in which certain communications are examined (Garbarino 1991; Sternberg & Lamb 1991); and for adopting a focus on potential harm when other studies have achieved increased understanding about the actual harm caused by psychological maltreatment (Hart & Brassard 1991).
Pillari (1991) argued that emotional abuse is intergenerational, highlighting deeply rooted patterns of scape-goating in families where children become the source of blame for the inability of parents to resolve the detrimental consequences of their own experiences of rejection and family trauma. Pillari notes that some professional systems continue to blame children for parental disturbances, further compounding the effects on the child and minimising the potential for parents to change behaviours and attitudes towards children.
O'Hagan (1993, 1995), in what is another important work in the field, made two theoretical delineations, arguing that an adequate definition should not only describe what emotional abuse is, but what it does. He also developed separate definitions for emotional and psychological abuse, maintaining that a significant source of confusion could be clarified as a result.
According to O'Hagan, emotional abuse is 'the sustained, repetitive, inappropriate emotional response to the child's expression of emotion and its accompanying expressive behaviour' (1993, p.28). Such abuse inhibits the child's capacity for spontaneous, positive and appropriate emotional expression (O'Hagan 1995). Psychological abuse is defined as 'sustained, repetitive, inappropriate behaviour which damages, or substantially reduces, the creative and developmental potential of crucially important mental faculties and mental processes of a child: these include intelligence, memory, recognition, perception, attention, language and moral development' (O'Hagan 1993, pp.33-34). Psychological abuse fundamentally undermines a child's capacity to understand and manage her/his environment by creating confusion and fear, thereby rendering the child more vulnerable and less confident (O'Hagan 1995).
Although O'Hagan distinguishes between emotional and psychological abuse, he does not claim that they are totally distinct entities. O'Hagan believes that, like all forms of maltreatment, they will frequently co-occur and each may impact negatively on both the child's emotional and mental life. When focusing on behaviour that impairs a child's emotional life and subsequent emotional development, O'Hagan concludes, 'emotional abuse' is the appropriate term; when the focus is the impairment of the child's mental life and subsequent mental development, 'psychological abuse' is the appropriate term. Thus what is required when the two types of abuse cooccur, is the recognition that the child is enduring both forms of abuse.
While a variety of forms have been proposed and debated, the elements common to most conceptualisations of emotional abuse are: that the inappropriate adult behaviour must be of a sustained and repetitive nature and considered within a cultural context; and that community standards about appropriate caregiver behaviour are constantly changing and are not homogenous or easily identifiable.
With regard to the effects on the child, it is commonly agreed that: the subjective meaning constructed by victims of their experience of violation should be incorporated into the definition; a developmental perspective should be adopted in the consideration of the abuse; emotional abuse can undermine the development of children's cognitive competency and skills; emotional abuse can have a detrimental effect on children's trust and on the way they form relationships and express emotions.
Nowhere is the need for clarity of definition more important than in child protection policy and legislation. Emotional abuse was recognised as a separate form of child maltreatment by legislators in the United Kingdom in the 1980s. However, it had been part of the child abuse statutes in several states within the United States as early as 1977 (Iwaniec 1995).
The language employed in the drafting of state laws which deal with emotional abuse has a direct influence on the successful adjudication of subsequent cases brought before the court. It affects the regulations, guidelines and policies of child protection agencies; the personal attitudes and training of child protection caseworkers; the opinions and competency of the lawyers representing the state; and the attitudes and knowledge of the judges deciding such cases (Corson & Davidson 1987).
It is contended that the definition of emotional abuse in most Australian and United States statutes reflects the history of confusion often associated with issues surrounding emotional abuse within the research and practice fields.
In a review of the United States federal and state legislative frameworks for emotional abuse, Corson and Davidson (1987) concluded that, even where statutes made reference to emotional abuse, the relevant provisions were too imprecise for much case law to have been produced in the area. Similarly, McGee and Wolfe (1991) noted that many legal and procedural definitions of emotional abuse were so broad that caseworkers commonly assumed that emotional abuse rarely existed on its own. Rather, it is assumed to occur primarily in combination with other types of child maltreatment.
With rare exceptions (e.g. Newfoundland and Alberta, Canada), few legally mandated definitions of emotional abuse exist that explicitly define a threshold or criterion for state intervention, or the nature of emotionally abusive parental acts (Wolfe 1991).
However, the degree of observable behavioural disruption required when considering whether or not a child needs legal protection, has been described (Wolfe 1991). For example, the American Bar Association (Corson & Davidson 1987) recommends protective intervention only when a child is already suffering serious emotional damage as evidenced by severe anxiety, depression, withdrawal, self-harming behaviour or aggressive behaviour towards others, and where the child's parents are unwilling to provide appropriate treatment.
There is currently no national, legal definition of child abuse and neglect in Australia. The Australian Institute of Health and Welfare provides a general definition of child abuse and neglect, as applied to substantiated child abuse notifications reported to the various State and Territory child protection services. Emotional abuse is defined as any 'act by a person having the care of a child which results in the child suffering any kind of significant emotional deprivation or trauma' (Broadbent & Bentley 1997, p.75). However, what constitutes 'significant' emotional deprivation or trauma is not defined.
The criticisms of Corson and Davidson (1987) and Wolfe (1991) also apply to Australian State and Territory legislation, which provides limited definitions of emotional abuse that are subject to a significant degree of interpretation. For example, under Section 63e of the Victorian Children and Young Persons Act 1989, a child is in need of protection in cases of emotional abuse if:
'The child has suffered, or is likely to suffer, emotional or psychological harm of such a kind that the child's emotional or intellectual development is, or is likely to be, significantly damaged and the child's parents have not protected, or are unlikely to protect, the child from harm of that type.'
Not only is the term 'emotional or psychological harm' in need of interpretation, but clarification of the term 'significant' is also critical to the process of decision making in child protection. In an attempt by the courts to clearly define the latter, Justice O'Bryan declared in the Supreme Court of Victoria that:
'In my opinion, in choosing the word significant the legislature intended that harm to the child's emotional or intellectual development will be more than trivial or insignificant but need not be as high as serious ... The word significant means 'important', 'notable', 'of consequence'... For the purposes of the act 'significantly damaged' means that the child's emotional or intellectual development is likely to be damaged in some respect that is important or of consequence to the child's emotional or intellectual development.' (Justice O'Bryan, 11 December 1992)
Unfortunately this judgement has not assisted greatly in achieving a more reliable conceptualisation of the term 'significant'. This is most notably reflected in the more recent Victorian Parliamentary Crime Prevention Committee's Inquiry into Sexual Offences Against Children, whose first recommendation was: 'that the word 'significant' be defined within the Children and Young Persons Act 1989 to ensure appropriate investigation.' (Crime Prevention Committee 1995, p.xiii)
In contrast to Australia and the United States, the United Kingdom Children Act 1989 appears to have reached a definition of emotional abuse that addresses a number of these criticisms. The provisions of the Act have been interpreted to identify emotional abuse as:
'... an actual or likely severe adverse effect on the emotional and behavioural development of a child caused by persistent or severe emotional ill-treatment or rejection. All abuse involves some emotional ill-treatment. This category should be used where it is the main or sole form of abuse' (Department of Health, Education and Science 1991, p.49).
Importantly, this definition ensures that a practice framework of child protection is able to single out emotional abuse as a discreet entity. Resultant social policy, intervention and treatment approaches are therefore more likely to achieve a greater degree of accuracy in a determination of emotional abuse and the subsequent protection of children.
Emotional abuse does not leave physical injuries and its ongoing nature usually means there is no crisis which would precipitate its identification by the health, welfare or criminal justice systems (Oates 1996). For that reason emotional abuse is the most hidden and underestimated form of child maltreatment.
Of the data available, and depending on the definition adopted, estimates of the prevalence of 'psychological maltreatment' vary from between 0.69 to 25.7 per cent of children (Fortin & Chamberland 1995). Emotional abuse accounts for approximately 7 per cent of all reported cases of child maltreatment across the United States (Second National Incidence Study 1986, NCANDS 1990, as cited in National Research Council 1993). However, the absence of operational definitions and true standards of severity means that the true occurrence of the extent of emotional abuse is unknown (National Research Council 1993).
The most recent national Australian data, produced by the Australian Institute of Health and Welfare, indicate that in 1995-96 emotional abuse cases accounted for 31 per cent of substantiated child maltreatment cases. The rate of emotional abuse among those aged 0-16 years (based on the number of substantiated child protection cases for the year) was 0.2 per cent (Broadbent & Bentley 1997). No other estimates of the prevalence or incidence of emotional abuse in Australia are known to the authors.
A more detailed investigation of the substantiation rates of emotional abuse cases across the nation serves to high-light the effect that variations in State and Territory child protection practices, legislation and policy contexts may have on the observable prevalence of emotional abuse.
The first national statistics (for 1988-89) describing rates of substantiated child maltreatment were presented at the opening of the Australian Child Protection Conference in 1990 (Calvert 1990) (see Table 1).
|State or Territory*||Type of Abuse|
|New South Wales||24.1||17.5||29.7||28.4|
Note: *no data provided for ACT.
Source: Calvert (1990)
As Goddard and Carew (1993) note: 'Even a cursory glance at this table reveals extraordinary differences in how abuse is defined, with almost half (48.3 per cent) of the referrals in Victoria classified as emotional abuse compared to an average of just over 8 per cent for the other States (ranging from 3 per cent in the Northern Territory to nearly 18 per cent in NSW). Even allowing for differences in reporting and data collection, it can only be assumed that even within Australia child abuse is defined differently' (Goddard & Carew 1993, p.208).
Unquestionably, the category of emotional abuse reflects the widest range of substantiation rates in comparison to other maltreatment types. It is also apparent from these figures that determining the prevalence of emotional abuse across Australia has been hampered by the failure to achieve an acceptable operational definition and standards of severity. For emotional abuse, as for other forms of child maltreatment, the debate about what is excluded or included in a definition of abuse ultimately affects how much of it can be identified.
Data compiled from a number of different Australian Institute of Health and Welfare child abuse and neglect Annual Reports (Angus, Wilkinson & Zabar 1994; Angus & Woodward 1995; Broadbent & Bentley 1997) indicate that the wide disparity in the range of substantiation rates of emotional abuse nationally has continued over the past decade (see Table 2). Indeed, no other form of child maltreatment appears to match the order of this difference.
|State or Territory||1995-96||1993-94||1995-96|
|New South Wales||32||33||38|
|Australian Capital Territory||19||37||24|
Source: Angus, Wilkinson & Zabar 1994; Angus & Woodward 1995; Broadbent & Bentley 1997
It would appear that just as different definitions of emotional abuse can produce different rates of child protection notifications and substantiations, so too can definitions affect the extent of legal protective intervention undertaken on the grounds of emotional abuse. Goddard contends, for example, that emotional abuse is 'virtually impossible to persuade the courts to recognise' (1996, p.38); however, this is not necessarily the case.
In Victoria, 46 per cent of all child maltreatment cases in 1994-95 for which child protection staff applied for protection applications, were on the grounds of emotional and/or intellectual harm under section 63(e) of the Children and Young Persons Act 1989 (Health and Community Services Victoria 1996).
Victoria, which together with New South Wales has the highest proportion of emotional abuse cases in its annual figures (see Table 2), also has one of the broadest definitions of what constitutes emotional abuse. The Victorian definition includes cases where children's functioning is adversely affected as a result of exposure to domestic violence and/or parental mental disorder (Broadbent & Bentley 1997).
Though specific data is not available, it is likely that this expanded definition is partially responsible for the high proportion of emotional abuse cases for which protective action has been taken. The new categories are somewhat easier to prove before a court (i.e. the presence of an incapacitating parental mental disorder or a history of serious spousal violence), in comparison with the traditional, more nebulous types of emotional abuse, such as yelling, threatening and withholding affection.
In a paper reviewing the protection of children exposed to domestic violence in the United Kingdom, Carroll concluded that:
'... many children who live in violent households respond to their circumstances with disturbed behaviours and feelings of high anxiety which impair their ability to develop and grow healthily. Thus they fulfil the criteria outlined in the legislation, of an impairment of their emotional and social development which amounts to 'significant harm'.' (1994, p.11)
There is a dearth of knowledge surrounding the causes of emotional abuse. Much of the literature devoted to the investigation or delineation of aspects of emotional abuse discusses the etiology in terms of child maltreatment in general (e.g. Wolfe 1991); that is, the effect of parental and child characteristics and socio-cultural context on the propensity for abuse.
However, adults or parents who emotionally abuse are frequently described as poorly equipped with the knowledge to cope effectively with children's normal demands at different developmental stages (Oates 1996). A study comparing emotionally abusive parents with a closely matched control group of 'problem' parents in a day nursery (Brazelton 1982, as cited in Oates 1996), indicated that emotionally abusive parents showed poorer coping skills, poorer child management strategies, and more difficulty in forming and maintaining relationships. These parents also reported more deviant behaviour in their children displayed than parents in the control group.
Previous Clearing House publications have described a number of parental and child characteristics that may enhance the potential for emotional abuse.
For example, two of the most prevalent mental disorders identified as affecting parents who maltreat their children, namely depression and substance abuse (Chaffin, Kelleher & Hollenberg 1996), are likely to increase the potential for emotionally abusive responses (see Child Maltreatment and Mental Disorder (Tomison 1996b) and Child Maltreatment and Substance Abuse (Tomison 1996c) for a more detailed discussion).
Similarly, neuropsychological deficits or intellectual disability may increase the likelihood for inappropriate parenting and/or emotional abuse as a function of the added stress such conditions may produce (Tomison 1996a).
With regard to child characteristics, a child with a physical or intellectual disability may be more vulnerable to emotional abuse because of the greater potential for disruptions in mother-child bonding and/or greater parental stress (see Child Maltreatment and Disability (Tomison 1996a)).
Types of Emotional Abuse
Verbal abuse is, perhaps, the core emotionally abusive behaviour.
Schaefer (1997) sought to determine which specific parental verbal utterances were generally perceived as psychologically harmful. A sample of 151 local mental health professionals and parents (120 women, 31 men) completed a questionnaire which described 18 categories of parental verbalisations commonly associated with psychological maltreatment in the literature.
Eighty per cent of respondents rated 10 of the 18 categories as being 'never acceptable' parenting practices. These were: rejection or withdrawal of love; verbal putdowns; perfectionism; negative prediction (e.g. 'you'll never amount to anything'); negative comparison (e.g. 'Why can't you be more like your sister?'); scapegoating; shaming; cursing or swearing; threats; and guilt trips (e.g. 'How could you do that after all I've done for you?').
Non-organic Failure to Thrive
Non-organic failure to thrive is one of the few forms of emotional abuse that generates observable physical symptomology for the child, and has produced a specific body of literature, particularly in the medical field.
Failure to thrive is a general term used to describe infants and children whose growth and development is significantly below age-related norms (Iwaniec, Herbert & Sluckin 1988). Cases can be classified into two categories (Oates 1982): organic failure to thrive, where a disease has caused the problem and medical treatment is prescribed; and nonorganic failure to thrive, where psychosocial factors are responsible and the treatment involves adequate feeding in combination with efforts to ensure the child's emotional needs are met. Non-organic failure to thrive has been described as the meeting point of emotional abuse and neglect (Goddard 1996).
Oates (1982) suggested that non-organic factors account for the highest proportion of failure to thrive cases, a contention supported by Schmitt (1978, as cited in Goddard 1996) who reported that organic reasons account for only 30 per cent of failure to thrive cases, while 20 per cent are nonorganic cases caused by underfeeding errors and the remaining 50 per cent are attributed to non-organic failure to thrive caused by parental neglect.
It is unclear, however, as to whether emotional deprivation alone can lead to growth failure (Jones et al. 1987). The early evidence from studies investigating the causes of failure to thrive was conflictual (Oates 1996). For example, growth failure caused by emotional deprivation was first documented in children in institutional settings (Spitz 1945, Widdowson 1951, both cited in Oates 1996). Despite living in an hygienic environment, the children received minimal individual attention, were prone to infection and displayed developmental delay and inadequate weight gains. However, the authors failed to report if an assessment of food intake was carried out (Oates 1996).
In contrast, other studies have reported that insufficient diet is the sole cause of non-organic failure to thrive (American Humane Association 1992, as cited in Goddard 1996; Whitten, Pettit & Fischoff 1969, as cited in Oates 1996). Yet others have concluded that the probable cause is a combination of emotional abuse and inadequate diet (Oates 1982).
Investigation of non-organic failure to thrive cases has indicated that there are often multiple family problemsoccurring, including poverty, housing problems, unemployment and marital discord (Oates 1996). The parents may have unconventional beliefs or perceptions about what constitutes a normal diet for an infant (Oates 1996); the primary caregiver (in the vast majority of cases, the mother) may be emotionally unresponsive to the child (Iwaniec, Herbert and Sluckin 1988; Oates 1996); and the mother-child relationship may appear fraught and unhappy (Iwaniec, Herbert and Sluckin 1988).
Mothers in these cases have been found to have poor parenting skills; to be immature or depressed; or to have a knowledge of parenting but to have failed to use it because of the overwhelming nature of other family problems. Some have wholly negative perceptions of their infants, accusing them of being deliberately naughty to annoy them (Oates 1982).
The infants in such cases have been described as being lethargic, anxious, fussier, more demanding and unsociable, less adaptable, more inconsolable and less happy than other babies (Iwaniec, Herbert & McNeish 1985; Oates 1996). It is not clear whether these factors merely increase the likelihood of failure to thrive, or result from it.
Overall, it is quite probable that other factors within the child, together with defects in parent-child interactions, poor dietary intake and insufficient affection and stimulation cause the condition (Oates 1996).
Oates (1989) contends that the key to diagnosis is the psychosocial history of the family. Health and medical staff may identify warning signs of nonorganic failure to thrive even during pregnancy. The American Humane Association Guide (1992, as cited in Goddard 1996) suggests that early warning signs for non-organic failure to thrive are: inadequate ante-natal care; consideration of abortion and/or adoption; substance abuse or psychiatric problems; a lack of social support; financial problems; a maternal history of being maltreated as a child; and inadequate attachment to the baby after birth.
Post-natally, home visitor services, and infant welfare nurses in particular, are ideally placed to identify the first signs of failure to thrive caused by a lack of parental care (Olds et al. 1986a; Olds et al. 1986b; Goddard 1996). These workers have much to offer inexperienced parents or those who do not understand or do not respond to their child's needs (Goddard 1996). Often such assistance is welcomed and the mothers respond well when it is provided (Oates 1982).
Witnessing Domestic Violence
There is growing recognition that domestic violence and child physical and sexual abuse are strongly associated (e.g. Goddard & Hiller 1993; Tomison 1995a). A growing body of research also suggests that children who witness domestic violence, but who are not actually physically assaulted, may suffer social and mental health problems as a result (Edleson 1995). Yet it is only in the last decade that the plight of the indirect victims of family violence, children who witness domestic violence, has been investigated (Fantuzzo et al. 1997).
Using national surveys of family violence, it is estimated that between 3.3 and 10 million children are at risk of witnessing domestic violence across the United States each year. However, no national prevalence studies of children who witness domestic violence have been conducted in the United States to date (Edleson 1995). Research has also been hampered by the failure to develop clear definitions of this form of abuse and systematic ways of substantiating accounts of witnessing violence (Geffner, Rosenbaum & Hughes 1988). Much of the information on children's exposure to domestic violence is derived from retrospective studies of female survivors in women's shelters, anonymous telephone surveys, or retrospective accounts from adult survivors of spousal violence (Fantuzzo et al. 1997).
In order to determine the prevalence of children exposed to substantiated cases of domestic violence by a more credible and direct method of sampling, Fantuzzo et al. (1997) undertook a secondary analysis of a United States domestic violence database from the Spousal Assault Replication Program. The database contains cases of adult female assaults in five major American cities collected by police and researchers in response to calls for police assistance.
Results indicated that, relative to the general population in these cities, the families experiencing domestic violence were significantly more likely to have children living in the household, and a significantly higher proportion of children aged five years or less. The latter were found to be most likely of all children under 17 years to have witnessed multiple incidents of domestic violence. On average, children under five years were present as witnesses in 48 per cent of domestic violence cases and in 21 per cent of cases involving multiple incidents.
A review of Victoria's domestic violence legislation revealed that children under five years were present in: 65 per cent of domestic disputes involving the threat or use of a gun; in 79 per cent of disputes involving a weapon (usually a knife); and in almost two-thirds of disputes where property was damaged (Wearing 1992).
Overall, the current state of knowledge of children who witness domestic violence is substantially smaller than that which focuses on children who are physically abused in families where spousal violence is also occurring (Fantuzzo et al. 1997). For that reason 'making definitive statements regarding the child witnessing phenomenon ... would be a risky endeavour' (Fantuzzo et al. 1997, p.116).
Redefining Physical Abuse as Emotional Abuse or Neglect
As noted earlier, child abuse and neglect concerns do not occur in isolation (Farmer & Owen 1995). In Spotlight on Neglect (Tomison 1995b), recent Australian research (Goddard & Hiller 1992; Tomison 1994) was discussed in terms of the identified propensity of workers in some instances to use official case labels to misclassify cases. It was contended that, when dealing with cases involving both abusive and neglectful concerns, workers sometimes minimised the abuse and mislabelled cases as emotional abuse or neglect.
It was argued that this misclassification occurs because emotional abuse and neglect cases are generally dealt with by the provision of family support services, whereas sexual and physical abuse cases are likely to require more stringent protective intervention.
Thus, the perceived lesser severity of emotional abuse or neglect may be used by some workers to minimise child abuse, and hence the level of protective intervention required. This minimisation would then lead to potentially inadequate child protection through the adoption of a caseplan tailored for a scenario that ignores specific aspects of the case.
This position is supported by research commissioned by the Victorian child protection services in response to the finding that almost half of all substantiated cases in Victoria in 1987-88 were labelled as emotional abuse (see Table 1). The resultant report indicated that a significant proportion of emotional abuse cases (between 14 and 22 per cent) registered on the Children At Risk Register (CARR) were registered inappropriately (Dwyer 1991).
The report's key conclusion was that the confusion in defining emotional abuse was due to an emphasis on 'emotional interaction' in the welfare-oriented training of the State's protective service staff. That is, child protection staff were focusing on the emotional distress of the child associated with the experience of child maltreatment in general, rather than classifying the case on the basis of the actual types of maltreatment suffered. This was perceived in some cases to result in a minimisation of the concerns (Dwyer 1991).
The findings led to a change in the way abuse was categorised, with the category 'Likelihood of Significant Emotional Harm' removed from the child protection classification system. This later action appears to have contributed to a reduction of approximately 31 per cent in the proportion of substantiated cases of emotional abuse over the next three years.
Systems abuse may be defined as the 'harm done to children in the context of policies or programs designed to provide care or protection. Children's welfare, development or security is undermined by the actions of individuals or by the lack of suitable policies, practices and procedures within systems or institutions' (Cashmore, Dolby & Brennan 1994, p.10).
This broad definition encompasses acts of commission and omission (neglect), and allows for the promotion of aspects of child development that are likely to produce optimal outcomes for children, rather than merely focusing on harm minimisation (Cashmore, Dolby & Brennan 1994).
Typically, systems abuse can be characterised as involving one or more of the following: the failure to consider children's needs; the unavailability of appropriate services for children; a failure to effectively organise and coordinate existing services; and institutional abuse (i.e. child maltreatment perpetrated within agencies or institutions with the responsibility for the care of children (Cashmore, Dolby & Brennan 1994).
Emotional abuse inflicted via systems abuse may occur as a consequence of: traumatic child protection investigations, as a function of the out-of-home care experience (in particular, having multiple placements, a lack of continuity of care, and separation of siblings in care); the practice of removing a sexually abused child rather than the perpetrator in cases of intrafamilial abuse; the failure to punish an abuser, combined with the removal of the child (which may appear to the child as punishment for disclosing the abuse); the failure to protect children in the care system from further abuse; the experience of child witnesses in the court system; and the experience of children in the Family Court system (in particular where access or custody issues exist) (Cashmore, Dolby & Brennan 1994; Briggs & Hawkins 1996).
A particular form of systems abuse that is not frequently mentioned in the literature, is emotional abuse within educational settings. A number of studies have indicated that a proportion of teachers commonly use emotional abuse in conjunction with other punitive disciplining practices as a means of exerting control (Hart, Germain & Brassard 1987; Briggs & Hawkins 1996).
While physical punishment has been banned in most educational settings, emotional abuse often passes without comment (Briggs & Hawkins 1996). Briggs and Hawkins (1996), in their book Child Protection: A Guide for Teachers and Child Care Professionals, cite studies by Krugman and Krugman (1984) and Hyman (1985), which found that teachers emotionally abused children by: overly restricting access to toilets for very young children; threatening to tell parents of a child's misbehaviour or unsatisfactory work; rejecting the child or their work; verbally abusing children; harassing, or allowing other children to harass children; labelling children as 'ineducable', 'dumb' or 'stupid'; screaming at children till they cried; and providing a 'continuous experience of failure by setting ... tasks that are inappropriate for their stages of development' (Briggs & Hawkins 1996, p.37).
Briggs and Hawkins describe other 'emotionally abusive' actions recorded in the two studies: pinching, shaking and pulling children by the ears; using fear-inducing techniques to control children; and tipping or pulling chairs out from under seated children. Such behaviours would seem to be more appropriately labelled as physically abusive, indicating yet again the difficulties experienced in developing clear definitions of emotionally abusive acts.
Finally, Briggs and Hawkins (1996) highlight as emotionally abusive the failure of teachers to deal with allegations or suspicions of child maltreatment, along with the experience of bullying by peers.
Finally, although not strictly a form of systems abuse, the extent of media reporting on child abuse and children may, in itself, constitute emotionally or psychologically abusive activity at the societal level (Franklin & Horwath 1996).
Since the Victorian era, the general perception of childhood has been one of a period of innocence - that children are 'innately good' (Franklin & Horwath 1996). More recently, however, children, and adolescents in particular, have been the victims of negative stereotypes held by the public and by professionals in western society (Franklin & Horwath 1996).
Media representations are the prime source of information on social problems for many people (Hutson & Liddiard 1994). Franklin and Horwath (1996) describe an ominous shift in society's perception of children, as evidenced in recent media reports in the United Kingdom. In an infamous case of child homicide in the United Kingdom in 1993, James Bulger, a two-year-old boy, was murdered by two ten-year-old boys. At the time, the two young offenders were described in the press as evil, 'powerful, destructive human being[s]' (Franklin & Horwath 1996, p.315).
Over time the media began surreptitiously to generalise their criticisms of the two boys such that the character of all children was impugned, challenging the concept of childhood innocence and the perception that children are 'innately good'. According to Franklin and Horwath, since the Bulger case media presentations of children and childhood in the United Kingdom have continued to be presented in a distinctive and sinister fashion.
It is contended that the promotion of negative stereotyping of children and young people is directly and indirectly emotionally and psychologically abusive.
First, developing the perception of children as powerful, evil creatures both dehumanises children and acts both as justification and reinforcement for the behaviour of perpetrators of sexual and physical abuse. Such perceptions reinforce a distorted view of children as evil and out of control - children who lead adults astray, and are thus in need of punishment. This victim blaming runs directly counter to, and conflicts with, current approaches to offender treatment, which focus on offenders acknowledging that their crimes are an abuse of power. 'How much more convenient, as well as morally reassuring, to blame the victim' (Franklin & Horwath 1996, p.317).
Second, the portrayal of children in a negative manner by the media may also lead child victims of maltreatment to blame themselves for the assaults they have suffered, internalising the messages of perpetrators that they 'deserve' to be abused, and increasing their willingness to accept the abuse.
Third, how society values and perceives children 'fundamentally affects the size and direction of public investment in their services' (Walby 1996, p.25). If children and young people are perceived in negative terms - as a 'problem group', a 'threat to social stability' or as 'disadvantaged' - the resultant policies are most likely to be designed to control, manage and rehabilitate youth, rather than to encourage and support young people's transition to adulthood (Drury & Jamrozik 1985). In contrast, promoting positive societal perceptions of children and young people may, in turn, lead to the development of 'child-friendly' government policies.
Partly as a result of concerns like Franklin and Horwath's, the United Kingdom National Commission of Inquiry into the Prevention of Child Abuse recommended that the media 'take a more balanced and sympathetic view of children' (1996, p.77). The Commission felt that the media had an obligation to consider a child's best interests in stories in which children feature, and that the failure to do so would constitute grounds for a complaint to a relevant authority.
Others would suggest that the media's obligation to providing a 'balanced view' of the child should be operationalised as regular campaigns which address society's negative expectations and perceptions of children (e.g. the concept of children as family property) (Fortin & Chamberland 1995) and to model and encourage the expression of warmth and positive regard for children (Garbarino & Garbarino 1994).
Although there is evidence that emotional abuse has longstanding and serious impacts on children's development and social functioning, public intervention in these cases is limited (Daro 1988). Despite a number of practice models proposed for working with sexually and physically abused children and their families (Giarretto 1978; Dale et al. 1986), little attention has been paid to how best to help children recover from the traumatic effects of emotional abuse.
Melton and Thompson (1987) describe the current system for dealing with emotionally abused children as 'woefully inadequate'. They argue that 'when professionals cannot eliminate even the grossest forms of physical violence against children, there is good reason to wonder about the likely success of interventions designed to change more subtle forms of maltreatment' (1987, p.206).
Many of the strategies suggested to prevent emotional abuse are adaptations of more generalist family support programs.
Fortin and Chamberland (1995) suggest a combination of alleviating socio-environmental stress, a reduction in familial dysfunction, the promotion of parenting skills and a positive self-concept, and social support.
Walsh (1996) advocates changing emotionally abusive interactions for children via the promotion of general family resilience, that is, identifying and fortifying the key processes that enable families to surmount persistent stresses.
Egeland and Erickson (1987) suggest a model of intervention for high-risk parents aimed at increasing parental understanding of children's cues, assisting their development of realistic expectations of child behaviour, and providing a detailed knowledge of child development. Egeland and Erikson also advocate the provision of ongoing support at times of crisis.
Given the importance of parent-child attachments, it is not surprising that a number of authors have proposed specific interventions to enhance these relationships (Hickox & Furnell 1989; Wolfe 1991).
McCluskey and Miller (1995), for example, have developed theme-focused family therapy that focuses exclusively on the inner-emotional world of the family. Their approach introduces a deliberate strategy to decrease the pace of communication between family members, encouraging individual reflection and giving children a voice and a leading role in the therapeutic process.
Wolfe (1991) describes a prevention approach in which physical or emotional abuse episodes 'are only the most visible markers of a more pervasive concern - a disturbed, dysfunctional parent-child relationship' (Wolfe 1991, p.36). He contends that tertiary interventions take place after abusive patterns of interaction have formed, are directed towards parents and fail to pay adequate attention to the long-term impact on the child. He advocates prevention which addresses the developmental differences that may emerge in a child as a function of child maltreatment, and which result from the child's attempt to learn social behaviours in the absence of sensitive parenting or careful guidance (Wolfe 1991).
Wolfe also supports teaching the abused child new methods for structuring experiences, thus enhancing social competence and setting the foundations for the development of a solid socio-emotional basis for relationship formation. This is achieved via the strengthening of children's self-identity and self-differentiation from an early age, either through improved parent-child relations or extrafamilial opportunities to develop appropriate interpersonal relationships.
Finally, Wolfe advocates the adoption of a 'strength-based approach' to dealing with at risk and abusive families. The focus of intervention is on enlisting greater cooperation from parents in order to develop desirable, effective strategies of childrearing and the promotion of an optimal balance between the needs of child and abilities of the parent, rather than a traditional approach, where the focus is on the identification of parental misdeeds.
Despite the growing acknowledgment of child maltreatment as a societal problem, it is often difficult to convince those in the broader community that they, themselves, may be part of the problem. It is easier to think of maltreaters in stereotypical ways, pathologising them as mentally ill, abnormal or evil, enabling non-offenders to distance themselves from the problem rather than to address the true causes of maltreatment, such as poverty, or a lack of social support (Wilczynski & Sinclair 1996).
However, most adults will have experienced emotional abuse as children (whether they have labelled it as such or not), and subsequently inflicted it on children themselves (Hart, Germain & Brassard 1987; Briggs & Hawkins 1996). It is contended that emotional abuse is therefore the form of maltreatment most likely to result in the public seeing themselves as 'part of the problem'.
A number of community education campaigns have been developed in the United States to prevent emotional abuse (e.g. Brassard & Hart 1987). One hallmark television and print media campaign, developed by the Chicagobased National Committee to Prevent Child Abuse, promoted the message: 'Children believe what their parents tell them. Watch what you say. Stop using words that hurt. Start using words that help.' (Cohn Donnelly 1991)
Following such campaigns, Daro (1988) noted that public concern regarding the potential impact of at least one aspect of emotional abuse - verbal abuse - was significant. A public opinion poll conducted for the United States National Committee for the Prevention of Child Abuse found that approximately three-quarters of respondents thought that severe verbal abuse, described as 'repeated yelling and swearing' at a child, 'very often' or 'often' resulted in long-term emotional problems for the child. In contrast, only 42 per cent perceived a similar level of harm to result from corporal punishment (Daro & Mitchell 1987, as cited in Daro 1988). This finding was described by Garbarino (1990) as providing the cornerstone for community action to prevent emotional abuse or 'psychological maltreatment'.
In Australia, a number of initiatives have been designed to prevent verbal abuse and emotional abuse as a whole.
'Use Words That Help Not Hurt', based on the United States campaign and developed by the National Association for the Prevention of Child Abuse and Neglect is one such initiative. Begun in 1995, the program aims to: increase community awareness of the harmful and long-term effects of harsh and abusive words on children; encourage positive communication which nurtures and supports children; and expand the 1995 National Child Protection Week theme 'Let's Talk With Children', which outlined positive ways adults could communicate effectively with their children. The program also encourages support for adults in parenting children by informing them of resources available to assist them when needed, and comprises a Community Service Announcement television advertisement, community education kit, poster and brochure.
The Victorian Board of Studies has developed the 'Healthy Families Project', a school-based community education program with an underlying message that cycles of behaviour are not inexorable. Adopting a proactive, positive approach, the educational program at the centre of the project both implicitly and explicitly strengthens children's natural resilience. It teaches children that individuals have the power to change their lives and to develop more constructive forms of parenting than they themselves experienced as children.
The program is firmly located within the mainstream primary school curriculum to ensure it reaches all children, and is intended to achieve three related sets of outcomes: a cultural and attitudinal change in the wider community, particularly among primary school teachers and parents, via media publicity, publications, workshops, seminars and conferences; structural improvements in the organisation of support services provided by the educational system and primary care agencies, to improve the coordination of services at the local level; and personal improvements in the quality of family relationships for participating children and parents.
One approach combining the objectives of both the family support and community education programs as they pertain to the prevention of emotional abuse, is the'Grow Together Campaign', developed by the West Australian Department for Community Development. Launched in the early 1990s, the 'Grow Together Campaign' is a community education campaign promoting positive family relationships. Specifically, it encourages positive attitudes towards the care of children, an understanding of the developmental stages of childhood, and an appreciation of a child's view of the world. The campaign also seeks to provide information on the availability of practical help and support to families who care for children.
Support Networks for Children
Social support plays an important role in ameliorating the effects of emotional abuse. Emotionally abused children may fail to develop the capacity to empathise with others - a precursor to difficulties with peers, intimate relationships, and inadequate parenting skills (Briggs & Hawkins 1996). Severe emotional abuse may lead the child to engage in antisocial, sometimes violent, behaviour, where the child offender exhibits a sociopathic response to the violence that has been perpetrated.
The common factor in survival cases (i.e. where the child has not suffered long-term damage), is the availability of another, close supportive person to whom the child can turn (Briggs & Hawkins 1996; Woodham & Lapsley 1996). Respondents in a recent New Zealand study (Woodham & Lapsley 1996), recalled positive and fond memories of their support person, often termed their 'bright light'. Such figures can assist the development of a child's capacity to make decisions and the establishment of a reality-based sense of right and wrong (Szur 1987). Such relationships also enable the child to detach themselves emotionally from the abusive parent and engage in other relationships (Briggs & Hawkins 1996).
Support for the positive effect of a supportive person also comes from Every Childhood Lasts a Lifetime (Owen 1996), a collection of personal testimonies from a diverse group of young Australians who as children were removed from the care of their families and placed under State or Territory guardianship. The authors describe a life without constancy, with multiple placements adversely affecting their ability to develop attachments to carers and friends, and to achieve stability in care and education. Access to one or two significant people able to provide ongoing social support appeared to make a substantial impact in the lives of these children and adolescents. As 'Michael' notes, 'what people need is somebody constant in their life' (Owen 1996, p.30).
Support Networks for Parents and Caregivers
Conversely, one factor which increases the propensity for emotional maltreatment is social isolation (Garbarino & Garbarino 1994). Parents need access to multiple perspectives on their child, themselves and on parent-child relationships. Each perspective provides 'separate, distinct, and special information to the parent [and to the child]' (Garbarino & Garbarino 1994, p.21), without which any parental disturbance or child behavioural problem may escalate into a pattern of emotional abuse.
Although not focused specifically on emotional abuse, Vinson, Baldry and Hargreaves (1996) conducted a study with important findings for the prevention of all maltreatment, assessing two adjoining neighbourhoods in Western Sydney which were both economically depressed but had contrasting rates of child maltreatment. Their intention was to determine why the difference in the rate of child maltreatment existed and whether this could be attributed to differences in the characteristics of the neighbourhoods as social entities.
The neighbourhoods were matched in terms of population, size and measures of social disadvantage. Based on analysis of demographic data and parents'/carers' ratings of their social environment, the locality as a place to raise children, transport and communication patterns, and specific aspects of each carer's support network, it was apparent that the one outstanding difference between the neighbourhoods was the structure of the social networks. The area with the higher rate of abuse suffered from a relative lack of connection between more immediate parts (familial) and more distant parts (usually peers) of the social network. These parents had a quite insular existence, with much less contact with the wider community.
Vinson, Baldry and Hargreaves concluded that the degree of network connectedness enabled them to distinguish between not just clinical and non-clinical populations (high abuse-low abuse), but also high and low risk localities. This has implications for the effective prevention of child maltreatment in that it indicates the importance of social support and social networks. They also suggested that the prevention of child maltreatment may be enhanced by programs which attempt to simulate some of the 'helpful child-rearing functions attributed to naturally occurring networks' (Vinson, Baldry & Hargreaves 1996, p.540).
These devised social networks are organised to fulfil functional roles, such as parent education, child care, parent enrichment courses and mutual support groups, and act as the means to improve the social connectedness of participants. Vinson, Baldry and Hargreaves (1996) describe the Child and Neighborhood Program (Powell 1987, as cited in Vinson, Baldry & Hargreaves 1996), which fulfils the role of the devised social network. This program provides parent education, emotional support, role models and information and referral services.
Child and Family Centres - The 'One Stop Shop'
The values underlying Powell's Child and Neighborhood Program approach (1987, as cited in Vinson, Baldry and Hargreaves 1996) are incorporated into a relatively new development that has begun operating in Australia. Child and Family Centres, frequently referred to as 'one stop shops', are multiservice community centres which aim to provide a local, non-stigmatising family support service that encourages families to proactively seek assistance.
Adopting an holistic approach to the prevention of child maltreatment and the promotion of a healthy community, they may offer services to address the following needs: mental health, child health, dental services, family support services, women's services, financial aid, legal advice and client advocacy. They may also operate drop-in centres, self-help courses, social groups and other community activities to enable those who are socially isolated to develop improved social networks.
Future Research Directions
The need for research into emotional abuse is self-evident. What form the research should take remains an issue to be addressed.In essence, given the variability of the assumptions underlying the conceptualisation of emotional abuse, one solution may be to attempt to reach a consensus on definition by placing greater emphasis on examining how understandings of emotional abuse are operationalised in practice. Such research would need to incorporate perceptions of routine casework and describe the content, process, and outcome of everyday investigations and interventions. The result would be the construction of a baseline of how the child protection and child welfare systems respond in cases of emotional abuse.
Gough (1993) has argued that such research would provide valuable information on current practice and case outcomes; lead to a better understanding of the context and influence of the legal and child protection systems on interventions in child abuse maltreatment; and serve to clarify the definitions and processes of child protection work as the basis for more coherent studies of programs and strategies aimed at protecting children from experiencing emotional abuse.
A relevant methodology for such a project would incorporate the capacity to listen to the experiences of children in a way that documents the stories they tell about emotional abuse; focus attention on the impact of the practices of child protection on children who have been emotionally abused; and examine how meanings associated with emotional abuse are negotiated within the protective system and between the protective system and the child and family.
Garbarino contends that as the 'study of children-at-risk matures ... it will turn increasingly to the concept of psychological maltreatment as its unifying theme. If we can set minimal standards of care that address directly emotional and intellectual development, identity and self-esteem, we as a society will have arrived at a mature conception of the social dimension of normality. Armed with this conception, we will be able to formulate better policy and practice for preventing developmental risk' (Garbarino 1990, p.297)'.
The adoption of such an integrated perspective has not been universal, in part because of the problems in arriving at concrete definitions of emotional abuse described in this paper. Difficulties in constructing universal definitions of emotional abuse or any form of maltreatment occur, in part, because of the lack of social consensus over what forms of parenting are unacceptable; uncertainty about whether to define maltreatment on the basis of adult characteristics, adult behaviour, the outcome for the child, and the environmental context in isolation or in combination; conflict over whether standards of risk or harm should be used in constructing definitions; and confusion as to whether similar definitions should be used for scientific, legal and clinical purposes (National Research Council 1993).
While there has been increased momentum in attempts to explicitly define and describe emotional abuse over the past decade, developing a uniform definition remains an elusive goal. As Goddard (1996) notes, defining emotional abuse and establishing the connection between parents' behaviour and the consequences for children are difficult tasks.
The tendency in society is to address the forms of child maltreatment which involve identifiable acts of omission or commission by adults, and which produce observable, negative consequences for children. Although recognised for the severity of its impact, emotional abuse remains on the margins of child abuse. It is contended that until emotional abuse is clearly defined and identifiable and is attended to with the vigour currently applied to prevention of the more overt forms of child maltreatment, the effective prevention of this 'hidden' form of abuse and its associated long-term consequences will remain a highly difficult task.
- Angus, G.and Woodward, S. (1995), Child Abuse and Neglect Australia 1993 - 1994, Child Welfare Series no.13, Australian Institute of Health and Welfare, Canberra.
- Angus, G., Wilkinson, K. and Zabar, P. (1994), Child Abuse and Neglect Australia 1991 - 1992, Child Welfare Series no.5, Australian Institute of Health and Welfare, Canberra.
- Barnett, D., Manly, T.J. and Cicchetti, D. (1991), 'Continuing toward an operational definition of psychological maltreatment', Development and Psychopathology, vol.3, pp.19 - 29.
- Bourton, A. and Burnham, L. (1992), 'Looking for clues', Social Work Today, 18 June, pp.16 - 17.
- Bowlby, J. (1969), Attachment and Loss: Volume 1 - Attachment, Basic Books, New York.
- Brassard, M.R. and Hart, S.N. (1987), Emotional Abuse: Words Can Hurt, National Committee to Prevent Child Abuse, Chicago.
- Brassard, M.R. and McNeil, L.E. (1987), 'Child sexual abuse', in M.R. Brassard, R. Germain and S.N. Hart (eds), Psychological Maltreatment of Children and Youth, Pergamon Press, New York.
- Briggs, F. (1995), From Victim to Offender: How Child Sexual Abuse Victims Become Offenders, Allen and Unwin, St Leonards, NSW.
- Briggs, F. and Hawkins, R.M.F. (1996), Child Protection: A guide for teachers and Child Care Professionals, Allen and Unwin, St Leonards, NSW.
- Broadbent, A. and Bentley, R. (1997), Child Abuse and Neglect Australia 1995 - 1996, Child Welfare Series no.17, Australian Institute of Health and Welfare, Canberra.
- Browne, K. (1988), 'The nature of child abuse and neglect: an overview', in K. Browne, C. Davies and P. Stratton (eds), Early Prediction and Prevention of Child Abuse, John Wiley and Sons, Chichester.
- Calvert, G. (1990), A brief overview of child protection, paper presented at the Australian Child Protection Conference, June 1990, Sydney, unpub.
- Carroll, J. (1994), 'The protection of children exposed to marital violence', Child Abuse Review, vol.3, pp.6 - 14.
- Cashmore, J., Dolby, R. and Brennan, D. (1994), Systems Abuse: Problems and Solutions, NSW Child Protection Council, Sydney.
- Chaffin, M., Kelleher, K. and Hollenberg, J. (1996), 'Onset of physical abuse and neglect: psychiatric, substance abuse, and social risk factors from prospective community data', Child Abuse and Neglect, vol.20, no.3, pp.191 - 203.
- Children Act 1989, HMSO, London.
- Children and Young Persons Act 1989, Act No. 56/1989, reprinted 24 August 1995 incorporating amendments up to Act No. 109/1994, Victorian Government Printers, Melbourne.
- Claussen, A.H. and Crittenden, P.M. (1991), 'Physical and psychological maltreatment: relations among types of maltreatment', Child Abuse and Neglect, vol.15, pp.5 - 18.
- Cohn Donnelly, A.H. (1991), 'What we have learned about prevention: what we should do about it', Child Abuse and Neglect, vol.15, Supp.1, pp.99 - 106.
- Corson, J. and Davidson, H. (1987), 'Emotional abuse and the law', in M.R. Brassard, R. Germain and S.N. Hart (eds), Psychological Maltreatment of Children and Youth, Pergamon Press, New York.
- Crime Prevention Committee, Parliament of Victoria (1995), Combating Child Sexual Assault: An Integrated Model, First Report, LV North, Government Printer, Melbourne.
- Dale, P., Davies, M., Morrison, T. and Waters, J. (1986), Dangerous Families: Assessment and Treatment of Child Abuse, Tavistock Publications, London.
- Daro, D. (1988), Confronting Child Abuse: Research for Effective Program Design, Free Press, New York.
- Department of Health, Education and Science (1991), Working Together Under the Children Act 1989: A Guide to Arrangements for Inter-agency Cooperation for the Protection of Children from Abuse, Department of Health, Education and Science, Home Office and Welsh Office, HMSO, London.
- Drury, S. and Jamrozik, A. (1985), 'Conceptual issues of relevance to social policy and services for young people, in A. Jamrozik (ed.), Issues in Social Welfare Policy 1985: Perceptions, Concepts and Practice (SWRC papers at ASPAA and ANZAAS), Social Welfare Research Centre, Kensington, NSW.
- Dwyer, G. (1991), Emotional Abuse: An Epidemic, a Misnomer, or a Case of Inappropriate Intervention, Community Services Victoria, Melbourne.
- Edleson, J.L. (1995), 'Mothers and children: understanding the links between woman battering and child abuse', paper presented to Strategic Planning Workshop on Violence Against Women, National Institute of Justice, Washington DC, 31 March 1995.
- Egeland, B. (1991), 'From data to definition', Development and Psychopathology, vol.3, pp.37 - 43.
- Egeland, B. and Erickson, M.F. (1987), 'Psychologically unavailable caregiving', in M.R. Brassard, R. Germain, and S.N. Hart (eds), Psychological Maltreatment of Children and Youth, Pergamon Press, New York.
- Fantuzzo, J., Boruch, R., Beriama, A., Atkins, M. and Marcus, S. (1997), 'Domestic violence and children: prevalence and risk in five major U.S. cities', Journal of the American Academy of Child and Adolescent Psychiatry, vol.36, no.1, pp.116 - 122.
- Farmer, E. and Owen, M. (1995), Child Protection Practice: Private Risks and Public Remedies, HMSO, London.
- Fortin, A. and Chamberland, C. (1995), 'Preventing the psychological maltreatment of children', Journal of Interpersonal Violence, vol.10, pp.275 - 95.
- Franklin, B. and Horwath, J. (1996), 'The media abuse of children: Jake's progress from demonic icon to restored childhood innocent', Child Abuse Review, vol. 5, pp. 310 - 18.
- Garbarino, J. (1978), 'The elusive 'crime' of emotional abuse', Child Abuse and Neglect, vol.2, pp.89 - 99.
- Garbarino, J. (1990), 'Future directions', in R.T. Ammerman and M. Hersen (eds), Children at Risk: An Evaluation of Factors Contributing to Child Abuse and Neglect, Plenum Press, New York.
- Garbarino, J. (1991), 'Not all bad developmental outcomes are the result of child abuse', Development and Psychopathology, vol.3, pp.45 - 50.
- Garbarino, J. and Garbarino, A.C. (1994), Emotional Maltreatment of Children (rev. edn), National Committee to Prevent Child Abuse, Chicago.
- Garbarino, J., Guttman, E. and Seeley, J.W. (1986), The Psychologically Battered Child, Jossey-Bass Publishers, California.
- Garbarino, J. and Vondra, J. (1987), 'Psychological maltreatment: issues and perspectives', in M.R. Brassard, R. Germain and S.N. Hart (eds), Psychological Maltreatment of Children and Youth, Pergamon Press, New York.
- Geffner, R., Rosenbaum, A. and Hughes, H. (1988), 'Research issues concerning family violence', in V. Van Hasselt, R. Morrison, Bellack, A. and M. Herson (eds), Handbook of Family Violence, Plenum Press, New York.
- Giarretto, H. (1978), 'Humanistic treatment of father - daughter incest', Journal of Humanistic Psychology, vol.18, pp.1 - 6.
- Giovannoni, J. (1989), 'Definitional issues in child maltreatment', in D. Cicchetti and V. Carlson (eds), Child Maltreatment: Theory and Research on the Causes and Consequences of Child Abuse and Neglect, Cambridge University Press, Cambridge.
- Giovannoni, J. (1991), 'Social policy considerations in defining psychological maltreatment', Development and Psycho-pathology, vol.3, pp.51 - 59.
- Goddard, C.R. (1996), Child Abuse and Child Protection: A Guide for Health, Education and Welfare Workers, Churchill Livingstone, South Melbourne.
- Goddard, C.R. and Carew, R. (1993), Responding to Children: Child Welfare Practice, Longman Cheshire, Melbourne.
- Goddard, C.R. and Hiller, P.C. (1992), Tracking Physical and Sexual Abuse Cases from a Hospital Setting into Victoria's Criminal Justice and Child Protection Systems: A Report for the Victorian Law Foundation, vols 1 - 3, Department of Social Work and Department of Anthropology and Sociology, Monash University, Melbourne.
- Goddard, C.R. and Hiller, P.C. (1993), 'Child sexual abuse: assault in a violent context', Australian Journal of Social Issues, vol.28, no.1, February, pp.20 - 33.
- Gough, D. (1993), Child Abuse Interventions: A Review of the Literature, Public Health Research Unit, University of Glasgow, Glasgow.
- Gough, D. (1996), 'The literature on child abuse and the media', Child Abuse Review, vol.5, pp.363 - 76.
- Hart, S.N. and Brassard, M.R. (1991), 'Psychological maltreatment: progress achieved, Development and Psychopathology, vol.3, pp.61 - 70.
- Hart, S.N., Germain, R.B. and Brassard, M.R. (1987), 'The challenge: to better understand and combat psychological maltreatment of children and youth', in M.R. Brassard, R. Germain and S.N. Hart (eds), Psychological Maltreatment of Children and Youth, Pergamon Press, New York.
- Health and Community Services Victoria (1996), Protective Services Annual Statistical Report 1994 - 1995, Health and Community Services Victoria, Melbourne.
- Herrenkohl, R.C. (1990), 'Research directions related to child abuse and neglect', in R.T. Ammerman and M. Hersen (eds), Children at Risk: An Evaluation of Factors Contributing to Child Abuse and Neglect, Plenum Press, New York.
- Hickox, A. and Furnell, J.R. (1989), 'Psychosocial and background factors in emotional abuse of children', Child Care, Health and Development, vol.15, pp.227 - 40.
- Hutson, S. and Liddiard, M. (1994), Youth Homelessness: The Construction of a Social Issue, Macmillan, Basingstoke.
- Hyman, I.A. (1987), 'Psychological correlates of corporal punishment', in M.R. Brassard, R. Germain and S.N. Hart (eds), Psychological Maltreatment of Children and Youth, Pergamon Press, New York.
- Iwaniec, D. (1995), The Emotionally Abused and Neglected Child: Identification, Assessment and Intervention, John Wiley and Sons, Chichester.
- Iwaniec, D., Herbert, M. and McNeish, A.S. (1985), 'Social work with failure-to-thrive children and their families: Part I, Psycho-social factors', British Journal of Social Work, vol.15, pp.243 - 59.
- Iwaniec, D., Herbert, M. and Sluckin, A. (1988), 'Helping emotionally abused children who fail to thrive', in K. Browne, C. Davies and P. Stratton (eds), Early Prediction and Prevention of Child Abuse, John Wiley and Sons, Chichester.
- Jones, D.N., Pickett, J., Oates, M.R. and Barbor, P. (1987), Understanding Child Abuse (2nd edn), Macmillan Education, Houndsmills, Basingstoke.
- Junewicz, W.J. (1983), 'A protective posture toward emotional neglect and abuse', Child Welfare, vol.62, pp.243 - 53.
- Kavanagh, C. (1982), 'Emotional abuse and mental injury: a critique of the concept and recommendation for practice', Journal of American Academy of Child and Adolescent Psychiatry, vol.21, pp.171 - 77.
- Korbin, J. (1991), 'Cross-cultural perspectives and research directions for the 21st century', Child Abuse and Neglect, vol.15, Suppl.1, pp.67 - 77.
- McCluskey, U. and Miller, L.B. (1995), 'Theme focused family therapy: the inner emotional world of the family, Journal of Family Therapy, vol.17, pp.411 - 34.
- McGee, R.A. and Wolfe, D.A. (1991), 'Psychological maltreatment: toward an operational definition', Development and Psychopathology, vol.3, pp.3 - 18.
- Melton, B. and Thompson, R.A. (1987), 'Legislative approaches to psychological maltreatment: a social policy analysis', in M.R. Brassard, R. Germain and S.N. Hart (eds), Psychological Maltreatment of Children and Youth, Pergamon Press, New York.
- Melton, G.R. and Davidson, H.A. (1987), 'Child protection and society: when should the state intervene?', American Psychologist, vol.42, pp.172 - 75.
- National Commission of Inquiry into the Prevention of Child Abuse (UK) (1996), Childhood Matters: Report of the National Commission of Inquiry into the Prevention of Child Abuse, Volume 1: The Report, The Stationery Office, Norwich.
- National Research Council (1993), Understanding Child Abuse and Neglect, National Academy Press, Washington DC.
- Navarre, E.L. (1987), 'Psychological maltreatment: the core component of child abuse', in M.R. Brassard, R. Germain and S.N. Hart (eds), Psychological Maltreatment of Children and Youth, Pergamon Press, New York.
- Nesbit, W.C. and Karagianis, L.D. (1987), 'Psychological abuse in the home and in the school', Canadian Journal of Education, vol.12, pp.177 - 83.
- Oates, R.K. (1982), 'Failure to thrive - part of the spectrum', in R.K. Oates (ed.), Child Abuse: A Community Concern, pp.119 - 29, Butterworths, London.
- Oates, R.K. (1989), 'The spectrum of child abuse', in G. Vimpani, T. Parry (eds), Community Child Health: An Australian Perspective, pp.439 - 59, Churchill Livingstone, Melbourne.
- Oates, R.K. (1996), The Spectrum of Child Abuse: Assessment, Treatment, and Prevention, Brunner/Mazel Inc., New York.
- O'Hagan, K. (1993), Emotional and Psychological Abuse of Children, Open University Press, Buckingham.
- O'Hagan, K. (1995), 'Emotional and psychological abuse: problems of definition', Child Abuse and Neglect, vol.19, 449 - 61.
- Olds, D. L., Henderson, C. R., Chamberlin, R. and Tatelbaum, R. (1986a), 'Preventing child abuse and neglect: a randomised trial of nurse intervention', Paediatrics, no.78, pp.65 - 78.
- Olds, D. L., Henderson, C. R., Tatelbaum, R. and Chamberlin, R. (1986b), 'Improving the delivery of prenatal care and outcomes of pregnancy: a randomised trial of nurse home visitation', Paediatrics, no.77, pp.16 - 28.
- Owen, J. (1996), Every Childhood Lasts a Lifetime: Personal Stories from the Frontline of Family Breakdown, Australian Association of Young People in Care, Brisbane.
- Patterson, G.R. (1982), Coercive Family Process, Eugene, Castalia.
- Pillari, V. (1991), Scapegoating in Families: Intergenerational Patterns of Physical and Emotional Abuse, Brunner/Mazel, New York.
- Schaefer, C. (1997), 'Defining verbal abuse of children: a survey', Psychological Reports, vol.80, p.626.
- Schakel, J.A. (1987), 'Emotional neglect and stimulus deprivation', in M.R. Brassard, R. Germain and S.N. Hart (eds), Psychological Maltreatment of Children and Youth, Pergamon Press, New York.
- Szur, R. (1987), 'Emotional abuse and neglect', in P. Maher (ed.), Child Abuse: The Educational Perspective, Basil Blackwell, Oxford.
- Tomison, A.M. (1994), An Evaluation of Decision Making in Child Abuse Services in the Barwon Region: A Report for the Victorian Health Promotion Foundation, Volumes I and II, Department of Social Work and Human Services, Monash University, Melbourne.
- Tomison, A.M. (1995a), 'Linking child abuse and other family violence: findings from a case tracking study', Family Matters, no.41, Winter, pp.33 - 38.
- Tomison, A.M. (1995b), Spotlight on Child Neglect, Issues Paper no.4, National Child Protection Clearing House, AIFS, Melbourne.
- Tomison, A.M. (1996a), Child Maltreatment and Disability, National Child Protection Clearing House Issues Paper no.7, AIFS, Melbourne.
- Tomison, A.M. (1996b), Child Maltreatment and Mental Disorder, National Child Protection Clearing House Discussion Paper no.3, AIFS, Melbourne.
- Tomison, A.M. (1996c), Child Maltreatment and Substance Abuse, National Child Protection Clearing House Discussion Paper no.2, AIFS, Melbourne.
- Vinson, T., Baldry, E. and Hargreaves, J. (1996), 'Neighbourhoods, networks and child abuse', British Journal of Social Work, vol.26, no.4, pp.523 - 43.
- Walby, C. (1996), 'Change of tack', Community Care, 31 October - 6 November, pp.24 - 25.
- Walsh, F. (1996), 'The concept of family resilience: crisis and challenge', Family Process, vol.35, pp.261 - 82.
- Wearing, R. (1992), Monitoring the impact of Crime (Family Violence) Act 1987, funded by the Family Law Foundation, Victoria.
- Whiting, L. (1976), 'Defining emotional neglect', Children Today, vol.5, pp.2 - 5.
- Wilczynski, A. and Sinclair, K. (1996), 'The presentation of child abuse in the media', The Other Voice, Newsletter of the Institute of Criminology, Faculty of Law, University of Sydney, vol.1, no.2, November, p.4.
- Wolfe, D.A. (1991), Preventing Physical and Emotional Abuse of Children, Guilford Press, New York.
- Woodham, M.J. and Lapsley, H. (1996), 'Child emotional abuse: treatment, intervention and prevention', in N.J. Taylor and A.B. Smith (eds), Investing in Children: Primary Prevention Strategies, Proceedings of the Children's Issues Centre Inaugural Child and Family Policy Conference, Children's Issues Centre, Dunedin, 10 - 13 July 1996.
Therapeutic residential care is becoming an increasingly relevant out-of-home care option for children and young people with multiple and complex n
Information on how to report suspected child abuse and neglect, including key contacts in each state and territory
Identifying the priorities for a national child protection research agenda.
An overview of the public health model and how it applies to the Australian child welfare and child protection system