Child abuse and neglect: a practical guide for professional school counselors.Rarely do ethical dilemmas confronting professional school counselors involve definitive "correct" or "incorrect" choices. However, when it comes to reporting suspected child abuse child abuse, physical, sexual, or emotional maltreatment or neglect of children by parents, guardians, or others responsible for a child's welfare. Physical abuse is characterized by physical injury, usually inflicted as a result of a beating or inappropriately harsh discipline. Sexual abuse includes molestation, incest, rape, prostitution, or use of a child for pornographic purposes. and/or neglect, explicit laws and policies require that counselors have appropriate procedures available for managing suspected abuse. This article (a) describes the prevalence and severity of abuse, (b) identifies the ethical and legal statutes associated with abuse, (c) presents indicators of abuse and guidelines for reporting suspected cases, and (d) offers a systemic prevention plan. ********** Child abuse and neglect is a pervasive problem. Often professional school counselors (PSCs) express feelings of anxiety at the prospect of working with such cases. Indeed, one of educators' greatest fears is dealing with child abuse and neglect cases (Wilson, Ireton, & Wood, 1997). Most PSCs know their legal responsibility to report cases of abuse and neglect; however, procedural uncertainty and other concerns may cause great anxiety. Numerous questions may arise for the PSC: "Whom should I call?" "Do I need to tell my principal I am reporting the case?" "Will I be legally liable in any way if the case is found to be untrue or unsubstantiated?" "What specific information do I need to report?" and "How will I feel in my future interactions with the suspected parents?" Many of these questions are common for both new and experienced PSCs. Not surprisingly, Crenshaw, Lichtenberg, and Bartell (1993) found common instances of noncompliance even when helping professionals knew the legal statutes pertaining to reporting suspected abuse. Further, the Federal National Child Abuse and Neglect Incidence Study found that within school settings, only a small percentage of suspected abuse cases known to school personnel were reported to Child Protective Services (CPS) for formal investigation (Sechrist, 2000). Most ethical dilemmas confronting PSCs do not involve a simple "right" or "wrong" answer (Remley & Huey, 2002). Reporting suspected child abuse and/or neglect, however, is dictated by explicit laws and procedures. For example, all states require that abuse and/or neglect be reported if there is physical injury (Cambron-McCabe, McCarthy, & Thomas, 2004; Crosson-Tower, 2002; Fischer, Schimmel, & Stellman, 2003). Nevertheless, counselors experience uncertainty and apprehension when working with suspected abuse, warranting a professional resource that outlines appropriate procedures for managing such cases. The purpose of this article is to serve as a resource providing pragmatic guidelines and information to assist PSCs in making appropriate ethical and legal decisions when working with victims of abuse. For the purposes of the article, the term abuse is used to encompass physical, emotional, and sexual abuse and neglect. To provide a common understanding of abuse, the following definitions of abuse and neglect are taken from the American School Counselor Association's Position Statement: Child Abuse (ASCA ASCA - Adult Survivors of Child Abuse ASCA - Advanced Satellite for Cosmology & Astrophysics ASCA - Advanced Spacecraft for Cosmology Astrophysics ASCA - Air Support Coordination Agency ASCA - Airplane Stability and Control Analyzer (Whirlwind) ASCA - Alberta Sporting Clay Association ASCA - American Safe Climbing Association ASCA - American School Counselor Association ASCA - American Society of Consulting Arborists, 1999): Abuse: The infliction of physical harm upon the body of a child by other than accidental means, continual psychological damage or denial of emotional needs (e.g., extensive bruises/patterns; burns/patterns; lacerations, welts or abrasions; injuries inconsistent with information offered; sexual abuse involving molestation or exploitation, including but not limited to rape, carnal knowledge, sodomy or unnatural sexual practices; emotional disturbance caused by continuous friction in the home, marital discord or mentally ill parents; cruel treatment). Neglect: The failure to provide necessary food, care, clothing, shelter, supervision or medical attention for a child (e.g., malnourished, ill-clad, dirty, without proper shelter or sleeping arrangements, lacking appropriate health care; unattended, lacking adequate supervision; ill and lacking essential medical attention; irregular/illegal absences from school; exploited, overworked; lacking essential psychological/ emotional nurturing; abandonment). (p. 1) The following discussion starts with an overview of the prevalence and severity of child abuse, followed by the ethical obligations and legal statutes associated with abuse, symptoms of abuse, and a systemic prevention plan to combat abuse. PREVALENCE AND SEVERITY OF CHILD ABUSE PSCs commonly encounter cases of suspected student abuse. Thus, determining whether to report suspected student abuse is the second most frequently reported ethical dilemma (89%) experienced by PSCs; the most frequently reported ethical dilemma is determining whether a student is suicidal (90%) (Hermann, 2002). Approximately 5 million cases of suspected child abuse were reported to CPS during the year 2000 in the United States, and 2,400 children were found to be victims of abuse each day (Prevent Child Abuse America, 2003; Prevent Child Abuse North Carolina, 2003a). Each week, CPS agencies receive more than 50,000 reports of suspected child abuse (Prevent Child Abuse America). Similar to many other states, in North Carolina the number of children reported as abused has increased by appropriately 10% each year for the past 3 years, with abuse being confirmed in about one third of the cases in any year (Prevent Child Abuse North Carolina). Sadly, the actual incidents of abuse are probably much higher, given that most abuse occurs in closed systems (families that remain distant and isolated from other families and social institutions), out of view of the public, thereby significantly reducing the likelihood of such cases being reported (Sechrist, 2000). For example, studies of adult survivors of child abuse indicate a high tendency not to tell anyone about their abuse for reasons such as fear of the abuser, fear of negative reactions from others, fear that no one would believe them, the belief that they deserved the abuse, and a lack of awareness that abuse was unacceptable (DeVoe & Faller, 1999; Palmer, Brown, Rae-Grant, & Loughlin, 1999; Sechrist). Therefore, based on national child abuse statistics and the occurrence of underreporting (Prevent Child Abuse America, 2003), it can be conservatively estimated that at least five students have been or will be reported as being possible victims of abuse in a typical teacher's classroom per year in the United States. An average of three to five children die every day as a result of abuse (Prevent Child Abuse America, 2003). Furthermore, it is estimated that 18,000 children per year sustain permanent disabilities as a result of abuse (U.S. Advisory Board on Child Abuse and Neglect, 1995). It is important to note that children younger than 1 year of age accounted for nearly one half (44%) of child abuse deaths reported in 2000 (Prevent Child Abuse America). In addition, it is estimated that 85% of childhood deaths from abuse are systematically misidentified as accidental, disease related, or due to other causes (National Research Council, 1993; U.S. Advisory Board on Child Abuse and Neglect). Therefore, reporting suspected child abuse is not only a moral, ethical, and legal decision, it is a life-or-death decision. Abuse is encountered in all socioeconomic groups, races, and religions. In 2000, for example, abuse victims for all ethnic and racial groups were reported, according to the following breakdown: 51% European Americans, 25% African Americans, 14% Hispanic Americans, 2% American Indian/ Alaska Natives, and 1% Asian/Pacific Islanders. In terms of gender, boys and girls suffer physical abuse equally, but girls are four times more likely to experience sexual abuse (Prevent Child Abuse America, 2003). According to Prevent Child Abuse America (2002a), at least 20% of American women and 5-16% of American men experience some form of sexual abuse as children. Further estimates of sexual abuse in the United States range from one in six to one in four individuals; other estimates have been as high as one third of the entire population (Cole, 1995; Vanderbilt, 1992). Therefore, based on national sexual abuse statistics (Cole), within an average PSC caseload of 477 students (U.S. Department of Education, 2003), approximately 95 students have been or will be sexually abused. POTENTIAL CONSEQUENCES OF ABUSE The potential consequences of abuse to victims are profound. Thus, research supports that abused children are 25%, more likely to repeat a grade, and 75% of all high school dropouts have a history of abuse or neglect (Prevent Child Abuse North Carolina, 1997). Each year, tens of thousands of victims of abuse endure psychological trauma, not only affecting the sufferer, but also his or her family members (Sechrist, 2000). Thus, child abuse affects all of society, from the offended to every social institution, including schools and mental health agencies. There are both long-term and short-term consequences of abuse. The long-term harm includes possible brain damage, developmental delay, learning disorders, problems forming relationships (interpersonal and social difficulties), aggressive behavior, depression, low academic achievement, substance abuse, teen pregnancy, sexual revictimization, and criminal behavior (Prevent Child Abuse America, 2003; Sechrist, 2000). The more immediate effects include feeling helpless, hopeless, and ashamed. Victims may feel unworthy of having friends and fearful that their "family secret" will be revealed; therefore, they may isolate themselves and withdraw. Such students may have increasingly pessimistic feelings about themselves, leading to decreased self-worth, self-blame, guilt and shame, as well as negative feelings about their own bodies (Cole, 1995; Russell, 1999). In some cases, these destructive feelings about "self' can manifest in self-mutilation. Other abused students may develop perfectionist tendencies and focus on overachievement as a form of escapism by concentrating on areas that may provide them with some sense of control (e.g., school success) (Horton & Cruise, 2001). This type of perfectionism may be accompanied by anxiety and inflexibility. PSCs need an understanding of the potential long-term and short-term consequences of abuse in order to be able to identify the symptoms of maltreatment as early as possible and intervene appropriately. Early identification and intervention for these students may reduce the potential consequences of the abuse. ETHICAL OBLIGATION AND LEGAL STATUTES ASSOCIATED WITH ABUSE PSCs have a moral, ethical, and legal obligation to students who have experienced abuse. Although all states require abuse and/or neglect to be reported if there is physical injury (Cottone & Tarvydas, 2003; Fischer et al., 2003), the specifics of the laws vary from state to state. For example, Georgia, Indiana, Iowa, Maryland, Minnesota, Oregon, and Wisconsin do not require reporting of emotional or mental injury. However, all states currently include sexual abuse and exploitation in their definition of child abuse. Some states explicitly identify PSCs among mandatory reporters of abuse, whereas others broaden the reporter to include "educators," "other school personnel," and "officials" or "employees" of any public or private schools (Fischer et al.). It is essential that PSCs be knowledgeable about their state's laws regarding abuse. Ethical Obligation All PSCs have an ethical obligation to report suspected abuse. Professional ethics are defined as best practices according to agreed-upon rules or standards of practice established by a profession, as in professional school counseling. A subtype of ethics is mandatory ethics, which is the most basic level of ethical functioning, focusing on compliance with the law imposing professional codes of practice. Such is the case of suspected child abuse (Cottone & Tarvydas, 2003). According to ASCA's (2004) Ethical Standards for School Counselors, a PSC ethically "is knowledgeable of laws, regulations, and policies relating to students and strives to protect and inform students regarding their rights" (A.1.d). Additionally, the ethical standards state that a PSC "keeps information confidential unless disclosure is required to prevent clear and imminent danger to the student or others or when legal requirements demand that confidential information be revealed. Counselors will consult with appropriate professionals when in doubt as to the validity of an exception" (A.2.b). Furthermore, ASCA's (2003a) Position Statement: Child Abuse/Neglect Prevention specifies that "it is the professional school counselor's legal, ethical and moral responsibility to report suspected cases of child abuse/neglect to the proper authorities" (p. 1). Based on these ethical standards and position statements, PSCs are ethically obligated to (a) keep informed of legal statutes and policies regarding abuse, (b) protect their students by disclosing confidential information with or without consent, and (c) report such information to the appropriate authorities if abuse is suspected. Legal Obligation In 1974, Congress enacted the National Child Abuse Prevention and Treatment Act (PL 93-247), whose title was changed in 1978 to Child Abuse Prevention and Treatment Act. On June 25, 2003, the act was amended, reauthorized, and renamed the Keeping Children and Families Safe Act of 2003 (PL 108-36). The 1974 act defined child abuse and neglect as the following: Physical or mental injury, sexual abuse or exploitation, negligent treatment, or maltreatment of a child under the age of eighteen or the age specified by the child protection law of the state in question, by a person who is responsible for the child's welfare under circumstances which indicate that the child's health or welfare is harmed or threatened thereby. (42 USCS [subsection] 5101) Child abuse is not a federal crime; however, the federal law made money available to states meeting the Child Abuse Prevention and Treatment Act's reporting guidelines and other standards (Fischer et al., 2003). In the late 1980s, the Child Abuse Prevention, Adoption, and Family Service Act of 1988 was passed, and money was allocated to address the national child abuse problem, additionally creating the National Center on Child Abuse and Neglect. Child abuse is a state crime, with variance in state statutes. For example, the following highlights key components of North Carolina's statutes. These components are somewhat typical of the rest of the country. G.S. [section] 7B-301: Duty to report abuse, neglect, dependency, or death due to maltreatment. Any person or institution who has cause to suspect that any juvenile is abused, neglected, or dependent, as defined by G.S. 7B-101, or has died as the result of maltreatment, shall report the case of that juvenile to the director of the department of social services in the county where the juvenile resides or is found. The report may be made orally, by telephone, or in writing. The report shall include information as is known to the person making it including the name and address of the juvenile; name and address of the juvenile's parents, guardians, or caretakers; the age of the juvenile; the name and age of other juveniles in the home; the present whereabouts of the juvenile if not at home address; the nature and extent of any injury or condition resulting from abuse, neglect, or dependency; and any other information which the reporter believes might be helpful in establishing the need for protective services or courts intervention. G.S. [section] 7B-309: Immunity of persons reporting and cooperating in an investigation. Anyone who makes a report pursuant to this Article ... is immune from any civil or criminal liability that might otherwise be incurred or imposed for that action provided that the person was acting in good faith. G.S. [section] 7B-310: Privileges not grounds for failing to report or for excluding evidence. No privilege shall be grounds for any person or institution failing to report that a juvenile may have been abused, neglected or dependent, even if the knowledge or suspicion is acquired in an official professional capacity.... North Carolina General Statutes, 2003) As is evident from the above congressional acts and state statutes, PSCs are criminally liable if they fail to report a suspected case of child abuse in most states (exceptions are Idaho, Illinois, Mississippi, Montana, and Wyoming) (Fischer et al., 2003). Furthermore, PSCs acting in good faith as mandated child abuse reporters are immune from any criminal and/or civil lawsuits. Finally even in states granting privilege to the PSC-student relationship, the duty to report suspected abuse supersedes privilege and confidential communication. Therefore, PSCs must report suspected abuse in all circumstances. SYMPTOMS OF ABUSE Educators, and specifically PSCs, play a critical role in safeguarding the well-being of students, as children have almost daily contact with school personnel. Thus, PSCs' interactions with students and their families offer them insight into possible cues to abuse (Lambie & Rokutani, 2002). Furthermore, a PSC educated about the symptoms of child abuse can work collaboratively with and provide education to other school personnel in identifying possible warning signs. It is important to note that symptoms do not necessarily mean that abuse is present and counselors' overreactions can make a situation worse. Thus, if counselors observe signs of possible abuse, they must communicate their perceptions to the student and receive clarification concerning their interpretations before proceeding. Nevertheless, having an understanding of abuse symptomology, is paramount in intervening as early as possible for the student's benefit. The following symptoms of abuse are organized by type--physical abuse, sexual abuse, emotional abuse, and neglect. Signs of Possible Physical Abuse Physical abuse may be defined as nonaccidental physical injury to a child, ranging from minor bruises to severe fractures or death as a result of punching, beating, kicking, biting, shaking, throwing, stabbing, choking, hitting, burning, or otherwise harming a child (Crosson-Tower, 2002; Prevent Child Abuse America, 2003). Signs of possible physical abuse include the following: Physical symptoms include (a) unexplained bruises in various stages of healing, as well as burns; (b) self-destructive behavior; (c) welts, human bite marks, or bald spots; and (d) unexplained fractures, abrasions, or other injuries. Behavioral warning signs include (a) nervous, hyperactive, aggressive, disruptive, or destructive behavior; (b) unusual apprehensiveness of physical contact; (c) being frightened of parents or caretaker; (d) expressing little or no emotion when hurt; and (e) being unusually shy, withdrawn, or passive (Crosson-Tower, 2002; Fischer et al., 2003; Prevent Child Abuse North Carolina, 2003b). Signs of Possible Sexual Abuse Sexual abuse may be defined as sexual involvement imposed upon a child by an adult who has greater power, knowledge, and resources, including activities by parents or caretakers such as fondling a child's genitals, penetration, incest, rape, sodomy, indecent exposure, and commercial exploitation through prostitution or the production of pornographic materials (Crosson-Tower, 2002; Prevent Child Abuse America, 2003). Sign of possible sexual abuse include the following: Physical symptoms include (a) sleep disturbances or nightmares; (b) difficulty walking or sitting; (c) pain, itching, bruising, or bleeding in the genitalia; (d) venereal disease; (e) frequent urinary tract or yeast infections; and (f) pregnancy. Behavioral warning signs include (a) engaging in sexual activity not appropriate for the child's age; (b) detailed and sophisticated understanding of sexual behavior; (c) going back to a behavior such as bedwetting or speech loss (regression); (d) unwillingness to change clothes or participate in physical education; and (e) poor interpersonal relationships with peers. Additionally, symptoms in adolescents include (a) delinquent or aggressive behaviors; (b) indicators of depression; (c) self-injurious behaviors such as substance abuse, self-mutilation, or attempted suicide; and (d) prostitution or running away (Crosson-Tower, 2002; Fischer et al., 2003; Prevent Child Abuse North Carolina, 2003b). Signs of Possible Emotional Abuse Emotional abuse underlies all types of abuse and neglect and may be defined as any pattern of behavior that impairs a child's emotional development or sense of self-worth, including constant criticism, threats, or rejection, as well as withholding love, support, or guidance (Crosson-Tower, 2002; Prevent Child Abuse America, 2003). Signs of possible emotional abuse include the following: Physical symptoms include (a) speech disorders; (b) delayed physical or emotional development; and (c) ulcers, asthma, or severe allergies. Behavioral warning signs include (a) habit disorders such as sucking, rocking, or biting; (b) an extreme passive and undemanding demeanor; (c) low self-esteem; (d) exceedingly demanding, aggressive, or angry behavior; (e) conduct disorder such as antisocial or destructive behavior; (f) depression and/or suicidal ideation; and (g) attention-seeking behavior (Crosson-Tower, 2002; Fischer et al., 2003; Prevent Child Abuse North Carolina, 2003b). Signs of Possible Neglect Neglect can be defined as a failure to provide for a child's basic needs, which can be broken into three categories--physical, educational, and emotional. Physical neglect is a lack of appropriate supervision or the failure to provide food, shelter, or medical care. Educational neglect is a failure to educate a child or attend to special education needs. The third type of neglect, emotional neglect, involves inattention to a child's emotional needs or exposure to domestic violence (Crosson-Tower, 2002; Prevent Child Abuse America, 2003). Signs of possible neglect include the following: Physical symptoms include (a) a consistent lack of supervision; (b) unattended medical needs or a pale and listless appearance; (c) abandonment by parents or caretaker; and (d) consistent hunger, inappropriate dress, poor hygiene, lice, or a distended stomach. Behavioral warning signs include (a) poor social skills; (b) an indiscriminate show of affection or craving for attention; (c) falling asleep in class and regularly displaying fatigue; (d) self-destructive behavior; (e) begging or stealing food; and (f) frequent school absences or tardiness (Crosson-Tower, 2002; Fischer et al., 2003; Prevent Child Abuse North Carolina, 2003b). GUIDELINES FOR REPORTING CASES OF SUSPECTED ABUSE As noted, PSCs are ethically and legally obligated to report cases of suspected child abuse. A PSC suspecting abuse may want to alert his or her principal. However, ultimately it is the PSC's responsibility to report the suspected cases of student abuse to the proper community agency (ASCA, 2004). In most states, failure to report is a misdemeanor carrying a penalty from a jail sentence of 5 to 30 days and/or a fine of $10 to $100 to a year in jail and a fine of $1,000. However, there have been no reported cases of criminal prosecution for failure to report a case of abuse because states generally require a "knowing" or "willful" failure to report, which is difficult to prove in a court of law (Cambron-McCabe et al., 2004; Fischer et al., 2003). Nevertheless, PSCs may be liable in a civil suit for failing to report suspected abuse; again, cases have been rare. Most states require the reporter to make an oral (i.e., telephone or in-person communication) report within a "reasonable period of time" to a designated protection agency, usually a division of social services (i.e., CPS). A definition of reasonable period of time to report ranges from 24 hours to 72 hours; some states permit up to 7 days to file the report (Fischer et al., 2003; Prevent Child Abuse North Carolina, 2003b). Once the PSC has a suspicion of abuse, the next step is to file the report. The information reported to CPS generally includes the following: (a) the name, address, and gender of the child; (b) the name and address of the parent, guardian, or caretaker; (c) the name and age of any other children/adolescents living in the home; (d) the child's condition, including the nature and extent of the injury; (c) an explanation of the injuries as given by the child; (f) any information regarding the presence of weapons, alcohol/drug abuse, or other factors affecting the social worker's safety; (g) actions taken by the reporter, such as detaining the child; and (h) any other information the reporter believes may be helpful in establishing the cause of injuries and/or protecting the child (Cambron-McCabe et al., 2004; Crosson-Tower, 2002; Fischer et al., 2003; Prevent Child Abuse North Carolina, 2003b). It is good practice to construct a written checklist of the information necessary to file a complete report before contacting CPS. Some school districts have written protocols making the reporting process more consistent throughout the system. When such a uniform reporting form is not available, it is suggested that the professional school counseling department advocate for the creation of such a schoolwide document. It is important to remember that the reporter does not have to prove that abuse has taken place; reasonable grounds for suspicion are sufficient. Furthermore, the reporter does not have to provide his or her name; reports may be filed anonymously. However, this limits the reporter's ability to receive feedback from CPS. Lastly, a reporter does not need the permission of the school, parents, or caregivers to make a report, and it is not necessary to tell them the report was made (Prevent Child Abuse North Carolina, 2003b). Because reporting guidelines vary from state to state, mandatory reporters (e.g., PSCs) should find out about the specific standards for making a report in their particular state of interest. The U.S. Department of Health and Human Services Administration for Children and Families (2004) hosts a website (http://nnanch.acf:hhs.gov/general/ legal/statutes/) that provide links to state-specific information and statutes related to standards for filing reports of suspected child abuse and neglect. When working with a student for whom abuse is suspected, PSCs must use sound and appropriate counseling skills. A student who discloses abuse may be feeling scared, guilty, ashamed, angry; or powerless, and the counselor may feel a sense of outrage, disgust, sadness, or disbelief. It is paramount that the counselor demonstrate to the student that he or she cares and is concerned. Care may be expressed by listening carefully to what the student says, telling the student that you believe him or her, expressing to the student that the abuse was not the child's fault, and letting the student know that making a report to help stop the abuse is necessary. It is not helpful to the student if the PSC (a) makes promises that cannot be kept, such as promising not to tell anyone; (b) pushes the student to give details about the abuse (the counselor's role is to listen to what the student wants to share); or (c) discusses what the student conveyed with others who are not directly involved in helping the child (Prevent Child Abuse North Carolina, 2003b). In brief, when a PSC interviews a student who has possibly been abused, he or she should balance gathering information about the abuse with building a sate therapeutic relationship. Additionally, before beginning any counseling relationship, the PSC should explain the limits of confidentiality to his or her students (i.e., clear and imminent danger to student or others, suspected child abuse, or suspected abuse of the elderly). Furthermore, ASCA's (2004) Ethical Standards for School Counselors specifics that PSCs "inform appropriate officials in accordance with school policy of conditions that may be potentially disruptive or damaging to the school's mission, personnel, and property, while honoring the confidentiality between the student and counselor" (D.1.b). A SYSTEMIC PREVENTION PROGRAM The prevention and early identification of abuse are critical to supporting students' healthy development and lifelong well-being. Ideally, abuse would never happen. However, when it does occur, early intervention soon after the onset of abuse can eliminate subsequent occurrences of abuse and provide an immediate opportunity for services to be delivered, thus minimizing the trauma (Sechrist, 2000). For a school to address student abuse appropriately, all school personnel must have an understanding of abuse as well as their legal and ethical responsibilities. Therefore, the first facet of a systemic prevention plan is collaborative education for all school personnel on the prevalence and symptoms of abuse and the establishment of school policy and procedures specific to abuse. The second component of a comprehensive plan should address parental and familial issues, because "the best way to prevent child abuse and neglect is to support families and provide parents with the skills and resources they need" (Prevent Child Abuse America, 2003, p. 9). These approaches support the ASCA National Model (2003b) themes of the PSC as a leader, advocate, collaborative teammate, and supporter of systemic change. Collaborative School-Based Education on Abuse For a system to function effectively, all of its parts must work together. With reference to abuse and schools, this translates to all school personnel having a knowledge base about abuse and being familiar with the school's protocol for addressing incidents of abuse. The need to educate school personnel about abuse is evident in the findings of a study in Illinois where 81% of teachers responding reported that they had received no child abuse information during college; 66% had received no education on abuse during in-service training (McIntyre, 1987). Furthermore, among the teachers in this study, only 21% were "very aware" of the signs of physical abuse, 19% of emotional abuse, and 30% of physical abuse and neglect, whereas 71% indicated that they would be unable to recognize indicators of sexual abuse (McIntyre). Additionally, Hazzard (1984) found that 68% of teachers sampled had received 3 or fewer hours of education about abuse. Similarly, Abrahams, Casey, and Daro (1991) found that teachers are commonly being confronted with abuse, yet they have been insufficiently educated to address the situation. Therefore, it is likely that the people with whom children have the most contact at school have received little to no training and education about child abuse and therefore are limited in their ability to identify possible symptoms of abuse. As specialists in human behavior, communication, and relational issues, PSCs receive specialized training in child development, therapeutic interventions, and crisis intervention such as child abuse. Based on their specialized training, PSCs are an ideal resource for educating other educators about abuse (Crosson-Tower, 2002). As part of such a prevention plan, the counselor can facilitate in-service training for all school personnel, including service staff such as custodians and bus drivers. The training should incorporate components discussed in this article, including the prevalence and consequences of abuse, the ethical and legal statutes associated with abuse, the symptoms of abuse, and the school's established guidelines for reporting suspected cases. Furthermore, consultation can be integrated into the training, with the counselor offering consultation services to all school personnel as needed, supporting the ASCA National Model (2003b) of the PSC being a collaborative teammate working to support the school's mission. Therefore, if any of the school personnel suspect abuse and are unsure about their impressions or how to manage a given situation, they are aware that they may consult about the circumstances with the counselor. It is important that all the school personnel work together collaboratively, respecting each other's expertise, and view their relationship as a partnership. Consistency supported by clear and explicit guidelines is important for ensuring effective implementation and practice of any program. Therefore, advocating for a formalized procedural process for managing suspected child abuse must be a priority for PSCs. Established guidelines need to specify the following in writing: (a) each educator's role in addressing suspected abuse, (b) designated reporters (if that is what a school chooses to implement), (c) established documentation measures, and (d) guidance about issues such as if a superior disagrees with the need to file a report. Some schools choose to establish a Child Protection Team (CPT), a team of educational professionals within the school who work collaboratively to address abuse with each member having delegated duties. The CPT can improve a school's ability to assist students who are suspected of having been abused and help the reporting process (Crosson-Tower, 2002). Supporting Parents, Families, and Students For schools to operate proactively concerning abuse, prevention is necessary. Prevention in this context means programmatic actions designed to promote students' development and level of resiliency, thereby reducing the potential for "at-risk" behaviors and attributes (Dollarhide, 2003). In brief, the goal is "to stop child abuse and neglect from happening in the first place, sparing children and families emotional and physical trauma and decreasing the need for costly intervention and treatment services" (Prevent Child Abuse America, 2003, p. 9). To prevent abuse, the "perpetrators" of the abuse need to be helped before abusing. Most abuse occurs at the hands of parents, with a minimum four out of five victims found to be abused by at least one parent. Whereas mothers acting alone were most commonly found responsible for physical abuse, nonrelatives and fathers acting alone were most commonly found responsible in sexual abuse cases. Finally, most physical abuse fatalities are caused by enraged or extremely stressed fathers or other male caretakers (Prevent Child Abuse America, 2003). The average abuse parent is in his or her mid-20s, lives near or below the poverty level, often has not finished high school, is depressed and unable to cope with stress, and has experienced violence firsthand. Providing children with education relating to abuse (i.e., defining what abuse is, teaching the students that they have the right to control access to their bodies, introducing "good" and "bad" touch, and teaching that some secrets should not be kept) through the classroom guidance curriculum can serve as a proactive prevention strategy (Prevent Child Abuse America; Reppucci & Haugaard, 1988). However, no single profile fits every case, and there are many exceptions to the "average" (U.S. Advisory Board on Child Abuse and Neglect, 1995). The most effective way to prevent child abuse is to support parents and families, while providing parents with the skills and resources necessary to become healthy individuals and parents who foster effective family functioning (Prevent Child Abuse America, 2003). The following are programs and/or activities that a school working collaboratively with other community agencies can offer to parents, families, and students in an effort to support their functionality and reduce their potential for abuse. Supporting new parents. Becoming a new parent marks a transition in the family life cycle that often is accompanied by high levels of anxiety, and stress. The ASCA National Model (2003b) promotes that PSCs should be proactive advocates who support systemic change, in which providing information can be helpful in relieving new parents' level of stress. For example, education regarding prenatal care; nonviolent discipline techniques; how to meet children's emotional, physical, and developmental needs; and stress management skills can help improve new parents' understanding of their children and promote their ability to manage stress, thereby reducing their likelihood to abuse. Furthermore, work and finances can be powerful sources of stress, so offering occupational skills training and financial planning also can be beneficial (Crosson-Tower, 2002; Prevent Child Abuse America, 2002b, 2003). Additionally, new family configurations such as blending two families may require additional support to negotiate this potentially stressful transition. Parental support groups. All families need support, and families that are systemically open to other systems (i.e., schools, other families, health care agencies) are less likely to encounter dysfunctionality. Family factors such as degree of parental nurturance and support, parent-child communication, and parental relationships have repeatedly been found to affect children's level of functionality (Lambie & Rokutani, 2002; Piercy, Volk, Trepper, Sprenkle, & Lewis, 1991). PSCs are in a position to support systemic change (ASCA, 2003b). A parental support group can offer new and more experienced parents the support they may need and provide new parents an opportunity to meet potential role models among other participating parents. Abuse is cyclical; many parents who have been abused have not witnessed appropriate parenting and need the opportunity to observe healthy parenting and communication. Additionally, the group can offer orientation about community resources, opening the family to the community's supports and reducing its isolation (Crosson-Tower, 2002; Prevent Child Abuse America, 2002b, 2003). Life skills training for students. Within a comprehensive prevention program, students also need to be involved. Many professional school counseling programs currently are providing child abuse prevention services to their students in the form of classroom guidance activities (the majority at the elementary school level). Children who have stronger coping skills are better able to seek and obtain needed resources and support. As mentioned, abuse is a cycle of dysfunction, and strengthening students' coping skills and their feelings about themselves can potentially break the cycle of abuse (Crosson-Tower, 2002). Life skills training can be incorporated into the professional school counseling roles of facilitating individual and group counseling, the classroom guidance curriculum, and consultation activities. Additionally, in their coordination role, counselors can advocate for life skills training being integrated into the curriculum. The focus of the life skills education can include (a) promoting students' ability to cope with crisis or stress, (b) decision-making skills, (c) taking responsibility for actions, (d) building self-concept, and (e) personal body protection (Crosson-Tower; Prevent Child Abuse America, 2002b, 2003). Students with skills and abilities in these areas will function more effectively in all facets of their lives, reducing the potential for abuse. CONCLUSION PSCs are ethically and legally bound to intervene in cases of suspected abuse. Early identification and intervention are essential for breaking the systemic homeostasis of this dysfunctionality that often leads to negative consequences for the student. By not working to identify and address abuse, schools are likely to facilitate the failure of the young person to achieve his or her potential as well as develop feelings of positive self-worth and self-respect. Therefore, PSCs need (a) an understanding of the prevalence and severity of abuse, (b) a knowledge base regarding the ethical and legal statutes associated with abuse, and (c) the ability to identify the syrup toms of abuse and subsequently report such cases promptly to the appropriate protection agency. Furthermore, PSCs must advocate for the establishment of child abuse prevention programs in their schools. As a part of such programs, all school personnel must be educated in the identification of abuse, the responsibilities and procedures involved in serving as a mandated reporter, and the methods of supporting abuse victims and their families. As a first step toward this important goal, child abuse inservice training for school personnel should be offered in which all faculty and staff receive a written copy of the school's child abuse protocol, including reporting requirements, procedures, policies, and updated listings for CPS and other referral sources within the community. Additionally, schools and the community have an ethical responsibility to offer abuse prevention training for parents and families. Because the causes of abuse are so varied, offering support, education, and resources as part of a comprehensive school counseling program (ASCA, 2003b) to parents may help to alleviate stresses and thereby prevent the potential for abusive behavior. This is not the exclusive responsibility, of the school; however, it is the obligation of all social systems and individuals to work to prevent abuse. Therefore, it is not suggested that PSCs attempt to achieve the prevention program presented here on their own, but that they work collaboratively with other community agencies to reduce incidents of abuse by offering support and resources to new parents, parental support groups, and life skills training to students. Remaining silent about abuse reinforces the dysfunctionality itself. By advocating for open communication, training, and prevention, PSCs model openness to families that may otherwise be closed and have a higher likelihood to abuse. As with most social ills, stopping abuse flora occurring may be impossible; however, intervening so abuse may not take place again and providing supports to minimize the trauma are reasonable expectations. To meet such expectations requires a system such as a school and its personnel to work collectively and collaboratively together. In such efforts, the PSC can be in a central position leading the way to stopping the cycle of abuse. References Abrahams, N., Casey, K., & Daro, D. (1991). Teachers' knowledge, attitudes, and beliefs about child abuse and its prevention. Child Abuse and Neglect, 16(2), 229-238. American School Counselor Association. (1999). Position statement: Child abuse: The professional school counselor and child abuse and neglect prevention. 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(2003). Ethical and professional issues in counseling (2nd ed.). Upper Saddle River, N J: Merrill Prentice Hall. Crenshaw, W. B., Lichtenberg, J. W., & Bartell, P. A. (1993). Mental health providers and child abuse: A multivariate analysis of the decision to report. Journal of Child Sexual Abuse, 2(4), 19-42. Crosson-Tower, C. (2002). When children are abused: An educator's guide to intervention. Boston: Allyn and Bacon. DeVoe, E., & Faller, K. (1999). The characteristics of disclosure among children who may have been sexually abused. Child Maltreatment, 4(3), 217-227. Dollarhide, C.T. (2003). The domains. In C.T. Dollarhide & K.A. Saginak (Eds.), School counseling in the secondary school: A comprehensive process and program (pp. 104-130). Boston: Allyn and Bacon. Fischer, L., Schimmel, D., & Stellman, L. R. (2003). Teachers and the law (6th ed.). Boston: Allyn and Bacon. Hazzard, A. (1984). Training teachers to identify and intervene with abused children. 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North Carolina General Statutes, Chapter 7B, Juvenile Codes, Subchapter I, Abuse, neglect, dependency, [sections] 7B-100-301 (2003). Palmer, S., Brown, R., Rae-Grant, N., & Laughlin, J. (I 999). Responding to children's disclosure of familial abuse: What survivors tell us. Child Welfare, 78(2), 259-282. Piercy, F. P., Volk, R. J., Trepper, T., Sprenkle, D. H., & Lewis, R. (1991). The relationship of family factors to patterns of adolescent substance abuse. Family Dynamics of Addiction Quarterly, 1(1), 41-54. Prevent Child Abuse America. (2002a). Fact sheet: Sexual abuse of children. Retrieved May 20, 2003, from http://www. preventchildabuse.org/learn_more/research_docs/ sexual abuse.pdf Prevent Child Abuse America. (2002b).Factsheet: An approach to preventing child abuse. Retrieved May 20, 2003, from http://www.preventchildabuse.org/learn more/ research_docs/an_approach_to_prevention.pdf Prevent Child Abuse America. (2003). What everyone can do to prevent child abuse: 2003 child abuse prevention community resource packet. Chicago: Author. Prevent Child Abuse North Carolina. (1997). Tips for schools: Recognizing and responding to child abuse and neglect for school personnel, Raleigh, NC: Author. Prevent Child Abuse North Carolina. (2003a). Facts about child abuse. Retrieved May 20, 2003, from http://www. preventchildabusenc.org/facts.htm Prevent Child Abuse North Carolina. (2003b). Recognizing and reporting child abuse. Retrieved May 20, 2003, from http://www.preventchildabusenc.org/report-abuse.htm Remley, T. P., Jr., & Huey, W. C. (2002). An ethical quiz for school counselors. Professional School Counseling, 6(1), 3-11. Reppucci, N. D., & Haugaard, J. J. (1988). Prevention of child sexual abuse: Myths or reality. American Psychologist, 44(10), 1266-1275. Russell, D. E. (1999). The secret trauma: Incest in the lives of girls and women (Rev. ed.). New York: Basic Books. Sechrist, W. (2000). Health educators and child maltreatment: A curious silence. Journal of School Health, 70(6), 241-243. U.S. Advisory Board on Child Abuse and Neglect. (1995). A nation's shame: Fatal child abuse and neglect in the United States (5th report). Washington, DC: Government Printing Office. U.S. Department of Education. (2003). National Center for Educational Statistics (2001 data year): United States student-to-counselor ratio. Washington, DC: Author. U.S. Department of Health and Human Services Administration for Children and Families. (2004, July). State laws related to child abuse and neglect. Retrieved September 22, 2004, from http://nccanch.acf.hhs.gov/ general/legal/statutes Vanderbilt, H. (1992). Incest: A chilling report. Lear's, 2, 49-77. Wilson, B., Ireton, E., & Wood, J. A. (1997). Beginning teacher fears. Education, 117, 396-402. Glenn W. Lambie, Ph.D., is an assistant professor with the Counseling and School Psychology Program, School of Education, Chapman University, Orange, CA. E-mail: glambie@chapman.edu |
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