ABSTRACT
Child neglect and abuse is a complex multifactorial problem with many contributing and interdependent variables (see Briere, Berliner, Bulkley, Jenny, & Reid, 1996). The number of reported cases of child maltreatment has increased markedly over the past decade. Indeed, approximately 3 million children were reportedly maltreated in the United States in 1993 (Curtis, Boyd, Liepold, & Petit, 1995), and child maltreatment is often associated with significant psychopathology. For instance, parents of maltreated children are often immature, easily annoyed, demonstrate inadequate knowledge of child development, have poor child management skills (Wolfe, 1985), are at risk to abuse illicit substances (Chaffin, Kelleher, & Hollenberg, 1996), and experience high rates of marital conflict and abuse (Stark & Flitcraft, 1988). Moreover, these psychopathologies reciprocally interact with the behaviors of their maltreated children. Relative to nonabused children, abused children are aggressive, demonstrate poor social skills (Fantuzzo, 1990), are poorly engaged in familial relationships, are disruptive, and demonstrate fears and anxieties (see Donohue, Ammerman, & Zelis, 1997). Therefore, investigators have underscored the heuristic value of examining and treating the family as a unit rather than targeting a “problem child” or “abusive parent” (Lutzker, 1990). In this light, the behavioral interventions are the treatment of choice for child abuse and neglect, as these standardized interventions emphasize functional assessment and are easily tailored to fit individual needs (Donohue et al., 1997). Indeed, cognitive-behavioral interventions are consistently more effective than other therapy modalities in the treatment of child maltreatment. These interventions have included child management skills training (e.g., Brunk, Henggeler, & Whelan, 1987; Egan, 1983), stress management and problem-solving skills training (e.g., Gaudin, Wodarski, Arkinson, & Avery, 1990; Schinke et al., 1986; Whiteman, Fanshel, & Grundy, 1987), or a combination of these interventions (e.g., Kolko, 1996). Uncontrolled studies have demonstrated improvements in home cleanliness and reductions in home hazards via identification of home stressors, installation of home safety equipment, and cleanliness training (see Tertinger, Greene, & Lutzker, 1984). Intervention appears to be augmented if it is administered in situ (i.e., the
setting where the difficulties take place; Kolko, 1996). When treatment occurs in the natural environment, and data are obtained on a range of relevant family variables, the approach transcends the usual unidimensional intervention to yield systematic and programmed maintenance effects across problematic areas and settings.
