Emotional Abuse of Children: Issues for Intervention by Celia Doyle A doctoral thesis submitted in fulfilment of the requirements for the award of Doctor of Philosophy of the University of Leicester 1998 UMI Number: U105B03 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. Dissertation Publishing UMI U105B0B Published by ProQuest LLC 2013. Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code. ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 EMOTIONAL ABUSE OF CHILDREN: ISSUES FOR INTERVENTION AUTHOR: Celia Doyle ABSTRACT This study is an examination of the emotional abuse of children, where it is the main or sole form of abuse. The ultimate aim of this applied social work project is to make a contribution to intervention in cases of psychological maltreatment. Intervention lacks credibility without some definition of the problem and an understanding of its prevalence, location and manifestation, as well as an appreciation of the type of intervention required. At the outset of the current project, an exploration of professional concerns, the wider context of child abuse and a review of the relevant literature revealed that, although defining emotional abuse has been partially addressed, there are substantial gaps and deficiencies in the knowledge of the prevalence, location, manifestation and intervention relating to emotional abuse. In order to facilitate intervention, these deficiencies were addressed in the current project. Both quantitative and qualitative data was required in order to address different aspects of the issues to be explored. Triangulation was therefore an integral part of the design, information being obtained from three sources: semi-structured interviews with child protection professionals, a population survey and in-depth interviews with adult emotional abuse survivors. The main outcome of the study was an increase in empirical knowledge in the areas of deficit and, consequently, a contribution to credible intervention. Specifically, a suggested operational definition and an indication of prevalence were both provided. Emotional abuse was found to occur in a broad range of families although it was more frequently located in those exposed to multiple stressors. It was most clearly manifested through behaviours which constituted a misuse of power. Concerning intervention itself, a notable contribution of the study was the identification of important life-lines for emotionally abused children. These provided the children with unconditional, positive regard and countered their sense of isolation and rejection. WORD COUNT: 100,006 Page ACKNOWLEDGEMENTS INTRODUCTION AND OVERVIEW i Rationale i Identifying the Issues ii Objectives vii Structure of the Thesis vii Theoretical Perspectives viii Terminology ix Conclusion X CHAPTER 1. CHILDREN AND EMOTION 1 Social Construction of Childhood 1 Modem childhood 2 Children’s Needs 7 Children’s Emotional Development 11 Emotion as a social constmct 14 Overview 15 CHAPTER 2. HISTORICAL AND POLICY CONTEXTS OF CHILD ABUSE 17 Historical Context 18 The Roots of abuse 18 The ‘rescue’ model of intervention and state protection 20 The medical model and emergence of procedures 22 Difficulties and dilemmas 25 The ‘discovery’ of sexual abuse and intervention re-evaluated 27 Change and the Children Act 1989 31 Present procedures for dealing with child abuse 32 Ecological theory 34 Necessary conditions 36 Social Policy Contexts 37 Four welfare models. 38 Overview 40 CHAPTER 3.THE CURRENT DEBATE ON EMOTIONAL ABUSE 43 Terminology 44 Issues of Definition 45 Abuse or neglect 45 Intentional or unintentional harm 46 Sustained ill-treatment or a single episode 48 Present or future harm 49 Children’s or parents’ behaviour 50 Wide or narrow definitions 53 A comprehensive definition 54 Prevalence 56 Location 57 Social and Cultural Contexts 58 Type of child 59 Manifestation 61 Parental behaviour 61 Children’s response 63 Intervention 64 Overview 67 CHAPTER 4. THE RESEARCH DESIGN 70 Methodological Considerations 71 Applied social work 71 Aspects of the objectives 72 Researching sensitive topics 75 Theoretical framework 75 Funding 76 Data Sources 76 Data Collection Methods 77 Samples 79 Register cases 79 Population sample 82 Survivor interview sample 84 Measures 86 Register cases: key worker interview schedule 86 Population survey: questionnaire. 95 Survivor interviews 99 Ethical considerations 100 Register cases 100 Population survey 100 Survivor interviews 101 Procedure 101 Register cases 101 Population survey 103 Survivor interviews 104 Data Analysis 104 Missing data 107 The Independent Judge 107 Identifying ‘Emotionally Abused’ Groups 108 Register cases 108 Population survey. 109 Presentation of Findings 111 FINDINGS PREFACE: SAMPLE PROFILES 113 Register cases 113 Population survey 114 Survivor interviews 115 CHAPTER 5. FINDINGS: EXTENT OF EMOTIONAL ABUSE 116 Definitions 116 Register cases 116 Population survey 117 Identifying the Emotional Abuse Group 118 Self-definition of being emotionally abused 119 Negative emotional experiences 121 Carers’ responsibility 123 Damaging nature of emotional abuse 123 Emotional abuse as the main form 125 Happy versus unhappy childhood. 126 Other Distress 127 Bullying 127 Discrimination 128 Separation and loss 128 Uncertainty about responsibility 129 Categorisation of each sample group 129 Prevalence of other forms of abuse 129 Sexual abuse 130 Physical abuse 130 Neglect 131 Overview 132 CHAPTER 6. FINDINGS: LOCATING EMOTIONAL ABUSE 135 Type of Child 135 Gender o f subj ects 136 Age of subjects 137 Birth/bonding problems 140 Ordinal position of subject 141 Family Profiles 142 Family size 142 Ages of parents 144 Partnerships and caregiver changes 146 Social support of isolation 151 Cultural heritage 153 Class dimensions 155 Potential Stressors 156 Economic status 156 Accommodation 158 Socio-economic deprivation 161 Physical disability issues 162 Learning disabilities 164 Mental health 164 Substance misuse 165 Bereavement and loss 168 Parental experience of childhood abuse 171 Stressors: an overview 174 Overview 180 CHAPTER 7. FINDINGS: MANIFESTATION OF EMOTIONAL ABUSE 182 Parental Behaviour 182 Categorisation process: register cases 185 Types of abusive behaviour 185 Responsibility 197 Determining responsibility 198 Responsibility identified 200 Manifestations in the Children 201 General indicators 201 School career 208 No evident ‘harm’ 211 Overview 212 CHAPTER 8. FINDINGS: INTERVENTION 214 Referral Information 214 Person or agency responsible for referral 214 Reason for referral 218 Interventions Offered or Imposed 221 Types of interventions 222 Numbers of interventions 229 Removal and legal intervention 231 Registration 233 Evaluation of Practice 234 Working in partnership 234 Anti-discriminatory practice 235 Subjective evaluation of intervention 236 Population survey and survivor evaluations 239 Life-lines for Children 240 Family members 241 Schools 243 Friends 243 Professional help 244 Religious groups 245 Non-human life-lines 245 Overview 246 CHAPTER 9. REVIEW AND IMPLICATIONS FOR POLICY AND PRACTICE 249 Overview of Issues Relating to the Project Design 249 Overview of Findings 254 Definition 254 Prevalence 257 Location 260 Manifestation 264 Intervention 267 Tertiary/residual intervention 269 Secondary/institutional intervention 271 Primary/developmental intervention 275 Conclusion 277 POST SCRIPT: TOWARDS A PRACTICE GUIDE 281 FOR INTERVENTION Part 1. Recognition 282 Introduction and definition 282 Power issues 282 Intent 282 Cultural aspects 283 Emotional distress 283 Determining the presence of emotional abuse 283 Part 2. Intervention 292 Registration Describing and communicating abusive behaviour Children in need 293 Providing assistance 293 Challenging oppression 293 Lifelines and supports for children 294 Summary of intervention 294 Appendices APPENDIX 1: Inquiry Reports 305 APPENDIX 2: Interview Schedule 307 APPENDIX 3: Population Questionnaire 312 APPENDIX 4: Practice Guide Evaluation 318 APPENDIX 5: Discriminant Function Analysis: Supplementary Information 325 REFERENCES 329