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The untreatable family.

D P Jones1

  • 1Park Hospital for Children, Oxford, U.K.

Child Abuse & Neglect
|January 1, 1987
PubMed
Summary

Identifying untreatable abusive families is crucial for child safety. Early recognition helps redirect resources to families with better treatment outcomes, preventing child maltreatment.

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Area of Science:

  • Child Abuse and Neglect
  • Family Therapy
  • Forensic Psychology

Background:

  • Untreatable families, where child safety is compromised, are often resistant to interventions.
  • High rates of parental re-abuse in physical (16-60%) and sexual (16%) abuse cases highlight treatment challenges.
  • Existing treatments show limited success, with many families remaining unchanged or worsening post-intervention.

Purpose of the Study:

  • To define characteristics of untreatable abusive families.
  • To identify factors associated with poor treatment outcomes in abusive families.
  • To emphasize the importance of early recognition of untreatability.

Main Methods:

  • Literature review of studies on child physical and sexual abuse.
  • Analysis of parental factors and abuse severity linked to treatment resistance.
  • Examination of treatment outcomes in abusive family populations.

Main Results:

  • Parental factors like history of abuse, denial, and substance abuse correlate with poor outcomes.
  • Severe abuse types (e.g., fractures, sexual sadism) and specific conditions (e.g., Munchausen by proxy) are more resistant to treatment.
  • A significant percentage of families show no improvement or deterioration after treatment.

Conclusions:

  • Early identification of untreatable families is essential for effective resource allocation.
  • Recognizing untreatability can prevent professional burnout by focusing efforts on amenable cases.
  • This approach aims to improve child safety by prioritizing interventions for families with higher potential for positive change.

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