Child Abuse Allegations: Multidisciplinary Team Approach

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Table of Contents

Question
Clinical bottom line
Characteristics of the Evidence
Best Practice Recommendations
Reference list

Question

In children with allegations of child abuse, what is the effectiveness of the multidisciplinary team approach compared to the non-multidisciplinary team approach on prosecution rates, mental health referrals, and provision of medical examinations?

Clinical bottom line

Child abuse which is also referred to as cruelty to children, refers to mistreating children physically, sexually, or emotionally. A long time ago, child abuse was only associated with the physical mistreatment of children. Nowadays, the application of child abuse has expanded, and it now includes unjustifiable verbal abuse, physical violence, medical treatment, rape cases, child –employment, and prostitution or pornography involvement, among others. The multidisciplinary team approach is more effective in allegations of child abuse compared to the non-multidisciplinary team approach on prosecution rates, mental health referrals, and provision of medical examinations.

A PubMed review showed that when medical evaluations indicate the possibility of child abuse, a multidisciplinary team approach is the most effective strategy. A social work assessment that includes developing the history of a child and the psychological assessment of the child’s family is recommendable. The approach includes an evaluation plan and effective coordination of services when the abused child is hospitalized. The PubMed review showed that the approach meets the best interests of children compared to the non-multidisciplinary team approach. [1]
A Cochrane review found that the absence of a multidisciplinary team approach leads clinicians and researchers in making decisions based on ordinal scales that inflict injury to the child. The review compares the multidisciplinary team approach to the non-multidisciplinary team approach. Medical practitioners with considerable academic and clinical experience took part in the study of examination of physically assaulted children. They concluded that the evaluation by the multidisciplinary team was more reliable than that of the non-multidisciplinary team. The information obtained was in favor of the peer review or the multidisciplinary strategies in the analysis of child abuse. [2]
A PubMed review showed that a multidisciplinary team approach is more efficient than a non-multidisciplinary team approach. A multidisciplinary structure of service provision is critical to achieving a more efficient and accommodating response from victims of child abuse. [3] The study research aimed at developing a child abuse prevention project to serve families and children from two neighboring communities in Canada. The project involved various organizations and institutions in the health sector. It also included law enforcement and social services agencies. It focused on preventing child abuse and neglect through a multidisciplinary, community-based model of service delivery. Compared to a non-multidisciplinary team approach, the multidisciplinary team approach is the most effective on prosecution rates, mental health referrals, and provision of medical examinations.
A PubMed review found that the integration of a multidisciplinary team approach is more effective in dealing with child sexual assaults than the non-multidisciplinary team approach. The approach allowed community dialogue, advocating reports and treatment for sexually assaulted children. Programs were developed for specific segments. Appropriate places for the distribution of messages and use of personal and public communication and promotion means were also developed. [4]
A Cochrane review showed that a community disciplinary team works in a unified approach to stop the sexual abuse of adolescents, disorders of sexual addiction, suicide in adolescents, depression, and eating disorders, among others. The review showed that a non-multidisciplinary team approach is ineffective in training, creating awareness, and educating adolescents on child sexual assault. The best approach in treating sexually assaulted children is a multidisciplinary approach that is provided by the advocacy team. The advocacy team receives training to become competent in the development of treatment protocols. [5]
A Data of Abstracts of Reviews of Effects (DARE) showed that compared to a non-multidisciplinary team approach, the multidisciplinary approach is the most effective in diagnosing, evaluating, and planning the treatment of child abuse and neglect victims. This was ascertained by hospitals and community-based teams, which advocated and adopted the approach. The review also showed that the CPS teams found that the non-multidisciplinary team approach showed a low probability of service acquisition. The multidisciplinary team approach was confirmed as the best approach in acquiring services that reduce child abuse and neglect. [6]
A PubMed review showed that multidisciplinary FTDCs approaches are common in serving cases in families, particularly those with child abuse issues. The data obtained in the research indicated that multidisciplinary FTDC parents had remarkably more reviews. It also suggested that they had motions hearings and were probably quicker to accept treatment and effectively finished the treatment regime. The multidisciplinary approach was instrumental in the positive treatment and well-being of children even without involving justice systems. [7]
The psyche information reviews showed a complex multidisciplinary approach is crucial in elucidating situations associated with social-medico-legal implications. The review found that it was more effective than the non-multidisciplinary team approach in cases that lack evidence of child abuse. The latter approach was found unreliable in cases where extended follow-up was needed. [8]
CINAHL reviews found that the multidisciplinary team approach is more effective in protecting children than the non-multidisciplinary team approach. The review found that the multidisciplinary team members showed a high discipline while developing their goals, designing their training, as well as while practicing to provide effective protection to the abused children. [9]
Psyche information reviews found that the medical-based multidisciplinary groups can guard against unnecessary out-of-home settlements and cases of neglect. By integrating a multidisciplinary team approach in child abuse prevention, unnecessary investigations performed by the law agencies were of no use. It was also found that the non-multidisciplinary team approach was unreliable in protecting the vice. [10]

Characteristics of the Evidence

The above evidence summary is based on a structured search of evidence-based health care databases, include

A Cochrane review of a physician and a troubled adolescent. [5]
A Cochrane review of medical practitioners with considerable academic and clinical expertise participated in the survey of analyzing physically abused children. [2]
A PubMed review of an evaluation plan and effective coordination of services by a multidisciplinary team when the abused child is hospitalized. [1]
A PubMed review of a project that involved various agencies in the health, law enforcement, as well as social services sectors. The project aimed at preventing child abuse and neglect through a multidisciplinary, community-based model of service delivery. [3]
A PubMed review of community dialogue, advocating reports, and treatment for sexually assaulted children supported this argument. The multidisciplinary approach facilitated the development of particular segments, appropriate places for the distribution of messages, and the use of personal and public communication promotion strategies. [4]
A PubMed review of FTDC parents who; had more review and hearings of motion, entered treatment without wasting much time, and successfully completed treatments. [7]
A CINAHL review of multidisciplinary team members, showing high disciplines while developing goals, designing training as well, and practicing to provide effective protection to the abused children. [9]
A Database of Abstracts of Reviews of Effects (DARE) strongly advocates and makes use of medical and society-based multidisciplinary CPS teams. They assist in the diagnosis, analysis, and scheduling of intervention measures for victims. [6]
A psyche information review of a complex multidisciplinary approach in elucidating situations associated with social-medico-legal implications. [8]
A psyche information review of medically-based multidisciplinary associations in guarding against unnecessary cases of abuse reports. [10]

Best Practice Recommendations

The use of multidisciplinary approaches is most effective on prosecution rates, mental health referrals, and provision of medical examinations, compared to a non-multidisciplinary approach.
The multidisciplinary team approach is the most recommended for children who have been abused physically, sexually, or emotionally.

Reference list

Weimer C, Goldfarb I, Slater H. Multidisciplinary approach to working with burn victims of child abuse. The Journal of Burn Care & Rehabilitation. 2013; 9(1): 79-82.

Lindberg D, Lindsell C, Shapiro R. Variability in expert assessments of child physical abuse likelihood. Pediatrics. 2008; 121(4): e945-e953.

Onyskiw J, Harrison M, Spady D, McConnan L. Formative evaluation of a collaborative community-based child abuse prevention project. Child Abuse & Neglect. 2012; 23(11): 1069-1081.

Boehm A, Itzhaky H. The social marketing approach: a way to increase reporting and treatment of sexual assault. Child Abuse & Neglect. 2004; 253-265.

Abrams M. Adolescent sexual abuse: clinical discussion of a community treatment response. Seminars in Adolescent Medicine. 2010; 3(1): 67-78.

Hochstadt NJ, Harwicke NJ. How effective is the multidisciplinary approach? A follow-up study. Child Abuse & Neglect. 2011; 9(3):365-72.

Bruns EJ, Pullmann MD, Weathers ES, Wirschem ML, Murphy JK. Effects of a multidisciplinary family treatment drug court on child and family outcomes: results of a quasi-experimental study. Child Maltreatment. 2012; 17(3):218-30.

Rodrigues EL, Portugal V, Rodrigues N, Napoles S, Casanova C. Anogenital warts in children: the importance of a multidisciplinary approach. Acta Médica Portuguesa. 2011; 24(2):367-70.

Feng J, Fetzer S, Chen Y, Yeh L, Huang M. Multidisciplinary collaboration reporting child abuse: A grounded theory study. International Journal of Nursing Studies. 2010; 47(12)1483-1490.

Wallace GH, Makoroff KL, Malott HA, Shapiro RA. Hospital-based multidisciplinary teams can prevent unnecessary child abuse reports and out-of-home placements. Child Abuse & Neglect. 2007, 31(6)623-629.

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Child Abuse Allegations: Multidisciplinary Team Approach

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