Alliance formation with parents: Limit-setting and the effect of mandated reporting.

Abstract

The ability of parents to cooperate in their children's treatment is not fixed, but is a potential that evolves in a clinical relationship. Such clinical work includes a hierarchy of limit-setting, ranging from education to legal intervention. The experience of an inpatient child psychosomatic service indicates that such limit-setting was relevant in more than 50% of cases, and served to enhance the alliance with parents and children.

Therapist Reporting of Suspected Child Abuse and Maltreatment: Factors Associated with Outcome

“…In the regression analysis, the quality of the relationship before the report made the greatest contribution towards predicting outcome, with a stronger alliance associated with positive outcome. The quality of the relationship was also among the most important variables in the Steinberg et al study (10), in addition to being cited as a factor related to positive outcome in Levine, Doueck and Associates (6), and Harper and Irvin (8). This finding appears to be rather robust given its appearance across several studies.…”

“…Steinberg, et al (10) conducted a nationwide mail survey whose sample consisted exclusively of psychologists, a majority of whom were men working in private practice settings. Three other studies differ from both the current study and the Steinberg et al (10) study in that they involved chart reviews (8,9), and in-person structured interviews (6), in agency settings. Despite these sampling differences, findings across studies are similar.…”

“…Taking personal responsibility for the action rather than attributing it elsewhere was related to positive outcome (10). A good relationship with the client before the report was associated with positive outcome (6,8,10).…”

“…Our approach is one of multiple perspectives, hypothesizing that Relationship Factors, Preservative/ Restorative Efforts, Therapist Attitude and Experience, Client Characteristics and Situational Factors are associated with outcome. With the exception of Steinberg et al (10), who also examined this area in depth, studies of factors related to outcome are limited (6,8,9). This study is the first to examine factors related to outcome in a sample of mental health professionals documented by CPS to have made a report.…”

Exploring the Ethics of Forewarning: Social Workers, Confidentiality and Potential Child Abuse Disclosures

“…As a result of opposing perspectives and practice experiences, some social workers do tell their clients about their child abuse reporting obligations at the beginning of professional relationships. However, significant quantities of social workers make no mention, whether or not licensure requires them to practice in accordance with a code of ethics and whether or not a breach of confidentiality is eminent (Harper & Irvine 1985;Watson & Levine 1989;Kalichman et al 1991;Anderson et al 1992;Crenshaw & Lichtenberg 1993;Levine et al 1995;Steinberg et al 1997;Weinstein et al 2000). Crenshaw and Lichtenberg (1993) report from their research that 36.9% (N=428) of human service workers (psychiatrists, psychologists and social workers) forewarned clients of child abuse reporting prior to commencing support.…”