Problems in the assessment and management of Munchausen Syndrome by Proxy abuse

Abstract

SUMMARY: ‘Munchausen Syndrome by Proxy’ describes the abuse incurred by children as a result of their parents inventing false illness stories. It is a complex mixture of emotional and physical abuse which, because of the medical elements, can be particularly difficult to manage through current procedures. The authors have been involved with more than 200 such families and studied the reasons for delay before intervention, problems with placement of the child and access arrangements, and the difficulties encountered by professionals in securing long‐term involvement and satisfactory supervision. These are considered in relation to the various outcomes for the children assessed at follow‐up 1–14 years after the initial abuse.

Munchausen Syndrome by Proxy: Implications for Professional Practice in Relation to Children's Education

“…In general, the notion that a mother might deliberately fabricate or provoke symptoms of illness or disability in her child, leading to unnecessary and harmful medical and/or educational consequences, is in itself an assertion that is hard to accept. Strongly-held, polarised views can be generated; between those professionals who defend particular mothers and those who suspect them (Horwath, 1999;Neale, Bools, & Meadow, 1991). In relation to the particular circumstances of specific children at a particular time, it may prove impossible for all the professionals to agree.…”