Psychological maltreatment: An international challenge to children's safety and well being.

BACKGROUND: Child psychological maltreatment (PM), also known as emotional abuse and neglect, mental violence, and emotional maltreatment, is the least recognized and addressed of the four major forms of child maltreatment. OBJECTIVES: This article provides an 1) the history of PM and its relationship to children's rights, 2) an overview of the current state of knowledge, 3) implications of diversity for the topic of PM, 4) an example of a topic-relevant intervention, and 5) a vision for further progress in addressing this form of child maltreatment. PARTICIPANTS AND SETTINGS: NA. METHOD: Literature review, intervention description of fabricated or induced illness, and expert opinion. RESULTS: PM is directly implicated in seven of the articles of the Convention. PM is common, reliable definitions of PM exist and need to be applied to practice and public health surveillance, harmfulness has been empirically established but is not fully appreciated, and countries vary dramatically in terms of incidence. CONCLUSIONS: PM is a human rights issue that must be addressed through child protection and promotion of child wellbeing. Adoption of reliable definitions of the different aspects of PM for Child Protective Service practice is a top policy goal. The development of empirically supported curricula on PM for training professionals and parents and culturally sensitive interventions to change social norms on the use of psychologically aggressive disciplinary practices and other forms of PM are critical research needs. Well-validated interventions to support quality parent-child relationships and support families exist and need to be widely adopted. Individual child protective measures should be confined to cases of ongoing serious PM when interventions have failed to reduce harm to the child.

A new age for child protection--General Comment 13: why it is important, how it was constructed, and what it intends?

Children continue to be subjected to high levels of violence (i.e., physical, psychological and sexual maltreatment) throughout the world. International concern about violence against children has increased significantly during the last decade. A Study on Violence Against Children, encouraged by the UN Committee on the Rights of the Child, conducted under the auspices of the United Nations Secretary General and reported in 2006, has become a rallying call to improve child protection. Child protection practices and systems have been judged to be generally inadequate and, in some cases, destructive. It is widely recognized that business as usual-more of the same-will not do. A General Comment (guide to fulfilling obligations) for Article 19, the central conceptualization of child protection of the UN Convention on the Rights of the Child, has the potential to promote a worldwide reformulation of child protection priorities, policies, and practices by virtue of the infusion of a child rights approach. It can be a mechanism for framing and promoting the transformational change needed - for a genuine paradigm shift. Here, explication is given for the historical context, rationale, centrality of child rights, process of development, holistic nature, and primary elements of General Comment 13 (GC13): The child's right to freedom from all forms of violence. GC13 embodies and champions a child rights approach to child protection entailing strong support for proactive primary prevention, promotion of good child care, and a commitment to secure the rights and well-being of all children. A child rights-based, comprehensive coordinating framework is recommended for the implementation of GC13.

Psychological maltreatment: maltreatment of the mind: a catalyst for advancing child protection toward proactive primary prevention and promotion of personal well-being.

OBJECTIVE: Child protection, as primarily applied toward narrow corrective intervention, has been judged to be inadequate in dealing with the wide variety of forms and levels of physical, psychological and sexual violence to which children are subjected throughout the world. Concern about this state of affairs has grown as a part of a global increase in commitments and expectations for nations and their societies to be accountable to and for children, particularly in association with the requirements of the UN Convention on the Rights of the Child. A reconstruction of child protection is needed. METHOD: Recently, a child rights approach to child protection has been gathering support to drive a transformation of child protection toward primary prevention capable of securing and promoting the rights, safety, well-being, health and development of children. This vision has been given concrete form by the UN Committee on the Rights of the Child through its recently adopted guide (General Comment 13) to fulfilling national obligations to the right of the child to freedom from all forms of violence. RESULTS/CONCLUSIONS: Here, it is argued that the desired transformation of child protection can be greatly facilitated by appreciation and application of knowledge about the psychological domain, in particular, psychological maltreatment, by promotion of an enlightened public health approach, and by giving high priority to determining the origins of violence and to establishing widespread commitment to full development of the uniqueness of each person.

Protecting children from violence and maltreatment: a qualitative comparative analysis assessing the implementation of U.N. CRC Article 19.

OBJECTIVES: (1) To identify which United Nations Convention on the Rights of the Child (CRC) recommended child protection (CP) measures, such as policy, reporting systems, and services for child abuse and neglect (CAN) victims, individually or in combination, were most important in establishing a basic level of child protection in 42 countries; and (2) to assess whether these measures were necessary or sufficient to achieve basic child protection in developing and industrialized countries. METHOD: Child protection and/or rights expert respondents from 42 countries completed a questionnaire on CRC Article 19 (CRC19) required CP measures implementation and rated their country's effectiveness in implementation, the current level of effectiveness of child protection, and the relevance of improvements in child protection since the CRC was adopted in 1989. Information from the Committee on the Rights of the Child Concluding Observations, as well as UNICEF and WHO indicators on child health and protection issues were used to check and supplement responses. Qualitative comparative analysis (QCA) was used to identify child protection measure implementation effectiveness. RESULTS: Results indicate that child protection judged as comparatively more successful among study countries is a result of having the following measures in place from two types of social programs: a CP infrastructure (legislation plus services) and at least one information-based intervention support program. CONCLUSIONS: Fourteen (33%) countries were determined to have established at least a basic CP system toward protection of children from violence and maltreatment. These countries reported having the three required elements described above. The study reinforces the need for governments to take a systems approach to child protection, including policy/legislation, information-based programs and social services, as well as professional training and public awareness raising. The top-ranked countries included: Australia, Bahrain, Belgium, Brazil, Canada, Estonia, Germany, Italy, Jordan, Lebanon, Malaysia, Republic of Korea, the Russian Federation, and the United Kingdom. PRACTICE IMPLICATIONS: Governments need to establish CP systems with multiple, well-integrated, effective CP measures as elaborated above, working with trained professionals and also raising public awareness to ensure successful protection for all children in every country. Partial measures are not effective. Further, in addition to establishing, implementing, and evaluating the effectiveness of professional interventions, the actual outcomes for children, not studied or reported on here, need to be the priority focus for child protection going forward.

The need for a General Comment for Article 19 of the UN Convention on the Rights of the Child: Toward enlightenment and progress for child protection.

OBJECTIVE: To present the need and plan for development of a General Comment for the UN Convention on the Rights of the Child Article 19 which has the potential to transform and advance child protection through the infusion of a child rights approach. METHODS: The Committee on the Rights of the Child (Committee) authorized ISPCAN and IICRD to draft a General Comment for CRC Article 19 (GC19) and to introduce implementation supports. An international working group (GC19WG), Expert Advisory Panel (EAP), and GC19 Focal Group of Committee members (GC19 CRC FG) have been organized to help guide and carry out the program of development. Analyses of relevant histories and knowledge, including effective and promising child protection strategies, are being applied to guide formulation of the GC and high priority implementation components. Consultations on the draft and supportive products will be conducted in cooperation with UNICEF, WHO, the NGO Group for the CRC, and other NGOs. Advice is to be solicited from interested parties and organizations in person and through distance communication throughout the world. RESULTS: In addition to the GC19, numerous implementation supports will be planned and some will be produced and piloted during the program of development. Under consideration are an implementation guide and resources; commentary; accountability models, indicators, measures and evaluation systems; a clearing house and resource website; a child-appropriate version of GC19; and education/training curricula and programs. PRACTICE IMPLICATIONS: GC19 has the potential to transform child protection by fostering a paradigm shift in its conceptualization, theory, research, and practice. Article 19 encourages an interpretation and application beyond narrow child protection conceptualizations and practices which have been found seriously inadequate. The General Comment can advance effective prevention of maltreatment and protection of personal security by promoting the child's rights, well-being, health, and development in all aspects of child protection. GC19 will provide support to the Committee on the Rights of the Child in its monitoring and guiding functions, and to States Parties, professionals, and civil society agents concerned with the protection and well-being of children.