Working with denial in families dealing with child abuse: A scoping review of the resolutions approach

The Resolutions Approach (RA) is a solution-based intervention that has unique way of dealing with parental denial child abuse occurrences. aim this scoping review to summarise knowledge about the benefits RA and identify areas for future research. After describing theoretical background, steps are illustrated. Next, results systematic literature search on effectiveness other clinical presented. Finally, we provide suggestions Our identified two published articles one dissertation. Findings indicate might be useful in stopping improving cooperation between families professionals. Parents experienced more control over their situation, guardians perceived method transparent. well-described respectfully deals which lack safety observed. Future empirical research necessary. El Enfoque de Resoluciones (RA por sus siglas en inglés) es una intervención basada soluciones que tiene forma única lidiar con la negación los padres casos abuso infantil. objetivo esta revisión alcance resumir el conocimiento sobre beneficios del e identificar áreas para futuras investigaciones. Después describir antecedentes teóricos, se ilustran pasos intervención. A continuación, presentan resultados búsqueda bibliográfica sistemática eficacia y otros clínicos RA. Finalmente, ofrecemos sugerencias Nuestra identificó dos artículos publicados tesis doctoral. Los hallazgos indican podría ser útil detener infantil mejorar cooperación entre familias profesionales. experimentaron un mayor su situación profesionales protección percibieron método era transparente. bien descrito trata respeto las observa falta seguridad. Se hace necesaria futura investigación empírica 解决方法(RA)是一种基于解决方案的干预措施，在处理父母否认虐待儿童的情况时具有独特效果。本范围综述的目的是总结RA的优势，并确认未来研究的领域。在描述理论背景后，本文说明了干预步骤。接下来，本文介绍了关于RA的有效性和其他临床优势的系统文献检索结果。最后，我们对未来研究提出了建议。我们通过搜索发现了两篇已发表的文章和一篇学位论文。研究结果表明，RA可能有助于阻止虐待儿童，并改善家庭和专业人员之间的合作。家长对自身处境有了更多的掌控，而监护人认为这种方法是透明的。RA是一种有着详尽说明的方法，它尊重那些被观察到缺乏安全性的家庭。未来，有必要对RA进行实证研究。 Child common worldwide (Stoltenborgh et al., 2015), consequences severe extend across lifespan (Felitti 1998; Mabanglo, 2002; Maguire 2015). comprises sexual, physical emotional neglect, being witness chronic or domestic violence educational neglect (Sedlak 2010). To stop abuse, it considered essential different parties involved work together efficiently. Frequently, professionals parents become entangled discussions possible perpetrators, denial, causes severity. Such can obstruct fruitful cooperation, thus preventing resolution families. end, was developed, not only help but also solutions challenging processes (Essex 1996; Turnell & Essex, 2006). introduced Netherlands 2008 2009. Professionals from various mental health institutions were trained by Susie Essex. Those who have since worked generally positive approach. However, little known method's effectiveness. Therefore, deemed appropriate an overview existing evidence, regardless its quality (Arksey O'Malley, 2005; Tricco 2018). major purpose paper deserve attention. main question is: What literature? First, describe method, underpinnings treatment process. illustrated using case example. Second, report studies concerned Third, evaluate current guide further Working as family therapist England, developers RA, noticed when suspected convinced they could confessed abuse. Essex saw difficult intervene when, hand, there concerns regarding child's safety, opinions circumstances These insights led development prevent doing too cannot proven much deny third final principle non-abusive parent members social network sources protection. points out accused often seen complicit. assumes people necessarily complicit may already play role increased (Turnell illustrate principles, below example provided mother her 7-year-old son. seven-year-old living single-parent household his mother. There no contact father. told schoolteacher hit him. Protective Services got after informed nearest neighbour. neighbour confirmed regularly discipline general practitioner unable establish proof any injuries. According school, absent. In response Services's intervention, court appointed guardian. described how she loved very never Nevertheless, decided place short-stay foster family. Thereafter, guardian referred live at home again. did know realise if denied hitting child. Following initial follow-up session three months later another six implementation plan evaluated. At first, resented had been beating By telling story point view, became clear herself severely abused parents. She beaten objects, such belt clog. claimed object admitted occasionally he disobedient. beliefs, without pedagogical blow regular basis acceptable. Moreover, think alternative methods. Gradually, conversation shifted towards what opinion topic be. Although initially stated network, cousin, aunt identified. women agreed (Step 2). Your teacher well judge worried you. You them mum used does allow children. That why you your Mum says wanted hurt Now wants that, future, will again while mum's. As first step, manager approved document. parents, shared family's network. Thus, secrecy surrounding broken 3). Contact established following step 4). Initially, played few hours guardian's office. Subsequently, returned time neighbour, aunt, cousin present. This gradually expanded. Then, 5) participated role-play exercise. asked imagine some form For example, posed questions hypothetical would impact mother–child relationship hurts child? How self-image affected abuse? behaviour influenced answering these questions, demonstrated talk contrasts earlier attempts subject; say anything than Finally 6), home. per pre-arranged agreement, call acute moments needed help. They come assess situation Every now then, drop unannounced. Furthermore, discussed systemic programme. Lastly, go themself felt unsafe. During 7), agreements family, meant checking whether still neighbour's, aunt's and/or cousin's occasions contacted members. It almost impossible do exploring connection Signs Safety (SofS) intervention. From our experience, observed parts incorporated SofS. SofS developed Edwards (1999) Australia give working youth protection tool create immediate directly signalled. Meanwhile al. (1996) tested therapeutic aimed enhance long-term legal process cases where insufficient evidence start Both interventions share approach seeks clarify professional concerns, honouring views, allowing collaboration respond situations disagreement actually happened, jeopardising cooperation. Together, wrote book Based previous practice, sometimes intermingled practice section, conducted RA's benefits. strategy selection process, followed preferred reporting items reviews meta-analyses (PRISMA) recommendations Liberati 2009; Moher 2018), depicted Figure 1. We searched 1997 March 2021. Studies selected met criteria: (i) evaluating (ii) sub-interventions. comprehensive possible, exclusion criteria formulated design studies; (quasi-)experimental designs qualitative descriptive single-case (experimental) allowed. same reason, restrictions made outcome variables studies. investigating outcomes tackled during because, mentioned before, expected protocol authors Gumbleton, Hiles, Luger Lusk universities graduated dissertations able retrieve (Gumbleton, 1997; Lean, 2012; Lusk, 1996). electronic databases searched: PsycINFO (Ovid), Ovid Medline, Embase Evidence-Based Medicine Reviews (Cochrane Library), Published International Literature Traumatic Stress (PILOTS), Google Scholar, Educational Resources Information Center (ERIC), Social Science Research Network (SSRN), Clinical Practice Guidelines (APA), Agency Healthcare Quality (AHRQ) National Institute Health Care Excellence (NICE). Additionally, consulted several Dutch databases, namely, Article Database Healthcare, Effective interventions, Intervention Centre Healthy Living, Youth Interventions Knowledge Adolescent Psychiatry. trial registers: WHO Trials Registry Platform (ICTRP), AHRQ's Guideline Clearinghouse ISRCTN registry. terms combinations used: ‘Andrew Turnell’, ‘Steve Edwards’, ‘Susie Essex’, ‘John Gumbleton’, ‘Colin Luger’ (author); ‘Signs Safety’, ‘SofS’, ‘Resolutions’ AND ‘Approach/family therapy/model/program(me)/services/work/consultancy/protection’, ‘Safe Together Step (STSS) (interventions)’, ‘child*’ ‘(abuse* mistreat* violent protect* danger*)’. Through above, 1,358 retrieved (Figure 1). screening duplicates, 1,210 remained. author screened titles abstracts relevance based inclusion excluded 1,121 articles. Two (MM TM) remaining 89 full-text independently each other; 69 because failed meet criteria. inter-rater reliability 93 cent. Disagreements resolved consensus. found 20 SofS; excluded. texts additionally inspected information: study explicitly mention use techniques text imply (i.e. named reference made)? criteria, 2012) article (Hiles Luger, 2006) included review. latter presented separate both evaluation universities, unfortunately obtain original reports PICOS format (population, comparison, outcome, design) gather information systematically (Methley 2014). Concerning population, extracted data type participant (child, guardians, members) number completed With regard (sub)-intervention under investigation. methodological characteristics, design, (primary secondary) assessment Data MM AS high agreement. An Table AMSTAR checklist (Shea 2017) (Supplement Study 1: 10 (out 7 families) 2: (of (a) Cooperative partnership workers (b) Parental satisfaction Guardians' experiences Semi-structured interview observable guardians; new visible according 6 5 9 Unexplained non-accidental injuries Physical maltreatment Sexual addition, nine evaluated additional component (Words pictures). indicated list asterisk. reports, goals (Baginsky 2017, 2019, 2020; Bunn, 2013; Holmgard Sorensen, Pichler Wurm, Skrypek Tierolf Vink 2017). All employing semi-structured interviews. One quantitative 1997). examined allegations unspecified sexual 2012). Different used. operationalised counting re-referrals comparing re-referral ratios literature. Other operationalisations increase Hiles 2006); growth resilience (Lean, 2012); parents' 2006), members' guardians' Regarding integrity, emphasised programme phases adjustments adapt individual families' expand specific made. Only funded. indications benefit: rate proved significantly lower 1997), effective building four five develop resilience, although degrees augmented resilience: holding helpful creating supportive patterns communicating well. On processes, ongoing struggles, renegotiating roles disadvantages, hampered familial resilience. users appeared satisfied improved, gained self-confidence better understood professionals' reported lives restored Referrers bring change mired order make safer anticipated subsystems appreciated present sessions observe concluded possibilities apparent through own While conducting search, protocol, ‘words pictures’. so originally, include modules including children ‘Words pictures’ engage assessing insecurity developing 2017; inform (Bunn, provides Consistent methodology, explored RA/SofS comprehensively studies' outcomes, literature, most grew resilient. found. Specifically, increasing family: cooperative involving (iii) breaking pay attention processes. show successfully established, families, realised. none investigated association changes partnership, (the severity of) serve mechanisms change. mechanism warrant worldwide, throughout individual's 1998). date shows methods (van der Put urgently needed. Little done predominantly qualitative. therefore early conclude available contribute children's within worthy knowledge, issue address sufficiently implemented derive integrity scarce. goal question, important parameter measuring success. striking safety. should consider operationalise reduction maltreatment. Greater consistency objectifying facilitate comparison possibility executing conflict tactic scales (CTSs) (Straus 2003) good choice. CTSs frequently partner prevalence United States (Euser 2013). advantage actual occurrence aggressive acts measured informants. randomised controlled trials. probably recruit motivate participate overcome problem take quantifying effects small-scale helpful. Single-case experimental (SCEDs) instance, case-by-case basis. result, fewer participants groups SCED suited investigate innovative approaches heterogeneous complex populations (Maric Norell-Clarke 2011). Because evidence-based addressing signs beneficial gain experience method. extent. studies, element added test significance crucial maintain integrity. aims seems valuable merits thank Jonna Lind, ARQ's librarian, strategy. funded Organisation Development (ZonMW; grant 707410098002; contact: https://www.zonmw.nl/nl/onderzoek-resultaten/jeugd/programmas/programma-detail/kindermishandeling/projecten/). declare potential conflicts interest respect research, authorship publication article. complied ethical standards, far determine. mentions approval committee. study, gave active consent, participation voluntarily.