Reducing Child Abuse Potential in Families Identified by Social Services: Implications for Assessment and Treatment

Improving the functioning of families at high risk of child maltreatment poses considerable challenges. One issue is the dilemma of how and when it is appropriate to provide an intervention designed to improve family functioning when the level of risk of the family to the child has not been fully established. A recently reported proposal is to assess the family’s capacity to change by assessing the family’s response to a brief intervention. This proposed model for assessing capacity to change rests on the assumption that brief interventions can achieve meaningful short-term change in high risk families. The current study evaluated the effectiveness of a home-based intensive treatment program in families referred by child protection services. The program, Parents Under Pressure, was designed for multiproblem families and addresses problems across ecological domains, including problem child behavior, parental stress, family relationships, social isolation, and coping with life demands. Ten families completed the program. Statistically significant improvement was found between the preand postassessment measures on measures of parent functioning, child functioning, parent–child relationships, and social contextual measures. The majority of families showed clinically significant improvement, although a small proportion of the families showed no change or deteriorated. The presenting problems and pattern of change varied between families. The study adds to the increasing body of evidence that intensive, ecologically informed interventions can achieve short-term change in some but not all multiproblem families. Implications of the results for assessing parental capacity to change are discussed. [Brief Treatment and Crisis Intervention 8:226–235 (2008)]