Behavioral intervention with child abuse and neglect.

The range of factors identified as related to child maltreatment has expanded over the years. The literature clearly calls for an ecological approach in which individual, family, community, and societal factors are considered. The behavioral literature to date reflects an unevenness in terms of acceptance of such an approach. Studies are also uneven concerning the faithfulness with which hallmarks of a behavioral approach have been applied. These include individually tailored assessment and intervention based on empirical data and planning for generalization and maintenance. Most intervention programs do attend to positive as well as negative parent behaviors. Little attention is devoted to environmental characteristics, such as poverty level incomes and impoverished social support systems that may contribute to maltreatment. Lack of comprehensive assessment and intervention programs is no doubt responsible for the modest changes described in many reports. Behavioral studies suffer from uncritical acceptance of the term "abuse" or "at risk" in a number of ways, one of which is a failure to clearly describe the nature of the alleged maltreatment and the immediate situational context. Another is in the assumption that one particular factor is responsible for the maltreatment, such as ineffective parenting skills. Too often a label identifies only one characteristic of a person, ignoring other attributes and related factors. Like all deviant labels, the poor and minority groups are more likely to receive negative labels (Newberger et al., 1976). Investigaters have not taken advantage of relevant literature in the area of child welfare. Familiarity with this material would be helpful in avoiding myths in the field to which many have fallen prey, such as the myth of classlessness of child maltreatment. Acceptance of this myth interferes with the development of programs that deal with difficult environmental problems. Reports suggest that a behavioral approach is promising. Attention to enhancement of child management skills is supported by research that shows that most abuse occurs as an extension of parental discipline attempts. A focus on describing the relationships between behaviors of concern and what happens before and afterward has yielded valuable information concerning interaction patterns in abusive, neglectful, and normal families. Advantages of viewing child abuse in the general context of family interaction are illustrated by the work of Patterson and his colleagues and by Gelles.(ABSTRACT TRUNCATED AT 400 WORDS)

Role of behavior modification in community mental health.

This paper briefly reviews the original concept of the community mental health movement; points to ways in which current service delivery systems deviate from this; offers and alternative framework for service delivery, that is, a behavioral model; and argues that its implementation would move community services closer to this conception. The implications of this model for intervention in the natural environment as well as for transitional and prosthetic facilities are described and examples given of its use. Emphasis is placed on working in the natural environment whenever possible via the use and cultivation of significant others as well as via provision of training in self-directed behavior change in addition to the blending of case management with careful evaluation of service.