Los programas de tratamiento de familias con problemas de maltrato y abandono infantil: descripción y evaluación

Resumen

El objetivo de los programas de tratamiento familiar en protección infantil consiste en finalizar la conducta maltratante y en que la familia adquiera un funcionamiento adaptativo, además de garantizar que mientras el proceso de cambio tiene lugar, el niño se encuentre protegido. Desde dicha perspectiva, se analizan algunas características particulares de este ámbito de trabajo: heterogeneidad de la problemática familiar, falta de motivación y voluntariedad de las familias, identificación del «cliente» del programa, necesidad de coordinación de los recursos y vulnerabilidad crónica de la mayoría de las familias. Se describen una serie de modelos y programas de tratamiento, diferenciando las tipologías de maltrato físico, abandono físico y abuso sexual. Por último, se abordan algunas cuestiones relevantes de la evaluación de programas de protección infantil: la evaluación de las necesidades y de la cobertura de los programas, la evaluación del proceso y la evaluación de resultados (objetivos, metodología y diseño).

Abstract

The goal of family intervention programmes in child protection consists in terminating abusive conduct and helping the family to work adaptively, as well as guaranteeing the child's protection while the changing process takes place. From this perspective some specific characteristics within this field are analysed: the heterogeneous nature of family problems; families' lack of motivation and wilful intent; the limited clarity in identifying the programmes' “client”; the need to coordinate resources; and the chronic vulnerability of most families. The paper describes a series of models and treatment programmes applied to physical abuse, physical neglect, and sexual abuse. Finally, it raises some relevant issues regarding the evaluation of child protection programmes, such as evaluating the programme's needs, its coverage, the process itself and its results (aims, methodology, and design).

Extended Summary

The paper reviews different types of family treatment programmes directed at ending the abusive behaviour and helping the family work adaptively, as well as guaranteeing children's protection while the changing process takes place. In general, these programmes still produce limited results, and their great challenge is to improve. To do so it is necessary to evaluate programmes in detail and adjust them to the particular types of child abuse they are targeting. The paper analyses some specific characteristics within this field, such as: the heterogenous nature of underlying family problems in each type of abuse; families' lack of motivation and wilful intent; the limited clarity in identifying the programmes' «client» (e.g., child, family, child protection services); the need to coordinate resources; and the chronic vulnerability of most families even after a successful intervention.

A series of models and treatment programmes are also described focussing on physical abuse, physical neglect, and sexual abuse. In the case of physical abuse, treatment programmes described are: cognitive-behavioural, multimodal, those based on social support, and intensive treatments in the home. In the case of physical neglect, treatments described are: behavioural, multimodal, family centred, in group, those aimed at reinforcing informal social support systems, and those using non-professional or volunteers. In the case of sexual abuse, treatments described focus on the one hand on abusers, and on the other on victims' recovery.

A final section addresses some relevant issues for evaluating child protection programmes so that high standards are maintained. Some prerequisites to evaluating a programmes' results, such as evaluating its needs and coverage are analysed together with some important issues for the process itself: how families are referred to a treatment programme, the context in which it takes place, resources available and their structure. In terms of evaluating the results of child protection programmes, we describe some specific aims and analyse some issues related to the methodology and design of this research work.

Palabras clave:

• Maltrato infantil
• abandono infantil
• tratamiento
• evaluación de programas

Keywords:

• Child abuse
• child neglect
• treatment
• programme evaluation