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符合社会的最大利益。

In the best interests of society.

作者信息

Harris William W, Lieberman Alicia F, Marans Steven

机构信息

Children's Research and Education Institute, Belmont, MA, USA.

出版信息

J Child Psychol Psychiatry. 2007 Mar-Apr;48(3-4):392-411. doi: 10.1111/j.1469-7610.2007.01732.x.

Abstract

Each year, exposure to violent trauma takes its toll on the development of millions of children. When their trauma goes unaddressed, children are at greater risk for school failure; anxiety and depression and other post-traumatic disorders; alcohol and drug abuse, and, later in life, engaging in violence similar to that to which they were originally exposed. In spite of the serious psychiatric/developmental sequelae of violence exposure, the majority of severely and chronically traumatized children and youth are not found in mental health clinics. Instead, they typically are seen as the 'trouble-children' in schools or emerge in the child protective, law enforcement, substance abuse treatment, and criminal justice systems, where the root of their problems in exposure to violence and abuse is typically not identified or addressed. Usually, providers in all of these diverse service systems have not been sufficiently trained to know and identify the traumatic origins of the children's presenting difficulties and are not sufficiently equipped to assist with their remediation. This multiplicity of traumatic manifestations outside the mental health setting leads to the inescapable conclusion that we are dealing with a supra-clinical problem that can only be resolved by going beyond the child's individual clinical needs to enlist a range of coordinated services for the child and the family. This paper will focus on domestic violence as a paradigmatic source of violent traumatization and will (a) describe the impact and consequences of exposure to violence on children's immediate and long-term development; (b) examine the opportunities for, as well as the barriers to, bridging the clinical phenomena of children's violent trauma and the existing systems of care that might best meet their needs; and (c) critique current national policies that militate against a more rational and coherent approach to addressing these needs.

摘要

每年,遭受暴力创伤都对数百万儿童的成长造成损害。如果他们的创伤得不到解决,儿童面临学业失败、焦虑、抑郁及其他创伤后障碍、酗酒和药物滥用的风险就会更高,而且在日后的生活中,他们还可能会实施与自己最初遭受的暴力行为类似的暴力。尽管暴力暴露会导致严重的精神/发育后遗症,但大多数遭受严重和长期创伤的儿童和青少年并未出现在心理健康诊所。相反,他们通常被视为学校里的“问题儿童”,或者出现在儿童保护、执法、药物滥用治疗和刑事司法系统中,而在这些地方,他们问题的根源——暴力和虐待暴露——通常未被识别或解决。通常情况下,所有这些不同服务系统的提供者都没有接受过足够的培训,无法了解和识别儿童当前困难的创伤根源,也没有足够的能力协助解决这些问题。心理健康环境之外的这种创伤表现的多样性导致了一个不可避免的结论:我们正在应对一个超临床问题,只有超越儿童的个体临床需求,为儿童及其家庭争取一系列协调服务,才能解决这个问题。本文将把家庭暴力作为暴力创伤的一个典型来源进行探讨,并将:(a)描述暴力暴露对儿童近期和长期发展的影响及后果;(b)研究弥合儿童暴力创伤的临床现象与可能最能满足其需求的现有护理系统之间的机会和障碍;(c)批评当前不利于采取更合理、连贯的方法来满足这些需求的国家政策。

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