Fischler R S
Child Abuse Negl. 1985;9(1):95-106. doi: 10.1016/0145-2134(85)90097-3.
Child abuse and neglect have recently been found to occur among American Indians at rates comparable to other American population groups. Little is known about the clinical spectrum of Indian maltreatment, the psychodynamics and effective treatment modalities. Cultural misunderstanding, modernization, poverty, situational stress, poor parenting skills because of early break-up of Indian families, alcoholism, unusual perceptions of children, handicapped children, and divorce constitute factors associated with maltreatment in cases cited. Old solutions of removing children from families were largely inappropriate and ineffective and are being replaced by local efforts to develop foster homes, supportive family services, and legal procedures to protect children. Communication between agencies involved and mistrust of outsiders plus a lack of trained personnel and available community resources continue to pose major barriers to effective treatment and prevention efforts. Recent federal policies and laws clearly place the responsibility for child welfare in the hands of Indian tribes and tribal courts. The non-Indian health professional has an important but limited role in providing technical expertise and in aiding development of community resources, taking care to support but not usurp the emerging leadership of Indian people.
最近发现，美国印第安人中虐待和忽视儿童的发生率与其他美国人群相当。对于印第安人虐待儿童的临床范围、心理动力学和有效的治疗方式，人们了解甚少。文化误解、现代化、贫困、情境压力、印第安家庭早期破裂导致的育儿技能差、酗酒、对儿童的异常认知、残疾儿童以及离婚，都是上述案例中与虐待儿童相关的因素。过去将儿童从家庭中带走的解决办法大多不合适且无效，如今正被地方上为建立寄养家庭、提供支持性家庭服务以及制定保护儿童的法律程序所取代。相关机构之间的沟通以及对外人的不信任，再加上缺乏训练有素的人员和可用的社区资源，仍然是有效治疗和预防工作的主要障碍。最近的联邦政策和法律明确将儿童福利的责任交给了印第安部落和部落法庭。非印第安裔健康专业人员在提供技术专长和协助社区资源发展方面发挥着重要但有限的作用，要注意支持而不是篡夺印第安人民正在形成的领导权。
