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儿童虐待的治疗:行为干预综述

Treatment of child abuse: a review of the behavioral interventions.

作者信息

Isaacs C D

出版信息

J Appl Behav Anal. 1982 Summer;15(2):273-94. doi: 10.1901/jaba.1982.15-273.

Abstract

Child abuse has probably existed as a social problem as long as parents and children have lived under the same roof, and in recent years it has received tremendous attention. Most of the research has focused on etiology rather than treatment, leaving large gaps in our knowledge about remediating abuse. Behavioral scientists have only begun to formulate a conceptual framework from which to work. Many theoretical questions are yet unanswered, particularly the question of what constitutes abuse. Burgess (1978) believes that conceptual problems exist because abuse falls along a continuum of parent-child relationships--a continuum that at one end might include verbal punishment (e.g., threats, ridicule) or milder forms of physical punishment (e.g., slap on the hand, spanking), and at the other end include extreme forms of physical punishment that exceed community mores (for example, hitting a child with a closed fist, scalding a child in hot water, torturing or killing a child). Thus, the question-- where does discipline stop and abuse begin?-- faces every researcher who must operationally define abuse. Identifying the consequences of abuse in a child's development is another area of inquiry that remains untreated. Most of the literature is filled with the subjective impressions of professionals speculating that abused children become the juvenile delinquents and the child abusers of the future; however, as yet no longitudinal studies have been conducted that compare the developmental outcomes of abused and non-abused children from early childhood to later adulthood. What if there were no differences? How might this influence our approaches to the treatment of abuse? Answers to these and other questions will take years of study. Increased awareness of the problem of child abuse has led to greater efforts to remediate the problem. Treatment efforts with abusive families are still in the initial stages, but, undoubtedly, information from these early programs can be the foundation for future researchers to formulate new, more effective intervention programs. Future researchers should focus on identifying those aspects of existing programs that lend themselves to empirical study and have led to more successful parent-child relationships.

摘要

只要父母与子女生活在同一屋檐下,虐待儿童作为一个社会问题可能就已存在,近年来它受到了极大关注。大部分研究都集中在病因而非治疗上,这使得我们在虐待补救方面的知识存在很大空白。行为科学家才刚刚开始构建一个可供开展研究的概念框架。许多理论问题仍未得到解答,尤其是关于什么构成虐待的问题。伯吉斯(1978年)认为存在概念问题,因为虐待处于亲子关系的连续统一体之中——这个连续统一体一端可能包括言语惩罚(如威胁、嘲笑)或较温和的体罚形式(如打手心、打屁股),另一端则包括超出社会习俗的极端体罚形式(例如,用拳头打孩子、用热水烫孩子、折磨或杀害孩子)。因此,“管教止于何处,虐待始于何处?”这个问题摆在了每个必须从操作层面界定虐待的研究者面前。确定虐待对儿童成长的影响是另一个尚未得到研究的领域。大多数文献充斥着专业人士的主观臆断,他们推测受虐儿童会成为未来的少年犯和虐童者;然而,目前尚未进行纵向研究来比较受虐儿童和未受虐儿童从幼儿期到成年后期的发展结果。要是没有差异会怎样?这可能会如何影响我们处理虐待问题的方法?要回答这些以及其他问题还需要数年的研究。对虐待儿童问题认识的提高促使人们加大了补救这一问题的力度。针对虐待家庭的治疗工作仍处于初始阶段,但毫无疑问,这些早期项目所提供的信息可以成为未来研究者制定新的、更有效的干预项目的基础。未来的研究者应专注于确定现有项目中那些适合进行实证研究且能带来更成功亲子关系的方面。

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