Appropriate intervention must be tailored to the type of neglect. Intervention with a non-organic failure to thrive child usually requires immediate hospitalization of the infant with intensive nutritional and emotional nurturing for 2 weeks, and intensive coaching and instruction for the parents. Recent research indicates that new, chronic neglect is characterized by high stress related to recent life crises. In these cases, a crisis intervention model of family preservation may be the most appropriate course of action. Chronic, multi-problem neglectful families require more sustained intervention with multiple services. Neglectful families, who are also abusive, require more attention to behavioral approaches such as anger control.
- Most neglectful parents want to be good parents, but lack the personal, financial, and/or supportive resources. Professional helpers must assume that parents want to improve the quality of care for their children. Interventions must be developed with that assumption.
- All parents have strengths that can be mobilized. The hidden strengths of the neglectful parent must be identified during the assessment process, reinforced, and the interventions built upon those strengths.
- Helping interventions must be culturally sensitive. Professional helpers must intervene with knowledge of and respect for the differences in life experiences, cultural and religious beliefs, child-rearing norms, and role expectations held by families of color.
- Each family is unique, regardless of ethnic or cultural background. Assumptions and generalizations about neglectful families lead to inappropriate intervention decisions.
- It is essential to set clearly stated, limited, achievable goals that are shared with and agreed upon by the parents and children. Goals should emerge from the problems identified by the parents and the professional helper, and from the causes or obstacles to remedying the problems. Goals should be clearly expressed in a written service/treatment plan, which is developed with the family.
- Exercising legal authority by the professional helper is often necessary to overcome the initial denial and apathy of the neglectful parent. Confrontation with the reality of legal mandates and the possibility of legal intervention are sometimes necessary to mobilize the parent to change neglectful parenting practices. The threat of legal action should be used only as a last resort after efforts to obtain cooperation have been tried.
- Neglectful families are typically poor and lack access to resources. Therefore, the intervention plan must include brokering and advocacy to mobilize concrete formal and informal helping resources. Successful mobilization of outside resources to meet the family's identified priorities helps to overcome the family's hopelessness, resistance, and distrust of professional helpers.
Family and Group Interventions
Family Focused Intervention
Interventions that include family members, rather than focusing only on the principal care provider, are more successful. Interventions must target the dysfunctional family system, not just the parent. Traditional, in-office, one-to-one counseling by professionals is ineffective with neglect. Assertive, intrusive intervention is necessary with neglectful families to disturb the dysfunctional family balance in the interest of achieving a more functional family system balance that does not sacrifice the needs of the children. Some examples of such family interventions are those that seek to reallocate family role tasks, establish clear inter-generational boundaries, clarify communication among family members, reframe parents' dysfunctional perceptions of themselves and their children, and enable parents to assume a strong leadership role in the family.
Participation in Parents Anonymous groups was found to be particularly effective, regardless of what other services were received by parents. Groups for neglectful parents that provide very basic child care information and skills, problem solving, home management, and social interaction skills were more successful with neglectful parents than those offering more general content on child development and needs of children.
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