Barriers to Providing Adequate Care

To change a pattern of neglect, the helping professional must address the causes rather than the symptoms. For example, if an infant is malnourished due to parent neglect, CPS intervention would be very different for a mother who lacked knowledge about how and what to feed her baby than for a mother whose abuse of alcohol resulted in the baby's malnourishment.

Assessments should include examination of problems, causes, and barriers at all system levels, that is, individual, family, organizational/community, and cultural. It is equally important to identify and acknowledge the strengths, coping skills, and resources of parents and other family members that may be mobilized to reduce the risk of further maltreatment. The availability and accessibility of informal social network supports and formally organized supportive services should also be considered in the assessment.

Understanding the interaction of stressful life circumstances, lack of environmental supports, and deficits in personal resources is the first step in developing a plan for intervention. The following factors should be considered in that assessment:

Individual Personality Factors

1. Strengths; e.g., motivation, concern for the children, willingness to learn, and resourcefulness.
2. Mental Status (while examples represent deficits, opposite assessment findings should be noted as strengths in mental status).
   • Diagnosis of serious mental illness or hospitalizations for mental illness.
   • Impaired intelligence level; e.g., evidence of mental disability or illiteracy.
   • Poor reality orientation; e.g., noticeable distortions of reality, disorientation to time, place, or circumstances.
   • Inappropriateness of affect; e.g., unusual elation or unhappiness.
   • Symptoms of depression; e.g., previous hospitalization for depression, loss of appetite, unexplained weight loss, restricted affect, listlessness, sleep disturbances, suicidal thoughts, poor self concept, or low self-esteem.
   • Poor judgment, especially in relation to care of children, use of money, etc.
   • Poor impulse control; e.g., difficulty in handling anger and controlling sexual urges, misspending money.
   • Substance abuse; e.g., abuse of alcohol or other drugs, or addictions.
   • Overstressed; e.g., overwhelming feelings of helplessness, fears, and confusion resulting from a crisis with the report of neglect often exacerbating the stress.
3. Parenting knowledge and skills; e.g., age-appropriate expectations of children, empathic ability with children, knowledge of children's medical needs, or safety consciousness.
4. Interpersonal skills; e.g., verbal and written communication, ability to maintain social relationships, stability of intimate relationships, handling of conflict, and problem-solving skills.
5. Physical health.
6. Cooperation, motivation for accepting help, improving adequacy of parenting, and willingness to engage in a helping relationship.