Large numbers of men enter substance use disorder treatment each year, yet very little attention is paid to the fatherhood and parenting status of these men. Substance use treatment programs rarely incorporate a parenting component into their treatment planning, despite increased success of women's treatment programs that focus on gender and motherhood. This paper provides: 1) a review of the literature on the fathering of substance using men, what has been learned from substance use disorder treatment for mothers, and the implications for children and families; 2) pilot quantitative and qualitative outcomes on implementation of a fatherhood focused intervention for men in a residential substance use treatment program; and 3) recommendations for the application of these findings for fathers in substance use disorder treatment and the implications of program modifications and increased focus on fathers for child welfare.

Exposure of children to domestic violence and abuse (DVA) is a form of child maltreatment with short- and long-term behavioural and mental health impact. Health care professionals are generally uncertain about how to respond to domestic violence and are particularly unclear about best practice with regards to children's exposure and their role in a multiagency response. In this systematic review, we report educational and structural or whole-system interventions that aim to improve professionals' understanding of, and response to, DVA survivors and their children. We searched 22 bibliographic databases and contacted topic experts for studies reporting quantitative outcomes for any type of intervention aiming to improve professional responses to disclosure of DVA with child involvement. We included interventions for physicians, nurses, social workers and teachers. Twenty-one studies met the inclusion criteria: three randomised controlled trials (RCTs), 18 pre-post intervention surveys. There were 18 training and three system-level interventions. Training interventions generally had positive effects on participants' knowledge, attitudes towards DVA and clinical competence. The results from the RCTs were consistent with the before-after surveys. Results from system-level interventions aimed to change organisational practice and inter-organisational collaboration demonstrates the benefit of coordinating system change in child welfare agencies with primary health care and other organisations. Implications for policy and research are discussed. © 2015 The Authors. published by John Wiley & Sons Ltd. 'We searched 22 bibliographic databases and contacted topic experts'.

The COVID-19 pandemic has resulted in negative consequences for children exposed to violence and abuse.Domestic violence refuge staff were greatly concerned about children both living outside and inside refuges.Domestic violence refuges have played a pivotal role during the COVID-19 pandemic and should receive wider acknowledgement and greater support for their work.

Although confessions related to abusive head trauma (AHT) are reported, no detailed analysis exists. Therefore, we systematically reviewed studies of AHT confessions and examined the details, including country of origin, mechanisms and perpetrators' characteristics [PUBLISHER - THE PRECEDING UNDERLINED TEXT IS FOR THE MARGIN]. Employing 36 search terms across three search engines, we searched Medline and CINAHL from 1963 to 2018. All relevant studies underwent two independent reviews and data extraction. Descriptive statistics were used to characterise the sample; chi square and Fisher's exact tests were used to assess differences in demographic and clinical characteristics. Of 6759 identified studies, 157 full texts were reviewed and 55 articles from 15 countries spanning four continents were included. Included articles contained 434 confessions. The mechanisms of abuse included shaking alone (64.1%), impact alone (17.1%), shaking plus impact (18.0%) and other (0.9%). There was no statistically significant difference in the percentage of confessions reporting shaking alone when comparing continents: North America (64.0%), Europe (64.2%) and Oceania (60.0%; =.92), or when comparing circumstances in which the confession was obtained: medical evaluation (74.6%) vs police or judicial investigations (63.4%; =.11). Of 119 cases with identified perpetrators, 67.2 per cent were cases with males alone. Confessions reveal striking similarities in the mechanism of AHT (predominantly shaking) and occur across the globe.

Previous studies on Abusive Head Trauma (AHT) suggest incidence may vary by geographic location and there is limited information regarding population-based risk factors on this form of child maltreatment. This study provides new knowledge regarding these two aspects using the population of the US state of Washington born between 1999 and 2013. We used a linked administrative dataset comprised of birth, hospital discharge, child protective services (CPS) and death records to identify the scale and risk factors for AHT for the state population using quantitative survival methods. We identified AHT using diagnostic codes in hospital discharge records defined by the US Centers for Disease Control. A total of 354 AHT hospitalisations were identified and the incidence for the state was 22.8 per 100 000 children under the age of one. Over 11 per cent of these children died. Risk factors included a teenaged mother at the time of birth, births paid for using public insurance, child's low birth weight, and maternal Native American race. The strongest risk factor was a prior CPS allegation, a similar finding to a California study on injury mortality. The practice and policy implications of these findings are discussed.

This study assessed the psychometric properties of a new measure, the Parental Support after Child Sexual Abuse (PSCSA) survey, and tested the association between parents' and children's parental support reports and children's post-traumatic stress disorder (PTSD) symptoms. A total of 99 Icelandic children (86.5% girls, 6-18 years old, = 13.9 years) starting therapy for child sexual abuse (CSA) and 98 non-offending parents (90.6% mothers, 23-58 years old, = 41.2 years) participated in the study. Participants completed questionnaires on parental support (PSCSA) and children's PTSD symptom severity (University of California at Los Angeles Post-Traumatic Stress Disorder Reaction Index for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition). A total of 18 items were considered for the PSCSA parent version and nine for the PSCSA child version. Five reliable factors emerged for the parent version (Emotional support, Instrumental support, Self-blame, Child blame and Disbelief) using 16 items and one factor (combined Emotional and instrumental support) emerged for the child's version using eight items. On average, ratings for both Emotional and Instrumental support were higher for parents than their children. Emotional support reported by both parents and children was negatively associated with PTSD symptom severity. The PSCSA survey is a promising dyadic measure for future research and clinical use in children's advocacy centres.

Increased stress and decreased resources during a lockdown and social distancing can augment the risk for child abuse and neglect during the COVID-19 pandemic.Health practitioners should continue to be prepared for potentially rising numbers of cases of child abuse and neglect.Child protection services and mental health care should be considered essential and be available for adults and children at all times.

Measures to combat transmission of the coronavirus presented unprecedented challenges for safeguarding and child protection practice, including through withdrawal of routine opportunities to observe and engage with children and families and disruption of systems for inter-agency communication and coordination. This article reports on a two-stage study designed to identify shared learning from adaptations to professional practice in response to the measures. Interviews with 67 London-based senior safeguarding leads from seven professional groups undertaken during the summer of 2020 informed an England-wide survey to similar groups in February-March 2021. SPSS was used to analyse 417 responses, which were supplemented by answers to open questions. Findings are reported using the six practice themes which the Child Safeguarding Practice Review Panel expects to inform shared learning to improve safeguarding at national and local levels. The study revealed the formidable barriers facing professionals in understanding the changing environments in which children were living and in identifying and assessing new or altered risks due to the pandemic; steps taken to respond to changing risks and to keep in touch and re-engage families; strategies to support critical thinking and challenge among professionals working under unprecedented pressure; and opportunities for enhanced multiagency working and inter-agency collaboration.

Adolescents with chronic pain can at times present with disability out of proportion to diagnostic workup. This is also a defining feature of medical child abuse (MCA). The aim of this study was to identify themes from the clinical narratives of adolescents with chronic pain that may indicate concern for MCA. This qualitative, retrospective study at an academic children's hospital between 2011 and 2019 identified 37 adolescents aged 13-18 years old with chronic pain and varying levels of concern for MCA. Conventional, inductive content analysis was used to identify themes from the medical records of all patients, which were reviewed by an interdisciplinary panel of experts. Themes were organised into three tiers related to the level of concern for MCA: 'Green zone' themes including fatigue or sleep problems, psychosocial distress, and social withdrawal were common among all patients. 'Yellow zone' themes including fragmented care, caregiver catastrophising, caregiver misrepresentation, medical provider exasperation, and sick identity were more common among patients in whom medical providers raised concern for MCA. A single 'red zone' theme, reportable harm to the child, was only present in patients diagnosed by a child abuse paediatrician as having MCA. A visual display of the results is provided for further research and clinical application.

South Africa has extraordinarily high levels of CSA with profound immediate and long-term mental health outcomes. This study aimed to investigate the mental health adjustment of children who experienced CSA and accessed support services using mixed methods. Structured interviews using validated mental health screening tools were conducted with children, between the ages of 7-18 years at three intervals over a 10-month period. Semi-structured qualitative interviews were conducted with primary caregivers to explore their views on the child's adjustment, and a validated parenting measure was used to assess parenting practices over time. Nearly 20% of all children met the clinical criteria for depression, but younger children showed increased recovery from depression over time. More than a third (37%) of younger children had full-symptom PTSD at baseline, with about a quarter (24%) of adolescents meeting the full-symptom PTSD criteria. We found that although full-symptom PTSD decreased to 26% for younger children, there was a slight increase (32%) in full-symptom PTSD among adolescents. Children's experiences of poly-victimisation were highlighted through caregiver interviews combined with caregivers' own experiences of unresolved trauma. Therapeutic models need to address the complex nature of trauma that children experience and unresolved trauma experienced by many families to break this intergenerational cycle.