The treatment of child neglect through a comprehensive service strategy including home-based therapy, play therapy, parent education, and parent-child interaction therapy

The problem. Child neglect affects nearly half a million children and their families each year in the United States. Victims of neglect manifest a variety of short- and long-term symptoms that dramatically reduce successful development as children and healthy living as adults. The prevalence of neglect is widely documented, yet much more research is needed to understand the complex interactions that result in situations of neglect in families. Issues such as poverty; substance abuse; parenting skills; child, parent, and environmental factors; parent-child relationships; social isolation; availability of resources; and parent motivation impact the occurrence of neglect. Treatment interventions may one day target specific deficits successfully, but current knowledge suggests the need for a comprehensive array of services that target these variables simultaneously.; Method. This project evaluated the treatment outcomes of NET (Neglect Ends Today), a broad-based service strategy conducted by Home Start, Inc., that targeted families referred for neglect in San Diego, California. Funded through the State of California Office of Criminal Justice and Planning, NET offered home-based therapy for parent and child, parent education, and Parent Child Interaction Therapy, collaborated with substance abuse treatment, made community referrals, and provided emergency assistance. Pre- and post-data were collected on participants, using the Family Risk Scales, Child Neglect Index, Parenting Stress Index, and Child Behavior Checklist. A Qualitative analysis was also conducted to assist in interpreting the results. Case files were reviewed and staff interviews conducted.; Results. Cautious support to the hypotheses is offered, using both qualitative and quantitative analysis. Severity of neglect, risk of abuse associated with the parent, stress reported by the parent, negativity in the interaction with the parent and child, and problems associated with the child were all reduced. No between-group difference was found between those referred while engaged in substance abuse day-treatment and those who were community-based, receiving no substance abuse service. Several problems associated with research protocols were evaluated and recommendations were given for further study and program modifications. The results support the application of a multidimensional approach to treating neglect with a diverse population that included substance abuse.