The discussion so far has suggested that research should be used in a rational way to inform decision-making. The reality, though, is that it can instead be used instrumentally to support decisions made for other reasons or simply to distract attention or to initiate time-taking responses that avoid decision-making (Weiss 1979).
Even if research is used rationally it is just one influence on policy and practice. During the development of the movement for the use of systematic research synthesis the term ‘evidence-based medicine’ was frequently used which gave the unfortunate impression that medical care was to be determined only by research evidence. This did not take into account all the other factors that need to be involved in any decision-making including ethics and human rights, resources, user needs, professional skills and knowledge, and other political issues. In order to avoid such confusion terms such as ‘evidence informed’ or ‘enabled’ are used to emphasize that decisions should be informed but not determined by research. Other influences on decision-making are as legitimate as research, but making the research component more explicit and
rational should also enable the other influences on decision-making to be more transparent.
The evidence from research on the use of research is that there are many barriers to its use in social care. How many readers of this book have the time and other resources to have an up-to-date understanding of all the research evidence relevant to their work on child neglect? Sheldon and Chivers (2000) have reported on the very limited knowledge of social workers of research studies. In education and social care, initial training and ongoing professional development focuses on practice rather than declarative research knowledge (Hargreaves 1996). In medicine and other disciplines there is a more even balance between these different types of knowledge.
If practitioners’ knowledge of research is limited then it is unlikely that research evidence is having much impact on practice. Even if the research was well known there would be other barriers to its use in practice. To address these issues SCIE has commissioned the Research Utilization Research Unit (RURU) at the University of St Andrews to review the use of social care research.
Previous work by RURU has shown that common barriers to research utiliza-tion are lack of resources for engaging in research, organizautiliza-tional resistance to use of research evidence, poor communication of research, and lack of rele-vance of research (Walter, Nutley and Davies 2003). To enable implementation research needs to be translated into local contexts and research needs to be inte-grated within organizational activities and systems.
How might this be achieved? Non-academic users of research cannot spend all their time being researchers. They can take leave from their normal work to be involved in a particular research project or be involved in research, including action research, undertaken within their workplace. This may provide insight into the research process and the particular research issues within the study in question. What is more difficult is for practitioners and policy makers to have an ongoing role as active participants in the research process.
Secondary research through systematic research synthesis provides an additional model. Involvement in primary research studies provides direct experience of doing research and the methods and practice of this direct form of knowledge production. Involvement in secondary research provides a differ-ent type of experience. It is less direct but provides a broader overview of how different research has, or has not, and can, or cannot, answer different ques-tions. It provides a more strategic view of what we know, how we know it, what we do not know and what research, by what methods, would be best placed to help answer these unanswered questions. Users of research such as practitio-ners, policy makers and users of services are in a sense researchers/experiment-ers as they adopt different strategies and respond to the feedback that they receive. It is just non-systematic investigation. A more strategic view of research from involvement in secondary research can assist such users of research to
adopt research thinking into their daily practice and thus make better use of their experimentation.
As argued earlier, research questions and research review questions need to be driven by the users of that research. This leads to agenda setting of what research questions need to be answered. In this way, practitioners and other non-academic users of research become in a sense managers of the research process and become more sophisticated about the research that will be of use to them without needing to spend time undertaking the time-consuming and technical issues of the primary research or of the systematic synthesis. System-atic research synthesis is sometimes criticized for being controlling of what research is undertaken for what purpose. On the contrary, it provides a means for all users of research to begin to control the research process. Not only does this enable practice-driven research, it also enables more democratic participa-tion in what we study and how we study it by all users of research including users of services. Research is too important to be left only to researchers.
Messages for practice
· Research evidence is only one driver of decision-making.
· Making the rational role of research more explicit could make the ideological and resource issues more transparent.
· Research evidence is only one type of knowledge and we need greater clarity about how research and practice knowledge can be combined to different effect.
· We need greater clarity about how research is utilized in practice and how this could change.
· Practitioners, policy makers and other users of research can benefit from involvement in primary research; involvement in secondary research allows a more strategic view of research, its methods and its potential impact on policy and practice.
· Involvement in systematic research synthesis can also lead to a much more powerful role in setting the research agenda. Research is too important to be left to researchers alone.
The Nature of Emotional Child Neglect and Abuse
Brian Minty
Introduction
The aim of this chapter is to try to clarify the nature and definition of child neglect, emotional neglect and emotional abuse and to demonstrate their inter-relationships. It is hoped that it will help practitioners better recognize emotional neglect and abuse, and respond with sensitivity. In particular, the sig-nificance of emotional neglect is emphasized, without downgrading the importance of physical neglect. The basic argument is that physical abuse and neglect have a character and impact that are as much emotional and psychologi-cal in nature as physipsychologi-cal, but that there are also other forms of abuse and neglect that are not expressed physically (or sexually) at all, and these are best catego-rized as emotional neglect and abuse. The impact and harm of these other forms of maltreatment have not always received the attention due to them. Also, emo-tional abuse and neglect can be used as residual terms. Types of abuse that are not physical or sexual should be categorized as emotional (or psychological) abuse. Types of neglect that are not physical should be categorized as emo-tional (or psychological) neglect.
The justification for undertaking this task is two-fold:
1. Experts in this field (Clausen and Crittenden 1991, p.6) suggest that the difficulties of defining terms and assessing aspects of child maltreatment have been a major obstacle in writing about child abuse and neglect.
2. Unless the full nature and diversity of child maltreatment is recognized, there is a danger that professional intervention may sometimes fail to grasp the reality of the harm done to children, and the nature of the help children and families require.
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The category of child neglect seems to have been somewhat under-used (relative to abuse) because some professional workers have held inadequate assumptions about it:
· that neglect is simply dirty children in dirty homes
· that, on the whole, neglect is a lesser form of maltreatment than abuse
· that neglect is simply a consequence of material poverty.
Our previous article about neglect (Minty and Pattinson 1994) arose as a response to social work colleagues who held such views. All three beliefs are far from the whole truth. Many of the most appalling cases of fatal child maltreat-ment have involved both severe neglect as well as abuse; for example, Maria Colwell (Department of Health and Social Security 1974), Jasmine Beckford (London Borough of Brent 1985) and Victoria Climbié (Lord Laming 2003).
However, these are extreme cases, and may be misleading. They might, in fact, lead social workers and health visitors to assume that neglect is relatively uncommon, whereas, at least in its emotional form, it is very common, and has the potential to seriously impair children psychologically and socially. It also seems near the heart of child maltreatment, as has been confirmed by Bifulco, Brown and Harris (1994), who found over several studies that of all the types of child maltreatment, neglect was the most closely correlated with the other types.
In relation to the belief that neglect is simply an effect of material poverty, two things seem clear. The first is that poverty and (physical) neglect are often found together, although the nature of the relationship is not agreed. In a study for the National Society for the Prevention of Cruelty to Children, Creighton (1992) found that parents who had a child registered for neglect were signifi-cantly more likely to live in families where nobody was in full-time employ-ment than was the case in the total population. However, unemployemploy-ment has a wider significance for families than that of reduced income by itself – serious though that may be. Families with children where nobody ever goes out to work or school may sometimes, in effect, be participating in their own social exclusion, with repercussions over more than one generation. At about the same time as the publication of Creighton’s British study, Pelton (1992), on the basis of a nationwide survey in the USA, advised the US Advisory Board on Abuse and Neglect that there was a close association between poverty and neglect.
The second point that must be made is that there are good reasons for believing that child neglect is not simply caused by poverty. The vast majority of families who live in (material) poverty have not had their children registered for child neglect; and, in fact, when children in the Third World are dying from hunger, due to poverty, we would in no way accuse their parents of neglecting them. Something different is needed for society to decide there is neglect. Of
course, it could well be that chronic poverty plays a part in many instances of physical child neglect, possibly by reducing morale, or by increasing a sense of general hopelessness and passivity (see also Chapter Two). It is also clear that there are stressors which could be related to neglect both directly and indirectly such as alcohol and drug abuse, and that some forms of mental illness might cause neglect directly, or cause it indirectly by dragging families into poverty.