Skip to main content
Top
Published in: BMC Health Services Research 1/2019

Open Access 01-12-2019 | Care | Research article

Entering an emotional minefield: professionals’ experiences with facilitators to address abuse in child interviews

Authors: Ane Ugland Albaek, Per-Einar Binder, Anne Marita Milde

Published in: BMC Health Services Research | Issue 1/2019

Login to get access

Abstract

Background

Extensive research documents that child abuse is widespread and that it has detrimental effects on victims’ physical, psychological and social well-being. Efforts to help abused children by removing stressors and administering restorative care can reverse these negative effects, but the evidence suggests that professionals often fail to expose child abuse. This study aims to generate insight into professionals’ experiences with facilitators in handling the challenges of addressing abuse in child interviews. We expect that this knowledge can improve interventions that qualify professionals in the identification, protection and care of abused children.

Methods

Within the qualitative approach and an Interpretive Description framework, we performed in-depth interviews with nineteen participants from southern Norway, specifically ten social workers from child protective services and nine psychologists from child mental health services. Then, Interpretive Description analysis was performed by using constant comparison, reflexive and critical examinations, and contextualized theoretical interpretations.

Results

The participants’ accounts revealed that various facilitators relative to the stages of the skill development and intrinsic motivation of the practitioner enhance the explorative work of the professional. We identified the following five main themes: (a) alleviating personal choice; (b) collective accountability; (c) sharing vulnerability; (d) finding your own way; and (e) doing it for the right reasons.

Conclusions

To facilitate explorative work, our findings suggest that competence development should apply goal-directed reflective practice combined with positive feedback on performance. Furthermore, our results indicate that developing personal competence is contingent on supporting individual choice and volition while decreasing demands towards following rules and guidelines. To promote the relatedness and the emotion regulation of professionals, we suggest endorsing shared vulnerability with colleagues and promoting an organizational culture that supports openness and allows professionals to discuss their emotions when addressing difficult and complex issues. It is also advisable to promote autonomy by helping professionals to find meaning in their work that is compatible with their personal values.
Appendix
Available only for authorised users
Literature
1.
go back to reference Albaek AU, Kinn LG, Milde AM. Walking children through a minefield: how professionals experience exploring adverse childhood experiences. Qual Health Res. 2018;28(2):231–44.CrossRef Albaek AU, Kinn LG, Milde AM. Walking children through a minefield: how professionals experience exploring adverse childhood experiences. Qual Health Res. 2018;28(2):231–44.CrossRef
3.
go back to reference Ofsted. The voice of the child: learning lessons from serious case reviews. In: The Office for Standards in Education CsSaS, editor. UK: crown; 2011. p. 25. Ofsted. The voice of the child: learning lessons from serious case reviews. In: The Office for Standards in Education CsSaS, editor. UK: crown; 2011. p. 25.
4.
go back to reference Priebe G, Svedin CG. Child sexual abuse is largely hidden from the adult society. An epidemiological study of adolescents' disclosures. Child Abuse Negl. 2008;32(12):1095–108.CrossRef Priebe G, Svedin CG. Child sexual abuse is largely hidden from the adult society. An epidemiological study of adolescents' disclosures. Child Abuse Negl. 2008;32(12):1095–108.CrossRef
5.
go back to reference Steine IM, Winje D, Nordhus IH, Milde AM, Bjorvatn B, Grønli J, Pallesen S. Delayed disclosure of sexual abuse: predictors and correlates among adult survivors of childhood sexual abuse. Norwegian Journal of Psychology. 2016;53(11):889–99. Steine IM, Winje D, Nordhus IH, Milde AM, Bjorvatn B, Grønli J, Pallesen S. Delayed disclosure of sexual abuse: predictors and correlates among adult survivors of childhood sexual abuse. Norwegian Journal of Psychology. 2016;53(11):889–99.
6.
go back to reference Berens AE, Jensen SKG, Nelson CA, 3rd. Biological embedding of childhood adversity: from physiological mechanisms to clinical implications. BMC Med 2017;15(1):135. Berens AE, Jensen SKG, Nelson CA, 3rd. Biological embedding of childhood adversity: from physiological mechanisms to clinical implications. BMC Med 2017;15(1):135.
7.
go back to reference De Bellis MD, Zisk A. The biological effects of childhood trauma. Child Adolesc Psychiatr Clin N Am. 2014;23(2):185–222 vii.CrossRef De Bellis MD, Zisk A. The biological effects of childhood trauma. Child Adolesc Psychiatr Clin N Am. 2014;23(2):185–222 vii.CrossRef
8.
go back to reference Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14(4):245–58.CrossRef Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14(4):245–58.CrossRef
9.
go back to reference LeDoux JE, Pine DS. Using neuroscience to help understand fear and anxiety: A two-system framework. Am J Psychiatry. 2016;173(11):1083–93.CrossRef LeDoux JE, Pine DS. Using neuroscience to help understand fear and anxiety: A two-system framework. Am J Psychiatry. 2016;173(11):1083–93.CrossRef
10.
go back to reference Van Niel C, Pachter LM, Wade R Jr, Felitti VJ, Stein MT. Adverse events in children: predictors of adult physical and mental conditions. J Dev Behav Pediatr. 2014;35(8):549–51.CrossRef Van Niel C, Pachter LM, Wade R Jr, Felitti VJ, Stein MT. Adverse events in children: predictors of adult physical and mental conditions. J Dev Behav Pediatr. 2014;35(8):549–51.CrossRef
11.
go back to reference Finkelhor D, Turner HA, Shattuck A, Hamby SL. Violence, crime, and abuse exposure in a national sample of children and youth: an update. JAMA Pediatr. 2013;167(7):614–21.CrossRef Finkelhor D, Turner HA, Shattuck A, Hamby SL. Violence, crime, and abuse exposure in a national sample of children and youth: an update. JAMA Pediatr. 2013;167(7):614–21.CrossRef
12.
go back to reference Jernbro CJ, S. A national survey. Violence against children in Sweden. The children's welfare foundation. 2016. Jernbro CJ, S. A national survey. Violence against children in Sweden. The children's welfare foundation. 2016.
13.
go back to reference Thoresen S, Myhre M, Wentzel-Larsen T, Aakvaag HF, Hjemdal OK. Violence against children, later victimisation, and mental health: a cross-sectional study of the general Norwegian population. Eur J Psychotraumatol. 2015;6:26259.CrossRef Thoresen S, Myhre M, Wentzel-Larsen T, Aakvaag HF, Hjemdal OK. Violence against children, later victimisation, and mental health: a cross-sectional study of the general Norwegian population. Eur J Psychotraumatol. 2015;6:26259.CrossRef
14.
go back to reference La Greca AMB, B. A.; Jaycox, L. H.; Kassam-Adams, N.; Mannarino, A. P.; Silverman, W. K.; Tuma, F.; Wong, M. Children and trauma. APA presidential task force on posttraumatic stress disorder and trauma in Children & Adolescents. American Psychological Association. 2009. La Greca AMB, B. A.; Jaycox, L. H.; Kassam-Adams, N.; Mannarino, A. P.; Silverman, W. K.; Tuma, F.; Wong, M. Children and trauma. APA presidential task force on posttraumatic stress disorder and trauma in Children & Adolescents. American Psychological Association. 2009.
15.
go back to reference Steinberg AMP, Robert S, Briggs EC, Gerrity ET, Layne CM, Vivrette RL, Beyerlein B, Fairbank JA. The National Child Traumatic Stress Network Core Data set: emerging findings, future directions, and implications for theory, research, practice, and policy. Psychol Trauma Theory Res Pract Policy. 2014;6(Suppl 1):50–7.CrossRef Steinberg AMP, Robert S, Briggs EC, Gerrity ET, Layne CM, Vivrette RL, Beyerlein B, Fairbank JA. The National Child Traumatic Stress Network Core Data set: emerging findings, future directions, and implications for theory, research, practice, and policy. Psychol Trauma Theory Res Pract Policy. 2014;6(Suppl 1):50–7.CrossRef
16.
go back to reference Blount RL, Simons LE, Devine KA, Jaaniste T, Cohen LL, Chambers CT, et al. Evidence-based assessment of coping and stress in pediatric psychology. J Pediatr Psychol. 2008;33(9):1021–45.CrossRef Blount RL, Simons LE, Devine KA, Jaaniste T, Cohen LL, Chambers CT, et al. Evidence-based assessment of coping and stress in pediatric psychology. J Pediatr Psychol. 2008;33(9):1021–45.CrossRef
17.
go back to reference Cameron M, Elkins J, and Guterman N. Assessment of trauma in children and youth. In N. B. Webb (Ed.), Working with traumatized youth in child welfare NY. Guilford Press; 2006. Cameron M, Elkins J, and Guterman N. Assessment of trauma in children and youth. In N. B. Webb (Ed.), Working with traumatized youth in child welfare NY. Guilford Press; 2006.
18.
go back to reference Reigstad B, Jørgensen K, Wichstrøm L. Diagnosed and self-reported childhood abuse in national and regional samples of child and adolescent psychiatric patients: Prevalences and correlates. Nordic Journal of Psychiatry. 2006;60(1):58–66.CrossRef Reigstad B, Jørgensen K, Wichstrøm L. Diagnosed and self-reported childhood abuse in national and regional samples of child and adolescent psychiatric patients: Prevalences and correlates. Nordic Journal of Psychiatry. 2006;60(1):58–66.CrossRef
19.
go back to reference Piltz A, Wachtel T. Barriers that inhibit nurses reporting suspected cases of child abuse and neglect. Aust J Adv Nurs. 2009;26(3):93–100. Piltz A, Wachtel T. Barriers that inhibit nurses reporting suspected cases of child abuse and neglect. Aust J Adv Nurs. 2009;26(3):93–100.
20.
go back to reference Thorne S, Kirkham SR, O'Flynn-Magee K. The analytic challenge in interpretive description. Int J Qual Methods. 2004;3(1):1–11.CrossRef Thorne S, Kirkham SR, O'Flynn-Magee K. The analytic challenge in interpretive description. Int J Qual Methods. 2004;3(1):1–11.CrossRef
21.
go back to reference Thorne S. In: Morse J, editor. Interpretive description. Qualitative research for applied practice. 2nd ed. New York: Routledge. Taylor & Francis Group; 2016. p. 336. Thorne S. In: Morse J, editor. Interpretive description. Qualitative research for applied practice. 2nd ed. New York: Routledge. Taylor & Francis Group; 2016. p. 336.
22.
go back to reference Heidegger M. Being and Time. Oxford: Blackwell Publishing; 1962. Heidegger M. Being and Time. Oxford: Blackwell Publishing; 1962.
23.
go back to reference Gadamer HG. Truth and method: continuum international publishing group; 1975. p. 593. Gadamer HG. Truth and method: continuum international publishing group; 1975. p. 593.
24.
go back to reference Binder P-E, Holgersen H, Moltu C. Staying close and reflexive: an explorative and reflexive approach to qualitative research on psychotherapy. Nordic Psychology. 2012;64(2):103–17.CrossRef Binder P-E, Holgersen H, Moltu C. Staying close and reflexive: an explorative and reflexive approach to qualitative research on psychotherapy. Nordic Psychology. 2012;64(2):103–17.CrossRef
25.
go back to reference Laverty SM. Hermeneutic phenomenology and phenomenology: A comparison of historical and methodological considerations. Int J Qual Methods. 2003;2(3):21–35.CrossRef Laverty SM. Hermeneutic phenomenology and phenomenology: A comparison of historical and methodological considerations. Int J Qual Methods. 2003;2(3):21–35.CrossRef
26.
go back to reference Alvesson MS, K. Reflexive Methodology: New vistas for qualitative research: SAGE; 2009. Alvesson MS, K. Reflexive Methodology: New vistas for qualitative research: SAGE; 2009.
27.
go back to reference Finlay LG, Reflexivity B. A practical guide for researchers in health and social science. Oxford: Blackwell Publishing; 2003. p. 250. Finlay LG, Reflexivity B. A practical guide for researchers in health and social science. Oxford: Blackwell Publishing; 2003. p. 250.
28.
go back to reference Kvale SB, Interviews S. Learning the craft of qualitative research interviewing. Los Angeles: SAGE; 2009. Kvale SB, Interviews S. Learning the craft of qualitative research interviewing. Los Angeles: SAGE; 2009.
29.
go back to reference Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68–78.CrossRef Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68–78.CrossRef
30.
go back to reference Ryan RM, Connell JP. Perceived locus of causality and internalization: examining reasons for acting in two domains. J Pers Soc Psychol. 1989;57(5):749–61.CrossRef Ryan RM, Connell JP. Perceived locus of causality and internalization: examining reasons for acting in two domains. J Pers Soc Psychol. 1989;57(5):749–61.CrossRef
31.
go back to reference Parker SL, Jimmieson NL, Amiot CE. Self-determination as a moderator of demands and control: implications for employee strain and engagement. J Vocat Behav. 2010;76(1):52–67.CrossRef Parker SL, Jimmieson NL, Amiot CE. Self-determination as a moderator of demands and control: implications for employee strain and engagement. J Vocat Behav. 2010;76(1):52–67.CrossRef
32.
go back to reference Vansteenkiste M, Soenens B, Lens W. Intrinsic versus extrinsic goal promotion in exercise and sport: understanding the differential impacts on performance and persistence. Intrinsic motivation and self-determination in exercise and sport. Champaign, IL: Human Kinetics; 2007. p. 167–80. 337-40 Vansteenkiste M, Soenens B, Lens W. Intrinsic versus extrinsic goal promotion in exercise and sport: understanding the differential impacts on performance and persistence. Intrinsic motivation and self-determination in exercise and sport. Champaign, IL: Human Kinetics; 2007. p. 167–80. 337-40
33.
go back to reference Schwartz B. Practical wisdom and organizations. Res Organ Behav. 2011;31:3–23.CrossRef Schwartz B. Practical wisdom and organizations. Res Organ Behav. 2011;31:3–23.CrossRef
34.
go back to reference Johansen I. Turnover in the municipal child protective services. In: Statistics Cbo, ed. Norway: Department of Children, equality, and inclusion; 2014. p. 35. Johansen I. Turnover in the municipal child protective services. In: Statistics Cbo, ed. Norway: Department of Children, equality, and inclusion; 2014. p. 35.
35.
go back to reference World Medical Association. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bulletin of the World Health Organization. 2001;79(4):373–74. World Medical Association. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bulletin of the World Health Organization. 2001;79(4):373–74.
Metadata
Title
Entering an emotional minefield: professionals’ experiences with facilitators to address abuse in child interviews
Authors
Ane Ugland Albaek
Per-Einar Binder
Anne Marita Milde
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-019-4128-8

Other articles of this Issue 1/2019

BMC Health Services Research 1/2019 Go to the issue