Table Of ContentT The Child Abusers
THE CHILD ABUSERS
Research and Controversy h
e
• How can we improve child protection?
• What can we learn from recent child abuse cases and research?
• Who are the child abusers? C R e s e a r c h a n d C o n t r o v e r s y
• Who kills children?
h
Child abuse horrifies the public, engenders fierce debate in the i
l
media, and creates anxiety in even the most experienced d
professionals. In this book, the author examines the available
evidence base in order to challenge the myths and controversies.
A
Readers are offered up-to-date research and case material to assist b
in the assessment of risk and physical danger. Emphasis is placed on
u
the importance of the child protection–psychiatry interface and, while
no absolute answers are offered, the debates around the subject are s
clearly outlined and suggestions for effective intervention are offered. e
The Child Abusersis essential reading for professionals and r
s
students in the field of child protection, including health and social
workers, police, nurses, medics, teachers, psychologists and
psychiatrists.
Colin Pritchardis Professor Emeritus, School of Medicine, University
of Southampton, and Research Professor in Psychiatric Social Work,
Institute of Health and Community Studies, Bournemouth University.
His research contributes to an effective evidence-based child
protection practice and includes studies of suicide, child homicide,
child abuse and the criminality of child sex abusers.
cover design: Kate Prentice
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The Child Abusers
The Child Abusers
Research and Controversy
Colin Pritchard
Open University Press
OpenUniversityPress
McGraw-HillEducation
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Firstpublished2004
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Contents
Preface vii
1 TheChild ProtectionControversy 1
2 Types ofAbuse:Incidence, Overlap,PsychiatricEffectsandPrevention 11
3 Within-FamilyAbusers 29
4 Extra-FamilyAbusers 47
5 SomeSpecial ProblemsforChildProtectionTeams 58
6 TheSocietal Abuser:Re-discoveringtheCycleofPoverty 83
7 TheExtremesofChild Abuse:WhoKillsChildrenandthe
Psychiatric-ChildAbuseInterface? 101
8 ProfessionalIatrogenesis:The‘HelpingHandStrikesAgain’ 130
9 Strategies forReducingChild AbuseandSexualOffending:
ProcessingandTherapy 145
Bibliography 177
NameIndex 211
Subject Index 217
Preface
Ithasbeenclaimedthatthereareonlytwocertaintiesinlife,‘deathandtaxes’
(BenjaminFranklin).Onreflection,mostwouldagreethatthethirdcertainty
is ‘childhood’, contained in everyhuman being, ineach of theirseven ages.
Thetriumphs,disasters,joys,painandmemoriesechothroughoutone’sadult
life. Thus ‘in our ends are our beginnings’ (T.S. Eliot: East Coker: The Four
Quartets), which are shaped in childhood and adolescence. In part, this is
why this book was written after some 40 years of practice and research, to
completeajourneythateveryonetravels,andwhichalloweadebttothose
yesteryears, and to seek to enhance the lives of other children, whose lives
weredamaged throughnofault of theirown.
The book’s origins started in an unlikely way. My practice background,
which has continued throughout my academic career, was mental health,
andalthoughovertheyearstheissueofchildabusehassometimesemerged
inmypractice,Iwasinnowayaspecialist.ButIhavelongbeenconcerned
aboutevidence-basedpractice,thatis,empiricallysupportedpractice.Asan
empiricist, I was invited in 1996 to evaluate the work of an NSPCC unit
specializing in the treatment of male child sex abusers. There were major
problems in seeking to determine outcomes, which could be related to im-
provedchildprotection.Myfirstlessonwasjusthowcomplexthefieldwas,
andhowmuchpsycho-babblewasaround,whichoftenobscuredratherthan
clarified. To obtain some hard facts, rather than rely upon conjecture
orexoneration,IcollaboratedwiththeDorsetPoliceandProbation,tomap
out something of the nature of the problem based upon life-time convic-
tionsofmalesexoffenders(PritchardandCox1997).Likeallgoodresearch,
there was new information to be discovered, as well as confirming earlier
findings.
The initial studies, based upon detailed analysis of police records, were
extendedtoHampshire,whichineffectprovidedabaselinepopulationof3.2
millionpeople,equivalenttomorethan5percentoftheEnglishpopulation,
enabledastudyof theprevalence of childabuseanditsextremes, knownto
the police. This included a study of a decade of child homicides in the two
counties, which identified the actual assailants and the relative risk of the
various categories of child killers (Pritchard and Bagley 2001). Both sets of
material were often distressing to handle, despite being an experienced
practitioner and researcher, nothing could prepare one for the extremes,
where aminority of men,had laid asidetheir humanity.
viii THECHILDABUSERS
Workwithstudentsinpracticeandclients,theimpactoftheroughend
ofthecontinuumofchildprotection,andthewaythepublicandsometimes
management responded to these situations, made me concerned with the
plight of theexposed professional. Irrespective of thefield of human service
in which we work, unlike the tabloid media stereotype, we can never have
perfecthindsight,especiallywhendealingwiththemultiplecomplexitiesof
living child protection situations. There is little need to rehearse the vortex
that surrounds child protection, with the perennial clash of interests and
rights, the efforts to make judgements in ever changing situations, when
invariablyonehaslessthanalltheinformationoneneeds.Workinthisand
thementalhealthfield,haslegalresponsibilitiesandobligations,whichoften
leaves the harassed practitioner, be they social worker, police person, psy-
chiatrist or nurse – with the feeling that they are flying by the seats of their
pants. Extreme pressure can surround such cases – even without a critical,
unsupportive management wrestling withtheproblems of under-funding.
Continued practice involvement in psychiatric social work has always
served to remind me of the living problems of practice. This has made me
acutely sympathetic to the needs of the harassed professional, especially as
the field of child protection and mental health are often surrounded with
assertions,anecdotesandoftenunsubstantiatedtheories,orworse–theories
and techniques that have passed their sell-by date, which means that some-
times thepractitionerdoes notalways havesoundbasis for practice.
Researchinginthechildprotectionfieldasanonespecialist,allowedone
toaskthose‘obvious’questions,whichareoftenmissedbythoseimmersedin
thefield.Themajororiginalstudies,whichchartedtheextremeendofchild
neglect and abuse had, virtually by accident, focused not upon the child
victim but rather upon the abuser (Pritchard and Cox 1997; Pritchard and
Bagley2000,2001;PritchardandKing2004).SinceKempe’sseminalpaperin
1962 which, at the time, truly shocked the Western world community, the
vastarrayofresearchhaslookedattheperspectiveofthechild–self-evidently
vital. But, in seeking to improve child protection, we also need to try to
understand the abuser – not to exonerate him or very rarely, her, but to
provide information for the practitioner, manager and policy maker that
would equip themtotakeeffective action inspecificcircumstance.
‘Neglect’and‘abuse’arebiglabels,whichcoveramultitudeofsins,and
unless or until we can understand neglecters and abusers, we are unable to
effectively take the life-affecting decisions required on behalf of children.
Moreover,weneedtobeparticularlyconcernedtobreakthecycleofpotential
neglectandabuse,whichmeansthatthepractitionernotonlyhastoconsider
the here-and-now situation, but the possible medium- and long-term out-
comes.
It should be acknowledged however, that evidence-based practice can
also serve to protect the rights of vulnerable adults, as undifferentiated
PREFACE ix
labelling and ‘over-the-top’ reactions can lead to miscarriages of justice,
which accumulative, undermine public confidence in the child protection
and criminal justice systems (Webster 1998). And at the outset, it must be
admittedthatthisbookmaywelloffend,asitchallengessomeoldnostrums
and ideological positions, often sincerely and fiercely held, but which new
research contradicts or asks for a re-evaluation, in the continued search for
improvedchildprotection.
Everything in this book aims to contribute to the improvement of the
protection of children. Typically, as the book unfolded, I had to re-think
earlierpositionsmodifiedasexploringcurrentresearchandpractice,provided
newlessonsandnewinsights.Hopefullythetrapofmanytextbookshasbeen
avoided,ofsoundingasiftheauthorknewalltheanswers–Ididnotanddo
not, as is illustrated from the many cases presented, all self-evidently made
anonymously, but highlightingthefraught natureof thefield.
Each case presents enormous complexity reflecting a unique combina-
tion of social and psychological circumstances, and this can make effective
decisionmakingdifficult.Thecasesoutlinedreflecttheday-to-daydilemmas
found in every practice across the disciplines concerned with protecting
children.
The book has nine chapters; which although schematically presenting
the issues, always stress needs to reflect the individuality of each specific
situation, and the limits of our knowledge. While seeking a degree of de-
tachment,itisadmittedthatthepowerfulemotionsthetopicarousescannot
beavoided,hencethesub-title,‘researchandcontroversy’.Indeed,anumber
of politically-correct cows are taken on, and if not slaughtered, are left
limping, for asFrancis Bacon says,
Thosewhowouldstartwithcertainties,endindoubt.Butiftheybe
contenttobegin withdoubts,then theycanfindcertainties,
(FrancisBacon: Advancement ofLearning)
which means we are on a journey which may require us to re-consider old
certaintiesofamoresimpleworld,tomakebettersenseofthenewknowledge
and incorporate it into practice. Indeed, as a lifelong supporter of the civil
rightsmovements,AmnestyandLiberty,thisresearchdemandedthatIthink
theunthinkable,intheuncomfortableethicalobligation,ofhavingtoreport
what onefinds,rather thanwhat onebelieves.
The core question is why do people, predominately adults, most often
parents, shatter all the taboos in either the feckless neglect of children, or
their active abuse? The enormity, indeed, abnormality of such behaviour
comes from a classic source, when Jesus of Nazareth asked the rhetorical
question,
