A review of the risk variables associated with child maltreatment highlight that the parents and caregivers of children at risk for maltreatment are themselves victims. They are in need of programs that are increasingly available and well established. Their needs for those supports are often easily ascertained in the early days of their children's lives, before catastrophic incidents of child maltreatment have occurred. Without these supports child maltreatment continues to be the largest preventable causal influence on child mental disorder in the United States. It is thus incumbent on child and adolescent psychiatrists to know and ascertain the warning signs among the families of their patients, to recognize and exhaustively pursue opportunities for preventive intervention. To do this they should become experts in the emerging science of child maltreatment prevention. Note that in child psychiatry there is rarely such a thing as a one-time inoculation against mental disorder, or, for that matter, against maltreatment. Behavior is complex, adaptive, and highly evolved (with many checks and balances). Often when things go awry the causes are multifactorial. For those children whose development is potentially compromised by the risk of child maltreatment, it is important that efforts to minimize such risk are sustained, comprehensive, and organized around the needs of individual families, not bureaucracies. The current generation of specialists in child mental health, clinicians and researchers alike, need to be trained in these methods and to be integral proponents of the advancing frontier of preventive intervention.44 In the next phase of development, concerted efforts to learn which interventions work, when in the child's development, targeted toward whom, sustained at what dosage, and for what duration, will bring about cost-effective reductions in the incidence of child maltreatment and consequent improvement in major public mental health outcomes. Embedding such intervention efforts in genetically and/or developmentally informative sampling designs with robust outcome measurements will ensure that the agenda of separating "baby from bathwater" in preventive intervention will itself contribute to the steady advancement of behavioral neuroscience.
|Number of pages||9|
|Journal||Child and Adolescent Psychiatric Clinics of North America|
|State||Published - Apr 1 2016|