par Haesevoets, Yves 
Référence Evolution psychiatrique, 68, 4, page (509-529)
Publication Publié, 2003-10
Référence Evolution psychiatrique, 68, 4, page (509-529)
Publication Publié, 2003-10
Article révisé par les pairs
| Résumé : | Although maltreatment (towards children) is an aspect of human violence in general, current clinical research in this field is aimed at establishing increasingly finer diagnostic criteria and more specific treatments. The abusive or vulnerable families are better 'screened', and treatment management is more case-specific. In Belgium, a multidisciplinary intervention unit has been set up: SOS Children-Families, consisting of teams specialized in the evaluation and treatment of child abuse which attempt to offer solutions that are better adapted to these particular families. The choice between a legal or a non-legal approach to managing maltreated children and their abusive families is not easy to make and each decision in this regard inevitably involves certain risks, but the multidisciplinary method described in this article is more flexible and opens up new avenues. With the sometimes exaggerated media coverage and collective anxiety aroused by publicity over extreme cases, the abusive families elicit reactions that are more frequently repressive than reconstructive. The new approach, however, seeks to avoid criticism or stigmatization and establish a therapeutic alliance with the families in question. Treatment management also tends to increasingly involve professionals from a wide range of disciplines, and collaboration depends on their pertinent intervention at different levels in the therapeutic process; although their approaches may not always be compatible and even sometimes contradictory, the protagonists are strongly committed towards treatment of the family unit. In spite of the official and institutionalized nature of treatment management of specific cases, the abusive families are exposed to numerous confrontational situations that require their commitment and involvement. In this particular and quite innovative context aimed at providing aid to abusive families, different propositions can be considered: a) the analysis of personal, institutional and familial reference systems; b) clarification (of the reasons for) the therapeutic intervention; c) the child's corroborative observation; d) an active and respectful dialogue between the therapists and the parties concerned; e) the construction of a therapeutic bond with the family; f) the initiation of a project for change; g) learning to develop empathy; h) a tried and tested ethical approach to treatment. In conclusion, the treatment approach, which is more socio-political than psychological, underlines the context in which therapeutic management should take place, the sharing of ethical values between the professionals involved, and the possibilities available to maltreated children and their abusive families. © 2003 Éditions scientifiques et médicales Elsevier SAS. Tous droits ré servés. |
