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Abuse treatment study moves to Australia by Dick Peterson Public Relations Methods used in a five-year, recently completed study to treat child abuse and neglect in at-risk families in Charleston County will be applied to troubled families in a culturally diverse Queensland, Australia, community. Training for the project began July 25.   Cindy Swenson, Ph.D., an associate professor in the MUSC Department of Psychiatry and Behavioral Sciences, is a co-investigator on the project, headed by Drs. William Bor and Brett McDermott.  The study involves implementation of Multisystemic Therapy (MST) techniques to provide as-needed support to families who come under the guidance of the Department of Child Safety due to child physical abuse. The study will be conducted in the Inala region, southwest of Brisbane, Queensland and will involve Australian Aboriginals, Samoans, Vietnamese, Torres Strait Islanders and a white Australian majority.   “This will be the first time MST for child abuse and neglect has been replicated since the Charleston County study concluded,” Swenson said. That study, with funding from the National Institute of Mental Health, worked with 86 families referred by Department of Social Services in Charleston County. Swenson was the principal investigator of the study.   “In the short term, we were able to keep the children safely at home as we counseled parents and trained them to discipline their children without getting physical,” Swenson said. “We’re now doing the analyses on the 16-month outcomes.” She explained that interviews were conducted with each family at enrollment, two-month, four-month, 10-month and 16-month intervals. The outcome results she provided to Australian researchers interested them in conducting the replication study, now funded by the Australian government (Department of Child Safety).   “Multisystemic therapy takes into account the children, the parents and everything going on in the family,” Swenson said, “everything that is driving the problem of abuse and neglect. We treat the children, their parents and all members of the family and help them function without getting physical.” Family therapists go to the home and, through counseling, help remove barriers that prevent the family from functioning in a healthy way.   “We engage families and view them as people deserving respect,” Swenson said. “We first ask them to work with us, and in the Charleston County study, 97 percent of the time they said, ‘Yes’.” She said that many parents are fearful of the Department of Social Services getting into their lives, so it becomes a trust factor.   “They have no huge reason to trust us,” she said, “so we appreciate it when they do take a chance on us.”   The therapy is difficult. Swenson said that the treatment runs for six to seven months and is very intensive, sometimes daily. “We work hard to get rapid change in families, and to do this we schedule ourselves to times that are convenient for them. And we are on call 24-seven, around the clock.” She said that typically a parent will call when the levels of frustration and anger rise to a point where they fear losing control.   “And sometimes the kid calls,” she said.   When a family therapist enters a home, they first assess what’s going on by interviewing every family member and setting the family’s goals for the treatment. “We teach them how to communicate and how to solve problems,” Swenson said. “We teach them how to set rules and to follow up on them.” She added that people in some families suffer from post traumatic stress disorder and alcohol and drug abuse, and some are suicidal.   She said that the treatments dealing with potential suicide, drug problems, anger management, family communication and parenting have proven research to support them.   In Australia, reports of abuse and neglect have more than doubled countrywide in recent years. While authorities differ about whether incidents are increasing or if they are becoming more likely to be reported, they agree that the problem needs to be addressed.   “In some cases, people moving to the area from other countries and cultures are unaware of the Australian laws about caring for children,” said project supervisor, Helen Stallman, D.C.P. Stallman visited MUSC in mid-August to coordinate the Inala project with Swenson. It is now known as Project SAFE, for Support and Family Empowerment.   “In many cases, it’s a lack of skills,” she said. “People don’t know or are unaware of what’s appropriate and not appropriate in Australia. They lack skills and they parent the only way they know how to parent.”   She said her study team would seek to target factors that lead to child abuse and neglect by decreasing alcohol and drug abuse, teaching anger management and communication skills, and increasing mutual support of families.   “The extended family and community is also an important resource. The more social support families have around them, the less likely it will be for abuse and neglect to occur,” Swenson said.     Friday, Sept. 9, 2005 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. 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