The first effectiveness study in the Netherlands of a multidisciplinary approach to child maltreatment, the Resolutions Approach.

We investigate the effectiveness of the Resolutions Approach in 15 families with children aged 8-13 years, alleged of child maltreatment. We use the Single-Case Experimental Design (SCED) methodology. We investigate whether the Resolutions Approach is effective in preventing new incidents of child abuse, reducing parental stress and reducing children's internalising and externalising problems and strengthening the relationship between parents and children. Also, we look at the potentially active mechanism behind the Resolutions Approach. We investigate whether the breakthrough of secrecy within the family is related to the decline in the number of incidents of child abuse within the family. The results of this study will be disseminated and implemented through existing partnerships with different training centres, supervision of colleagues and (inter) national congresses and publications.

We investigate the effectiveness of a multidisciplinary treatment Resolutions Approach (RA) in families with alleged child abuse supplemented with the assessment form of Turnell (Turnell et al., 2009). We investigate the effects of RA on the primary and secondary outcome measures of new incidents of child maltreatment, child’s emotional and behavioural problems (including posttraumatic stress symptoms), parental stress feelings, and the bond between the child and the parent(s). We make use of the Single Case Experimental Design (SCED) method and regular, personalised assessments related to family treatment goals. SCED is a valuable alternative for RCTs to test (novel) intervention effects in youth and families in which heterogeneity of the problems is rather a rule than an exception.

The secondary objective of this study is to explore potential mechanisms of change behind RA effects. Most families keep the maltreatment undisclosed because they are ashamed or anxious for out of home placement of their children. Theories (Turnell et al., 2010) and clinical practice suggest that breaking through the secrecy of child maltreatment and domestic violence, and increasing openness of communication (aims of RA) about maltreatment, often lead to fewer incidents of child maltreatment after RA.

Also, treatment integrity (adherence to RA treatment protocol) will be monitored.

The quantitative measures will be assessed at five measurement points (T0 – T4): start of the baseline phase (T0), start of the treatment phase (T1), end of the treatment phase (T2), first follow-up meeting after three months (T3) and second follow-up meeting after six months (T4). Clinically relevant change in the client symptoms relative to the normgroup will be analysed using the outcomes on the extensive measurements and the reliable change index (RCI) (Jacobson & Truax, 1991). The RCI is a method to determine whether the symptom change within the participant is statistically reliable and represents a real improvement. This is the case if the RCI is greater than 1.96.

The Resolutions Approach (Turnell, 2010)(RA) in families with alleged child abuse. In this study, the actual signals of child maltreatment are mapped using the assessment form of Turnell (Turnell et al., 2009), as is the case with the Signs of Safety method.