The influence of clinicians’ previous trauma exposure on their assessment of child abuse risk

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The Journal of Nervous & Mental Disease, Volume 198, Issue 9, pp. 614-618.

Child protection professionals face extremely difficult decisions. Child welfare services in various parts of North America have implemented standardized risk assessment models to assist child protection professionals in accurately identifying children at risk of harm. The authors argue that worker attributes, attitudes, and experiences may influence the manner in which the worker utilizes standardized risk assessment instruments. This study used standardized patients to enact a clinical situation, in order to investigate the degree to which previous experience and emotional state influence the professional judgement of child welfare workers. Ninety-six child welfare workers, ranging in age from 22 to 63 years, participated in this study. These workers were employed at 12 different child welfare offices located in a large urban centre, smaller cities, and rural communities. Participants completed a series of questionnaires relating to previous history of traumatic exposure in the workplace and current emotional state. After the workers participated in the clinical scenario with the standardized patients, they were asked to complete various risk assessment measures based on the clinical scenario including the Ontario Risk Assessment Measure (ORAM), the Ontario Safety Assessment (OSA), and the Ontario Family Risk Assessment (OFRA). Worker level of education and age were not associated with scoring on the risk assessment measures. The authors report that increased traumatic exposure, increased stress, and increased levels of post-traumatic symptoms are associated with a decreased likelihood that the worker will determine that a child is at risk. Limitations of this study include the use of clinical situations that may not accurately reflect real-life encounters. The authors also did not outline the sampling strategy utilized in this study, implying that it was a volunteer sample. The authors conclude that workers should seek consultation when making decisions about risk.

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Canadian CW research
Journal article