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The Consequences of Adversity Build-up -
Child Neglect & Abuse

Interventions to Address Build-up of Adversity

When there are too many long-lasting stressors at one time, it can undermine a person's mental and physical health and become harmful. Stress, in everyday terms, is a feeling that people experience in all socioeconomic levels when they are overloaded and struggling to cope with demands. It often leads to poor parenting, child abuse and neglect.


Stress—is a common defining feature of life for almost everyone involved with the child welfare system. This is true not only for children who have been abused or neglected, but also for their parents, who in many cases have experienced toxic stress in their own childhood. Both children and their parents are usually dealing with powerful external stressors such as poverty, racism, and living in dangerous neighborhoods; these may be compounded by individual situations such as living as an undocumented immigrant, or having a sexual orientation or gender identity that is not accepted by relatives and neighbors.


Involvement with the child welfare system, with the risk that children will be separated from their family, is itself an additional source of extraordinary stress. Functioning well under these circumstances would challenge anyone, but the challenge is even greater for parents and children who have experienced toxic stress, with its implications for executive function and self-regulation.

Promoting Safe, Stable, and Nurturing Relationships as a Prevention Strategy

There is substantial evidence that promoting Safe Stable Nurturing Relationships can be effective in reducing child abuse. The most basic approach to facilitating SSNRs is teaching parents positive child-rearing, for example, forming key responsive relationships and management skills and strategies that are safe and nurturing. There is substantial evidence that parent training programs or behavioral family interventions delivered in clinical settings and focused on influencing children’s behavior through positive reinforcement are effective at influencing the child-rearing practices of families.1,2


Some evidence also suggests that these types of programs can reduce Child abuse. Parent child interaction therapy (PCIT) has also been effective in reducing physical child abuse in families who have been referred to child protective services or who are at risk of maltreatment for other reasons.  PCIT is an intensive behavioral intervention for parents and children that involves training parents on specific skills using live coaching and dyadic parent-child sessions. Each of these programs confers information and skills to parents that enable them to keep their children safer and nurture them more effectively.

SSNRs can also be facilitated by providing social support to parents and families. The availability, adequacy, and use of social support by families has long been established as an important intervention of Child maltreatment.


Evaluate the effectiveness of parenting-focused strategies for preventing Child abuse and promoting Safe Stable and Nurturing Relationships. Healthy caregiver-child relationships are fundamental in protecting children from abuse and consequently the development of children’s physical, emotional, social, behavioral, and intellectual capacities. These healthy caregiver-child relationships are not just the product of the influence and skills of parents and families, but also of the social contexts in which these relationships exist. Parenting programs can include those that teach parents or caregivers to provide appropriate physical and emotional care and manage their children’s behavior by using positive parenting strategies and non-coercive discipline strategies as well as programs designed to provide social support to parents raising children under difficult circumstances.


The effectiveness of parenting-related policies for primary prevention of child abuse and promoting SSNRs such as welfare reform and parental leave should be evaluated, paying special attention to their effectiveness in different settings and populations. Additional research areas should include moderators of intervention effects, such as differences in effects by population or methods used. This evaluation research also should document the economic efficiency of these approaches to prevention.

Evaluate the effectiveness of public and organizational policies for preventing Child abuse and promoting Safe Stable Nurturing Relationships. Public and organizational policies can play a key role in preventing Child abuse . Public policy is expressed through laws, regulations, judicial decisions, and government action. An organizational policy is reflected in the rules and regulations governing its operation. These policies can be critical in shaping the environment in which Child abuse occurs. Public and organizational policies should be evaluated to determine if they are effective in promoting SSNRs and preventing child abuse. The economic efficiency of evidence-based policies should also be determined where feasible.

1. Taylor TK, Biglan A.Behavioral family interventions for improving child-rearing: a review of the literature for clinicians and policy-makers. Clinical Child and Family Psychology Review 1998;1(1):41–60.
2. Lundahl B, Risser HJ, Lovejoy MC.A meta-analysis of parent training: moderators and follow-up effects. Clinical Psychology Review 2006;26:86–104.

3. Chaffin M, Silovsky JF, Funderburk B, Valle LA, Brestan EV, Balachova T, et al..Parent-child interaction therapy with physically abusive parents: efficacy for reducing future abuse reports. Journal of Consulting and Clinical Psychology 2004;72:500–10.

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