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This thesis offers a critical assessment of dominant child trafficking, child labour and child domestic work narratives using a case study of children in domestic work in South-West Nigeria. Based on a multi-sited ethnography spanning six months, this thesis confirms that some of these children face adverse situations in their work, but also shows that the work is characterised by many benefits for individuals without viable alternatives and functional social protection systems. The thesis contends that child domestic work cannot be properly understood and properly addressed (where it is problematic) without addressing the structures that underpin it. The perceptions and decisions of parents, children, adult caretakers, and intermediaries around the involvement of children in paid and unpaid domestic labour are examined through a post-colonial perspective to reveal that the present dominant focus on supply related factors (such as poverty and ignorance) as popularly presented is too narrow to understand the phenomenon. Instead, child domestic work is better understood through the lens of an informal support system that exists and thrives in the absence of a state welfare system to address the demand and supply factors as they affect different actors. However, the dominant child rescue narrative obscures these socio-economic contexts and complexities as they are guided by assumptions and stereotypes that in most cases run parallel to, and misrepresent, the realities of these children and/or their families. Thus, the main challenge for the child rescue narrative is not to rescue children from what it denotes as exploitative child labour or child domestic work, but from the conditions that produce it. Based on the foregoing, the thesis argues that this relates to a broader call for equity on a global scale, which includes addressing the paternalistic ideologies and institutions which underpin child rescue missions.

Children living with parents who misuse substances are a group of children who are overlooked in policy and practice. Although research has identified that parental substance misuse (PSM) can cause significant harm to children, responses in practice remain fragmented. This research set out to understand the needs of children living with PSM and of frontline practitioners in their endeavour to support these children, with the overarching aim to bridge the gap between research and practice. This research engages reflexively with qualitative research, adopting empirical creative methods, with the voices of children privileged at the centre. Guided by the principles of hermeneutic phenomenological research, seven children aged 7-16 years, participated in creative interviews, designed and analysed using interpretive phenomenological analysis with a total of four superordinate and 24 subordinate themes presented. The research design included three focus groups attended by 22 professionals, which were thematically analysed, with a total of three superordinate and 23 subordinate themes presented. Through a reflexive engagement with this methodology, the findings provide a rich and in-depth understanding of the lived experience of children living with PSM. A discussion of the findings focusses on the complexity of the lives of children, including the severity of risk factors and enduring harm. The discussion of findings also focuses on the protective factors in the lives of children living with PSM, including the value of trusted adults to mitigate and lessen the burden. The discussion presents an exploration of the systemic failings in legislation, policy and practice, set against a backdrop of continued austerity measures, outlining the need for a whole system response for children living with PSM. Through attention to the children's narrative this thesis bridges the gap between research and practice, by proposing a model, informed by children for children. Further, a training model for front-line practitioners is proposed, to improve the assessment of risk and identify the needs of children living with PSM.

Published in 2009, the Report of the Commission to Inquire into Child Abuse (Ryan Report) offered an extensive and detailed examination of twentieth-century institutional abuse, shedding light on the treatment of vulnerable and impoverished children in industrial schools, reformatories, and other predominantly church-operated institutions. Four years later, the Report of the Interdepartmental Committee to establish the facts of State involvement with the Magdalen Laundries (McAleese Report) examined Ireland's church-run Magdalen laundries for unmarried mothers and other women who it was deemed had broken moral boundaries. The Ryan and McAleese Reports were contributory to and, indeed, symptomatic of a late-twentieth-century inquiry culture and sought to facilitate a process of recognition, reconciliation, and redress. This thesis presents a collective and comparative analysis of the Commission to Inquire into Child Abuse (CICA) and the McAleese Committee, evaluating their mandate and aims, composition and powers, as well as their outcomes. Based on a close-reading of the Ryan and McAleese Reports and an examination of the response of survivors, the Catholic Church, academics, and journalists, this study identifies inaccuracies, omissions, and potential bias in the reports and questions whether the CICA and McAleese Committee consulted all available evidence and presented their findings effectively. Through a comparison of the survivor-driven CICA and the more time and cost-efficient administrative inquiry into state involvement with the Magdalen laundries, it is possible to identify a hierarchy of victimhood, reflecting the difficulty the Magdalen laundry survivors faced in gaining legitimate victim status. Beyond the report's limited and, indeed, questionable statistical analysis, the McAleese Committee's greatest failing was its inability to prioritise the statements presented by women who lived and worked in the Magdalen laundries. Consequently, while the CICA's findings have been widely accepted, the McAleese Report's narrative minimises the extent to which women were exploited and abused in the Magdalen laundries. Questions therefore arise regarding the accuracy of the McAleese Report and how far its publication contributed to wider efforts to come to terms with and learn from Ireland's institutional history.

Online grooming and sexual exploitation of children and young people is an increasing concern for parents, internet providers as well as professionals involved in safeguarding children and detecting offenders. The existing literature has reported online grooming processes as well as risk factors that are associated with victimisation and perpetration (O’Connell, 2003; Webster et al., 2012). However, there is little theoretical understanding of risk factors associated with children and young people being vulnerable to online sexual exploitation. The first part of the PhD programme included synthesising and critically appraising literature on: 1) factors that relate to adolescents engaging in risky internet use, 2) victim risk, resilience and protective factors, 3) online groomer characteristics, and 4) the process involved in an adult grooming an adolescent. These systematic reviews identified methodological and theoretical gaps in the literature and influenced the design of the subsequent empirical studies. The first empirical study explored the influence psychological, interpersonal, developmental and behavioural factors had on online sexual soliciation and exploitation. This study used a quantiative approach and collected data from university students using an online survey. The second empirical study adopted a qualitative approach and interviewed law enforcement personnel and professionals who had encountered at least one victim of online sexual exploitation. In addition, 2 victims of online grooming and sexual exploitation were also interviewed. The results highlighted that behavioural (i.e., online and offline risky behaviours), social, interpersonal and psychological factors increased the likelihood of online sexual soliciation and exploitation. This PhD also developed a typology of victims of online sexual exploitation and this includes ‘naïve / curious’, ‘chaotic’ and ‘situational vulnerability’ victims.

In 2011, three-quarters of young people reported experiencing survey-defined physical violence before turning 18 in the Tanzania Violence Against Children Survey (VACS). Physical punishment is, however, legal across all settings of children’s lives on mainland Tanzania. This ethnography focuses on the space between community perceptions and experiences of child discipline and the discourse on children’s rights. The study’s conceptual framework combines a socio-ecological model with the concept of liminality to consider policies, practices and perspectives about physical punishment within a rapidly transforming society. Data were collected April 2016 – May 2017 in a northwest Tanzania peri-urban town, with some Dar es Salaam national-level data also collected. Methods included observation, in-depth interviews, group discussions with teachers, caregivers, and children (8-12 years), and policy and media reviews. As a term, physical punishment proved more consistently understood for discussing children’s experiences of violence than corporal punishment. Physical punishment was common in the peri-urban town and mostly considered necessary. Some national rights translators, adults and children across the socio-ecological model contest the practice. Adults resisted physical punishment’s abolishment using enactments of avoidance, negotiation and/or outright rejection. Multiple childhood realities emerged along class lines with middle-class providing some protection from physical punishment. Children mostly said physical punishments were necessary for maintaining respect and obedience, but also relayed that excessive physical punishment was violence and created fear and stress that could undermine learning. This ethnography demonstrates the value of combined methods in understanding children’s daily realities and the complicated and uncomfortable relativist ethics of researching physical punishment of children. I argue that global rights discourse is not just imposed. Rather, it is resisted, debated and dynamic, occupying a liminal space within broader societal change. Resolution on use of physical punishment has not yet been reached; however, transformations are on-going which considered the best interest of the child.

Domestic violence is a phenomenon which affects a significant proportion of children across the globe. In response to its extensive scale and social consequences primary prevention emerged as a key strategy to end domestic violence. A recent shift in UK government policy resulted in statutory relationships education, for all children in primary schools in England and Wales from September 2020. As prevention education on domestic violence would be located within the relationships education curriculum this is a significant development, yet very little evidence exists regarding the effectiveness of interventions for younger children which tackle the range of issues within relationships education. This study aims to address this gap by providing evidence of the effectiveness and acceptability of a programme currently being delivered to children aged 10 to 11 in London primary schools. Eighty children participated in this mixed-method evaluation across three London primary schools: pre and post programme surveys explored children’s knowledge of programme topics and a six month follow up survey data tested for longer term effects. Observations of programme delivery examined children’s and adults’ reactions, comments and behaviours. Focus groups including 29 children, and interviews with six programme facilitators, three teachers and four parents explored perceptions of the programme and its impact. Drama-based activities emerged as an important factor in children’s engagement. Programme topics were acceptable to most children, although a minority expressed discomfort around material on sexual abuse. Improved relationships were reported amongst children in one school following the programme. Most children held existing positive attitudes in relation to: gender equality; managing conflict; peer pressure; seeking help. Improvements in attitudes were perceptible in relation to: breaking promises to friends; challenging adult authority; good and bad touch. Feminist and childhood sociological theories enabled school-based prevention programmes to be conceptualised as a tool for the empowerment of children by encouraging them to recognise and assert their rights and to actively seek support in the context of child-adult power relations. Understandings of children as dynamic social actors require programmes to employ participatory approaches which appeal to children in their current, rather than future lives. Adopting a whole-school approach through the engagement of all members of the school community would be a consequence and means of developing readiness for effective school-based prevention work.

In the 1980’s research began to highlight how adolescents who display harmful sexual behaviour and adult sexual offenders were two distinct groups with distinct characteristics. This distinction led to the development of a range of assessment tools and interventions that are tailored to the specific group’s risks and needs. The process of assessment and risk management of harmful sexual behaviour is undertaken by a variety of statutory and non-statutory services, these services have different assessment focuses creating assessments that differ in structure and content. This thesis uses a mixed methods approach to explore the assessment of adolescents who display harmful sexual behaviour as they transition to adulthood. It explores the developmental transition, risk assessment tools, the link between risk assessment and risk management and the experience of the assessment process. The qualitative research focuses on interviews with young people who have displayed harmful sexual behaviour and professionals that work with them (Police, Probation, Youth Offending Service, Social Work and Clinical). The quantitative research focuses on case file information exploring how risk assessment tools analyse risk and how the assessment tools relate to each other. This research highlights how there are challenges to assessing adolescents who display harmful sexual behaviour as they transition to adult services. There are issues in relation to strategic alignment, organisational alignment, and role and goal alignment within the assessment process. There are difficulties establishing the context for risk assessment and identifying risks associated with harmful sexual behaviour, issues with assessing and evaluating sexual risk and how risk is managed, monitored and reviewed. There are also concerns in relation to consultation, communication and intervention. These issues not only have an impact of the effectiveness of the assessment process but also have an impact on the experiences of those involved within the process. The research findings highlight key factors that could improve the effectiveness of the risk assessment and risk management processes including greater clarity about professionals’ roles and responsibilities and how create an overarching multi-agency framework. It highlights the need for a more standardised approach to assessment and risk management, with increased training for professionals and access to resources, improved monitoring and reviewing processes, and more effective communication between professionals and between the professional and the young person.

This thesis advances understandings of the historic abuse of children in care through an exploration of power and also offers new insights in relation to conceptualising power within the field of social work. Drawing on interviews with victims/survivors of historic abuse from Scotland, this thesis will argue that understanding power within the context of historic abuse is central to advancing both social policy and social work practice in this area. Furthermore, despite the existence of a plethora of knowledge on the topic of power, an exploration of power specifically in relation to the historic abuse of children in care, allows for theoretical advancements in conceptualising and understanding power within the social work context. Through an analysis of the data derived from interviews with victims/survivors of historic abuse, three key findings are presented. Firstly, it is evidenced that power in relation to the historic abuse of children in care is exercised on three interrelated yet distinct levels, namely that of the individual, professional and structural. Whilst secondly, it is shown that the exercise of such power may impact individuals in limiting, productive and simultaneously limiting/productive ways. And thirdly, it is argued that the prevailing dichotomy which features so centrally in theoretical conceptualisations of power within social work as something 'good or bad', 'positive or negative' and 'productive or limiting' is essentially false, and that power also needs to be recognised as something which may impact in a dualistic way; and therefore a new framework for 'Power Informed Practice' is offered. As a result of these findings, it is imperative that those concerned with the historic abuse of children in care, are mindful of the workings of power in how practice and policy responses are shaped.

Previous research has highlighted that child neglect is a significant factor in child deaths, and should therefore be taken as seriously as other forms of abuse. Child neglect is a multifaceted, ‘wicked’ issue, which requires a multi-dimensional response from many professionals. With such multi-dimensional perspectives, however, arise difficulties in defining the problem and agreeing solutions. The aim of this study was therefore, to examine how guidance about child neglect is passed from government to the Local Safeguarding Children Boards (LSCBs) for local implementation and coordination. The study adopted a qualitative, multiple case study approach, and used semi structured interviews. It used a governance network model to discuss and present the findings. Research findings indicate that child neglect messages coming out from government are disjointed, inconsistent and often unclear, making it difficult for LSCBs to develop a clear and informed understanding of the policy problem. In turn, LSCBs do not have a dissemination strategy for transferring their neglect messages to operational and front-line practitioners. This is often an ad hoc process, and responsibility for disseminating guidance disappears once the send button has been pressed. Furthermore, front-line practitioners did not perceive email as being the most effective format for communicating guidance, preferring instead face-to-face forms of knowledge transfer.

The overarching aim of this thesis is to explore child sexual grooming offences, particularly the offence actions and offender characteristics associated with contact versus non-contact outcomes. This work makes use of two samples of child sexual grooming police case files, which have been content analysed to form quantitative data sets that have been subsequently analysed. The first sample consists of 95 No Further Action (NFA) grooming cases from a single UK Police force. The second sample consists of 136 grooming cases taken from range of police forces across England and Wales. In total, six studies have been conducted. First, a systematic review of the offence action and offender characteristic differences between contact and noncontact child sexual grooming offences. The findings of this review indicate that while differences exist, there is a large amount of disagreement between studies. Second, a comparison of online versus offline grooming offences was conducted, indicating several similarities and differences. While it appears as though the offence process is similar across contexts, the outcomes of the process appear to be different. Study three is a typological study utilising the newly established MCA-CA-DFA approach to examine variation in child grooming offences. A two-dimensional model was established, indicating that grooming offences could be classified on whether they had contact or non-contact outcomes, and a personal or impersonal style. Finally, studies four, five and six sought to examine the offence action and offender characteristic differences between contact and non-contact child sexual grooming offences. Study five made use of the first NFA sample and found that contact offences were more likely to be initiated offline, involve a receptive victim, and to not involve the taking/receiving of indecent images. Study six sought to replicate the findings of the previous study using the second sample, however the only consistent finding was that offline-initiated offences predict contact outcomes. As both studies indicated a large effect of offline initiation, a concern that effects specific to online initiation were being overshadowed. Consequently, study six involved another replication, however this time using a combined sample of all the online-initated cases from both samples. Findings indicate that in online-initiated grooming offences, the development of a boyfriend/girlfriend relationship was the only significant predictor of contact offence outcomes. Overall, this thesis makes several contributions to knowledge. Firstly, the systematic literature review collates and critically appraises the current knowledge on the differences between contact and non-contact grooming offences to identify gaps within the literature. As part of this review, a high degree of conflicting findings were found. Therefore, the second contribution of the thesis involves a validation of these previous findings to highlight which findings have the most support. Thirdly, the research has contributed to knowledge by conducting research using authentic offender-victim grooming offences. A large body of the previous literature makes use of offender-decoy samples obtained by vigilante organisations. This is problematic as the actions and reactions of these decoys may not reflect genuine victims, potentially altering offender behaviour. By conducting research using a sample of offender-victim cases, this can indicate how reliable this previous offender-decoy research is. Fourthly, a new typology of child sexual grooming offenders has been constructed using more robust methods than those that have previously been used in the literature. Finally, the research has identified a number of variables that may be useful in the prediction of contact versus non-contact child grooming outcomes that have not previously been acknowledged; including victim receptivity, different forms of sexual communication, and evidence of co-offenders. These contributions also have a number of real-world implication, such as educating law enforcement on the typical signs that predict contact sexual offences in grooming cases, which would allow them to prioritise investigations.

The aim of this research is to explore the impact of childhood emotional abuse on mental health in Saudi Arabia. The research focused on understanding how adults relate their experiences of emotional abuse in childhood to their mental health status. The aim of the study is to enable adults who have experienced mental health problems and childhood emotional abuse in Saudi Arabia to tell their stories and express their opinion as to whether, in their understanding, their experiences of childhood emotional abuse have impacted on their mental health problems in adulthood. The study explores three main issues. These are the relationship between the experiences of childhood emotional abuse and the impact on mental health in adulthood, the barriers that people who have experienced mental health problems and have a history of childhood emotional abuse face when seeking help, and any potential recommendations for policy and practice to improve health and social care responses in mental health settings for adults who have experienced childhood emotional abuse. Semi-structured narrative interviews were undertaken with twenty adult survivors of childhood emotional abuse (ten male and ten female) aged between 16 and 45 years who are currently receiving outpatient treatment at the Mental Health Unit of King Abdulaziz Hospital in Riyadh, Saudi Arabia. The participants were asked to describe the abuse they experienced in childhood and their present mental health. The participants were also invited to discuss whether they felt that the abuse they had experienced had any bearing on their mental health in adult life. The interviews undertaken with the study participants were then analysed thematically. As such, key themes were identified that occurred throughout these narratives and these themes were considered in relation to the relationship between the abuse the participants had experienced in childhood and their present mental health. It was found that there was a strong relationship between the experience of childhood emotional abuse and mental health problems including depression, anxiety, post-traumatic stress disorder (PTSD), and suicidal ideation in adulthood. It was also apparent that adult survivors of childhood emotional abuse tended to socially isolate themselves and retain a sense of victimhood in adulthood. The last finding could be attributed to particular aspects of Saudi culture as the patriarchal nature of Saudi society was found to encourage a sense of victimhood and reinforcement of low status amongst victims of childhood abuse. Importance and Relevance: The prevalence of child abuse in Saudi Arabia and the lack of sufficient understanding of how such experiences affect an individual's mental health status are the main reasons why the current study is important. Unlike earlier studies on child abuse in Saudi Arabia and its effects, this study gives a unique perspective as its approach involves understanding the topic through the descriptions of people who have mental health problems and who have experienced childhood emotional abuse. By understanding how such individuals relate their childhood experiences to their current mental health status, this study provides important insights that can help policymakers to adopt better approaches to improve the lives of people affected by childhood emotional abuse, and poor mental health in adulthood.

This thesis explores the extent to which existing national transitional justice policy frameworks structuring reintegration and integration interventions enable the effective or successful integration of children born in captivity (CBIC) in Uganda. These children were born to females subjected to ‘forced marriage’ to Lord’s Resistance Army soldiers while in captivity. Now living among the post-conflict communities of integration, the CBIC experience unresolved problems of stigma and discrimination. The thesis attributes part of the reason for this to a failure to distinguish between integration and reintegration as distinct processes in both academic analysis, policy and practice. Therefore, this thesis argues the need to distinguish between the processes, and contributes by developing a framework that can help the understanding of integration as experienced by Uganda’s CBIC. Secondly, the thesis responds to the scarcity of information on how reparation can address the plight of these children by suggesting a broad approach. This approach would enable both recognition and redistribution in response to the integration plight of CBIC living in Uganda. Therefore, this thesis has implications for academia, policy and practice. Empirical research was conducted among three post-conflict communities in Uganda using a combination of qualitative research methods in in-depth fieldwork that explored the integration of these children. The findings were analysed using qualitative content analysis and the outcomes presented in two sets of empirical chapters – one on integration and the other on reparations claims for these children. The empirical chapters from the three sub-regions consulted reflect the relevance of ensuring effective or successful integration for both CBIC and post-conflict communities of integration. The thesis concludes with the claim that, in fragile contexts where suitable transitional justice options for CBIC are not considered or adopted, existing policy and programme interventions encourage only a ‘shallow and unsustainable integration’. This requires a distinct conceptualisation and response to integration to enable the interventions to respond to the specificities of CBIC as beneficiaries of the process. By contrast, when reparations address the needs of CBIC, they foster recognition and redistribution, thereby leading to an improvement in integration towards a deep and sustainable state.

Background: Non-offending caregivers (NOCs) of children who have disclosed sexual abuse have a vital role in supporting their child post-disclosure. Nevertheless, research indicates that NOCs experience clinically elevated levels of distress, which may impact their ability to support their child. Despite this, services have been found to often overlook the support needs of NOCs and there are gaps in the literature around NOCs' own experiences and distress post-disclosure. This research portfolio aimed to address these research gaps in two parts: 1) a systematic review investigating what key factors have been found to be associated with NOCs' psychological distress; and 2) a mixed-methods empirical paper exploring NOCs' post-disclosure experiences, with secondary aims to investigate their help-seeking experiences and the psychological construct 'mentalization' in this population. Method: A systematic search of quantitative literature was conducted to identify papers exploring the association of key factors, such as psychosocial, environmental, personal, familial and abuse-related characteristics, with NOCs' psychological distress. An appraisal tool was used to assess the quality of the studies. The empirical paper adopted a predominantly qualitative mixed-methods design which primarily involved an in-depth exploration of the post-disclosure and help-seeking experiences of NOCs via interviews, with mentalization being measured via a questionnaire. Grounded theory was used to integrate these findings into a model illustrating the themes derived from the data. Results: The systematic review indicated that psychological factors, such as cognitive processes, as well as social and environmental factors, such as social support, had the most evidence for being associated with distress. The evidence was weaker and the findings were more contradictory for the associations between other factors and psychological distress, including NOCs' abuse history, abuse-related factors, and child and parent characteristics. The empirical study's grounded theory model centred around core categories of NOCs' perceptions of feeling out of control and isolated. These linked to other themes around the parental role, including parental self-efficacy, as well as the importance of feeling listened to and supported by the wider system, including services. Quantitative mentalization scores were linked with emotional expressiveness in interviews. Qualitative themes related to mentalization were indicated to be linked to NOCs' distress in the more immediate disclosure aftermath. Conclusions: While tentative inferences can be made from the systematic review about the most important factors associated with NOCs' distress, methodological issues in the studies made it difficult to draw firm conclusions. For example, the predominantly cross-sectional nature of studies and their exploration of factors in isolation meant that a more in-depth understanding of interactional processes over time was not possible. The grounded theory model suggests that NOCs have complex multifaceted experiences post-disclosure, characterised by interacting processes linking to their distress. These are not fully accounted for in existing theories of secondary traumatization. Clinical and future research implications are discussed.

Childhood maltreatment is one of the most potent predictors of future psychopathology. While progress has been made in documenting a number of cognitive and neurobiological mechanisms that might underpin this association, investigations to date have focused on a limited number of domains. The primary aim of this thesis was, therefore, to advance and extend our understanding of the neurocognitive domains that may contribute to increased psychiatric vulnerability following childhood maltreatment. In the first empirical chapter (Chapter Two), using a model-based fMRI analytic approach and a probabilistic passive-avoidance task, we showed that childhood maltreatment is associated with recalibrations in the neurocomputational processes that underlie reinforcement-based decision-making. These are expected-value representation and prediction-error signalling to reward and punishment cues. In Chapter Three we showed that altered brain responses to threat (in the form of heighted amygdala reactivity) and an increased propensity to experience stressful life events predict future internalising symptoms among individuals with a history of maltreatment. In Chapter Four we found that experiencing maltreatment during childhood is associated with difficulties in imagining specific and detailed possible future scenarios ('Overgeneral Episodic Future Thinking'). In Chapter Five, a history of maltreatment was linked to deficits in interpersonal problem solving skills - this, in turn, contributed to the association between maltreatment and poor mental health. The findings of this thesis increase our understanding of how childhood maltreatment impacts neurobiological, cognitive and social functioning in ways that may potentiate subsequent risk of psychopathology. In the longer term, it is hoped that these findings will contribute to the development of screening tools and novel preventative clinical approaches that could foster a resilient outcome for those maltreated individuals at greatest psychiatric vulnerability.

A systematic narrative literature review explored views of young child sexual abuse (CSA) survivors whose abuse was unknown to authorities, about confidentiality. Due to paucity of research, the review included literature about sexual health service users. Seventeen databases and eleven journals were searched and thirty-three papers were identified. Analysis involved exploratory interpretist approach focusing on emergent themes and methodologies. Findings indicated limited participation and that young people want; (i) confidentiality (ii) control of their lives and (iii) they fear child protection agencies. Empirical research then explored views about confidentiality with young CSA survivors whose abuse was unknown to child protection agencies. Eight survivors engaged as co-researchers in participatory action research utilising a mixed methods approach; using surveys, focus groups, online chats, graffiti walls and interviews. One hundred and forty survivors participated. Age range was 11- 30, with 25 males, 114 females and 1 gender neutral. Researchers designed tools, gathered and analysed qualitative and quantitative data using a social construction thematic approach. Results found (i) all participants wanted higher confidentiality, with males and under 16's demanding highest confidentiality (ii) males were reluctant to disclose CSA compared to females (iii) abuse retractions were related to loss of confidentiality (iv) involvement as co-researchers was positive and empowering. With limited confidentiality the identified themes for young people were: fear of consequences, lost control, abuse retractions and protecting abusers. With high confidentiality themes were: talking openly, control, empowerment, exploring options, respect and being believed. Young researchers reported improvement in self-esteem and positive life changes. Conclusions: Young CSA survivors whose abuse was unknown to child protection services want higher confidentiality to build trust and be able to talk about abuse; and involvement of young people in participatory research is positive and empowering. Recommendations: There appears to be a need for increased confidentiality if young people whose abuse is unknown to child protection services are to disclose their abuse. Further participatory research is needed to explore whether other groups of young people unknown to services report similar and/or different needs.

Background: Child sexual abuse (CSA) is prevalent worldwide and represents a significant public health burden given the adverse outcomes associated with it. While CSA has been linked to multiple adverse outcomes, including poorer mental and physical health, it has also been linked to women's subsequent parenting of their own offspring. Objectives: This thesis seeks to 1) synthesize existing literature on the association between CSA and the subsequent parenting practices these women engage in; 2) determine what mechanisms may underlie this association, according to the existing literature; 3) determine what parenting interventions are currently available for mothers who experienced CSA (MCSA) and if these interventions are efficacious; 4) conduct surveys with a diverse sample of MCSA to determine how they perceive their experiences to have affected their parenting, what they may want from an intervention to address any consequences of these experiences, and to determine how they define CSA. Methods: To address objectives one and two above, a series of linked systematic reviews of the existing qualitative and quantitative literature on the association between CSA and the subsequent parenting practices of these women were conducted. Potential studies were located through seven academic databases, a review of the grey literature, by reviewing the reference lists of included studies, and by reviewing the titles of studies that cited studies included in this review. Results were divided into three papers by study design (qualitative or quantitative), and the quantitative results were further divided by content (whether parenting was abuse related or non-abuse related). Qualitative data were synthesized using thematic analysis, while quantitative data were narratively synthesized. To address objective three, a systematic review of existing evaluations of interventions for MCSA was conducted. Potential studies were located by searching nine academic databases, grey literature, the reference lists of included studies, and the titles of studies that cited studies included in this review. To address objective four, and to fill gaps in the existing literature identified in the systematic reviews, an online mixedmethods survey was created to assess the past experiences, mental health, and parenting of MCSA. Further, as part of this survey, MCSA were asked about what they may want from an intervention designed to address their experiences and how they would define CSA. Results: Results related to objective one indicated that CSA affects the parenting behaviors of MCSA. Specifically, qualitative results of the review found that MCSA desire to protect their children from abuse. Despite this, many did have children who experienced abuse, with abuse being perpetrated by both the mother and others. CSA was also perceived to both positively and negatively affect the mother-child relationship, breastfeeding, child-rearing practices, perceptions of their child, and perceptions of motherhood. Additionally, MCSA discussed aspects of the parenting experience that helped them cope with their past CSA experiences. Quantitative results also found associations between CSA and the parenting behaviors listed previously, though much heterogeneity existed, especially with results related to general parenting. In most instances, significant findings were in the expected direction, with MCSA experiencing more parenting difficulties than Mno-CSA. However, in several instances, MCSA were found to have fewer parenting difficulties than Mno-CSA. Mechanisms that may explain the quantitative associations (objective two) included mediators and moderators, such as mental health, physical health, and substance misuse. Theories prominently used to explain this association in the qualitative and quantitative literature included attachment theory, trauma theory, systems theory, and social learning theory. Only four interventions have currently been evaluated to address the parenting needs of this population (objective three). The majority of these evaluations had small sample sizes, lacked a comparison group, or contained components lacking a sufficient evidence base. The mixed-methods online survey was completed by 35 women recruited from a diverse range of organizations (objective 4). MCSA reported that many aspects of their parenting, including the ones described previously, had been affected by their CSA experiences. Perceived effects of CSA on parenting often did not vary based on demographic characteristics, mental health, and specific aspects of the CSA experience in subgroup analyses. MCSA reported being open to interventions to address their experiences, suggesting that these interventions provide information related to parenting and take place in a group setting. Finally, MCSA provided their own definitions of CSA (objective 4). These definitions often included both contact and non-contact forms of abuse, defined a child as being under 16 or under 18, and did not require the perpetrator to be a certain number of years older than the child, a definition often used in the literature. Conclusions: The reviews in this thesis represent the first attempt to synthesize the vast literature on CSA and the subsequent parenting of mothers who have had these experiences. These reviews informed the primary research conducted as part of this thesis, allowing gaps in the literature to be filled. Ultimately, studies in the four systematic reviews (270 studies reviewed in total) and online survey demonstrated that experiences of CSA can negatively affect parenting behaviors, with these findings being demonstrated both quantitatively and qualitatively, though there was significant heterogeneity in the quantitative studies. Given the pernicious effect that CSA can have on parenting for some MCSA, and the potential negative effect that parenting difficulties can have on the children of these women, it is critical that interventions address these issues. Further, given issues surrounding the definition of CSA found throughout this thesis, efforts should be made to standardize this definition. The results of this thesis form a strong basis for the development of future parenting interventions and research with this population.

This thesis examines whether the risks associated with child maltreatment have changed over time in the UK; investigating changing risks at the societal and individual level. By adopting a unique socioecological approach, the thesis aims to determine whether: (a) the national incidence of child maltreatment has changed over the last 150 years, and (b) the impacts of child maltreatment on the risk of antisocial behaviour change across an individual's life-course. The following methods were used to address these research aims and overcome challenges in child maltreatment research: multiple measures of child maltreatment, pre-existing sources of historical epidemiological data, observational study designs, and analytical methods that are sensitive to repeated measures (e.g. time series analyses, latent growth curve analyses). Research included developing a novel data source on the incidence of child maltreatment over time (iCoverT data source), examining long-term trends in child maltreatment from 1858 to 2016, and analysing 50 years of longitudinal data from the 1958 British birth cohort study. Results from examining societal risk over time showed that long-term trends in the incidence of child maltreatment have decreased since the 1850s. However, more recent trends have increased since 2000, especially for child protection registrations for emotional abuse and neglect. Results from examining risk across an individual's life-course found that child maltreatment is associated with an increased risk of antisocial behaviour, with a persistent and stable association remaining up to 50 years old. Together, these findings demonstrate the long-lasting burden of child maltreatment at the societal and individual level. This thesis makes an important contribution to the literature by highlighting the role of time and epidemiological research methods in better understanding child maltreatment, and helps identify future directions for reducing the burden of child maltreatment.

There is a great deal of research into multiple aspects of childhood sexual abuse, including prevalence, effects, treatment and recovery. However, very little research focusses on the knowledge held by people who have experienced CSA, and far fewer studies are designed by people who have experienced it. This thesis outlines insider designed and delivered research. It employs a salutogenic approach to examine what helps and hinders recovering. These issues are explored through thematic analysis of a qualitative survey (n=140) and 21 interviews. Participants described three types of harm caused by the abuse they had experienced, including physical and mental health consequences but also an underlying, enduring sense of danger. The results demonstrate that adults who have experienced CSA are active in their recovering, which they conceptualise as a movement towards health and well-being, rather than a binary of either being ill or well. Health services were very useful, particularly counselling and therapy. Respondents also valued personal relationships and interactions in supporting recovering. Finally, they described a sense of flow, a pleasurable absorption in a task, as being highly beneficial. However, they also described the ways in which society, at every level from micro to macro, inhibited recovering. Thus, they called for fundamental societal change, challenging destructive discourses around CSA and inhibiting structural issues. Further research is required to establish if these beneficial actions and challenges apply equally to individuals who identify as being in earlier stages of recovering.

Background Nationally and internationally, there has been a growing recognition of the importance of identifying, documenting and reporting suspected and confirmed child maltreatment. Formally collected data on the extent of child maltreatment in social services and criminal justice records are likely to be an underestimate of actual cases. Aims The aims of this study are firstly to introduce the problem of child maltreatment. Secondly, to explore mothers, care-experienced young people and professional attitudes regarding the collection and linkage of maltreatment data for research. Thirdly, to investigate how markers and risk factors of maltreatment relate to outcomes that may indicate maltreatment, and to illustrate this using case studies. Methods The study involves formally reviewing the background to each research question by structured literature review. The study takes a mixed-methods approach. Secondary regression analysis of data explored potential risk factors and markers of outcomes that may indicate maltreatment. Exploratory focus group interviews with mothers, care-experienced young people and professional stakeholders were conducted. Findings When exploring mothers, care-experienced young people and professionals’ attitudes towards collecting and linking maltreatment data for research three major themes were identified:consent, trust and understanding. Mothers with outcomes that may indicate maltreatment in their child were more likely to have higher parental stress, be more deprived, and show their child negativity. They were also more likely to have a child attending A&E with a nerve, contusion, head or ano-genital injury, with a congenital abnormality, and themselves had a higher number of antenatal check-ups. When collecting data on child maltreatment researchers should not utilise a dataset containing a subset of participants as the main population. They should not utilise a dataset less complete than another, and be mindful that self-report may be less reliable than routinely collected data. Case studies were useful in gaining a deeper understanding of the pattern of variables that could be related to outcome.

(1) Childhood Physical and Sexual Abuse as Predictors of Reoffending: A Systematic Review Abstract: Background: Experiences of childhood trauma, such as physical and sexual abuse are common among offender populations, and a trauma history is related to increases in the risk of criminal conduct. Previous reviews on the link between childhood trauma and reoffending are limited in scope as they only investigate adolescent populations. Objective: The aim of the current systematic review was to explore the association between childhood physical and sexual abuse and its prediction on actual reoffending rates in adult population(s). Method: Four databases (PsycINFO, Web of Science, PubMed and PILOTS) were searched and the final included articles were quality assessed by two reviewers. Results: 3,151 studies were identified, and 13 met the a priori eligibility criteria. Most of the studies obtained high quality ratings. Conclusion: A narrative synthesis of the results suggest that childhood physical and sexual abuse are generally high among the prison population and tend to be even higher among those who reoffend. A substantial number of studies found that childhood physical and sexual abuse predict reoffending, and the majority of the studies found a positive direction for this association, albeit of a small magnitude. These findings suggest that prisons should consider trauma-informed assessment and rehabilitation of offenders. (2) Childhood Trauma as a Predictor of Reoffending in a Northern Irish Probation Sample Abstract: Background: It is well-documented that there is a high prevalence rate of childhood trauma experiences among the prison population, and studies have found a link between childhood trauma and later acts of violence. Objective: The aim of the current study was to investigate whether childhood trauma (i.e., physical, sexual, emotional abuse and physical neglect) among offenders who have served a life sentence in Northern Ireland was associated with general and violent reoffending patterns. The study also explored the relationship between childhood trauma resulting from the sectarian conflict “The Troubles” in the region and its impact on reoffending. Method: The casefiles of 100 offenders were coded for trauma experiences and official reoffending data was extracted. Logistic regression analysis was performed to explore the relationship between trauma and reoffending. Results: The most common form of childhood trauma were emotional abuse and/or emotional neglect (n=43), conflict-related trauma (n=43) and physical abuse (n=40). Only age (OR .91) and conflict-related trauma (OR 5.57) emerged as significant predictors (p < .05) of general reoffending at any time post release. Similarly, only age (OR .92) and conflict-related trauma (OR 4.47) emerged as significant predictors (p<.05) of violent reoffending. Although it did not reach significance (p = .09), childhood physical abuse was related to an increase in the odds of violently reoffending, of a large magnitude (OR 4.09). Conclusions: Conflict-related trauma significantly predicted general and violent reoffending among offenders with previous violent convictions.

The present study seeks to explore young Turkish people's exposure to domestic violence during childhood. In doing so it examines their perspectives, the impact of domestic violence on their behaviour and psychological wellbeing, their coping strategies at the time of violence and in its immediate aftermath and it also considers their ideas about possible intervention by support agencies and protection measures. This is a qualitative study, which draws on feminist theory, which centralises gender within the power and control framework, to understand the complex nature of domestic violence. This thesis applies the concept of intersectionality to explore the impacts of intersecting social categories on young people's experiences. In addition, social learning theory, which sees children as passive victims, and sociology of childhood perspectives, which see children as active agencies, were adopted to explore how young people develop perspectives, responses and coping mechanism. The findings from in-depth interviews revealed that young people perceived the externalizing and internalizing impacts of exposure to domestic violence on their well-being and behaviours including depression, anxiety, low self-confidence, powerlessness, worthlessness and aggression. Findings outlined that domestic violence is considered a private issue and is most likely perpetrated due to gender inequalities and male domination in a Turkish context. Domestic violence is internalised by young people as a way to discipline a wife. Findings showed that complex interaction of factors shapes coping strategies; hiding, saving siblings, calling outside help, leaving home, involvement, marrying in early ages and pretending like a male. The young people also stressed the need to develop parentfocused and child and young people focused strategies to support people of victims of domestic violence. Finally. They highlighted the importance of schools to improve awareness and develop initial support for young survivors of domestic violence and reformulating gender roles to eradicate the issue.

Commercial Sexual Exploitation of Children (CSEC) is a serious violation of the Human Rights with global and local implications. The multidimensionality of CSEC requires us to understand its historical elements, legal definitions, and psychosocial characteristics. International agencies, states, and national agencies (statutory and voluntary sectors) have agreed on an agenda of responses including research on CSEC, partnership and collaboration, legal changes and adjustment, promoting criminal prosecution, social policies and interventions for children and young people that have been made subject to CSEC. These interventions are diverse in their approaches, purposes, types of services, models, and critical points. In accordance with international agreements, the Chilean State recognised CSEC as a social problem and developed social policies, legal changes and intervention programmes across the country. In this context, practitioners have built a 'know-how' of social intervention in CSEC based on technical guidelines (social policy on CSEC), institutional directions and pragmatic decisions from fieldwork reflexivity. However, there is no clear evidence about the rationale, models, practices, strategies and critical points in the interventions and weakness in the monitoring and evaluations. Applied Discourse Analysis was conducted to explore the relationship between different levels of social intervention on CSEC: policy, intervention models and practices. The research purpose was to describe, understand, and analyse the programmes of social intervention in CSEC, the social intervention models, and the interdisciplinary practices in Commercial Sexual Exploitation of Children, implemented in the decade of 2004-2014 in Chile. Government and alternative documents were analysed (13 each), discussion groups with interdisciplinary professional teams in CSEC (3), and a focus group (1) composed of policymakers, academics, researchers, police and judicial representatives was undertaken. These materials were data-managed and analysed using the software dedoose. All University of Edinburgh Research Ethics procedures were followed. The findings indicate that Government documents highlight two discursive styles: Mandatory and Pragmatic, regarding the intervention and the approaches used. These discourses (1) defined the interventions as a part of a system or building a network of services, (2) established a condition of the intervention that recognised children as a subject of law or recognised the specialised character of the intervention, and (3) based interventions on guidelines and ethical principles or challenges, and evidence-based approaches. Alternative documents developed a discursive style of Monitoring and Evaluation that emphasised (1) the complexity of CSEC and the need to develop responses, (2) then recognised challenges such a making visible CSEC and problems with the interventions; and finally (3) recommended the basis for the intervention. Mixed Stakeholders group (1) emphasised CSEC characteristics, and the institutional responses (2) specified the structure of the intervention, and (3) identified tensions and challenges in the adjustments of social policies and intervention practices, methodological needs, and the judicial system rationale and practices. These findings are significant because they help us to understand the processes involved in building appropriate and situated responses for children and young people that have been made subject to CSE on a local, regional and global level.

Identifying those at risk of harm is a critical issue in safeguarding victims and their children from domestic abuse. Research shows that aggression and impulsivity relate to domestic abuse perpetration, however there is a gap in the literature in how those constructs could be applied to victim-perception risk assessments. Furthermore, considering the high numbers of children that are present within families experiencing domestic abuse, there is a gap regarding the potential contribution these children could make in risk assessment procedures, particularly to ensure their voices are included. The aim of this project was to provide an original contribution to knowledge by exploring these gaps with a view to informing the risk assessment literature and practice in the UK. Through use of mixed methods, this project conducted three phases of study. Analysis from the first study revealed a complexity of domestic abuse lived experience via five superordinate themes, within them showing participants could recognise their abusive partners’ aggressive and impulsive behaviours, as well as revealing that they could recall an array of risk management techniques they used in order to minimise risk, these recollections were more tangible than recalling their feelings of risk. The second phase of study measured impulsivity using the Barratt Impulsiveness Scale (BIS-11) and aggression levels, using the Buss-Perry Aggression Questionnaire (BPAQ) and the Aggressive Acts Questionnaire (AAQ; Barratt, Stanford, Dowdy, Liebman, & Kent, 1999) in 113 participants’ self-reports and their reports on their partners. Important differences were found, with those who experienced domestic abuse measuring their abusers as significantly higher on the BIS-11, the BPAQ and the AAQ, than those who had not experienced domestic abuse. The family case study phase revealed powerful themes regarding a family’s shared experience of domestic abuse. The use of sand tray and art-based play with children, aided by rapport building techniques, provided them with the tools they needed to explore their experiences and talk about them in a non-direct and non-intrusive way. This resulted in their disclosures of witnessing abuse between their parents, as well as internalising and externalising behaviours being apparent. Taken together, the findings from the three phases of study expand our knowledge of domestic abuse victims’ perceptions of risk, impulsivity and aggression in their abusive partners. It is suggested that victim-perception risk assessments would benefit from the addition of impulsivity and aggression items, as well as rapport building and play techniques being an ideal method for practitioners to elicit important risk assessment information from children.

There is a substantial body of research on the nature of child neglect, its impact on children and how professionals respond. National initiatives have promoted early help to prevent escalation of family problems more generally. Research has begun to bring these strands together to examine early help in the context of child neglect. This small scale qualitative study investigates early help for families where there is neglect of young children. Taking a social constructionist approach, it explores the experiences of families where there has been child neglect, and of practitioners and community members who work with them. Thirty-five participants took part through five focus groups (practitioners and community members) and five semi-structured interviews (parent/carers) to examine how people understand the constructs, how services respond to different early levels of neglect, factors influencing access to early help and possible improvements in how help is provided. Data is analysed using NVivo11 software, and thematic network analysis. Interpretation of findings draws upon ideas from ecological analysis and street level bureaucracy. A change of work role for the author part way through permits comparison of researching as an insider and as an outsider. Practitioners and community members show broad understanding of neglect with community members showing more clarity about emotional neglect. Parents see the issues as reflecting the practical challenges they face rather than being about neglect as such. Inhibiting factors preventing earlier help are outlined for parents (fear of their children being removed, lack of awareness of the need, not knowing what help is available) and for practitioners (workload pressures, a ‘referring-on’ culture, achieving parental commitment). Practitioner groups recognise and respond differentially to different early levels of neglect without any shared overall model for early help. The dual researcher roles (insider and outsider) identified lessons for organisationally based research. Implications for children’s services practice and for further research are outlined.

The research reported in this thesis aims to evaluate the current child safeguarding practices adhered to by practitioners to identify and respond to deception in parents and carers. The thesis also aims to establish whether any developments in professional practice could contribute to the reduction of child homicide and serious abuse. This study employs a qualitative approach drawing on secondary data from Serious Case Review (SCR) overview reports, and on primary data through interviews with key participants and frontline child safeguarding professionals in England and the United States, as well as ethnographical observational fieldwork. Although this thesis primarily focuses on the work of practitioners in police, social and health care services in England within the scope of their roles in child safeguarding, the experiences of child safeguarding professionals in the United States are drawn upon to provide an insight into any alternative strategies to deal with potentially deceptive parents. This current research reveals that amidst the widespread occurrence of deceit, child safeguarding professionals are well attuned to it on the whole and are largely aware when they are being lied to by parents. Although no specific deception detection training is offered to professionals to assist them to detect parental deceit, a combination of approaches, including intuition, verbal and nonverbal signs of deception, as well as practice wisdom, are employed by these professionals to help them recognise the signs. It is the professionals' subsequent response to the deceit that determines the effectiveness of their decision-making, and the extent of interventions in relation to the child. The research has revealed serious and concerning deficiencies in the response to parental deceit. The differentiated response by professionals to suspected or confirmed parental deception is underpinned by organisational values and ethos, but is largely actioned through the paradigm of relationship-based practice and the 'working with families' culture.

Understanding and responding to the complex causes and effects of children’s experience of neglect is a challenge for society and government. Judging its chronicity, severity and impact on children and delivering timely and proportionate services, are core functions of statutory social work. This thesis examines how assessments and decisions are made in neglect cases. Its findings draw on the narratives of social workers and team managers based in two Welsh local authorities. The practitioners are consistent in describing the organisational parameters and imperatives, and their experience of delivering their roles and responsibilities. They acknowledge the environmental pressures that influence how parents live and behave, and the histories and circumstances that contribute to their limitations as parents. They are much less clear about the effect on their practice of the partially resolved, inter-related practice-moral phenomena such as cause and effect and agency and responsibility. The practitioners recognise that critical decisions about children’s futures are founded on how they and the parents exercise their respective proxy and individual agency. The family-professional relationship is characterised as seeking a complementary approach to meeting common goals through co-agency. The location of the practitioners’ work with families lies somewhere between their designation of just good enough parenting and causing significant harm, focusing on the immediate presentation, and making judgements about the directions of the case and the allocation of limited resources. The impact of poverty and intergenerational/community deprivation on the parenting and the children is described, but not approached, as issues that social work can tackle beyond the immediate family. The practitioners generally accept the focus of their practice as located at the point of children’s greatest need and risk. Whether due to political and budgetary constraints, or organisational incapacity for change, the status quo for social work has settled on a high plateau of intervention.

At a time when nations and states across the world are critically examining historical childcare practices, it may be overlooked that until the late 1980s, there was little public awareness of the abuse of children in public care. Since then, despite public inquiries, autobiographies and scholarly writing, little research has explored the influence of such experiences on care leavers'€™ lives. This study sets out to address this. Fourteen adult care leavers shared personal narratives of childhood experiences in residential care between 1915 and the early 1970s and adult lives thereafter. Experiences varied widely but narratives converged in that all identified themselves as having encountered what is now known as historical institutional child abuse. Most identified this as having impacted varyingly on personal identity, self-confidence, adult relationships and emotional wellbeing. This study explores survivors' narratives and the process whereby they made meaning of experiences of historical institutional child abuse over the course of their lives. To fully understand survivors' narratives, it was necessary to consider a number of contextual factors. Interviews with ten participants from service provider agencies helped explain the obstacles encountered by survivor participants in completing their life narratives while literature illuminated the changing constructs of childhood, child abuse and children's rights; changes in law, the developing notion of transitional justice and the process whereby historical institutional child abuse has come to be perceived as historical injustice. These have been influenced in turn by processes associated with late modernity, which impacted on personal lives and service providers' systems and practice. Arguably what has been the public narrative of the care of vulnerable children in Scotland historically is now being challenged by survivors' narratives. This study offers lessons for practice, in respect of survivors of historical institutional child abuse and children in care today.

This study charts and describes, within a live and emergent environment, how a large organisation responded to the requirements of the Scottish child abuse inquiry. Using action research and a records continuum perspective, the study explores the role of records and the issues identified by previous research and care leaver communities about their importance, existence and use. Framed using the Heideggerian concept of records as tools - present-at-hand and ready-at-hand - the study explores the management of identifying record sources and record types that exist, the purpose these records provide through their content, and how they function formally as evidence. Difficulties inherent from the historic eighty-year scope and the issues with accessing a national and organisational memory are described. The legal and moral aspects of recordkeeping are highlighted as having equal importance for the state in its legislative and regulatory role, and for care providers in their statutory role as corporate parents. The emerging themes whilst centred on records and their accessibility, meaning and use, also draw on the experience of witnesses and organisational stakeholders within the context of the inquiry and organisation, their multi-disciplinary, attitudinal positions and the timescales involved in the processes. For the care leavers, state legislators and institutional corporate parenting bodies of the past, the present, and in the future, their dependency on the legal and moral dimensions of recordkeeping as a national and institutional narrative is key. The study supports the conclusion that recordkeeping is fundamental in enabling our society to fully understand and come to terms with the past, understand the present and prepare for the future.

In the United Kingdom (UK), revelations of child abuse on an unprecedented scale have led to calls for better detection methods. Paramedics are invited into private households and are uniquely positioned to assist with this. This study aimed to explore the role that paramedics may play in child protection with a view to informing paramedic policy, education and practice. Literature contains few empirical studies on paramedics and child protection. Legislation and policy documents acknowledge their potential contribution, but data is scant. Research is needed on their actual involvement, level of knowledge and skills. This study, undertaken in one UK ambulance service, employed a sequential mixed method design of two phases. In Phase 1, paramedics (N=276) completed a survey on their experiences, perceptions and attitudes. The resulting data informed Phase 2: paramedic focus groups (N=7). Discussions were thematically analysed. Carper’s ‘ways of knowing’ was used as a theoretical framework throughout. Findings suggest paramedics understand they have a key role to play, but lack clarity over the role. Although confident in their knowledge of physical abuse and neglect, they are less confident in their knowledge of sexual abuse (SA), childhood sexual exploitation (CSE) and female genital mutilation (FGM). More than half of respondents felt child protection referrals had not been made, that should have been. Barriers to safe practice include limited access to ‘expert’ led training; lack of feedback from social services, and lack of time. Decision making is heavily dependent on intuition. Closer working relationships between paramedicine and social services are needed. Timely bi-directional communication is vital. Training input from social services is needed if paramedics are to develop greater confidence in detecting SA, CSE, and FGM. Finally, paramedicine needs to reflect further on the challenges that can arise in prioritising the best interests of children when working with families.

Background and Aims: The importance of the involvement of parents in treatment approaches for Children and Young People (CYP) who have engaged in Harmful Sexual Behaviour (HSB) has been consistently highlighted within the literature. Given that HSB arises in a family context, parents are considered key agents for change where CYP remain in their care. Professionals may work with them as a means of improving the CYP's therapeutic outcomes. Despite this, little is known about their personal lived experiences and representations of meaning, which remain largely unexplored. The current study aimed to address this gap and gain a rich understanding of the experiences of parents, from their own perspective. Methodology: Semi-structured interviews were used with six biological parents who were recruited via purposive sampling from a specialist service working with CYP who have engaged in HSB and their families. During interviews, four broad areas of interest were explored: the personal psychological impact of their child engaging in HSB; the impact on the parent-child relationship; wider familial and community responses; and parental coping. Interviews were audio-recorded and their verbatim transcripts analysed using Interpretative Phenomenological Analysis (IPA). Findings and Conclusions: The analysis produced four main themes; 'A devastated and overwhelmed life'; 'Threatened and trying to feel safer'; 'A challenged relationship with son'; and 'Space for hope in the face of hopelessness?'. It was highlighted that parents' experiences and meaning-making appeared intimately woven with a complex web of powerful relational and socially constructed factors. The research outcomes provide valuable insights for professionals working with young people who have engaged in HSB and their families. In learning more about what it is like to be the parent of a CYP who has engaged in HSB, it is hoped that professionals will have a richer framework from which to provide support to both the parent and to their child. Implications for clinical practice, the strengths and limitations of the methodology and directions for future research are discussed.

Statistics highlight child neglect is the most common form of child maltreatment within the United Kingdom. The research described here was an exploratory study which used the pragmatic approach of a survey design to explore how social workers identify child neglect. Social workers complete assessments of children in need of help and protection and this assessment process determines whether a referral should be responded to as a child in need of support (as per Section 17, Children Act 1989) or as a child in need of protection (as per Section 47, Children Act 1989). The definition of child neglect is provided by the Department for Education for use by social workers in its assessment. However, the usefulness of the definition of child neglect is questioned within the literature due to differences in the breath and scope of what is considered a basic need and differences in what are considered to be adequate standards of provision to meet them. The study used an online survey directed at members of the British Association of Social Workers (BASW) and social workers from one Local Authority in the North West of England. There were five sections in the online survey: information on participants’ demographics, the second category focussed on caseloads, identification of child neglect, resources to support the identification of child neglect resources and finally the health and wellbeing of social workers. The major findings were that factors relating to the child were most salient when assessing neglect. This is in clear contrast to previous studies using the same criteria which found that factors relating to the parent were the most significant. The definition of child neglect provided by the Department for Education was highlighted as being problematic with approximately two thirds of participants reporting that the definition was helpful but over a third of participants found it unhelpful. Challenges in defining child neglect appear to be exacerbated by a lack of agreement among professionals from the same group on the nature of neglect. Up to one third of participants reported that they did not feel equipped to work with families in cases of neglect, and approximately half of participants reported that they were not able to follow up on concerns due to their workload. The implication of the findings is that whilst neglect continues to be a primary reason for social work intervention, social work practitioners appear to be working with a definition which the majority find helpful yet acknowledge that there is much less consensus on the nature of neglect. This is a concerning matter as social work practitioners are working with ambiguity yet are agents of the state protecting children from harm when they are unclear about thresholds and level of need.

This thesis investigates attitudes to sexual violence against children as revealed in penal codes and criminal courts in Florence during the long nineteenth century. The main question is: how did the approach to sexual violence against children shown by institutions of the state, society and family change throughout the so-called century of childhood? The choice of Florence as a case study of child abuse in Italy was made for three main reasons: first, the succession of several régimes –not unusual in Italy during this period- permits me to examine how different governments regulated sexual violence towards children, tracing continuities and changes; second, the considerable attention paid to children, to their health and education, by private and public institutions in Florence throughout the century would lead historians to assume there was a general condemnation of child sexual abuse; last but not least, the widespread historical assumption that Tuscany possessed especially advanced and modern penal codes made me wonder whether Tuscany was also especially progressive in attitudes to sexual violence against children. Given the gulf between law and judicial practice, the latter has been analysed through criminal records. Even though during the body of the thesis sexual violence against girls, and against boys, and within the context of incestuous relationship have been analysed within different sections, in the conclusions they have been brought together offering a nuanced account of varieties of response, while also keeping in mind the central research question.

The National Society of Protection and Cruelty to Children (NSPCC) estimate that 1 in 20 children are a victim of sexual abuse (Bentley, O’Hagan, Raff, & Bhatti, 2016). Furthermore, recent figures indicate that there has been a rise in child sexual abuse cases across the UK. Research into perpetrators of child sexual abuse have focused primarily on male offenders. Researchers have explored the cognitive distortions of male offenders and developed theories of sexual offending based on the risk factors associated with this population. More recently, studies have explored the core beliefs and schemas of child offenders to understand the factors that underpin their cognitive distortions. This empirical paper explores the Early Maladaptive Schemas and Implicit Theories of mentally disordered child sex offenders. Historically, societal perspectives of women indicated that females were highly unlikely to perpetrate sexual offences against children. More recent findings suggest that females account for approximately 5% of all sexual offenders across the UK, Canada, USA, Australia and New Zealand. However, this statistic varies depending on the data gathering methods employed: self-report studies indicate higher prevalence rates of female perpetrated sexual abuse compared to case report studies. This systematic review explores societal perspectives of female child sex offenders compared to male perpetrators.

Background and Objectives: The rise in cases of online child sexual exploitation has become a global problem. Understanding both the psychological profiles of this offender group and the strategies employed during the process of exploitation, is crucial for aiding prevention and detection of these crimes as well as informing treatment and educational programmes. Thus, there were two main aims of the thesis. Firstly, a systematic review was conducted to investigate the psychological characteristics of online child sexual offenders (OCSO). Secondly, research was carried out to examine the utility of a pre-existing process model of grooming in the online sexual exploitation of children (O'Connell, 2003). Methodology: A systematic search of papers published between 2006 and 2016 was carried out. Those eligible for inclusion measured psychological characteristics using psychometric tools. A quality checklist was designed to appraise the methodological robustness of each paper. For the research study, qualitative content analysis of 63 online chat logs between offenders and children was undertaken. Logs were initially coded for correspondence to stages and strategies outlined by O'Connell, and additional codes assigned to themed text that did not fit this model. Results: The systematic review revealed fourteen papers for inclusion, and collective strengths and weaknesses were identified. Compared to contact offenders, few differences in psychological characteristics were identified; however tentative evidence suggests that online offenders experience greater interpersonal deficits whilst contact offenders present with more antisocial difficulties. Qualitative content analysis of chat logs revealed partial support for O'Connell's model. Several offender strategies proposed to take place during the sexual stage were evidenced. However, no logs showed evidence of all six stages. Additional offender strategies identified included flattery and minimising their behaviour. Various child strategies were identified, with children refusing all sexual advances in the majority of logs (n=34). Conclusions: Generic sexual offender treatment packages may not best meet the needs of OCSO. An alternative is discussed. Future research should focus on the development of psychometric tools for use with OCSO. Offenders appear heterogeneous in their approach to online sexual exploitation of children. Effective educational programmes must emphasise the speed at which many offenders will introduce sexual content, for whom traditional notions of grooming do not apply.

In summary this thesis addresses a gap in the literature by examining the role of shame and guilt in the experiences of non- offending parents of children who have been sexually abused. Three studies were undertaken in order to address specific questions in relation to shame and guilt experiences in this population. Firstly, Interpretative Phenomenological Analysis was used to examine the lived experience of mothers whose children have been abused. The results revealed the following superordinate themes; 'The Sins of the Mother', 'Impotent Anger' and 'It Changed me as a Parent'. A central concept underlying the themes was that of self-blame. As there is a wealth of research indicating that shame and guilt are two distinct emotions underlying self-blame, Study 2 and 3 examined the level and nature of shame and guilt separately in this population. Study 2 compared levels of shame (state and trait) and guilt (state and trait) across 3 populations of parents; 1)parents of children who have been sexually abused, 2) parents of children who attend child and adolescent mental health services and 3) parents of children in a community GP sample. This study found heightened levels of state shame and guilt in parents of sexually abused children compared to parents of non-abused children. Study 3 then examined predictors and implications of shame and guilt in this population. This study found evidence to suggest that parental guilt in the context of adult anxious attachment styles may be detrimental to a child's social, emotional and behavioural outcomes, ultimately reducing the quality of the parent-child relationship.

Among the many researched outcomes of childhood sexual abuse (‘CSA’), relational difficulties have been well documented. However, male CSA survivors may experience several outcomes that are unique to their gendered experience and yet remain largely under-represented in the literature. A gap was identified in the research around the experience of the male survivor in therapy for childhood sexual abuse, particularly where it relates to relationship building. Therefore the research aimed to explore this from the perspective of the survivors, with a focus on trust within the therapeutic relationship. To achieve this, the researcher interviewed 6 male survivors of sexual abuse, all of whom had greater than one years’ experience in a therapy that focused on their abuse. The researcher adopted a semi-structured interview format which facilitates partial guidance by the new data introduced by the participant. Transcripts of the interviews were analysed using interpretative phenomenal analysis with a consistent curiosity stance that allowed the researcher to partially bracket their prior knowledge. The analysis resulted in four master themes emerging; i) Finding and Connecting; ii) Negotiating Masculine identity, iii) Accepting and Committing to the process; and iv) Trust. Findings highlighted the necessity of reducing epistemic vigilance in the early relationship and the importance of negotiating power dynamics with support for challenge by the client in order to facilitate trust. The experience of masculine social expectations in a male CSA survivor is explored with regards to the trust relationship and an unexpected finding was made in the importance of group work. These findings were linked to previous research in the area of male CSA, recommendations are made for future research and implications for practitioners were explored.

An extensive review of research and policy literature revealed that links are made between: going missing and forced marriage; going missing and child sexual exploitation; and forced marriage and child sexual exploitation. However, despite these overlaps, no links are made between all three issues. Given that some South Asian young women will run away from home in order to avoid being forced into marriage and that young people who run away or go missing from home are at risk of, or abused, through child sexual exploitation a research proposition was developed on the basis that a three way link was theoretically possible. A case study methodology was developed to test the research proposition. Eight cases were identified in which South Asian young people (under 18 years of age) had experienced some combination of all three issues. However, the pattern identified within the research proposition was not the ‘final explanation’. Analysis of the research findings revealed that variation existed within the pattern proposed. Moreover, a second pattern was identified in which forced marriage emerged as a parental response to young people who were already being sexually exploited and going missing in this context. The patterns identified were confirmed through analysis of interviews undertaken with twelve subject experts (key informants) and resonated with a specifically selected group of nine young people who were presented with a composite case study during focus group discussion. I argue that awareness of patterns linking all three issues will help practitioners to identify and respond appropriately to cases where the issues of going missing, forced marriage and child sexual exploitation overlap. That said the complexity of the cases highlighted risks associated with overlooking diversities: social divisions related to age, gender, ethnicity, class, sexuality and disability were explored to see how they shaped the young people’s experiences. This process revealed that they were located within complex axes of power which then intersected with social systems, including family, community and public institutions. As a consequence, young people lacked relational support and had limited access to safe accommodation and economic resources. This resulted in some young people making attempts to try and self-manage the competing harms that they were facing. The practitioners who supported the young people highlighted the challenges involved in working with them. Analysis of practitioners’ accounts further revealed how power dynamics within multi-agency working arrangements also impacted their efforts to respond to the needs of young people. Through testing the research proposition, I addressed a recognised need for more focused research into the issue of going missing as it relates to young people from different ethnic backgrounds (Berelowitz et al. 2012; Berelowitz et al., 2013; OCC, 2012; Patel, 1994; Safe on the Streets Research Team, 1999; Stein et al. 1994) as well as furthering knowledge about how child sexual exploitation is experienced by young people from black and minority ethnic (BME) communities (Chase & Statham, 2004; CEOP, 2011b; Jago et al., 2011; Berelowitz et al., 2013; Thiara & Gill, 2010; Kelly, 2013; Ward & Patel, 2006). The development of a typology of patterns linking going missing, forced marriage and child sexual exploitation provides a unique contribution to the scholarly literature.

Researchers speculated that some child sex offenders who gather and accumulate indecent images of children (IIOC) appear to be engaged in some form of collecting behaviour. Original sentencing guidelines (2004) for IIOC offending recommended higher sentences based on the nature of the images accumulated, the size of the IIOC accumulation and whether it is organised. Updated sentencing guidelines, such as the A, B, C classifications (Sexual Offences Definitive Guidelines in 2014) still see some collecting processes pointing to deviancy in IIOC offenders. This collecting-offending hypothesis is untested and was a prompt for undertaking this thesis. Collecting terminology is not well-defined, there is no unifying psychological theory of collecting and no empirical studies investigating image collecting. Chapter one sought to review the literature in an attempt to operationalise the concept of collecting. From this first formal review of collecting literature coherence in collecting language emerged and a new collecting frame was posited. This collecting frame is thought to incorporate three core collecting units termed the collectible, the collection and the collector. Three core elements are proposed, that is nature, function and process, and these along with the collecting units form part of a relational matrix which was termed the collecting frame. In chapter one the boundary between pathological (hoarding disorder) and normative collecting is also reviewed and it was concluded that whilst further boundary refinement work is needed they are likely to be distinct phenomena. Chapter two contributes original work, as IIOC offending research is reviewed through a collecting lens. Applying the new collecting frame from Chapter one to IIOC offending was not straightforward, and the terms used for core collecting units needed to be adapted to account for the abusive and illegal nature of some images and to avoid reinforcing offence supportive distorted thinking which might encourage further IIOC offending (Sheldon & Howitt 2007). The term collector was changed to IIOC offender, the collectible became the IIOC or images of child erotica, and collection was referred to as the IIOC accumulation. The collecting process was discussed in regard to actual behaviours, that is, gathering, acquiring, keeping and maintaining accumulations. Applying the collecting frame helped map the topography of the extant IIOC literature which pertains to the collecting-offending hypothesis under study. It was identified that whilst the use of objective measures of IIOC classification and collection configuration are popular and useful, this approach fails to take account of the dominant view from collecting theory which emphasises that what is defined as a collectible and collection can also be subjectively defined. The implications of examining the subjective and objective nature of collecting amongst IIOC offenders is examined, and the lack of studies holistically and prospectively studying the function and processes in IIOC offenders accumulating is pointed out based on the review of expert opinion and empirical papers. A case is also made for systematic testing of McIntosh and Schmeichel's (2004) psychological model of collecting process, using a parsimonious model which integrates collecting and offending processes. This thesis also contributes three original studies, using a mixed method design to explore the collecting-offending hypothesis. The first IPA study in this thesis addressed a gap in the collecting literature by exploring the experiences of image collectors. Next a similarly designed IPA study was conducted to examine the subjective experiences of a sample of convicted sex offenders who self-reported gathering and accumulating indecent images of children. Finally in study three a newly developed survey drawn from collecting theory and IIOC research was implemented to examine whether a collecting group could be identified, along with the nature, function and process of collecting-offending in a convicted sample of IIOC offenders. This study also aims to examine the pathological collecting-offending hypothesis suggested by Sheldon and Howitt (2007) and Murrie, Warren, Kristiansson and Dietz (2002), by measuring hoarding and Asperger related symptomology. In this thesis qualitative and quantitative data were given equal priority and the findings from all the studies were merged in the final conclusion to give meaning and detail to our understanding of collecting behaviour and the collecting-offending hypothesis associated with IIOC offending. Key findings: Using an adapted version of McIntosh and Schmeichel's (2004) model of collecting, a collecting group was identified in the IIOC sample in study three. For both image collectors and IIOC offenders, collecting their objects of interest was an evolving process, and similar collecting processes were found for image collectors and IIOC offenders with a collecting interest, that is the hunt, acquisition, post-acquisition behaviours and refinement. Both groups gained from input with like-minded others, but involvement in collecting communities was especially popular amongst image (postcard) collectors. The function of collecting served cognitive, emotional, behavioural and social functions, and seems to be perpetuated by both positive and negative reinforcement. A possible pathological collecting function was identified for a small minority of IIOC offenders in study three, and any link between IIOC offending and collected related disorders would need further investigation before conclusions could be drawn. Cognitive-emotional processes used to relate to the image and to continue collecting differed significantly between image collectors and IIOC offenders. IIOC offenders seem to project shame and anxiety onto the image, and use cognitive distortions to support abuse of children. The image collectors appear to imbue images with affection and many built long-term attachments to the images they collected. With more clarity about the processes or steps taken when collecting, McIntosh and Schmeichel’s (2004) model of collecting was adapted and updated to develop a new testable model of normative collecting and a modified version of this new collecting model was developed for IIOC offenders. Limitations and implications for each of the studies are discussed, along with ideas for future research.

There is a high prevalence of child sexual abuse (CSA) in India and the UK (Laccino, 2014). However, there is a lack of research on culturally-specific aspects of psychotherapy offered to child and adolescent survivors of CSA in both these countries. Therapeutic interventions with sexually abused children raise complex concerns due to the heterogeneity based on the developmental stage of children; varied impact, presenting difficulties and needs; and characteristics of abuse, age, gender, ethnicity and cultural factors. Numerous therapeutic interventions for CSA have been documented, with varying theoretical constructs, structure, content and outcome (Reavey & Warner, 2001), ranging from cognitive behavioural, psychoanalytic, humanistic and feminist paradigm (Misurell, Springer, & Tryon, 2011). Most of these approaches do not provide sufficient guides to therapy (Reavey & Warner, 2001). Few of these are widely studied and clinically accepted, while most lack empirical evidence. Although existing studies conclude that therapy is better than no treatment, there is lack of consensus on treatment characteristics important in child and adolescent sexual abuse therapy (Hetzel-Riggin, Brausch, & Montgomery, 2007). Further, little is known about culturally-specific holistic and coherent responses to CSA. A Constructivist Grounded Theory (Charmaz, 2006) study was conducted to investigate therapeutic approaches practiced by professionals in India and the UK with child and adolescent survivors of CSA, and to understand the factors that govern the choice of an approach or model adopted. In-depth, semi-structured interviews were undertaken with 32 professionals (16 each in India and the UK) from different settings including statutory, voluntary and private sector. NVIVO 10 was used for data management and analysis of the digitally recorded and transcribed interviews. Although there is a growing emphasis on evidence-based therapies, with most empirical studies focussing on traditional forms of psychotherapy, the actual practice of the professionals interviewed reflected a more fluid, flexible, multi-modal, ecological and integrative approach to CSA-therapy. The findings indicate that the therapeutic interventions progress through four different phases, based on the goals identified by professionals. The goals in turn are influenced by the socio-cultural context, structural factors, and/or trauma understanding of the professionals. Four phases identified in the study are: 1. Social Action Framework, with the goal to identify silenced and invisible children, particularly in a culture of silence and suppression in India; 2. Stabilisation and Resilience Building Framework, found to be practiced in India and the UK, with the goal to ensure safety and build the foundation for ensuing phase of therapy; 3. CSA-Trauma Resolution Framework, where the goal is to uncover the sexual abuse details to facilitate recovery and reintegrate the traumatised child, more visible in therapeutic practice in the UK; and 4. Maintenance and Relapse Prevention Framework, with the goal to prevent relapse and protect from revictimisation and future developmental difficulties. These phases may be mutually exclusive, follow a linear trajectory, or there may be a back and forth movement from one phase to the other. These four phases were integrated to construct a culturally relevant, ecological-based theoretical model of CSA therapy with child and adolescent survivors.

Aims: Our understanding of adolescent attachment representations is limited, largely due to the lack measures which exist to assess attachment in this developmental period. The current study aimed to explore the psychometric properties and clinical utility of the Adolescent Story Stem Profile (ASSP); an online measure of internal representations, adapted from narrative story-stem techniques. Methods: A community sample of 253 adolescents in mainstream secondary schools completed the ASSP, and their responses were used to assess the ASSP's ability to predict self- and teacher-rated difficulties as measured by the SDQ and CGAS. Responses of a clinical sample of 32 adolescents in residential or foster care were compared to those of an age- and gender-matched subset of the community sample. Results: The factor structure of the ASSP was analysed using principal component analysis, revealing a four-factor model. These factors were found to predict responses on two of the five SDQ subscales, but not the total SDQ difficulties or the CGAS. Scores on two of the four factors were found to differ significantly in the clinical sample when compared to the subset of the community sample. Conclusions: The ASSP shows promising results in its ability to measure the attachment representations of adolescents, however improvements could be made. This are discussed with reference to the limitations of the study, and suggestions for future work are made.

Background: Despite the global increase in public awareness of child safeguarding issues, there is significant variation in policy, service systems and practice internationally. Professional training is an essential component of child protection services, usually in an inter-agency context. A number of high profile cases of child abuse in Saudi Arabia resulted in a growing number of initiatives, with the goal of preventing and managing child maltreatment. However, there is still a lack of an evidence-base on systematic evidence on the profile of children at risk, those attending services, and the impact of interventions, including training programmes. Aim: To explore professionals’ perceptions of factors promoting or hindering the implementation of an inter-agency child protection training programme. Methodology: The National Family Safety Programme (NFSP) was established in 2005, and has established child protection centres and inter-agency training courses. The training objective is to provide participants with basic skills in identifying and managing child maltreatment. A qualitative research design was based on semi-structured interviews with 26 professionals from different disciplines, who had attended the training programme 18 months earlier. Thematic analytic framework was used. Results: Three major themes emerged, on: a) benefits of translating training into practice; b) constraints of translating training into practice; and c) recommendations for improving training, services and policy in the future. This was identified as having positive impact by increasing knowledge, developing skills, and raising awareness. However, participants noted that the implementation of the training programme was often rendered difficult by social factors and bureaucratic impedances. Conclusion: The study highlighted that there is a demand for further legislation, as well as a range of organizational actions and processes to protect children from maltreatment. There is further need for on-going and sustainable training; inter-agency co-operation at policy and operational level; and awareness programmes to change cultural attitudes.

‘Child trafficking’ as a phenomenon requiring a policy and practice response has, in recent years gathered considerable pace. ‘Child trafficking’ is a crosscutting social issue, relevant to policy areas of child protection, child migration, criminal justice, immigration, social policy and human rights. This thesis explores children’s own accounts and lived experiences of ‘child trafficking’, addressing a notable gap in hearing from children directly. The thesis critically engages with the social construction of the ‘trafficked child’ examining how contemporary concepts of childhood shape and inform ‘child trafficking’ policy and practice. How ‘child trafficking’ policy has been constructed politically is examined, in shaping how ‘child trafficking’ is defined in practice. The implications for children experiencing trafficking of a system built on current assumptions about childhood and ‘child trafficking’ are considered. The study explores how children’s experiences of their childhood and ‘child trafficking’ challenge many assumptions underpinning policy and practice. The findings reveal a disjuncture between immigration-driven and prosecution focused ‘child trafficking’ practice and children requiring a welfare and individualised response to their needs. Children needed practitioners to listen to them, believe them and take action upon child protection concerns. A conclusion is drawn that the way in which ‘child trafficking’ policy and practice in England is presently constructed, and experienced, appears not to reflect the lived ‘realties’ of young people in this study. A new approach to ‘child trafficking’ policy and practice is recommended underpinned by a conceptual shift in how we perceive childhood and adolescence. Intended audiences of this study include policy-makers and front-line practitioners including social workers, the police, immigration officers and other services. This qualitative study contributes in developing methods with a hard to access population addressing a difficult subject area, promoting children and young people’s participation in research.

Background: In high-income countries, parenting programmes have been shown to be effective in reducing the risk of child maltreatment. However, there is limited evidence of their effectiveness in low- and middle-income countries. This thesis focuses on the development and pilot randomised controlled trial (RCT) of a parenting programme to reduce the risk of child maltreatment in low-income families with young children in Cape Town, South Africa. Methods: This thesis is comprised of three studies submitted as papers for publication. The first study focused on the development of an evidence-informed, locally relevant parenting programme for families with children aged three to eight years in Cape Town, South Africa. Intervention development took place over three stages: (a) identification of core intervention components common in evidence-based parenting programmes; (b) formative evaluation using qualitative in-depth interviews and semi-structured focus groups with South African practitioners and low-income parents; and (c) integration of evidence-based approaches and local contextual issues to develop the intervention structure, protocols, and manual. The second study used a pilot RCT (N = 68 parent-child dyads) to examine the evaluation feasibility and initial effects of the parenting programme developed during the first study in Cape Town - the Sinovuyo Caring Families Programme. Parents of children aged three to eight years with clinical levels of parent-reported child behaviour problems were randomly allocated to either a 12-session, group-based parenting programme or a wait-list control group. Primary outcomes included parent-report and observational assessments of positive parenting, harsh parenting, and child behaviour problems; secondary outcomes included parent-report of parent depression, parenting stress, and social support. Assessments occurred at baseline and immediate post-test (i.e., 3-months after baseline). The third study was a mixed-methods process evaluation assessing the feasibility of the parenting programme based on three theoretical dimensions: participation, implementation, and acceptability. Quantitative data included attendance registers, fidelity checklists, satisfaction surveys, and parent-report of engagement in home practice activities. Qualitative data included post-programme focus groups with community facilitators (n = 8), individual interviews with a randomly selected group of parents (n = 15), transcripts from parenting sessions, and minutes from supervision sessions with facilitators. Results: In the first study, the formative evaluation suggested that many evidence-based parenting programme components and approaches were compatible with the local cultural context. These included managing child behaviour problems, learning effective discipline strategies, building positive parent-child relationships, and reducing parenting stress. Findings also suggested that programmes may benefit from including additional content on keeping children safe in violent communities, communicating about HIV/AIDS and poverty, involving fathers and alternative caregivers, and incorporating cultural values of social responsibility and respect. The pilot RCT in the second study showed high levels of study recruitment and retention, outcome measurement reliability and response rates, and a minimal effect of clustering due to delivering the intervention in groups of parents. Analyses showed moderate intervention effects for parent-report of increased positive parenting and observations of improved child-led play. However, observational assessments also found reduced frequency of positive child behaviour in the treatment group in comparison to controls. In the third study, quantitative results showed high levels of programme acceptability, implementation, and participation. Thematic analysis of qualitative data identified seven themes related to feasibility: (a) receptivity to strengthening existing parenting practices, (b) initial resistance to new parenting skills, (c) contextualising content within a cultural framework, (d) reinforcing implementation fidelity and improving quality of delivery, (e) challenges delivering content on nonviolent discipline, (f) supporting participant involvement, and (g) engagement in a collaborative learning approach. Conclusion: This thesis is the first in sub-Saharan Africa to use a systematic approach to develop and rigorously pilot a parenting programme to reduce the risk of maltreatment against young children in low-resource settings. Initial results indicate that a parenting programme derived from evidence-based approaches is feasible, culturally acceptable, and has the potential to reduce the risk of child maltreatment by improving positive parenting behaviour. Further intervention development and testing is necessary to strengthen core programme components and determine programme effectiveness.

The child protection conference is a key part of the child protection process in England and other UK countries. This study sought to explore how child focused these meetings are in cases of child neglect and the factors which affect child focused information sharing, assessment and decision making. The study used an interpretivist approach and mix of qualitative methods. Data were gathered from two areas in three stages: audio recordings of 14 child protection conferences, documentary analysis of the reports from these meetings, interviews with 26 staff who chair or minute conferences and six focus groups with practitioners from a range of agencies. The thesis proposes a model of child focused practice which considers the individual child’s experience of child neglect, draws on knowledge of their daily life, promotes the active engagement of children and young people in child protection processes and decisions; and is orientated towards promoting child welfare outcomes which directly relate to the individual child’s experiences and circumstances. This concept is examined through consideration of the stages of the conference. It details how the work of practitioners prior to the conference, in their assessments with families and production of reports, can shape the child focus of the meeting. The influence of child and family participation in conferences is assessed and the meeting itself is explored through analysis of the conference discussion and the decision making and planning which takes place. The study found that practitioners can find it difficult to be explicit about child neglect in conferences. The thesis argues that factors such as the family’s participation, the role of the chair and the competence of practitioners can influence the degree to which the conference is child focused. The extent to which a child protection conference can be considered child focused and the implications of this for theory and practice are explored.

Domestic abuse has been widely researched, however one area relatively absent from such research is that of parent abuse, which sees abuse perpetrated by children against parents. Academic research into parent abuse has begun to increase over recent years, yet this still remains a significantly under-researched area of family violence. This thesis seeks to develop an understanding of key themes and collaborative prevention opportunities in relation to parent abuse in Greater Manchester, and makes recommendations for the development of practitioner responses. Accordingly, the research follows a qualitative paradigm in order to build a better understanding of key issues and to explore opportunities for collaborative responding in the current austere economic climate. The research design consisted of in-depth interviews conducted with practitioners drawn from a variety of public and third-sector agencies working within three boroughs across central Greater Manchester, and utilised open coding in a grounded theoretical approach. The research findings suggest that parent abuse is a unique problem that is complicated by bonds that exist between parent-victims and their abusive children. Parental reluctance to report incidents, through a fear of criminalising or losing their children adds to the difficulties for those responding to parent abuse. Furthermore, the research found problems created by an absence of specific policy, resulting in parent abuse being dealt with via child protection, social care or criminal justice processes. The research also revealed that young male perpetrators were highly prone to mental health and behavioural problems, and there was disproportionate cannabis use amongst young perpetrators. Whilst this may also be the case in the wider youth population, the potential for such correlation is worthy of specific consideration when seeking to further an understanding of parent abuse. Additionally, the importance of collaborative working was highlighted, which revealed opportunities for early intervention. Accordingly, the need for an integrated ‘toolkit’ for responding effectively to deal with parent abuse is proposed, which considers the key issues identified within this thesis. These issues contribute towards both academic knowledge and professional practice in an important but under-researched area of crime and victimisation.

Background: It is estimated that adolescent offenders account for 65% of contact child sexual abuse. A range of explanatory theories and models of intervention have been proposed. These are mainly based on cognitive theories with Cognitive Behavioural Therapy (CBT) and psycho-education remaining as the dominant models of treatment intervention. This research explored the issue of harmful sexual behaviour from the psychosocial perspective, drawing on attachment theory and social constructionism. Aim: The research explored attachment strategies among young people with harmful sexual behaviour. It examined young people’s understanding and explanations regarding their sexually abusive behaviour. This included an exploration of how the participants’ accounts and defensive strategies were shaped by wider family and cultural discourses regarding masculinity and sexual activity. In selected cases, the family intergenerational patterns of attachment and emotional regulation were analysed. Furthermore, the research explored the prevalence of harmful sexual behaviour in the study area. This included an exploration of statutory responses and services which were offered to people who engaged in harmful sexual behaviour. Methods: The research employed three interconnected research methods: a) a quantitative audit data of fifty cases which had been reported to the Children’s Services; b) qualitative and descriptive quantitative exploration of eight Transition to Adulthood Attachment Interviews and semi-structured interviews; c) qualitative exploration of the family context and trans-generational patterns of defensive strategies by conducting an Adult Attachment Interview in three cases. The analysis of the attachment and open-ended interviews utilised a combination of the structured ‘discourse analysis’ developed for the Adult Attachment Interview and Critical Discourse Analysis. Findings: The research found that there was no clear and consistent pathway of social care for young people who engaged in harmful sexual behaviour. The analysis of psychological defensive processes found that all of the participants presented with complex insecure attachment strategies alongside intrusions of unresolved traumas or losses. The exploration of intergenerational patterns of attachment strategies identified that all parents showed complex avoidant attachment strategies with intrusion of unresolved trauma and loss. The qualitative study identified a range of discourse themes and strategies in the accounts the young people offered in order to explain their actions and to maintain their sense of self. The dominant discourse themes shared by the young people were: a) life is hard and violence is normal; b) a sense of powerlessness; c) sexual entitlement, d) bravado and denial of vulnerability. Conclusion: Complex insecure attachment strategies with intrusion of trauma and loss play a significant role in the development of harmful sexual behaviour. In addition, the study suggests that the complex relationship between care, comfort and sexual behaviour should be a central focus of clinical interventions with this group of young people and should be investigated further in future research studies.

Since the emergence of the global child rights movement in the late 1990s, there has been a notable increase in research and policy focusing on child sexual abuse (CSA) in African settings (Mildred & Plummer, 2009). My thesis contributes to this field by using a case study approach to examine how residents of an informal settlement define and respond to CSA. Studies in Tanzanian settings have started to explore communities’ perceptions of CSA (Abeid, Muganyizi, Olsson, Darj, & Axemo, 2014; Kisanga, Nystrom, Hogan, & Emmelin, 2011). However, the thesis moves beyond questioning what types of sexual acts are understood to constitute CSA, instead asking why some acts are considered abusive and others not. Recognizing the culturally constructed nature of abuse, it examines how living within the informal settlement context affects residents’ understandings of two prominent themes: consent and harm. The thesis also examines local protective mechanisms for preventing and responding to acts of CSA. When considering CSA prevention, it notes that local prevention strategies typically utilize a risk avoidance approach; there is consequently inadequate emphasis on addressing social, economic and infrastructural factors perpetuating the risk of CSA within informal settlements. Moreover, in a research setting where statutory and community-based normative frameworks co-exist, the thesis analyses the impact of legal pluralism on decision-making relating to access to justice. Drawing on Moore’s (1973) concept of semi-autonomous social fields, it argues that the co-existence of multiple systems allows for a high level of choice over which interventions to pursue. However, adults typically make decisions on victims’ behalf, potentially choosing interventions that meet their own interests, rather than prioritizing the child’s. The choice offered by co-existing normative systems can therefore disadvantage victims of CSA in their pursuit of justice.

Child maltreatment is a pervasive societal concern that has affected countless young people, families, communities and nations with detrimental effects at the physical, psychological, neurobiological and social levels. Despite exposure to chronic adversity, a remarkable number of individuals are able to display resilience and demonstrate positive adaptation following their experience of trauma. This thesis aims to examine the impact of attachment and coping styles in the context of resilience following child maltreatment utilising a systemic framework. Chapter One provides an overview of the theoretical literature relating to resilience, attachment, coping and child maltreatment. Chapter Two explores the construct of resilience and critiques the Connor Davidson Resilience Scale (CD-RISC; Connor & Davidson, 2003) as one of the few standardised measures of resilience. This measure focuses on assessing internal factors that promote positive adaptation following adversity with little attention given to external or systemic drivers in the resilience building process. In order to understand the protective role of attachment and coping and its impact upon resilience at multiple levels of functioning, Chapter Three presents a systematic review that explores the literature on the effects of attachment and/or coping styles on resilience following child maltreatment within the framework of a socio-ecological approach with a particular emphasis on female experiences. Chapter Four presents an empirical paper exploring the impact of multiple maltreatment experiences (victimisation, perpetration and abuse types) upon attachment, coping and resilience with an exclusively female sample. Chapter Five summarises the conclusions and limitations from all the chapters in the thesis discussion.