Out of Harm's Way
Can mothers who have abused children be rehabilitated?
It's a life-and-death question for those who work in this realm.
By Devin Rose, Tribune staff reporter
Originally published in The Chicago Tribune, January 23, 2002
They are two of the excruciating cases of child abuse that the courts are contending with this month:
A Streamwood couple, Kristian and Amanda Fredrickson, are charged in the starvation of their 18-month-old son, who died on a December day when they reportedly picked up fast food for themselves and their 5-year-old daughter.
A teenage mother in Chicago, LaTonya Starnes, who prosecutors say wanted the freedom to resume her normal life, is accused of applying so much pressure to her 11-month-old son's abdomen that his liver nearly split before he died days after Christmas.
The cases are extreme, but such horrors are not unprecedented. And the difficulty surrounding them doesn't end when verdicts are handed down, time is served, or surviving children are sent to foster care. That fact couldn't be more clear than in the case of Sheryl Hardy, of Jerseyville, Ill., who is now fighting to keep her new son after serving nine years in prison for her part in her 2-year-old son's death in 1989. The boy's stepfather beat him to death as she watched, and she admitted to inflicting previous abuse.
She says she has changed. The state child-welfare agency says her new baby is unsafe, and the state is appealing a judge's decision to let her keep her son.
That case, as much as any in the heart-wrenching history of child abuse, has observers asking: Can a mother who abuses a child truly change? Should she get another chance, and if so, under what circumstances? The answers society comes up with could be a matter of life or death-and any answers are tough to come by.
"We're very embryonic in understanding and treating child abuse," says Dr. Jill Glick, medical director of child protective services at University of Chicago Children's Hospital.
Many more studies need to be done, Glick says, so decisions on how to deal with victims and abusers are based on science, not emotion. For example, statistics are limited on whether men or women are more likely to abuse a child.
Lois Pierce, chairwoman of the social work department at the University of Missouri-St. Louis, says her research shows that women are more likely to physically abuse children than men "because women are more likely to be at home around the children. They have more opportunity." But she adds that, though she has no hard numbers to back this up, from what she has seen, "the more severe abuse is done by men."
And when it comes to rehabilitating abusers, Glick says, "there's no research that can tell you who's going to re-abuse a child."
With all that there is still to know, those in the trenches do seem comfortable saying that the chances of successfully rehabilitating a child abuser depend on the type of abuser.
"There are three kinds of abuser," says Andrew Vachss, a New York lawyer and consultant in child-welfare issues who has represented hundreds of children in abuse cases. "There are the inadequate parents, who simply don't know how to parent. There are people who are crazy, and we really can't discuss rehabilitation for those people; for them it's a matter of whether the psychiatric disorder they suffer can be controlled. And finally, we have people who are evil—or, whatever you want to call them—people who do what they want to do because it gratifies them in some way. These people are beyond rehabilitation."
The real hope of change, in Vachss' view, lies with the first group of parents.
"We get a tremendous bang for the buck when we work with any form of inadequacy," he says. "Say you have a perfectly decent woman who is overwhelmed, impoverished, can't afford day care, has a special-needs child, and has no help or support. She doesn't do a good job, she smacks the kids. . . . That woman can be helped. That's very different from women who like to burn their children with cigarettes."
By her estimate, Glick treats at least a thousand abused kids each year. She acknowledges that "sometimes kids come in who have methodically been tortured, but parents who do that are in the minority of child abusers. And a good part of that population is mentally ill."
Coordinating care
Glick says so much time is spent trying to determine whether abuse has even occurred that not enough resources have been devoted to treating abuse victims and rehabilitating abusers. Toward those ends, she is developing a state model for teams of experts that can investigate child abuse. The teams, which would involve social workers, police and forensic pediatricians (who are trained to distinguish between abuse and accidental injury), ideally would identify abuse cases efficiently. That would leave more time and money for treatment and rehabilitation. And even then, Glick stresses, coordination of care is crucial. That means doctors, psychologists and social workers should all be involved in deciding what needs to be done for both parents and children. Too often now, care is fragmented, and those involved don't have complete facts in the case.
"It's not about more money, it's about reorganization of the system," Glick says.
Cook County Public Guardian Patrick Murphy, whose office acts as legal advocate for abused and neglected children, holds a dim view of rehabilitation for child abusers. For starters, he says, "There are some kinds of child abuse for which we should not try to rehabilitate people, such as sexual abuse and torture. For some crimes, there is no second chance."
And Murphy has his doubts about second chances in the cases that reach the courts.
"You can answer the question of rehabilitation in a facile way and say we need programs for the parents, parenting classes, things like that," he says. "But by the time we see the parent, we typically have a mother who's 22, 23, on drugs, has three or four kids, the father is long gone. . . . So what do you do? The simple fact is, we should try to do whatever we can while realizing it probably ain't gonna work."
In fact, Murphy says, he has never seen an abuser be truly rehabilitated. "We just try to help, so maybe they can get a little better, maybe they can walk out of here understanding that you can't beat the hell out of your kids."
Each year, more than 3 million children in the U.S. are reported abused or neglected, and more than 1 million of those reports are confirmed, according to the national non-profit charity Prevent Child Abuse America. In 1999 (the most recent figures available), about three children died each day in the U.S. from abuse or neglect.
When it comes to ending child abuse, Murphy's money is on prevention. The best way to stop people from becoming abusers in the future, he says, is to "prevent teenage pregnancy, prevent drug use and keep kids in school."
Though fully aware of the murky waters they're wading through, many experts are hopeful about rehabilitating abusers, because they attribute most cases to the weight of stress among adults who haven't learned adequate coping skills.
"We have so many stresses on parents today," says Donna Fiedler, an assistant professor of social work at La Salle University in Philadelphia and a fellow of the American Academy of Experts in Traumatic Stress. "Most abuse occurs because of high, high levels of stress, a lack of support and a lack of resources. Then, if you add anything, like someone loses a job or a child is having problems or is sick, that just adds more stress."
The University of Missouri's Pierce adds another factor to the combustible mix for many abusive women: a relationship in which they themselves are abused.
"It's hard for most of us to realize how easy it is, if you don't feel good about yourself, to get pulled into abusive situations," she says. Then abuse gets passed down to the child. "It's the whole cycle."
Alluding to such a cycle in "Mothers Who Kill Their Children," authors Cheryl L. Meyer and Michelle Oberman point to studies suggesting that "the most potent factors for predicting whether a mother would abuse her child were childhood exposure to aggression and adult domestic violence."
The authors also maintain that "in general, depressed mothers have more thoughts of harming their children than do non-depressed mothers." And Glick says the whole area of mental health and child abuse needs to be better studied.
"We've always looked at mental illness as an embarrassment," she says. "We hide maternal depression in our homes. For example, when it comes to postpartum depression, it's a real entity. Families need to be aware that it exists, and women need to be able to go to their doctor and talk about it. But when it comes to addictions and mental illness, people don't have a grasp that they're disease entities that need to be treated. Instead, we make it a matter of right and wrong."
A glimpse of the system
Working with abused children and parents "in the system" is a complicated and at times unwieldy process, says John Gold, deputy director of the child protection division of the state's Department of Children and Family Services. When abuse is reported, caseworkers assess the situation to determine how safe the child is.
If a child is in immediate danger, DCFS can take temporary custody for up to two working days. To maintain custody beyond that, the agency must seek temporary custody in juvenile court. The child could be placed with relatives or in a licensed foster home or a shelter. From that point on, the parents must work through a series of hearings and other steps before getting their children back (or, in some cases, they could find themselves in criminal court).
Experts agree that foster care is not ideal in any situation.
"You have to understand that a kid has bonded with the parent, and taking that kid away is major surgery," Murphy says. "People keep talking about `the best interest of the child.' It isn't about that at all. These kids have been so fouled up. What you're trying to do is avoid what's in the kid's worst interest. Putting the kid back home is bad, but keeping the kid in the system is bad, because you're breaking a bond that is important to the child."
Gold and other experts say state child-protection agencies work hard to help parents get the resources they need to deal with daily stress. In Cook County, for example, DCFS spends about $10 million a year on services provided by agencies DCFS is under contract with, such as Catholic Charities and the Juvenile Protection Association, to keep children "safely at home," Gold says.
Many families need intense help to cope, some experts say.
"You need, say, a trained social worker who goes into the home and helps the family for a few hours every day," Fiedler says. "This is not cheap. But how much does foster care cost? We put this money out after the fact all the time."
Child-protection agencies rely on a variety of community programs to help families. Sometimes parents are ordered by the courts to use such programs; other times, their involvement is voluntary. Prevent Child Abuse America runs two such programs.
One of the programs, Healthy Families of America, offers the kind of help Fiedler suggests. A trained staffer goes into the home to help the parents, at no charge to the parents. Ideally, the visits are once a week and last at least an hour.
"That home volunteer hooks them up to medical care, educates them about child development and helps them interact with their child," says Barbara Rawn, director of programs at Prevent Child Abuse. "When there's abuse in the family, there's often a lot of isolation. You have parents who don't know what to do, who haven't had great parenting themselves, who are living in different situations of violence, perhaps with a substance-abusing mate. Part of breaking that isolation is to help them connect with resources in the community."
More moms make use of the program than dads, Rawn says.
"The sad part is that more dads aren't involved," she says. "Dads have such an impact, in terms of self-esteem and development if they're around, but they tend not to get involved in this kind of stuff."
Another Prevent Child Abuse program, "parent-led mutual self-help support groups," are for "parents who know there's a better way for coping and want to learn from other parents and share their success," says national coordinator Sue Campbell.
About 85 percent of those attending such groups are women, Campbell says. Parents usually find out about the self-help groups, which are free, from word of mouth or from their state child welfare agency. Trained facilitators are part of each group, but parents help lead.
Such programs have their critics, who say intensive help is costly and successful with only the most motivated of parents.
"Parents who are willing to have people come into their homes aren't the population we need to focus on," Glick says. "Also, once the home workers leave the house, the incidents of physical abuse go back up again."
Glick says outpatient clinics could help new parents who are at risk of abusing their kids. There, "you sit down with those parents, you develop a relationship early on with them, and you build trust. You make it clear what they have to do to care for their kids. Can you force a parent to go? No. And that's the problem."
But without a parent's motivation and willingness to change, chances for any kind of rehabilitation, no matter what it entails, might be slim. As Vachss puts it: "The one thing we do know about rehabilitation is that it's not possible absent deep commitment on the part of the offender."
The need to take responsibility
Along with being motivated, abusers must take responsibility for their actions.
"The parents need to acknowledge that they've abused the child," Fiedler says. "There may be all these reasons, but the bottom line is, the parent is responsible."
Sheryl Hardy, the mother who served prison time in the death of son Bradley in Florida, resettled in Jerseyville and married the father of her new boy, who is almost a year old. Repeated attempts to reach Hardy for this story were unsuccessful, but in November, after a judge decided to let the baby remain with her and her husband, she told the Tribune that the boy is safe.
"You can tell America that this child will not end up dead," she said. "I've learned a lot since I was young."
Because the judge's decision is being appealed, those involved either declined to comment or did so carefully.
"One of the best predictors of what a person might do is what they have done in the past," Gold says. "And that raises some level of concern in this case." He adds that "DCFS doesn't remove kids from families unless it feels there's a real need to do so."
Hardy told the Tribune that she was a victim as well. Her mother abused her as a child, she said. When she was 17, she said, she was raped and became pregnant; she gave birth to Bradley when she was 18. She married a man who hit and ridiculed her until she was so broken she couldn't protect her son. In his ruling, Jersey County Circuit Court Judge Thomas Russell attributed her participation in her son's death largely to abuse she herself had suffered.
Vachss, the New York lawyer who represents children in abuse cases, pounces on the victim theme: "Sure, I've seen people's lives spin out of control. But I've seen women literally risk their lives to protect their children. The idea that [the responsibility] to protect your child is waivable if your life is unhappy frankly spooks me a little."
Glick says that based on what she has read about the Hardy case, "she should never have access to this child. This was heinous abuse."
But Public Guardian Murphy doesn't criticize the judge's decision. "You've got to look at each case separately. If you're going to take all the kids away, you might as well sterilize everyone."
Sharon Lamb, psychology professor at St. Michael's College in Vermont and author of "The Trouble With Blame: Victims, Perpetrators and Responsibility," says: "It's not fair to punish someone who already has been punished. But she needs a lot of support. Also, both of the parents should be learning how to parent, so all the responsibility isn't on the mom."
Lamb recalls a fatal child-abuse case in which "a father, in a moment of anger, had smashed his baby's skull. He went to jail for six years. When he got out, his children had been through so many foster homes that his agency wanted to put the children back with him. And they did. These were older children, and he felt bad about what he did. I think things went OK, because he had lots of supports. It happens all the time that kids get sent back to their parents, and we just don't hear about them, because things go OK."
Hardy says she took parenting classes and got counseling in prison. The Florida Department of Corrections won't comment on what kind of classes or therapy she received or about their classes in general.
But there's no evidence that parenting classes work in any case, Glick says.
"For one thing, you're not re-creating the same scenario," she says. "We want to believe that they make a difference, but we don't know."
But Lamb says such classes make sense.
"They give you alternatives for punishment and give you ideas of what skills are appropriate for your child's age," she says. "A big cause of physical abuse is when parents get frustrated. Part of that is caused by unrealistic expectations of what a child at a certain age should be able to do. Parenting classes can teach [that] it's normal for kids at a certain age to whine or scream to get their way."
She also says that ideally, Hardy's counseling in prison "addressed feelings of guilt and remorse, taking responsibility and making reparations in any way—though how could you make reparations in this case? That would indicate to me that there was some personality change."
Evidence of progress when it comes to the rehabilitation of child abusers is tough to quantify.
But Gold of DCFS offers one encouraging measure: "In fiscal year 1997, there was a total of 4,217 families in Cook County in which there were children who were abused or neglected subsequently [meaning they were repeat cases]. In fiscal 2001, that number was 2,243 families."
And Glick says, "The reality is, most parents really do love their children. Some just don't know how."
