Fostering Assessment in the Context of Child Sexual Abuse: A Literature Review

        Andrew Kendrick

        July 1994

        The causes of sexual abuse are multiple and complex. The professional should be aware that the abuse has its origins in some level of sexual feelings and superego deficits on the part of the perpetrator. In addition it is important to systematically examine the context of the victimization for cultural, environmental, individual, and family factors that contribute to sexual abuse. The role played by these factors will vary from case to case. (Faller, 1988, p. 115)

        1 INTRODUCTION

        1.1 This paper reviews the literature on assessment of foster families in the context of child sexual abuse by foster carers and their children. The paper covers the available evidence on the incidence of abuse in foster care. It then discusses factors which have been associated with child sexual abuse. The literature on this topic is vast and the review does not claim to be comprehensive. Rather it raises the difficulties and problems associated with predicting child sexual abuse or identifying potential abusers. The paper then addresses some of the issues concerning the fostering of sexually abused children, particularly the issue of sexualized behaviour and the possibilities of further abuse. This leads on to the issue of allegations of abuse made against foster carers and the need for clear policy and procedures which are made known to all foster carers. The paper then discusses literature relating to assessment of foster carers, in particular the paper by Pat Francis which addresses assessment in the context of child sexual abuse. Finally, the paper deals with the need for training of foster family members, including fathers and children, in relation to child sexual abuse.

        2 THE INCIDENCE OF ABUSE IN FOSTER CARE

        2.1 The literature on the abuse and neglect of children in foster care placements is scarce. While a good deal has been written about abuse in residential settings (e.g. NSPCC, 1992; Bloom, 1992; Nunno and Rindfleisch, 1991), and in the US about abuse in day care settings (e.g. Finkelhor, Williams and Burns, 1988; Margolin, 1991), relatively little has appeared on the incidence of abuse by foster carers. In 1986, however, Roberts, discussing the issue of fostering children who had been sexually abused, commented that, given the rate of child sexual abuse in the general population, "it must be happening in some foster homes at the moment" (Roberts, 1986, p. 10)

        2.2 Material from the United States on child abuse and neglect in substitute family care tends to be more systematic than that available in this country. Rosenthal et al (1991) describe 290 reported incidents of abuse and neglect in family foster homes, group homes, residential treatment centres and institutions in Colorado. 38 per cent (102 of 272; 18 missing cases) of the reported incidents took place in foster homes (50 incidents of physical abuse, 22 of neglect, and 30 of sexual abuse). Overall, 29 per cent of the cases were confirmed (56 per cent of sexual abuse cases, 18 per cent of physical abuse cases, and 28 per cent of neglect cases). 38 per cent of the reported incidents in foster homes were confirmed. Males were the predominant victims of both physical abuse and neglect while females were the predominant sexual abuse victims.

        2.3 325 perpetrators were identified from 261 reported incidents (29 cases missing). Foster carers were identified in 45 cases of physical abuse, 34 or neglect and 20 of sexual abuse. Foster siblings were identified in 7 cases of physical abuse, 9 of neglect and 15 of sexual abuse. Sexual abuse referrals were most likely to result in removal and children were removed more often from family foster homes. Children were removed in 64 per cent of the family foster home referrals and 95 per cent of the confirmed family foster home referrals.

        2.4 A point with important policy implications to be taken from this study is the number of foster siblings perpetrating sexual abuse. This can be linked to the findings that sexual abuse by non-parental adolescent care-givers is more common than that by older non-parental care-givers (Margolin and Craft, 1990; Margolin, 1991).

        2.5 In discussion, Rosenthal et al suggest that multiple factors lead to abuse. There are shortages of foster homes because of low pay. This creates pressure to license marginal homes. Further, the emphasis on placing children in the least restrictive setting leads to difficult, behaviourally disturbed children being fostered. There is a lack of adequate support for foster carers because of large caseloads.

        These events combine with stress in the family home - perhaps the husband is laid off at work - to create a tension-filled setting. A foster child reacts to this tension with provoking behavior and is abused. The children are removed, placed in another home, and a similar cycle repeats. The county investigation assigns blame to the foster family, (Rosenthal et al, 1991, pp. 257 - 258)

        2.6 In a study of the Casey Family Program, Fanshel et al report that 15 per cent of a sample of former foster children revealed that someone in their foster home had tried to `take advantage of them sexually' (Fanshel et al, 1990, cited in Pringle, 1993). However, these figures have been criticised on methodological grounds (Pecora, 1991, cited in Pringle, 1993).

        2.7 In her study of rape and sexual abuse, Russell (1984) interviewed 930 adult women residents of San Francisco. Sixteen per cent (152) of this sample had at least one experience of incestuous abuse before they were eighteen. 74 of the 186 cases of incestuous child abuse occurred within the nuclear family.

        Forty-two women reported an incestuous relationship with their fathers before the age of 18 (including 27 biological fathers, 15 step, 1 foster, and 1 adoptive father). (Russell, 1984, p. 186)

        2.8 In the UK, as Pringle (1993) points out, evidence tends to be more anecdotal. However, some studies do have information relating to sexual abuse in foster and adoptive families. In research which focused on the issues of caring for sexually abused children in foster placements, Macaskill (1991) gives details of the abuse. She studied 66 foster families but she acknowledges that these families do not constitute a representative sample since they were nominated by the 11 social services departments and 8 voluntary agencies who agreed to take part in the research. The placements of 80 children were studied in depth and the research found 8 cases of abuse in previous foster or adoptive placements. The foster or adoptive father was the abuser in 5 cases and the foster mother's boyfriend in another case. In one case the abuse was perpetrated by the foster mother and in one case by a foster brother (Macaskill, 1991).

        2.9 La Fontaine studied 204 cases referred to the child sexual abuse unit of a London hospital between 1981 and 1984 (La Fontaine, 1990). Details are given of 259 perpetrators in these cases (220 perpetrators where the victim was a girl and 39 perpetrators where the victim was a boy). Four per cent of the perpetrators abusing girls and three per cent of those abusing boys were classified as a foster father or foster brother. In addition to this, three adoptive fathers perpetrated the sexual abuse. This compares to only one case where the perpetrator was a worker in a children's home (La Fontaine, 1990, p. 121)

        2.10 Reflecting possibly the high profile nature of some of the scandals of abuse in residential care, there has been an assumption that abuse of children in care tends to take place in residential homes. Waller and Lindsay, for example, state that opportunities for abuse are greatest in residential care (Waller and Lindsay, 1990). La Fontaine's figures suggest that this might not be the case. Pringle (1993), while acknowledging that more research is required before an absolute judgement can be made, argues that fostering seems just as unsafe as residential care. He cites his experience in working in an independent agency which specialised in family placement of teenagers who were `difficult to place' and/or who had been sexually abused. He states that "it was common to take referral of adolescents who had been abused in local authority foster placements" (Pringle, 1993, p. 6).

        2.11 There is also some evidence that abuse (but not specific to child sexual abuse) is more prevalent in foster care than the general population. A Canadian study of the abuse of children in foster care estimates that proportionately children in care are more susceptible to being abused (Dawson, 1989, cited in Waller and Lindsay, 1990). In New York a report from the central registry suggests that fatalities in foster care due to abuse and neglect, although small in absolute numbers,may appear at two to three times the frequency of the general population (New York State Department of Social Services, 1980, cited in Nunno and Motz, 1988). While it is difficult to ascertain the exact scale of sexual abuse in foster care, it cannot be disputed that it occurs and with a frequency which makes surprising the lack of detailed study.

        3 PREDICTING CHILD SEXUAL ABUSE

        3.1 Finkelhor (1984) proposed that the variety of motives leading to child sexual abuse can be organised into four categories: those relating to emotional congruence (the emotional gratification that the child represents); sexual arousal (the sexual-preference element); blockage (an impaired ability to meet sexual and emotional needs through more conventional relationships); and disinhibition (the undermining of social norms and taboos surrounding sexual contact with children) (Finkelhor, 1984).

        3.2 Salter (1988) lists the array of factors which have been cited in the literature as either causal factors or correlates of intrafamilial child sexual abuse: social isolation; unsatisfactory marital sexual relationship; marital discord; role reversal; wife colluding, passive, powerless or dependent; wife mentally ill; wife physically ill or psychosomatic; sex punitive mother, absent mother; family dysfunction or involvement; alcoholism; seductive child (Salter, 1988; pp. 43 - 44).

        3.3 The problem with many of these factors is that either the research is contradictory or else the correlation of a factor with child sexual abuse does not mean that it was a factor in all, or even the majority of cases of abuse. Some especially the notion of the seductive child have been heavily criticized.

        3.4 Brodie (1992), in his review of the literature, comments that in a number of early studies sexual abuse was frequently classified as accidental, that victims were participating or collaborative or that perpetrators were viewed as "harmless individuals" while the children were seen as "provocative", "aggressive", or "seductive" (Brodie, 1992, pp. 24 - 25). Brodie concludes that this blaming of the victim is unacceptable and it is important to hold the perpetrator accountable for the abuse (Brodie, 1992, p. 29). Faller calls the contention that victims are often seductive, enjoy the sexual abuse or at least tolerated it, as "gross distortions" (Faller, 1988, p. 113; see also Salter, 1988, p. 45). Importantly, she writes:

        While some children who have been sexually abused may appear somewhat seductive, this is a result of the sexual abuse, not a cause. (Faller, 1988, p. 114)

        3.5 In relation to the cluster of factors centred around the non-abusing mother, Russell makes the cogent point:

        It has been easier to blame mothers than to face the fact that daughters are vulnerable to sexual abuse when they do not have strong mothers to protect them from their own fathers and other male relatives. But mothers should not have to protect their children from their children's fathers! And a mother's "failure" to protect her child should not be seen as a causative factor in child sexual abuse. (Russell, 1984, p.264)

        3.6 Unemployment has frequently been seen as a factor in child sexual abuse both in terms of the stress and sense of powerlessness that it creates and in terms of increased access to the children. Russell (1984) notes that while some studies have shown high rates of unemployment among incestuous fathers, others have shown incestuous fathers having good occupational histories (Russell, 1984, p. 265, see also Faller, 1988, p. 95 - 99).

        MacFarlane maintains that in general, sexual abuse is more likely to occur in stressed families, and that unemployment is but one factor in causing stress. (Russell, 1984, p. 265)

        3.7 Social isolation has also been linked to child sexual abuse. Faller writes:

        Social isolation may play a causal role in, may prolong, or may be an effect of sexual abuse. Furthermore, social isolation may be environmentally induced, imposed by the perpetrator, or imposed by the family upon itself. (Faller, 1988, p. 98)

        3.8 The main purpose of this brief review has been to highlight the problems in using the factors linked to sexual abuse of children as predictors. Dingwall (1989) questions the validity of attempts to establish predictive instruments of child abuse and highlights the statistical fallacy where "the failure to recognise that, when one is dealing with a phenomenon which has a low rate of prevalence, even the best predictors yield a high and probably unacceptable level of errors" (Dingwall, 1989, p. 42). He concludes:

        The amount of scientifically-validated research on child abuse and neglect is vanishingly small. The value of any self-styled checklist is negligible. Indeed such tools probably do more harm than good because of the way they further undervalue and undermine professional judgement. (Dingwall, 1989, p. 51)

        4 FOSTERING THE SEXUALLY ABUSED CHILD

        4.1 The difficulties and problems involved in fostering children who have been sexually abused have been discussed by Macaskill (1991); Roberts (1986, 1989, and 1993) and Batty (1991). Of particular relevance to this review is the incidence of sexualized behaviour. Macaskill's study showed that there was clear evidence of sexualized behaviour in 80 per cent of the 80 cases (Macaskill, 1991, p. 71)

        Sexual overtures from abused children included a range of behaviour from touching the foster or adoptive parents' genital areas, through to demands for sexual intercourse (Macaskill, 1991, p 73)

        4.2 In over half the placements, some type of sexual activity was directed towards another child in the family (Macaskill, 1991, p. 86). Roberts also discusses this. She writes:

        The most immediate problem for many foster families is that the sexually abused child will teach other children in the home sexual play. Very young children may be particularly vulnerable to being interfered with. At the other extreme, older children in the home may be invited and provoked into a sexual relationship which they do not understand (Roberts, 1986, p. 10)

        4.3 What effect this behaviour has on the further likelihood of sexual abuse in foster care? A study in the US found that younger children who were sexually abused in foster homes were likely to have been previously sexually abused although this was not as likely for older victims (McFadden and Ryan, 1991, p. 224). Russell suggests that perpetrators of sexual abuse may be able to identify and exploit children who have already been sexually abused and "MacFarlane reports that approximately 25 per cent of the children in one study who were in treatment were revictimized by someone else during the treatment period (personal communication, 1982)" (Russell, 1984, p. 267). In linking inappropriate sexual behaviour to the possibilities of further sexual abuse, however, care must be take not to repeat the argument of the `seductive child'. Responsibility for the abuse must remain firmly with the perpetrator.

        4.4 It was noted above that stress could be a factor in the sexual abuse of children, and Macaskill points out that fostering for children who have been sexually abused is itself extremely stressful.

        Abused children invaded family life, unsettling established roles and relationships and sapping away the energies of those caring for them. Foster and adoptive parents were especially vulnerable as their tolerance level was often stretched to its ultimate level. Several admitted that it was virtually impossible to estimate in advance how heavy the personal toll would be of caring for an abused child. (Mackaskill, 1991, p. 69)

        4.5 McFadden and Ryan (1991) comment that much of abuse in foster care happens "not in inadequate families but in families stressed by the rigors of fostering, especially sequential overloading" (McFadden and Ryan, 1991, p. 215). They go on to stress the importance of regular reviews which would assess levels of stress in the foster home. This also raises important issues about the need for additional supports and resources to foster carers who are caring for children and young people who are severely troubled and exhibiting disturbed behaviour. The call for foster care to be incorporated into the formal economy as a professional, salaried service (Maclean, 1989; Rhodes, 1993; Robinson, 1991) has recently led to the establishment of such a service in some departments.

        5 ALLEGATIONS OF ABUSE IN FOSTER CARE

        5.1 Interestingly, there is a larger literature on the problem of foster carers dealing with allegations of abuse than on the incidence of abuse by foster carers. In the UK, a survey of 36 foster carers for whom allegations were unsubstantiated showed that foster carers were often not told the precise nature of the allegation and so did not know what they were accused of. Investigations were protracted and foster families frequently received little or no support (Hicks and Nixon, 1991; see also Seymour, 1990; Sone; 1992). NFCA has stressed the importance of a code of practice where foster families have been accused of abuse and they should have: the right to be told of the substance of the allegation; to be heard by people not directly involved in the complaint; to place on record their perception of events; to a second medical opinion where physical abuse is alleged and medical evidence is being presented; to proper investigation by competent, experienced and independent people; to support both during the investigation and after it has made its findings; to receive decisions in writing; and the right to appeal (Lowe and Verity, 1989).

        5.2 In the United States, Carbino (1991, 1992) has also stressed the importance of policy and sets out the characteristics of a constructive policy. Staff members and foster carers should be prepared and trained for the reality of allegations. Information needs to be provided about the fact that allegations occur; that the agency will investigate all reports; about the process of the investigation and the decision-making process; what rights foster carers have and do not have; and what resources are available for the support of the foster carers. Throughout the investigation of allegations of abuse, foster carers need to be reminded of resources for information on exactly what the involved agencies are likely to do and what the likely time frame is. Constructive policy should avoid unnecessary or unplanned removals of children. Input of the foster family to a fair and thorough investigation should be guaranteed and support for the family should be provided for interviews and hearings. Timely information on the progress of the investigation and a written notice of the final disposition of the investigation and what it means should be provided (Carbino, 1992, pp. 502 - 504). Following disposition of the report, the foster family should be reminded of agency procedures for this phase, what is likely to take place, and what the avenues for review and appeal of decisions are (Carbino, 1992, p. 506).

        5.3 Carbino makes little mention of the fact that abuse does take place in foster care. Macaskill devotes a chapter in her book to the trauma of allegations but does place this in the context of sexual abuse taking place in foster care. The absence of preparation was a common feature. The research indicated that the idea of being accused of sexual malpractice had not occurred to over one-third of the foster families.

        An absence of basic information resulted in some families engaging in a reckless type of parenting which failed to take cognisance of the child's sexual history (Macaskill, 1991, p. 104).

        5.4 When an allegation of abuse did take place, the lack of information continued and foster families were often unaware of what was taking place. Given the emphasis on the importance of professionals listening to the child and believing the child's story, Macaskill writes that it is "grossly unfair to expect substitute families to take on a sexually abused child without explaining to them how crucial the abused child's words will be if any allegation does occur" (Macaskill, 1991, p. 109).

        5.5 Macaskill sets out a list of recommendations based on the experiences of foster families:

        a) Every local authority and voluntary agency needs to devise clear guidelines for handling allegations.
        b) The importance of alerting every foster and adoptive family to the potential risk of allegations of sexual abuse being made against them.
        c) Familiarize every substitute family with the opportunity to consider changes which may be essential in their lifestyle to protect all family members against allegations. Repeat this exercise in a specific way whenever a new placement occurs, taking into consideration the unique factors in each child's history.
        e) Ensure that the following issues are clarified at the outset of the placement:
        - Who will offer support should an allegation occur?
        - What type of support will be available (including support for other children in the family)?
        - For what length of time will support be available?
        (Macaskill, 1991, p. 109)

        6 FOSTER ASSESSMENT AND CHILD SEXUAL ABUSE

        6.1 Lynette Anderson comments that reviewing the literature:

        ... leads one to conclude that there is a common agreement about the qualities that are needed for good foster parenting, a frustration over how to determine ahead of time whether applicants possess those qualities, and a concern about the time involved in doing the studies. (Anderson, 1982, pp. 37 - 38)

        6.2 Anderson advocates an assessment process which involves: an initial interview to describe the agency and screen out grossly unsuitable applicants; a second interview to complete a questionnaire based on research by Patricia Cautley; a third interview to administer a genogram, a social and emotional history that includes detailed information about marriages, relationships, family, and occupation and education; a home visit to meet all members of the applicant family and to assess their emotional system and communication skills and interviews with referees (Anderson, 1982, pp. 42 - 43). In terms of evaluation of this assessment process, however, Anderson gives little more than general comments about it having a clearer structure and being less dependent on the intuitive skill of the worker (Anderson. 1982, pp. 44).

        6.3 Anderson does raise the issue that "the process depends heavily on self-reporting and people do not always tell the truth, or the whole truth, about themselves" (Anderson, 1982, p. 45). This issue has been addressed by Murray Ryburn and he argues for a model of assessment in which "the social work role is one of skilled facilitation and the evaluative judgements are those of the consumers" (Ryburn, 1991, p. 25).

        6.4 Only one article was identified as focusing specifically on the issue of child sexual abuse in relation to the assessment of foster families. Barnardo's New Families in Humberside, following an instance of sexual abuse by the foster father with the knowledge of the foster mother, changed their method of assessing foster carers. The assessment process stressed:

        information giving (interview with social worker + full day group meeting). Most of the children on referral to the Project were known to have been sexually abused and the likelihood of disclosure was stressed to prospective adopters. The need to investigate and assess as to whether the applicants' family is a safe one is clearly stated (to be open about what the procedures entail, and hopefully to deter potential sexual abusers)
        information collection (obtaining statutory and personal references, police checks, medicals etc). With the knowledge and permission of the applicants, all referees are specifically asked whether they have any reason to believe that the applicant(s) would physically or sexually abuse a child. Previously married applicants are asked permission to contact their ex-spouse or a referee who knew them well during the previous marriage.

        6.5 At this stage, a brief report goes forward to the adoption panel asking for a recommendation for the application to proceed or not.

        Family and Individual Interviews (a long family form is completed by applicants, individual interviews and a family interview are conducted). The family form includes questions on how they learned the facts of life, previous significant relationships, courtship, adjustments to sex, and present sexual relationships. Individual interviews include questions on whether they feel a child would be `safe' in their family, and about issues of sexuality, and growing up. The family interview will address issues such as:
        - the adults' and children's ability to be open and comfortable about bodily parts
        - power relationships within the family
        - family boundaries
        - `open' and `closed' families
        - the family's ability to accept and express feelings
        - family secrets
        - adult understanding of norms and taboos
        (Francis, 1991, pp. 72 - 77)

        6.6 Francis concludes that this paper is "one agency's attempt to address what we believe to be hitherto unexamined areas of work" and that the "fear that we may, despite all of our attempts to assess accurately, approve further abusing families is very real and does not go away" (Francis, 1991, p 78). NFCA also stress the importance of addressing attitudes to sex and sexuality in assessment as these will have direct implications for children placed in foster care. Assessment should provide:

        ... opportunity for discussion of sexual matters and provides a start for looking at sexual relationships both within and outside the family. It also opens discussion on dealing with sexualized behaviour from potential foster children, and gives an opportunity for considering how safe the placement can be for everyone. (NFCA, 1993)

        6.7 Finkelhor, Williams and Burns suggest that in relation to day-care, "many of the most heated public policy debates revolve around whether it is possible to develop procedures that would more effectively exclude potential abusers from day-care operations" (Finkelhor, Williams and Burns, 1988, p. 65). They concluded from their study that perpetrators did not have characteristics which would distinguish them easily from other staff members or other people in general. While a number of abusers had problem histories which may or may not have been related to their abusing, "the number of cases is truly impressive in which perpetrators appeared to be very upstanding individuals who made a good impression on parents and licensers and who had nothing noteworthy in their backgrounds" (Finkelhor, Williams and Burns, 1988, p. 68). They conclude that it is not feasible to screen people for problems in their backgrounds and ferret out child molesters.

        6.8 There is no reason to believe that the situation would be any different in terms of foster families and it is unlikely that assessment will ever be able to effectively screen out all abusive foster or adoptive families (Pringle, 1993, p. 9). Macaskill writes:

        Even when social workers may consider that they have undertaken the most thorough assessment and preparation of a substitute family, it is essential for them to recognize the possibility that sexual abuse could still occur within this foster or adoptive family (Macaskill, 1991, pp. 108 - 109)

        7 PREPARATION AND TRAINING OF FOSTER FAMILIES

        7.1 The training and support of foster carers has been stressed as vital. Blumler et al (1986) organised four training session on child sexual abuse for Merton foster carers. The course aimed to open up the topic of child sexual abuse and to help foster carers to recognise their own emotions. Both foster mothers and foster fathers attended the training. In the first session, foster carers were invited to recall their first awareness of sexuality, of physical differences between the sexes, and childhood names for parts of the body to help them to begin to talk about sex to each other. The second session dealt with `facts and feelings'. The myths about the sexual abuse of children were questioned by presenting statistics and information. The possible causes of child sexual abuse were discussed. Two brief role play episodes aimed at illustrating the complex issues in disclosure and protection. In groups, the foster carers each looked at the situation from one family member's perspective. The third session was devoted to the American video Breaking the Silence in which several adults talk about the profound effects of early abuse on their lives. The final session dealt with `fostering a sexually abused child'. The session was divided into an examination of a child's emotions and behaviours and with ways of handling these. The large group focused on foster carers' feelings: about the child, the abuser, the abuser's partner, themselves - and ways of protecting the family. A flow chart was devised indicating the possible sequence of events following a disclosure. The department's duty to investigate an allegation made by a child against a foster parent was also addressed.

        7.2 Blumler et al did consider that it would have been beneficial to have had someone from outside the authority to act as counsellor as group members had matters that they would have preferred to discuss in confidence or anonymity (Blumler et al, 1986, p. 33).

        7.3 Devine and Tate (1991) also ran an introductory training course for foster carers in Strathclyde Region. The first day offered an opportunity to carers to identify their fears, concerns and uncertainties about child sexual abuse. Definitions and examples of child sexual abuse were considered and facts and figures were used to demonstrate the reality of abuse. Participants were asked to reflect on why they thought adults - mainly men - abuse children. The second day focused on ways to help the child, especially regarding telling about abuse. Verbal and non-verbal communication, particularly about sex and sexual behaviour, was considered from the child's perspective. The third day addressed issues about the non-abusing parent and participants explored the dilemmas that mothers have to face in accepting that their child has been abused by a partner. It also considered the perpetrator and issues of male sexual behaviour. The final session, aimed at placing child sexual abuse back in the broader context of child care, recognising the need for foster carers to be part of the child care and protection team.

        7.4 While the Merton training sessions included foster fathers, the Strathclyde training only involved foster mothers. Finkelhor, Williams and Burns, in relation to day-care, stress the importance of:

        ... clear sexual-abuse-deterrence training for family members of day-care operators. Classes, literature, and briefings could be made mandatory for all those in the household, explicitly discussing sexual abuse, in the hope of thereby deterring some possible perpetrators. (Finkelhor, 1988, p. 69)

        7.5 Macaskill also highlights the importance of preparing other children in the foster family. While most families in the study made some attempt to prepare the other children in a general way, very few prepared them in terms of the issue of sexual abuse and how this might affect them. She found clear evidence that "bringing a sexually abused child into the family placed the other children in a vulnerable situation, especially when they were not adequately forewarned about potential difficulties" (Macaskill, 1991, p. 84). She highlights the need to prepare other children for: sexual overtures from the abused child; disruptive and anti-social behaviour; and inevitable loss of parental attention (Macaskill, 1991, p. 90).

        7.6 Since most sexual abuse in foster families is carried out by foster fathers, it is also crucial that they are included in preparation and training about abuse and its effects on the victim.

        8 CONCLUSION

        8.1 Given the difficulties which have been identified in assessment and review procedures being able to screen out all abusive families, the emphasis in relation to selection, training and retention of foster carers must be that child abuse, including child sexual abuse, is high on the agenda of the social work agencies. This must incorporate the fact that child abuse and child sexual abuse takes place in foster care. This means:

        8.2 Assessment

        - child abuse and child sexual abuse must be discussed in the assessment of prospective foster and adoptive families.

        - assessment of prospective foster and adoptive families must deal with issues of sexuality and power relationships in the family.

        - all members of the family, including the foster carers' children must be included in the process of assessment.

        8.3 Training

        - training must be provided to address with foster carers:

        the incidence of child sexual abuse;
        the causes of child sexual abuse
        the behavioural and emotional effects of abuse on children
        the emotional impact for carers of fostering a sexually abused child
        the Social Work Department's duty to investigate allegations of abuse

        - training, preparation or support should involve all members of the foster family

        - training must be provided to social work staff on the incidence of abuse in foster care

        8.4 Investigation of Allegations of Child Sexual Abuse

        - clear policy and procedures should be formulated for the investigation of allegations of abuse in foster care

        - foster carers should know the policy and procedures and be aware of the process of investigation

        - support systems for foster carers in the event of allegations should be established

        - foster carers should be kept informed at all stages of the investigation

        - removal of children should not take place in a precipitate, unplanned way

        - where allegations are upheld, support should be given to foster families as it would be to other families

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