Interventions with families in difficulty and the role of the multi-disciplinary team (MDT): The UK approach

Early prevention and detection of problem parenting, family violence and child maltreatment is traditionally classified into three levels: primary prevention (universal services aimed at the whole population); secondary prevention (targeted services for families identified as in need of further support); and tertiary prevention (services offered once difficulties have occurred). However, increasingly it has been argued that problem parenting and child maltreatment should be considered within the broader context of child welfare, families and communities (World Health Organisation, 2002; Browne et al, 2006). This has been termed the public health approach which promotes child care and protection within the broader context of child welfare, families and communities. Families who come into contact with health and social services can be assessed in terms of need by considering the following three factors: • Assessment of children’s development needs in general • Assessment of the parent(s) capacity to respond appropriately to their child’s needs • Assessment of the wider social and environmental factors that impact on the capacity to parent Aims: The primary focus of health care professionals is the prevention of child disability, morbidity and mortality. To promote the early detection of child maltreatment, history-taking by doctors and nurses should include components that identify risk factors associated with child abuse and neglect. Conclusion and discussion: However, the risk approach will identify a number of false alarms and so these at risk families should not be labelled but placed in priority for services. Most authors conclude that a multi-sector, multi-disciplinary team (MDT) approach is the most effective way of working together to promote children’s rights to grow and develop in a safe family environment and provide care and protection to children.