Oxford University Press Analysis of nine countries produced three categories of child abuse systems. The countries are Belgium, Canada, Denmark, England, Finland, Germany, the Netherlands, Sweden, and the United States. The three types of system are 1) child protection orientation which emphasize legalistic interventions, 2) family service orientation with mandated reporting, and 3) family service orientation with nonmandatory reporting. The two family service orientation systems emphasize therapeutic interventions. The United States, Canada, and England are child protection systems. Denmark, Sweden, and Finland are family service orientations with mandatory reporting and Belgium, the Netherlands, and Germany are family service orientation systems without mandatory reporting. Each country in this 255-page book is covered in a chapter devoted to a comparative analysis of the frequency and type of abuse encountered and the way the system responds. A concluding chapter summarizes the findings and presents the commonalities observed. There are references following each chapter and the book closes with subject and author indexes. The contrast between child protective systems and family service systems is rather stark. Child protection sees the problem as the protection of children from harm by degenerate relatives, usually a parent. The system is a mechanism of deviance control. Inevitably this sets up an adversarial relationship between parents, system, and children. The family service systems see the problems in families as coming from social and psychological difficulties that are responsive to public assistance and services. Here the relationship becomes a cooperative and compassionate response of assistance. While there is not a specific conclusion, the book provides data strongly suggesting that the welfare of children is best served by the family services systems rather than the child protection approach. For the United States, the data indicate a prevalence rate (from birth to age 18) of 4% of the child population that is abused. This includes all types of abuse — physical abuse, neglect, emotional abuse, and sexual abuse. The percentage of reports substantiated is about 40% while 60% are unsubstantiated. The shift to funding primarily the deviance control mechanism and the adversarial child protection approach has led to a major reduction in the services actually provided to families. In California in 1976, 70% of families where abuse was reported and investigated received services beyond the initial investigation. In 1992 only 6% of reports resulted in services to assist the families. The child saving approach has led to near abandonment of child welfare and the public effort to serve the interests of the child. In every country except the United States, while child abuse reporting rates are rapidly increasing, out-of-home placement rates are declining. Only in the United States is there an increase in out-of-home placements. In California the rate rose from 5.7 to 9.3 per 1,000 children, close to doubling in five years, between 1986 and 1991. There is no evidence that care by the government in fact does a better job of providing for the needs of children. This book is important because it shows there are different approaches and differing models for responding to the fact that some big people savage some little people. It also documents how different structures can permit a more compassionate and less intrusive governmental involvement in the lives of families and children. At this point, based on the facts known, it seems desirable to move away from child protection and child saving as the way to think about abuse and find ways to emphasize a family services understanding and program. All professionals concerned with the abuse of children should study this book and the information it includes thoroughly and carefully. Reviewed by Ralph Underwager, Institute for Psychological Therapies, Northfield, Minnesota.
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