Maltreating caregivers: An application of the transtheoretical model of change

Many of the decisions that must be made by child protective service (CPS) agencies involve assessing the extent to which maltreating caregivers have made or are ready to make changes in their parenting behaviors. Yet, little is known about the process of change for these caregivers and no method is available to systematically measure their success in making the changes that CPS agencies require of them. The current study applies the Transtheoretical Model of Change to the problem of child abuse and neglect. The Transtheoretical Model has successfully measured change in many health-related behaviors including smoking and exercise. More recently, the model has been applied to more complex social problems such as domestic violence and criminal behavior. Three preliminary scales based on the model\u27s constructs, “Stages of Change”, “Decisional Balance”, and “Self-Efficacy”, were administered to 157 caregivers involved with Rhode Island\u27s Department of Children Youth and Families (RIDCYF). These measures were refined and analyses indicated the psychometric properties of each scale were solid. Principal Components Analysis performed on the “Stages of Change” scale supported three stages of change, “Precontemplation”, “Contemplation”, and “Action”. Cluster analysis based on staging profiles identified six clusters of maltreating caregivers hypothesized to represent subgroups with different attitudes and intentions regarding change. These groups were labeled, “Resistant”, “Non-Reflective Action”, “Discouraged”, “Ambivalent”, “Participation”, and “Action.” Differences between the cluster groups on the “Decisional Balance” and “Self-Efficacy” scales supported hypotheses about these groups and offered preliminary support for the applicability of the TTM in this area. Comparison of the groups on two additional scales “Cooperative Attitudes toward Child Protective Services” (CACPS) and “Concerns About Substance Abuse” (CASA) also provided useful information about differences between these sub-groups. Relevance of the findings for child welfare policy and service provision were discussed as well as recommendations for future research