The Effects of Spanking, Corporal Punishment and Physical Abuse on Children and Treatment...

Running head: EFFECTS OF SPANKING AND TREATMENT 1

The Effects of Spanking, Corporal Punishment and Physical Abuse on Children and Treatment

Implications for Counselors Working in Urban Environments

Oscar C. Carr

The University of Memphis

EFFECTS OF SPANKING AND TREATMENT 2

Abstract

This paper explores the literature exploring the short and longer term effects of spanking and

physical abuse on children. The literature, however, is unclear about the definition of spanking

and this ambiguity is explored. The mental health effects of spanking and physical abuse on

large, urban cities like Memphis, Tennessee are also explored. Various interventions and their

efficacy are discussed, including community interventions, psychoeducation, family

interventions, psychopharmacology, group therapy, various clinical techniques including eye

movement desensitization and reprocessing (EMDR), cognitive behavioral therapy (CBT),

mindfulness, and spiritual therapy as well as various trauma based therapies. The paper also

discusses implications for counselors including the need for specialized training in asking,

assessing, and treating clients who have been abused.

Keywords: Spanking, Corporal Punishment, Child Abuse, Physical Abuse, Interventions,

Treatment, Trauma, post-traumatic stress disorder, PTSD, cognitive behavioral therapy, CBT,

trauma focused cognitive behavioral therapy, TF-CBT, EMDR, Family therapy, Multimodal

Trauma Treatment, MMT, Seeking Safety, Psychoeducation, Mindfulness, Assessment, Schools,

Urban, Poverty, ACE Study, Violence, Substance Abuse, Schools.


The Effects of Spanking and Physical Abuse on Children and Treatment Implications for

Counselors Working in Urban Environments

Introduction and Description of the Problem

The issue of spanking and corporal punishment is an important issue in the Memphis

metropolitan area for both educators and parents. The Memphis City Schools only banned

corporal punishment in 2004. (Kelly, 2013). As of 2014, the Memphis City School system has

been absorbed by the Shelby County School System. (Kelly, 2013). In June of 2013, Dorsey

Hopson, who was the interim superintendent and now the permanent superintendent, proposed a

permanent ban to prohibit corporal punishment in Shelby County Schools. (Kelly, 2013). David

Reaves, who was a member of the Unified Memphis and Shelby County School District

questioned the academic research presented. (Kelly, 2013). Mr. Hopson that stated there is no

academic or disciplinary benefits to corporal punishment. (Kelly, 2013). Mr. Reaves responded,

“[m]y own research tells me it works. My kids do great.” (Kelly, 2013). Another board member

and experienced educator, Joe Clayton, stated at the school board meeting that not having the

right to use corporal punishment is like “like sending a soldier into a combat zone and telling

him he can’t take his weapon.” (Kelly, 2013).

But does corporal punishment work? Should Mr. Clayton, who uses his “own research”,

which appears to be based on anecdotal evidence, be the standard for measuring whether

physical violence used on a child is a sound public policy. For parents, does spanking have a

positive effect on children’s behavior and mental health? What the possible long term effects of

using physical force on children. How can a counselor provide treatment interventions for

children who have been spanked, had harsh corporal punishment used against them or who have

been or are being physically abused.


Additionally, what does it say about the thought process of Memphis educators when one

of them refers to the educational environment as a combat zone and corporal punishment as a

weapon. Are the children being educated to be seen as enemy soldiers who are to be deterred by

possible physical violence with the “weapon” of corporal punishment? The academic literature

suggests that spanking is still a tool used by both educators and parents to control and discipline

children. The practice continues even though numerous studies have shown that spanking has

multiple negative mental health effects on children, which can include a lifetime of emotional,

behavioral and interpersonal impairments.

Despite the overwhelming research, the Shelby County Unified School District voted to

table the potential ban on corporal punishment in order “to research the pros and cons of

spanking students.” As of the April 24, 2014, the Shelby County School’s website still has Policy

6025 listed its website which allows a principal or their employee to administer corporal

punishment with a paddle. (Shelby County Board of Education, 2013).

Literature Review

While one might think parents would have more patience and understanding for their

children than educators who think they work in combat zones, the academic research shows that

parents are still very much in favor of using physical force against their own child. For instance,

Straus and Paschal (2009) reported that 93% of parents had hit their 2- to 4-year-old child within

a 2-week period with or without an object while 58% of parents had hit their 5- to 9-year-old

child within a 2-week period. Additionally, 65% of American women and 77% of American men

in a national survey in 2008 agreed that child sometimes need a ‘‘good, hard spanking.”

(Lansford, Wager, Bates, Pettit, & Dodge, 2012).


When asked, parents often say they use spanking to teach their children right from wrong,

to respect authority and to treat others fairly. (Taylor, Hamvas, & Paris, 2012). Parents have

given four more specific justifications for spanking: (1) it is an expression of love and not harm,

(2) it promotes child safety and respect, (3) it works when all else fails, and (4) it taught children

long-term lessons for operating in the world. (Taylor et al., 2012). While mothers may think

loving behavior and attunement can make up for spanking, (Berlin et al., 2010) found that a

mother’s emotional responsiveness did not moderate the effects of spanking.

While the research shows that child corporal punishment and physical abuse is a national

issue, Memphis as an urban metropolitan city in the Southeastern part of the United States has a

higher likelihood of approval and use of corporal punishment, especially with its large mix of

African-Americans and conservative, white Protestants. In a national survey of parents, parents

in the South gave spanking the highest approval rating of any geographic area in the United

States. (Taylor, Hamvas, Rice, Newman, & DeJong, 2011). Approval of spanking was also

higher among African-American Parents and Conservative Protestant Parents. (Taylor et al.,

2011). Numerous studies have consistently shown that African-American parents spank their

children more than white parents. (Berlin et al., 2010). However, one smaller, localized study,

limited to parents in North Carolina who had children under two years of age, found that

African-American mothers reported spanking their children less often than Caucasian mothers

(Zolotor, Robinson, Runyan, Barr, & Murphy, 2011) although another study by one of the same

researchers revealed that the Deep South had different parental spanking patterns than the

Southeast, which included North Carolina. (Zolotor, Theodore, Runyan, D. K., Chang, and

Laskey, 2011). Younger, less educated, lower earning, single, and depressed and stressed parents

are also more likely to spank their children. (Berlin et al., 2010).


Parents with lower socioeconomic status also had higher rates of approval of spanking.

(Taylor et al., 2011). The state of Tennessee, of which Memphis has a large part of the

population, has one of highest percentages of people living in poverty areas of all of the states in

the United States. (Bureau, 2011). Being economically disadvantaged has been linked to

emotional and behavioral problem in children, and has been associated with lower levels of

material investment by parents in their children. (Rijlaarsdam et al., 2013). Poverty has also been

associated with poorer parenting because poverty effects the parental psyche by contributing to

depression and other mental health issues in the parents, which, in turn, effects the parenting

skills and disciplinary measures used by these parents. (Rijlaarsdam et al., 2013).

Not only is the rate of spanking in Memphis likely to be higher than the national average

because of its poverty and demographics, the negative effects of urbanization on mental health

have been carefully documented. (Anakwenze & Zuberi, 2013). These effects must also be

factored into the assessment, intervention and treatment plan for individuals who have been

spanked or suffered caregiver physical violence. Memphians, as urban dwellers, also have a

higher risk of anxiety disorders, mood disorders and schizophrenia. (Anakwenze & Zuberi,

2013). Urban environments often have less green space, higher crime, more violence and as a

result has higher poverty, more unemployment, and higher rates of substance abuse, sexual abuse

and numerous other negative factors that lead to mental health issues. (Anakwenze & Zuberi,

2013). As a result of environmental factors, researchers also have shown that children living in

urban poverty are more likely to experience chronic and complex trauma. (Collins et al., 2011).

Traumatic issues, like multigenerational, family addiction or violence, victimization, gang

violence, incarceration, failing schools, and community violence make parenting difficult and

often result in a higher risk of child maltreatment. (Collins et al., 2011).


It is also important to also counselors to know the institutional racism and systematic

oppression that may affect how parents care for their children in a city like Memphis, which has

a large African-American population. In The New Jim Crow: Mass Incarceration in the Age of

Colorblindness, Stanford law professor Michelle Alexander wrote that there is "a stunningly

comprehensive and well-disguised system of racialized social control" that has created a

"segregated, second-class citizenship" for black men in America (Alexander, 2010, pp. 5, 21). In

large American cities, like Memphis, the young, black male population may have criminal

records up to eighty percent of the time. (Alexander, 2010). Having a criminal record can result

in the lifetime denial of housing, public benefits, access to employment and societal

stigmatization. (Alexander, 2010). The effect of these societal inequalities on how children are

raised and parented cannot be underestimated.

Operational Definition of Spanking, Corporal Punishment and Physical Abuse

Defining spanking versus corporal punishment versus physical abuse is a confusing issue

in the academic literature. Gershoff (2002) reviewed over 300 academic research articles

including 65 dissertations searching for a definition of corporal punishment. Gershoff (2002)

noted that none of the studies included in her meta-analysis questioned the parents about how

they identified corporal punishment but rather provided differing definitions to the parents to

decide whether the parent’s behavior fit the researcher’s definition. At the end of her meta-

analysis, Gershoff (2002) calls for researchers to be more precise in their definitions when

conducting research.

Despite Gershoff’s (2002) meta-analysis and warning to researchers, Gromoske and

Maguire-Jack (2012) did not provide a definition of spanking to mothers completed ten years

later. They did note that mothers likely had different conceptualizations of what spanking


actually is, which is a fact that may constitute a measurement problem. (Maguire-Jack, 2012).

Other scholars have noted numerous studies have investigated spanking without defining the

term, nor have they even asked for parents’ own definitions of spanking. (Berlin et al., 2010).

Other researchers have noted that spanking is one form of corporal punishment that may consist

of swatting a child with a hand or the use of an object to hit a child including but not limited to a

paddle, belt or switch and that the definition of spanking will differ from parent to parent and

researcher to researcher. (Lansford et al., 2012).

While there is disagreement within academia, the majority of spanking researchers hold

that spanking is a subset of corporal punishment, which has been defined as “the use of physical

force with the intention of causing a child to experience pain, but not injury, for the purpose of

correction or control of the child’s behavior.” (Lansford et al., 2012, p. 225). Other researchers

have classified corporal punishment as “bodily punishment of any kind as a form of discipline.”

(Baumrind & Larzelere, 2010). Baumrind & Larzelere (2010, p. 60) define spanking as a type of

corporal punishment that is “a. physically non-injurious; b. intended to modify behavior; and c.

administered with an opened hand to the extremities or buttocks.” The authors then state that

they are adopting a definition of spanking which is limited to “nonabusive usage” and also

excludes severe corporal punishment. (Baumrind & Larzelere, 2010, p. 60). The problem with

these authors’ definition is that they fail to define what is abusive as well as what they consider

to be severe corporal punishment. (Baumrind & Larzelere, 2010).

The Center for Disease Control and Prevention (CDC) defines child abuse as “words or

overt actions that cause harm, potential harm, or threat of harm to a child.” (Center for Disease

Control and Prevention, 2014). The CDC (2014) definition of child abuse is much more

expansive and inclusive than most spanking researchers have defined it to be. (Gershoff, 2002).


Throughout the rest of this paper, the CDC definition of abuse will be the measurement of what

constitutes abuse, a fact, which means that spanking, corporal punishment and physical violence

are all considered to be forms of child abuse when counselors treat clients.

Spanking and Corporal Punishment as a Form of Child Abuse and Violence

Many researchers consider any corporal punishment to be a form of child physical abuse

(Perrin, 2011). In her meta-analysis of over 300 academic articles on spanking and corporal

punishment, Gershoff (2002, p.540) notes that “the majority of child abuse researchers view

corporal punishment and potentially abusive techniques as points on a continuum of physical

acts toward children.” Some researchers hold that hitting a child with an object such as a paddle,

switch or spoon is not normal corporal punishment. (Baumrind, Larzelere, & Cowan, 2002).

Researchers have found that escalated spanking often results in Child protective services

becoming involved and substantiating the behavior as abuse. (Zolotor et al., 2011). There is also

research finding that abusive parents are more likely to spank than parents who are not

considered to be abusers. (Zolotor et al., 2011). Parents who had abused their children noted that

up to two thirds of their abusive episodes began as efforts to influence children’s conduct or to

“teach them a lesson.” (Gershoff, 2002, p. 542).

Sociologists do not believe that there is anything such as normal violence, including

corporal punishment (Perrin, 2011). Citing Albert Bandura’s social learning theory, they assert

that caregiver violence models to children that authority figures can use violence and that it is

acceptable and condoned when the authority figure has the power to use it. (Perrin, 2011). Other

recent research shows a strong association between corporal punishment and violence. In fact,

corporal punishment has been shown to be a strong risk factor for child maltreatment. (Taylor et

al., 2011). When there is intimate partner aggression and violence in the home, there is more


likely to be corporal punishment of children. (Taylor et al., 2011). It is also interesting to note

that the American Academy of Pediatrics strongly opposes hitting a child for any reason (Afifi,

Mota, Dasiewicz, MacMillan, & Sareen, 2012).

The Effects of Spanking and Child Abuse

Whether it is spanking with an open hand, using an object to spank, or more severe

violence, numerous studies have documented the negative effects of using physical force on

children. In what they claim to be first study using a nationally representative sample,

researchers, after adjusting for variables including differing social, demographic, and family

history, found that harsh physical punishment was associated with increased chances of anxiety

disorders, mood disorders, alcohol and drug dependence and abuse, and numerous personality

disorders. (Afifi et al., 2012). Weitzman (2005, p.323) has noted that even one act of violence

towards a young child can “constrict personality functioning and, if untreated, burrow itself into

the child's personality to create massive characterological distortions.” Mistreated children also

have a greater risk of suffering from cognitive impairments. (Buckstein & Horner, 2010).

Numerous studies have also shown that child spanking is associated a child’s later

externalizing or acting out behavior, (Gromoske & Maguire-Jack, 2012) which includes

hyperactivity as well as the development of Oppositional Defiant Disorder and Conduct Disorder

in children. (Lansford et al., 2012). In her meta-analysis, Gershoff (2002) found that corporal

punishment was associated with increased aggressive behaviors, violence, antisocial behavior,

delinquency, and adult criminality in the punished children. Gershoff (2002) also found that

harsh punishment has been linked to decreased assertiveness and confidence in children as well

as feelings of helplessness and humiliation.


Additionally, children who have had physical force used against them may have greater

interpersonal issues as a children and adults. Spanking can hurt the parent-child relationship

because children can become anxious and fearful of the parent, which may result in the child

failing to bond with the parent because of issues of trust. (Gershoff, 2002). As adults, these

children may also be more likely to continue the intergenerational transmission of trauma and

antisocial behavior to the next generation. (Coley, Carrano, & Lewin-Bizan, 2011). Mistreated

children also have a greater risk of unstable peer relationships (Conrad, 2006) and more

difficulty in having healthy interpersonal relationships. (Habib, Labruna, & Newman, 2013).

Recent research has also shown that physical abuse is associated with higher rates of

juvenile delinquency and PTSD in girls between the ages of 13-17. (Ford, Steinberg, Hawke,

Levine, & Zhang, 2012). Abuse may also create a combination of acting in behaviors including

depression and anxiety mixed with acting out behaviors like impulsivity, aggression and

substance abuse which can combine to create emotional chaos in the victim leading to the

emotionally hijack the victim’s physical and cognitive response systems in stressful situations.

(Ford et al., 2012)

Physical abuse also puts a severe economic strain on communities and families. When

compared to other hospitalized children, children admitted to hospitals for documented physical

abuse were more likely to die, have to stay longer, had twice the diagnosis rate, and double the

financial charges than the non-abused children. (Rovi, Chen, & Johnson, 2004). The directs

costs, which include the investigation of abuse and neglect, and the funding of judicial, law

enforcement, health, and mental health systems is estimated to be 24 billion dollars a year.

(Conrad, 2006). The indirect costs of child abuse, which include associated juvenile and adult

criminal activity, mental illness, substance abuse, and domestic violence as well as the cost of


special education services, loss of efficiency due to joblessness and underemployment, and

greater use of the health care system are estimated at 69 billion dollars a year. (Conrad, 2006).

The long term health effects of childhood maltreatment and abuse are severe. 30% of all

victims of child maltreatment have chronic health problems associated with the abuse. (Conrad,

2006). The Center for Disease Control and Prevention (CDC) and Kaiser Permanente also

completed assessed the association of childhood maltreatment and later life physical well-being.

(CDC, 2013). The ACE Study investigated over 17,000 individuals who had experienced

Adverse Childhood Experiences (ACE) as children. (CDC, 2013). ACE events were separated

into three different categories including abuse, neglect and household dysfunction. (CDC, 2013).

Abuse events were defined as emotional abuse, physical abuse, and sexual abuse. (CDC, 2013).

Neglect events were defined as emotional neglect and physical neglect. (CDC, 2013). Household

dysfunction events were mother treated violently, household substance abuse, household mental

illness, parental separation or divorce, or incarcerated household member. (CDC, 2013). The

ACE Study defined physical abuse as being “sometimes, often, or very often pushed, grabbed,

slapped, or had something thrown at you or ever hit you so hard that you had marks or were

injured.” (CDC, 2013).

Under the ACE definition of physical abuse, it is likely that most forms of spanking

would be included under that definition although some proponents of spanking may dispute that

assertion. (CDC, 2013). The ACE study found that the greater number of ACE events in a child’s

life the greater likelihood of negative mental, physical, and emotional issues later in life. While

the ACE study is too exhaustive to be fully developed in this paper, the ACE researchers created

an ACE Pyramid which best captures the association between negative childhood events and

later life consequences.


Figure 1 The ACE Pyramid showing the links between Adverse Childhood Experiences and

issues and consequences later in life adapted from CDC (2013).

Effective Treatment Interventions for Abuse Victims

There are a number of interventions available to counselors to both prevent spanking,

corporal punishment and child physical abuse and to treat children and adult survivors. At the

societal and communal level, counselors can advocate and educate for changes that may decrease

the risks associated with growing up in a poor, urban environment. At the individual and family

level, counselors can use psychoeducation, family interventions, psychopharmacology, group

therapy, various clinical techniques including eye movement desensitization and reprocessing

(EMDR), cognitive behavioral therapy (CBT), mindfulness, and various trauma based therapies.

At the community level, there are a number of preventative programs and interventions

that can be used to ameliorate the harm of growing up in urban poverty where there is a greater

likelihood of physical abuse and spanking as well as mental health issues. Researchers suggest

that mental health coalitions made up of various agencies, institutions, parents and government

entities at the state, local and federal level ally themselves to address the needs of children in

urban environments and to increase beneficial social networks for children. (Anakwenze &

Zuberi, 2013). Urban children have a harder time accessing mental health services, and studies

have shown that minority children living an urban environment are never connected to a mental

health service providers at two-thirds less than other children. (Anakwenze & Zuberi, 2013).


Researchers also suggest that mental health questionnaires and screening for child abuse be

administered in public health clinics, preschools, daycares, and pediatrician offices. (Stephens,

2006).

Other strategies are to have trained mental health workers, who are culturally sensitive,

engage the family of the child who is suffering from a mental health disorder and to provide

family services as well as child services. (Anakwenze & Zuberi, 2013). The promotion, support

and engagement of school based services and education about mental health and spanking is also

another effective strategy for reaching children in an urban environment. (Anakwenze & Zuberi,

2013). Counselor engagement of urban churches and pastors to educate them and use them as

allies and referral sources for children suffering from physical abuse or mental health issues.

(Anakwenze & Zuberi, 2013). Finally, researchers have suggest public information campaigns

against spanking, like those campaigns against alcohol and tobacco use, to reduce the incidence

of spanking by parents. (Taylor et al., 2011).

Researchers have also created a trauma based community approach based on family

interventions as well as evidence based trauma therapies. (Collins et al., 2011). This family

trauma intervention approach targets children and families living in cities with urban poverty

who are more likely to have child mistreatment. (Collins et al., 2011). The focus of the

intervention is on breaking the chain of multigenerational trauma family interventions focusing

on normalizing trauma reactions, emotion regulation, family-shared meaning of trauma and

social support. (Collins et al., 2011).

While the family focused trauma intervention model appears to be very

comprehensive, it may cost prohibitive for many communities because of the amount of

staff and training it would take to implement such a plan in urban areas with millions of


people. Unfortunately, the authors of the study did not include a cost component in their

recommendation. (Berlin et al., 2010). Other researchers have found that trauma

informed therapy for disenfranchised urban children and youth can be helpful if it is done

in the proper manner. (Becker, Greenwald, & Mitchell, 2011). Trauma informed

treatment involves Fairy Tale therapy, a modality where children are encouraged to

engage in a narrative where they face and overcome their trauma. (Black, Woodworth,

Tremblay, & Carpenter, 2012).Trauma informed therapy also includes more traditional

trauma exposure and emotional regulation exercises (Black et al., 2012).

A 2012 study of traumatized adolescents using from the Substance Abuse and

Mental Health Services Administration (SAMHSA) and the Center for Substance Abuse

Treatment (CSAT) found that traumatized youth need an integrated care system for

trauma and substance abuse issues. (Suarez, Belcher, Briggs, & Titus, 2012). Suarez et al.

(2012) noted that numerous research studies have shown the link between childhood

trauma and the later development of substance abuse in adolescence, yet there have been

few studies showing how specialized care can be delivered to adolescents who suffer

from both trauma and substance abuse.

After analyzing the data set Suarez et al. (2012) found the need for mental health,

community and school systems to engage in systematic screening and assessment for

trauma exposure, traumatic stress symptoms and substance abuse problems should be

routinely provided across service systems and for youth to have access to a wide range of

treatment options and services that provide higher levels of care. Suarez et al. (2012) also

noted the need to develop structural resources that facilitate communication and

connections among mental health providers to foster integrated service sectors, and cross


training of providers in both trauma and substance abuse so that mental health services

can provide comprehensive services to abused adolescents.

While there are numerous community and family intervention type interventions,

a counselor may be working with a child, teenager or adult who no longer lives with their

family of origin or who does not have access to their client’s family. In this case,

individual or group therapy interventions may be the best approach. Music and art

therapy have been shown to be effective in helping abused clients. (Weitzman, 2005).

EMDR has also shown to be effective in reducing the anxiety related to specific

memories of abuse and has been shown to be more efficient with children and

adolescents than CBT. (Becker et al., 2011). Counselors also need to be aware of a

client’s use of psychopharmaceuticals and have a working relationship with a psychiatrist

who can prescribe antidepressants and other medications as needed. (Perrin, 2011).

Other researchers claim that CBT that is specifically designed for children, which

is called Multimodal Trauma Treatment (MMT), is the most effective therapy for

children and adolescents. (Black et al., 2012). MMT consists of a group of children or

adolescents who engage in a number of exercises with a counselor including

psychoeducation, narrative therapy, including journaling about their trauma, exposure to

memories of the trauma, relaxation techniques and cognitive restructuring. (Black et al.,

2012). Psychoeducation is usually a counselor’s first option and is used to help a person

understand what a traumatic event is, how experiencing trauma affects that person, and

how trauma-related symptoms may continue long after the traumatic event. (Black et al.,

2012).


Trauma Focused Cognitive Behavioral Therapy has (TF-CBT) also been shown to

be effective in treating single or multiple trauma by numerous studies involving both

Caucasian and African-American children. TF-CBT has been shown to positively reduce

post-traumatic stress disorder (PTSD) symptoms, depression, and behavioral issues in

children when compared to other therapeutic modalities (Black et al., 2012).

Seeking Safety is a treatment that focuses on trauma related symptoms as well as

substance use disorders in adolescents and adults. (Black et al., 2012). Seeking safety has

been shown to be effective in reducing symptoms of PTSD and substance abuse. (Black

et al., 2012). It focuses on five basic principles: personal safety as a priority, the

integrated treatment of both trauma and PTSD, an emphasis on a client’s needs, attention

to the therapeutic process, and an emphasis on four definite client content areas—

behaviors, interpersonal interactions, cognitions and case management. (Black et al.,

2012).

For adults and adolescents, enhancing spiritual connection and mindfulness may

help relieve the effect of physical abuse. “Mindfulness is described as moment-to-

moment, non- judgmental attention and awareness actively cultivated and developed

through meditation.” (Kimbrough, Magyari, Langenberg, Chesney, & Berman, 2010).

Mindfulness has been empirically shown to reduce symptoms of depression, anxiety and

somatic complaints. (Kimbrough et al., 2010). In one of the first studies of its kind,

Kimbrough et al. (2010) measured PTSD and depressive symptoms in childhood sexual

abuse survivors and found that after only eight class sessions, one all day retreat and light

homework assignments that PTSD symptoms including avoidance, numbing, re-

experiencing, hyperarousal and depressive symptoms all decreased at clinically


significant rates. (Kimbrough et al., 2010). While this research did not address children

who were abused, it does lend support that PTSD type symptoms and depression in adult

child abuse victims may be treated by mindfulness.

Implications for Counselors in Urban Areas

Counselors living in Memphis need to know how to treat clients that have been spanked,

harshly punished, or physically abused. The research shows that a large proportion of the

Memphis population has likely been spanked or physically abused. Memphis has all of the

attendant risk factors for high rates of spanking and abuse. Memphis is a large, urban city located

in the Deep South with a large religiously conservative, white population, a large African-

American population and high rates of generational poverty and crime. At a general level, it has

also been shown that mental health clients were likely abused as children so counselors should

be prepared to treat such abuse wherever they may be working. For example, a review of 46

studies of female in-patient and outpatient population showed that 48% of them had suffered

from physical abuse during childhood and the male in-patient and outpatient population showed

that 50% of them had suffered from physical abuse during childhood. (Read, Hammersley, &

Rudegeair, 2007).

When counselors perform an intake and assessment of a client living in Memphis, the

counselor should take a careful trauma history of their client. Studies have shown that survivors

of childhood abuse often wait ten to fifteen years to tell anyone about child abuse. (Read et al.,

2007). Individuals are not more likely to tell mental health professionals about abuse (Read et al.,

2007) so counselors should not wait to be spontaneously told about abuse. In fact, studies have

found that psychiatric patients may actually underreport their abuse. (Read et al., 2007). Studies

have also shown that mental health professionals often fail to ask clients about abuse and that


statistically clinicians miss more than half of the abuse that is reported to researchers. (Read et

al., 2007). One study that asked mental health service client if they had been asked about abuse

found that 78% of them were not asked about it in their initial assessment. (Read et al., 2007).

Counselors often fail to ask clients about abuse because they believe other issues are

more important and pressing, are afraid it will disturb or anger the client or that questioning may

cause false memories to appear. (Read et al., 2007). Studies have shown that clients are often

angry if they are not asked about abuse. (Read et al., 2007). Additionally, client reports of

childhood abuse have been shown to be quite reliable even with those client who have psychosis.

(Read et al., 2007). Other barriers to asking questions about abuse are a clinician’s fear of being

vicariously traumatized, the client being male or client being the opposite gender of the

counselor, lack of clinician’s training on how to respond to abuse, and a strong belief that mental

health problems are a result of biology and genetics rather than traumatic abuse. (Read et al.,

2007).

Researchers recommend that clinicians take a number of steps to address abuse. First,

clinicians should ask every client about abuse not just clients that appear to have PTSD. (Read et

al., 2007). Second, even when clinicians do ask about abuse, they often do not offer a sufficient

response in that they do not offer additional resources to clients, refer them to additional or

specialized counseling, document the abuse in their files, include treating the abuse in their

treatment plan, or consider reporting the abuse to authorities. (Read et al., 2007). Clinicians must

become more aware of how to follow all of these protocols by seeking proper training and

following through with what they have learned.

Clinicians must learn how to ask the proper questions in the proper way. Instead of

asking questions like, “were you abused traumatized a child”, which may lead to an answer of


“No”, a counselor should ask questions without using professional jargon. (Read et al., 2007). It

is suggested that clinicians use a “funnel” of questions that start with the general and become

more specific as they are being asked. (Read et al., 2007). For instance, a counselor might ask a

client, “please tell me about your childhood” and then ask, “how did your parents punish you as

a child?”, or “what was the angriest you ever saw one of your parents? What did they do to

you?” (Read et al., 2007).

When responding to abuse, experts suggest a few things. First, the clinician should affirm

that it is a positive thing for the client to share about the abuse. (Read et al., 2007). A clinician

can then ask if this is the first time that the client has told anyone about the abuse. (Read et al.,

2007). If it is the first time, it may have been years since the abuse, and the client may need more

support than someone who told someone right after the abuse and received treatment and support

at the time. (Read et al., 2007). The first sharing, however, is not the time for the clinician to

gather every, specific detail about the abuse. (Read et al., 2007). It is also important for the

clinician to offer specific treatment options to the abused client. (Read et al., 2007). The clinician

should then ask their clients if they believe their current emotional issues are related to their past

abuse. (Read et al., 2007). This question about a causal connection should be asked even if the

clinician does not think that is the case. (Read et al., 2007). At the end of the session, clinicians

should do an emotional check-in to ask how the client is doing after disclosing abuse and provide

support resources and phone numbers in case the client becomes upset at a later date. (Read et

al., 2007). Clinicians should also take very detailed notes and include quotations, in cases of

abuse, and consider reporting to authorities as required or needed. (Read et al., 2007). It is also

suggested that clinicians seek out a specific training program or workshops on assessing and


treating abuse. (Read et al., 2007). Clinicians with specific abuse training have been shown to

identify abuse at higher rates than those who have not received such training. (Read et al., 2007).

Conclusions

As show by the research above, the implications for counselors in urban areas like

Memphis are great. Counselors need to seek greater training for treating abuse victims. The

literature shows that a large percentage of both children and adults are likely to have been

effected by spanking or more serious physical abuse. Counselors working with this population

may also need to seek greater training as to the specific interventions to be used like EMDR, TF-

CBT, art and music therapy, family interventions, Seeking Safety, and MMT. Counselors need to

be able to assess, diagnose, and treat both victims and perpetrators of violence.

Counselors may also choose to become publicly involved in advocating the abolishment

of corporal punishment in public schools like the type used in Shelby County, Tennessee or any

other school system or institution for children. Despite one school board’s comments, the

academic literature shows that corporal punishment is not an effective “weapon” against children

who misbehave. In fact, spanking is associated with higher rates of mental health issues.

Counselors should inform current and future parents, educators and caregivers as to the massive

amounts of academic research showing both the short and long term negative effects of spanking

on children. Counselors can also become involved in community efforts to integrate treatment by

doing their part to communicate with other institutions and systems, like their clients’ schools,

places of worship, community centers, local, state and federal governments and any other

treatment providers that may be involved with their clients or their family.


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