This groundbreaking new book is a major contribution to ongoing development which will safeguard and promote the welfare of the children who have illness fabricated or induced (FII), previously known as 'Munchausen Syndrome by Proxy'. Promoting a multi-disciplinary and multi-agency approach with a parent and carer focus, this book is the ideal ready reference for the busy children's services professional. It includes reports from both healthcare professionals and victims of FII, and features tables, case studies, examples, appendices, an index, a glossary of terms and is referenced for further reading. The information is wide-ranging and is a collaboration from professionals with varied backgrounds. This book supports national guidance on FII and is vital for all health, social care and education professionals and the Police. It will also be invaluable for therapists including psychologists, psychiatrists and mental healthcare workers.
Table of Contents
Overview. What is Fabricated or Induced Illness (FII)? Statement re nomenclature. Nature of the phenomena. Presentations of FII. Thirteen examples to illustrate presentations of FII. Verbal fabrications. Falsification of specimens. Illness induction. A possible fabricated psychiatric disorder. Fabrication in the setting of genuine physical illness. Presentations in obstetric settings. Symptom coaching. Examples of participation by the child. Impact on victims. The short-term consequences for the victim. Mortality and serious physical effects. Co-morbidity in the short term. Effects at follow up. Accounts by survivors. The perpetrators. Behaviour of fabricators. The mother-child relationship. Psychopathology. Overview of psychopathology. Fathers as fabricators. Understanding FII in context. Understanding using a developmental and family systems approach. A narrative approach. Early life experiences and family patterns of fabricators. Trans-generational attachment. Dimensions of parent behaviour. The psychosomatic continuum: what is not FII. The 'vulnerable child'. Illness behaviour and abnormal illness behaviour. What is somatization? What is somatization disorder? What influences the development of somatization? Responses by professionals: challenges for the multi-disciplinary response. Policy and Practice. The starting position. Uncertainty in FII. Degree of certainty of the diagnosis of fabrication or induction. Addressing particular difficulties in managing FII. Developing good inter-agency practice. Implications for training. Contributions by psychiatric services. Overview. Individual psychotherapy as an outpatient. Individual psychotherapy as an inpatient. Family therapy. Outcome of psychiatric intervention. Incidence, Knowledge and Prevention of FII. How common, or rare, is FII? A study in New Zealand. A survey of pediatricians in the USA. What do professionals know about FII? Effects on a paediatric nursing staff. A model of the staff reactions. Prevention of FII. Strategies for prevention. Universal strategies. Targeted prevention. Specialist prevention.