1st Edition

Munchausen by Proxy Identification, Intervention, and Case Management

By Louisa Lasher, Mary S Sheridan Copyright 2004
    374 Pages
    by Routledge

    374 Pages
    by Routledge

    This step-by-step guide will help you identify and manage cases of this unique form of child maltreatment!

    Munchausen by proxy (MBP) is a dangerous kind of maltreatment in which a caretaker deliberately and repeatedly exaggerates, fabricates, and/or induces a health problem or problems in someone under his or her care. Munchausen by Proxy: Identification, Intervention, and Case Management is the first book to walk you step-by-step through a suspected MBP maltreatment case from suspicion onward. This skills-based, practical book contains a thorough, up-to-date overview of MBP and includes suggestions for identifying and reporting to child protection agencies, investigating and gathering evidence, and legal and court procedures. Its easy readability and immediate applicability make this text a valuable tool in identifying and preventing this form of child abuse.

    Munchausen by Proxy is divided into three parts. The first covers the definition of MBP, the role of the perpetrator and victim, and the ethical issues affecting professionals, patients, and family. Part two addresses case work from initial suspicions through the investigative and confirmation/disconfirmation process. The third section is dedicated to case planning and case management once MBP has been confirmed, including intervention, immediate child protection, and legal activities.

    Those involved in a suspected or confirmed MBP case will learn about:

    • the limits of the DSM-IV as applied to MBP
    • perpetrator-consistent characteristics
    • the MBP situational suspicion indicators
    • the inappropriateness of risk assessment tools developed for other forms of maltreatment
    • the danger when MBP perpetrators realize they are under suspicion
    • and more!
    This volume is generously enhanced with case examples, sample forms, figures, and representative management plans. In Munchausen by Proxy, authors Lasher and Sheridan—experts in MBP and child protection—have come together to fill the gap in the libraries of anyone who may become involved with a MBP case. This includes child welfare professionals and staff, law enforcement, school personnel, health care practitioners, judges and lawyers, and social workers.

    • Foreword (Marc D. Feldman)
    • Preface and Acknowledgments
    • Chapter 1. Defining Munchausen by Proxy
    • Elements of the Definition
    • Terminology Issues
    • A Controversy: Does MBP Exist?
    • Chapter 2. Perpetrators, Victims, and Others
    • Perpetrators
    • Victims
    • Others
    • Chapter 3. Integrity in MBP Practice
    • Fairness
    • Reporting to Child Protective Agencies
    • Confidentiality
    • Qualifications to Practice in the Field
    • Colleague Relationships
    • System Issues
    • Public Awareness of MBP
    • Building a Solid Knowledge Base for MBP Theory and Practice
    • Chapter 4. Essential Elements in the Confirmation/Disconfirmation Process
    • Description of the Essential Elements
    • The Essential Elements for MBP Case Success Applied to a Case Example
    • Chapter 5. Suspecting and Reporting
    • Suspecting MBP
    • Reporting MBP
    • Criteria for Confirming/Disconfirming MBP
    • Initial Child Protective Agency Response to a Report of MBP Suspicions
    • Chapter 6. Gathering Information: The MBP Investigation
    • Written Records and Documents
    • Interviews
    • Other Methods of Information Gathering
    • Chapter 7. Information Evaluation, Information Organization, and the Confirmation/Disconfirmation Decision
    • Information Evaluation
    • Organizing Information
    • The MBP Confirmation/Disconfirmation Decision and the Functioning of the MMT
    • The Work of the MMT: Initial and Subsequent Meetings
    • Chapter 8. Essential Elements in Case Planning and Case Management When MBP Has Been Confirmed
    • The Essential Elements Following Confirmation
    • Summary of the Formula for MBP Case Success: A Case Example
    • Chapter 9. Initial Postconfirmation Victim and Case Protection
    • Initial Task 1: Risk Assessment
    • Initial Task 2: Protecting the Victim and the Case
    • Initial Task 3: Removing the Victim from the Care, Custody, Control, and Influence of the Perpetrator; Placement in an Appropriate Setting
    • Initial Task 4: The Postconfirmation/Confrontation Interview
    • Appendix: Munchausen by Proxy Risk Assessment Work Sheet
    • Chapter 10. MBP Case Planning and Management
    • Case Planning in Child Protection and MBP Cases
    • Case Planning Goal 1: Ensuring the Safety of the Victim(s) and Sibling(s)
    • Case Planning Goal 2: Provision of Appropriate Case Services
    • Case Planning Goals 3 and 4: Determining the Permanency Goal, Time Line, and Future Planning
    • Appendix: Recommended Case Plan Elements in MBP
    • Chapter 11. MBP Maltreatment Legal Activities and Considerations
    • Attorney Selection
    • The MBP Expert
    • Selecting the MBP Expert
    • Common MBP Maltreatment Legal Strategies
    • Motions
    • Educating the Court About MBP Maltreatment
    • The Probable Cause Hearing
    • A Final Observation on the Importance of the Court Process
    • Chapter 12. Therapeutic Considerations with Perpetrators
    • Therapy in the MBP Literature
    • Diagnosis and Prognosis in MBP
    • Conclusion
    • Chapter 13. Implications for Intervention with Victims
    • Assessing the Victim’s Need for Psychosocial Treatment
    • Consequences of MBP to Victims
    • Therapeutic Approaches Described in the Literature
    • MBP and Child Sexual Abuse: An Analogy
    • References
    • Index


    Mary S Sheridan, Louisa Lasher