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Trust and Betrayal in the Treatment of Child Abuse

Laurie K. MacKinnon

July 16, 1999
ISBN 9781572305236
Price: $34.00 $25.50
260 Pages
Size: 6" x 9"
Copyright Date: 1998

Offering a practical new approach to the management of child-at-risk cases, this book illuminates how parents perceive therapists and child protection workers and why, from their own point of view, they so frequently refuse to cooperate with intervention. Amply illustrated by case examples and interviews with parents, the book helps readers overcome common difficulties associated with the referral process while maximizing parents' cooperation and motivation for therapy. MacKinnon challenges dominant professional discourses that attribute abuse to parents' “pathology” or “dysfunction,” showing instead how family violence and the referral process itself are inextricably linked to dynamics of gender, class, power, and powerlessness. Readers learn to develop an effective relationship discourse with families, giving voice to the experience of each member and eliciting their commitment to nonviolence, fairness, and equality. Special attention is given to the therapist's role as a “power broker” who can prevent problems and intervene in difficulties between families and child protection agencies.

“This work is exceptionally readable and very appropriate for an undergraduate library. It should be required reading not only for undergraduates interested in the issue of child abuse but also for graduate students in a variety of majors and professionals who must deal with child abuse. Strongly recommended.”


“MacKinnon's book draws clear lines between the high table of her ideas and the kitchen table of her practice. The examples and anecdotes that illustrate her procedural building blocks are logical and set forth in lucid, intelligent prose. As a result, the book is both fascinating and enjoyable to read. This is a book of originality, skill, and daring, possessing exceptional synthetic power. After ceaseless wrangles among family therapists, feminists, child protection authorities, and trauma experts, and in spite of the enduring conflict between the aims of therapy and social control, MacKinnon has come up with a framework that deals respectfully and elegantly with all these agendas. My prediction is that her book will become a bible in the field. It will also form a table around which warring therapeutic clans, as well as families caught in the middle, can gather to make their peace.”

—Lynn Hoffman, ACSW, Adjunct Lecturer, Smith School of Social Work

“MacKinnon provides a compelling analysis of what makes child-at-risk cases so difficult for therapists, child protection workers, and families. Drawing on her own research, she elucidates the experiences of parents who become caught in a system they feel to be oppressive and punitive. But it need not be so: MacKinnon's extensive clinical experience, and her appreciation of issues of class, gender, and power, are the bases for a detailed account of an alternative approach founded on trust—which counters oppression without itself being oppressive. This important book charts a new path for therapists working in this difficult field.”

—John Carpenter, CPsychol, Director, Centre for Applied Social Studies, University of Durham, UK, Co-editor, Journal of Family Therapy

“Laurie MacKinnon's deeply thoughtful and helpful book on the family treatment of children at risk is in the best tradition of family therapy.... Everyone who does this work needs brave and detailed books like this—books that in their thick description walk the walk, providing expert guidance, reassurance, and innovative technical suggestions that mobilize agency and create space for dialogue between all the parties.”

—From the Foreword by Virginia Goldner, PhD, Co-Director, Gender and Violence Project, Ackerman Institute for the Family

Table of Contents


I. Child Abuse in Context

1. Why Are Child-at-Risk Cases So Difficult?

2. Routes to Therapy

3. Becoming a Client of "the Welfare"

4. Working-Class Life and the Family Ideal

5. The Genealogy of Relationships

II. The Therapist as Power Broker

6. Initial Meetings: Earning the Parents' Trust

7. Working with "the Welfare" in Child-at-Risk Cases

8. Raising the Stakes in Child-at-Risk Cases: Eliciting and Maintaining Parents' Motivation

9. Rewriting the Story of Abuse

10. Creating a Relationship Discourse

11. Conclusion

Appendix: The Research Project

About the Author

Laurie K. MacKinnon, PhD, is a family therapist in private practice as the Director of Insite Therapy and Consulting in Sydney, Australia. Since 1985, she has lectured in family therapy and provided supervision and training to a number of Australian organizations. Originally from Calgary, Canada, where she received her masters in social work and began her training and practice in family therapy, she received her doctorate from the University of Sydney, Australia. She is an Approved Supervisor of the American Association of Marital and Family Therapy and has published a number of articles relating to theory and clinical practice.


Professionals working with families, including practitioners and students of social work, family therapy, psychology, counseling, and related mental health fields, as well as child protection workers and supervisors. In addition, sociologists and family researchers will appreciate the book's powerful insights into working-class family life.

May serve as a text in advanced courses on child welfare, child abuse, and family therapy.

Course Use

May serve as a text in advanced courses on child welfare, child abuse, and family therapy.