Reframing Child Abuse & Neglect for Increased Understanding & Engagement:
Defining the Need for Strategic Reframing
By Kevin T. Kirkpatrick, MS, Vice President, Marketing,
Communications and Advancement, Prevent Child Abuse America*

Abusive behavior is considered to be a very individual and private act against society, and therefore difficult to detect. Nearly everyone agreed that the existence of, and accessibility to, extensive educational programs is the one most significant factor in the reduction of the problem. In accordance with the above, it was felt that society has a responsibility to train those parents who have had no, little or improper training to become more cognizant of their children's needs. And it was also recognized, that although society can offer educational services, there will always be a portion of society that still fails to recognize any need for behavioral modification (1).

Introduction
The observation above, included in a 1983 research study commissioned by Prevent Child Abuse America (PCA America) could just as easily have been written today. Numerous market research projects completed since 2001, in fact, illustrate that public attitudes about child abuse and neglect have remained largely unchanged for the past 20 years.

Since the mid-1970s, public service campaigns (led by the nearly three decade partnership between Prevent Child Abuse America and the Advertising Council) have effectively raised awareness of the existence of the problem from less than 10 percent to greater than 90 percent. But, they have been unable to convince the public that prevention is possible and to motivate positive behavior change, at either the individual or societal levels, in support of prevention.

And although child abuse and neglect is killing nearly 1,000 children every year and is harming millions of others, the issue has never been successfully raised to the level of public policy priority. Funding of both research and prevention programs has been difficult to obtain (and retain) in even the most robust economic periods, undoubtedly due at least in part to the lack of public understanding on the issue and the perceived importance of prevention.

Why?
A number of theories have been posed in recent years to answer this question. Is it because the majority of Americans believe that child abuse and neglect happens to "other people" and, therefore, feels an emotional distance from the issue? Is it because the public has come to accept a certain amount of child abuse and neglect as a societal "given"? Is it because cultural values associated with parenting and privacy actively discourage people from getting involved in any substantive way on prevention? Or are the "benefits" of prevention too far removed from the act of prevention itself, making it difficult to comprehend the relationship between cause and effect?

It is likely that all of these questions are true to varying degrees.

It is almost certainly true that the strategies employed so successfully by the child abuse and neglect prevention field to generate media coverage and public awareness starting in the mid-1970s have resulted in a vicious cycle in which new communications on the issue tends to conform to, and reinforce, the existing frame of reference.

The overwhelming imbalance between media coverage of the negative aspects of the child abuse and neglect story compared to its coverage of potential solutions to the problem is likely both a reflection of, and part of the reason for, the general public's sense of hopelessness on the issue. A recent analysis by Prevent Child Abuse America, in fact, shows that national television and radio news broadcasts during the period 1993 to mid-2002 carried 664 stories on the subject of child abductions and 282 on child molestation while carrying only four stories on "positive parenting" and 67 on child abuse prevention during this same period of time. (2)

While the establishment of a certain degree of public horror relative to the issue of child abuse and neglect was probably necessary in the early years to create public awareness of the issue, the resulting conceptual model adopted by the public has become one of the largest barriers to advancing the issue further in terms of individual behavior change, societal solutions and policy priorities.

It is not surprising, then, that raising the prominence of child abuse and neglect prevention on the public agenda has been difficult, as has been any marked improvement in human behavior. Because of the lack of understanding of the community's role in prevention - and because child abuse and neglect is seen primarily as an issue for "poor people" - calls for increased public funding for prevention programs are interpreted by a cynical middle class as "another handout" for the poor. And because people have clear boundaries about the privacy and rights of a parent, it has proven nearly impossible to motivate individual action on the subject of prevention except when the situation has become so egregious that reporting to the appropriate authorities is necessary.

Strategic Reframing
In early 2003, PCA America began to explore the concept of "strategic reframing" of the issue of child abuse and neglect prevention. The goal was to identify a more effective strategy for communicating about, and advocating on behalf of, child abuse and neglect prevention, based on a thorough understanding of the public's frame of reference on the issue.

Strategic reframing has been employed by numerous social causes in recent years. Advocates for HIV/AIDS prevention, for example, failed to galvanize widespread public support in the early years of the epidemic at least in part because of the public's frame of reference on the issue, which was then limited to the homosexual community and intravenous drug users. It wasn't until the issue was reframed to include children like Ryan White and woman like Elizabeth Glaser that status as a public policy (and funding) priority was finally awarded.

Clearly, the time is right for "reframing" the issue of child abuse and neglect prevention.

The FrameWorks Institute
Founded in 1999 by Susan Nall Bales, the mission of the FrameWorks Institute is "to advance the nonprofit sector's communications capacity by identifying, translating and modeling relevant scholarly research for framing and re-framing the public discourse about social problems." More specifically, FrameWorks designs, commissions, manages and publishes communications research to "prepare non-profit organizations to expand their constituency base, to build public will, and to further public understanding of specific social issues." (3)

Since 1999, its funders have included the Annie E. Casey Foundation, the W.T. Grant Foundation, Benton Foundation, David & Lucile Packard Foundation, Rockefeller Brothers Foundation, A.L. Mailman Foundation, Robert Wood Johnson Foundation and the National Institutes of Health, among others.

The concept of "strategic frame analysis" was developed in partnership with UCLA's Center for Communications and Community. Although the concept is relatively new, Susan Nall Bales reports that it is grounded in theory and practice going back to the 1922 publication of Walter Lippmann's book, Public Opinion. This book represented the first attempt to connect mass communications to public attitudes and policy preferences by recognizing that "the way in which the world is imagined determines at any particular moment what men will do."(4) The current concept of "frames" harkens back directly to Lippmann's definition of the "way in which the world is imagined." (5)

Frames
As described by Susan Nall Bales on the website for the FrameWorks Institute, framing refers to the construct of a communication - its language, visuals and messengers - and the way it signals to the listener or observer how to interpret and classify new information. In practice, framing recognizes that messages can be encoded with meaning associated with existing beliefs or ideas to allow for easier public comprehension of new information or ideas. (6)

Framing theory recognizes that people use "mental shortcuts" to make sense of the world around them. And when presented with new information, we look for "cues" to help us connect the new information to our "stored images of the world." The processing of incoming information and sorting it based on our past experiences or view of the world is called "indexing." (7)

Susan Nall Bales reports that the frames allow us to process information more efficiently. "If people believe that kids are in trouble (and they do), they will be drawn to facts in a news story that reinforce this notion, and will disregard those that deny it," she writes. "If the facts don't fit the frame, it's the facts that are rejected, not the frame." (8)

This may help to explain why the public has never come to accept the premise that any parent could be "an abuser," including themselves.

Applying Strategic Frame Analysis
Susan Nall Bales describes how Strategic Frame Analysis employs a multidisciplinary team of researchers and practitioners to ask and answer important questions about how the public perceives a specific issue and what consequences those perceptions hold for the policies that advocates wish to promote. The initial goal of the process is to arrive at a situation analysis of what advocates are up against in advancing their issue, and which reframing strategies hold the best potential for galvanizing public support for their positions and policies.

In applying the concept of frames to the arena of social policy, the FrameWorks Institute develops a process to answer the following questions:

1. How does the public think about a particular social or political issue?
2. What is the public discourse on the issue? And, how is this discourse influenced by the way media frames the issue?
3. How do these public and private frames affect public choices?
4. How can an issue be reframed to evoke a different way of thinking, one that illuminates a broader range of alternative policy choices? (9)

Research Process
In undertaking a strategic frame analysis of child abuse and neglect prevention, PCA America contracted with the FrameWorks Institute thanks to the generous support of the Doris Duke Charitable Foundation. The foundation had provided $1.4 million over three years to PCA America in support of its public service advertising program, and had enthusiastically supported the redeployment of a portion of the grant's funding to conduct the strategic reframing exercise.

The key components of the research conducted by the FrameWorks Institute and its partners at Public Knowledge and Cultural Logic during 2003 were the following:

1. Meta-Analysis of existing public awareness, understanding and opinion on child abuse and neglect going back over 20 years;
2. In-depth one-on-one interviews conducted for purposes of exploring not "what" people think about child abuse and neglect, but "how";
3. Six focus groups in three locations;
4. Analysis of marketing materials used by prevention advocates over the years to identify the "frames" used in explaining the issue;
5. News content analysis of media coverage of child abuse and neglect;
6. Development of a simplifying model to explain child abuse and neglect prevention, and "talk-back" testing of the model; and,
7. Final report with recommendations for employing the reframe.

Working Hypotheses
To help in identifying a research action plan as part of the strategic reframing project, PCA America developed a set of working hypotheses based on its own experiences and observations over the years, and influenced by available market research studies and other reports. These working hypotheses are summarized below, including reference to external research sources where appropriate.

Hypothesis #1: Although it is not a top-of-mind issue with most Americans, general awareness of, and concern about, the issue of child abuse and neglect has been, and continues to be high.

By the early 1980s, focus groups conducted on behalf of PCA America showed that awareness of the types of child abuse in all groups was virtually 100%. Even the lesser-known aspects of abusive behavior, such as verbal, sexual and neglect, were mentioned frequently on an unaided basis. Most respondents admitted that physical abuse came to mind first, no doubt due to the amount of publicity garnered from the media as well as its identifiable nature. (10)

The focus group report prepared by Campbell-Ewald Company concluded that "the premise that the overall awareness of child abuse has been established appears to be well-founded. Physical, as well as psychological, verbal, sexual and neglect were all mentioned on an unaided basis in each group. People seem to be well aware of the prevalence and the seriousness of the problem on a nationwide basis." (11)

Two decades later, focus groups conducted as part of the development of a new public service campaign showed that awareness of the issue of child abuse and neglect continued to be high. Although few mentioned the subject unaided, "when the specific words 'child abuse' are introduced, all agree that it is certainly a big problem."(12) Further, it appears that the general public's understanding of child abuse is more informed than one might have suspected, as shown by the following statement: "Eventually, when specifically trying to define child abuse, all types of abuse are mentioned. All are considered serious and causing long-lasting damage." (13)

Hypothesis #2: Public understanding of the root causes and long-term effects of child abuse and neglect is also high.

As early as 1981, focus group research reported that "virtually everyone was convinced that excessive exposure to abusive treatment over time, regardless of the type of abuse, would lead ultimately to severe emotional problems in later life. Thus, one form of abuse was not considered any less serious than another, given chronic exposure to that abuse in early life." (14)

Mirroring the review of substantiated cases conducted by PCA America in 2000, focus groups conducted in 2001 by PCA America found that the general public understands that while child abuse and neglect can occur "in all segments of society no matter economic or social status or how normal-seeming the home, eventually abuse is often linked with poverty, alcoholism, drug addition and limited education." (15)

Hypothesis #3: When the public thinks about the issue of child abuse and neglect, it thinks primarily of the most extreme cases, such as those cases resulting in the death of a child or a dramatic incident of neglect that generates local or national news coverage.

This supposition is supported by research conducted by Martin & Glantz in 1997, which concluded the following:

"It is difficult to engage the general public in a conversation on child abuse and neglect. Largely because of the media, the phrase 'child abuse and neglect' seems to almost always bring up images of the most extreme and high profile cases which quickly moves the discussion to the problem of dealing with the most severe cases. In fact, the true picture of reported cases of abuse and neglect is far different from the imagery." (16)

Hypothesis #4: Discussion of less severe types of abuse or neglect tend to confuse the general public, which assumes that such cases could logically be the result of an accident or extenuating circumstances beyond a parent's control.
In testing alternative language for describing child abuse and neglect prevention in 1997, Martin & Glantz found that "terms like 'protecting children' or 'child safety' moved one so far from the issues of abuse and neglect in the mind of the general public that one finds the questions and issues raised are those surrounding topics such as drug use, gangs and bicycle safety."(17) Similarly, message testing in 2001 as part of PCA America's PSA development found that the general public was quick to think of neglect-related scenarios as "child safety" issues, drawing a clear distinction between such issues and child abuse, which is perceived only as being intentional.

Hypothesis #5: While the general public wants to avoid judging parents (or being judged themselves) for unintentional harm to a child, people have little sympathy for intentionally abusive or neglectful parents.

Martin & Glantz reported in 1997 that, "Community respondents across all focus groups were extremely judgmental of 'abusive parents.' They noted that parents of 'this generation' did not have the same values and morals instilled in them that 'we had coming up.' Focus group participants also noted a lack of responsibility demonstrated by parents today. In addition, they recognized that parents today don't have the support network that once existed." (18)

In 1999, the Coalition for America's Children found 46 percent of parents identified "lack of parental supervision" as a very serious problem in their own communities, and that 79 percent agreed (49% strongly) that "it may be necessary for mothers to be working because the family needs money, but it would be better if she could stay home and just take care of the house and children." (19)

The report also found that 67 percent simply believe that parents today are doing a worse job of raising their children compared to parents 20 years ago, while only 4 percent think they are doing a better job. (20)

Hypothesis #6: At the same time - and possibly as a defense mechanism to protect themselves from harsh judgment of themselves as parents - people acknowledge that the job of parenting is much harder these days, that children require stronger discipline and that too many people are judging their parenting performance.

Research conducted by Public Agenda in 1997 found that 78% of Americans believe it is "much harder" to be a parent these days.(21) PCA America's public opinion poll in 2000 found that nearly half of Americans (46%) believe parents "sometimes" or "very often" find themselves in situations where they are afraid they might abuse or neglect their child. (22)

On the other hand, the Coalition for America's Children reported in 1999 that the general public believes a lack of parental involvement and a lack of discipline are the two most important issues facing America's children. (23)

Hypothesis #7: Although many parents express the wish that they had received more support or education in the early years of parenting, it is seldom seen as a sign of strength to ask for help. Many parents are reluctant to ask for help, and most Americans assume that any help they might offer would be resented.

The 1999 Public Awareness Survey conducted by PCA America found that an overwhelming majority of American parents (74 percent) wished they had received assistance in learning how to take care of their newborns. In addition, the majority of Americans (67 percent) believed that lack of parenting experience or skills was among the primary reasons for child abuse and neglect. (24)

Clearly, there currently exists a stigma in asking for guidance or assistance in parenting. Parents believe that they should know what to do, or that they will be judged harshly (or punished by "the system") if they ask for assistance.

In addition to the stigma involved in seeking help, many parents are barraged with unwanted advice, causing them to be defensive of their parenting skills and reinforcing their reluctance to seek help even from a source they actually trust. "Kids These Days" reported in 1997 that more than 4 in 10 people (43%) think it's very common for parents to resent advice about their kids - even when that advice comes from people who mean well. (25)

Hypothesis #8: Perhaps because people tend to only think of child abuse and neglect as intentional and extreme, people feel powerless to do anything about it, either individually or systemically.

Focus group research commissioned by PCA America in 2001 found that "the upshot of all these converging attitudes to possible action regarding child abuse is an impression of powerlessness: respondents are hesitant to act directly, and they are not sure what else is out there for them to do about something, that, though serious, in most cases is not what comes to mind first as a compelling and attention-getting social issue." (26)

Hypothesis #9: The only individual activity associated with "preventing" abuse or neglect is to report it to the authorities. But, the general public is reluctant to do so because of the perception that the government, and the child protective service system in particular, are incapable of responding effectively.

In 2000, PCA America's public opinion poll found that 64% of Americans believe they can do "some" or "a lot" to prevent child abuse and neglect and 49% believe you can do a lot to prevent abuse and neglect before it starts.(27) Yet, questions seeking input on what kinds of activities are possible to prevent child abuse and neglect, respondents generally come up empty, other than the "automatic default to reporting" observed so frequently.

This default continues to be strong, with telephone surveys conducted on behalf of PCA America in 2003 finding that "reporting it" was the activity cited most often in response to the following question: "What do you think you could do to prevent child abuse and neglect?"

Hypothesis #10: Beyond citing "the government", the police or their state or local child protective service departments, most people have no idea who is responsible for prevention of child abuse and neglect.

Twenty years ago, PCA America found that there was virtually no awareness of any existing groups and/or organizations within the country dedicated to the prevention of child abuse. There was some local awareness of hotlines, safe homes, and locally developed advertising. While some respondents could describe the local campaigns, there was no awareness as to their sponsors. (28)

Public Agenda reported in 1997 that, "When asked who should offer assistance when parents have serious problems raising their kids properly, 79% would rely on private efforts such as volunteer organizations or neighbors and citizens who pull together." (29)

This continued to be a problem through the next two decades, with the Coalition for America's Children reporting in 1999 that "part of the problem has been, and continues to be, that there is little conversation about the ways in which government acts on behalf of children outside of education. When asked whether or not their member of Congress supported or opposed increased spending for children's programs, a majority of voters (58%) have no idea." (30)

Looking Ahead
As mentioned above, the working hypotheses summarized in this document have been used in the development of new research conducted as part of the strategic reframing project. We expect the ongoing research to validate some of these hypotheses and possibly amend or eliminate others.

At this writing, PCA America is continuing to work with the FrameWorks Institute to review the findings of the research phase and discuss their implications. A second white paper will describe the results of the research phase and offer recommendations for reframing child abuse and neglect prevention for greater public understanding and engagement.