Can Common Elements Support a Public Health Approach to Child Maltreatment?

Abstract

Abstract Despite ongoing reforms to child protection systems and calls for a greater focus on prevention and early intervention, demand on statutory services continues to grow across developed countries. The reasons for this are multiple and complex and include: (1) barriers that exist within service systems themselves; (2) the entrenched and interwoven nature of the drivers of child maltreatment and (3) limited access to programs that can be implemented at scale. This means that empirically supported interventions that can address child maltreatment are not widely available to support a public health response. Several innovations to address the aforementioned challenges draw on ‘common elements’ approaches. Common elements are the discrete techniques commonly found in programs supported by evidence. Over the last 30 years, the evidence base regarding therapeutic techniques for child maltreatment has remained relatively stable, yet there has been a significant increase in the number of evidence-based programs or protocols available. Many of these protocols consist of different combinations of the same therapeutic elements. The Institute of Medicine in the USA has recently called for further research into common elements for psychosocial interventions as an approach to widening access to empirically supported techniques. This article will explore whether common elements may assist in overcoming some of the challenges we are facing in ‘realising’ a public health response to child maltreatment. The potential benefits and limitations of the approach will be outlined, as well as the existing evidence base, and future directions for research and evaluation.