兒保工作人員對兒虐案件之風險研判與處遇決策

隨著兒童虐待與疏忽的個案量逐年增加，受虐兒童再度受虐致死的事件時有所聞，各國兒童保護體系在日益緊縮的福利資源條件下，已發展建立一套有效的資料蒐集、分析與管理之「風險研判」系統來增進兒童保護服務的品質。雖然在國內，內政部已發展建立一套有關兒童及少年虐待與被疏忽的研判指標，但台灣地區的兒保工作人員在研判兒童虐待或再度受虐可能性的風險時，很少會依據現有的研判工具作為風險評量的輔助，大多是透過與督導、同事的討論，或根據本身的工作經驗來進行研判與決策。因此，本研究的目的在探討這種討論式、經驗式的風險評量系統之運作架構，以瞭解目前兒保工作人員對兒虐事件風險研判所依據的概念架構與現有評量工具在使用上的問題，期待未來國內在訂定一套令兒保工作人員更友善的「風險研判」系統時參考。為了理解兒保工作人員的風險研判之概念架構，本研究深度訪談七位來自公部門與私部門的兒保工作人員有關「風險研判」的經驗，依據所處遇的十九個兒虐事件之案例分析，找出他們在進行辨識兒童虐待事件的發生、再度發生的風險研判與提供處遇服務的決策時所持有的研判與決策之認知架構，使用現有風險研判工具的阻力與助力。大致來說，本研究的發現大約圍繞在三個主軸上，一是受訪兒保工作人員整體所謂的「風險研判」架構，與內政部版的風險研判指標相距不遠，但個人考量的決策指標則重點不一；二是受訪兒保工作人員所謂的「高風險」研判與「兒童受傷嚴重程度」的研判相關程度高，但在是否需要「家外安置」的處遇決策上則因「兒童的年齡與自我保護能力」、「家庭的支持系統」、「施虐者的配合度」等保護性「風險因素」的不同重視而有所變異；三是受訪兒保工作人員對於內政部版的「風險研判」工具之看法，因使用與否的經驗而各有其評價。最後，本研究針對兒保工作人員有關兒虐案件的風險研判系統提出相關的政策與實務的建議。

關鍵字

風險研判；兒童保護；兒童虐待

並列摘要

In Taiwan, there is a substantial increase in child abuse cases in past few years. However, the incidences of child death as a result of abuse reoccurrence happened from time to time. With limited welfare resources allocated in child protection, developing risk assessment systems to effectively predict, analyze, and manage child abuse occurrence and its reoccurrence has been urgent and active in many modem nations. Despite that the Interior Department in Taiwan has developed a set of risk assessment indicators for use, most child protection workers depend on mainly consultation with supervisors or co-workers, or personal experience to identify children at risk of maltreatment and its reoccurrence. This study intends to explore the subjective conceptual framework that child protection workers used to practice risk assessment and treatment decision-making procedure in securing child's safety at home. In order to comprehend the subjective framework of risk assessment and treatment, seven child protection workers, as a total, from public and private sectors were interviewed in an in-depth way. In interview, they were first asked to present actual case examples reported to them in the past month that could be identified as ”high risk” cases. They were then asked to explain to what extent they defined a case as ”high risk” and what kind of risk factors they would consider in making a decision of out-of- home placement for a child at high risk. From seven workers, nineteen case examples were extracted from the interview. Results of this study indicated that the overall conceptual framework that seven child protection workers relying on to assess children at risk was not too far away from the risk indicators included in the officially-developed indicators. And, a child was identified at ”high risk” was in accordance with the severity of harm. An out-of-home placement was decided mainly based on three risk factors such as child age or self-protection capability, family support, and abusers' willingness to cooperate. Implications and discussion regarding risk assessment and treatment decision in child protection system were included as conclusion.