Abuse and Neglect in Schools M A X S U G A R , M . D . * New Orleans, LA

Abuse and neglect oj students by teachers, and abuse of teachers by students are widespread, but their frequency and consequences are undocumented. The effects are seen in some patients with diagnoses such as posttraumatic stress disorder, dissociative episodes, and a disruption in emotional development. It appears that transference feelings interfere with the students' reporting of teachers. Teachers seem to refrain from reporting students for fear of retaliation. With our greater attunement in recent years to the frequency and varieties of physical and sexual abuse of children, our sensitivity to this subject has been increasing and we have become more concerned with how widespread these problems may be outside the family. Many children attend preschools and complete their college education, and most generally spend about a third of their day in or about schools from age 5 until age 16. This provides a long exposure of children and adolescents to the classroom. The education literature on child abuse and neglect for the past ten years lists mostly articles from psychiatric, social work, or psychology journals, with a markedly increased number in the past three to four years. Most of the articles are on recognition, reporting, and helping the child. There were none about teachers being abused or threatened by students, or on fear of retaliation by families for reporting, except for being noted as an aside. The applicable education literature contained: one article with a large section about bullying of students by students ; an article recommending better screening in teacher applications to avoid hiring pedophiles ; and a general review about emotional abuse by teachers. An attempt is made here to review maltreatment of students and teachers using data from the health, psychiatric, medical and education literature and clinical material. 1

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*Clinical Professor of Psychiatry, Department of Psychiatry, Louisiana State University and Tulane University Schools of Medicine, New Orleans. Mailing address: 17 Rosa Park Place, New Orleans, L A 70115.

A M E R I C A N J O U R N A L O F PSYCHOTHERAPY, Vol. X L I V , No. 4, October 1990

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I. ABUSE OF TEACHERS

Abuse of Teachers by Students Most abuse investigations focus on abuse by adults of children, yet there is mounting evidence that teachers are abused by students. Unfortunately, this abuse is mostly undocumented and dealt wi•ineffectively. It is noteworthy that there has been so little research on abuse of teachers. In a written poll about corporal punishment, Pross found that among her 550 survey respondents (most of whom were teachers, while some were principals and librarians) there were 33 percent who had felt physically threatened by a student. She quoted a teacher who said that for some students the "ultimate status symbol is punching out a teacher." Another teacher in the poll reported that several teachers in her area had been assaulted by students. But I could locate no survey of numbers of teachers actually hurt physically by students in a school district or nationally. Students may be angry at a teacher for various reasons, real or transferential, and heap abuse on the teacher through lack of cooperation, whispering obscene epithets, sailing spitballs, and leaving the room in disarray. Although these may occur with the regular teacher, they usually increase markedly with a substitute teacher. At times the teacher in class or after hours is directly exposed to physical abuse, or the threat of it. Psychotic or other severely disturbed youngsters may hit teachers. Adolescents have sexually abused their female teachers. When teachers are threatened or abused physically or sexually, they sometimes withdraw from the particular school and request a reassignment. Other teachers with such experiences give up teaching altogether and find a new vocation. 4

Case 1 A high school teacher who observed a senior student football player cheating repeatedly during an exam, asked him, after several warnings, to turn in his paper, and report to the principal. F o r a while he disrupted the class by sulking and procrastinating defiantly. W h e n she insisted that he leave, he raised his arm to hit her. Despite her fear, she made some remarks about the consequences of his intended act, and then he lowered his arm and left. T h e principal did not discipline the student despite the teacher's complaint and protest. T h e football coach was angry at the teacher and discontinued ordinary friendliness because she failed the student, which disqualified him from the football team. Some weeks after this, five of the youngster's teammates grabbed the teacher on the high school grounds during lunch, held her down as if about to have a gang rape, and each kissed her on the cheek. None of the teachers or students came to her aid. W h e n she reported the incident to the principal, he did nothing about it. T h e teacher had suffered physical threats and abuse, sexual molestation, and emotional abuse with intense fear. She felt a loss of authority, humiliation, degradation, as

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well as resentment at the lack of support by the administration. She left for a teaching position elsewhere at the end of the year. These incidents contributed to her feeling worthless, inadequate, and guilty as if she had been at fault, until dealt with in therapy years later. This occurred in a middle-class, white school and was not reported to legal authorities. There have been numerous reports in the media indicating that abuse of teachers is frequent, especially in the ghetto areas of inner cities. The movie, "The Blackboard Jungle," provided a dramatic exposure of this. Reports on nonclinical groups also challenge the validity of comments by Chase and others that abuse is a feature of low socio-economic status. The impulse to hurt others or oneself is neither the property of any group nor limited to it. 5-8

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Abuse of Teachers by Parents When teachers confront parents about their child's poor grades or misbehavior, give a detention, suspend or expel the child, they may be threatened, emotionally abused or physical assaulted. After teachers report physical or sexual abuse of children, they may become the victims of physical abuse by the alleged abuser. This has created a dilemma for teachers—despite the obligation to report abuse—about whether it is safe and wise to do so. Abuse of Teachers by School

Administration

Case 1 provides a combined example of physical, sexual, and emotional abuse of a teacher by students and neglect by administration. Blatt observed that the teachers in institutions for retardates seemed involved with "the daze of institutional purposelessness" and defended it with "If you complain to get changes or more support, it goes on your record as a mark against you" (p. 192). Pross cites many cases in her survey of inadequate or missing support for teachers by principals and the school administration but provides no figures on this. Chase (p. 37) described the suspension of a teacher after he informed the press about beatings of children in school. 10

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E F F E C T S O F A B U S E ON T E A C H E R S

Teachers who are abused may feel that they went into the wrong field, or did a poor job, or invited the abuse. Teachers are emotionally damaged by their loss of self-esteem and respect (despite sympathy or pity by the administration, and even by peers) regardless of the kind of abuse inflicted by the student. This also has not been researched and can only be reported at present on the basis of individual clinical experience as in case 1.

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Abuse and Neglect in Schools II. ABUSE OF STUDENTS

Emotional Abuse of Students by Teachers The Study Findings of the U.S. Department of Health and Human Services estimates that 25.2 per thousand children in the U.S.A. were endangered or already harmed due to abuse or neglect at home, while stating that these were minimum figures. The countable rate of cases of maltreatment included sexual, emotional, and physical abuse, and neglect. In this survey (as in the previous two) there was no reference to abuse of any kind of children by teachers or vice-versa. These estimates are exceedingly low, especially for sexual abuse, when compared with other reports, and particularly with that from Canada (p. 175). The latter, which is derived from the most thorough national study available to date, found that almost one in two females and one in three males have been sexually abused, mostly as youngsters. Since physical and emotional abuse are far more frequent than sexual abuse, the estimates of the Study Findings have to be viewed as overlooking a huge number of these. Verbal and emotional abuse by teachers is very minimally noted, and although it happens almost constantly, there is very little in the literature on this subject. Occasionally some brief remarks allude to it. The report by Conlee is a general review. Paulson provides very good illustrations of covert and overt emotional and physical abuse in preschools at all socio-economic levels. Among her observations of five years' duration she notes that verbal punishment was the most frequent form of maltreatment and occurred "with depressing regularity and frequency." Krugman and Krugman cite a teacher who upset third and fourth graders with emotional verbal abuse. The children's disturbed reactions ended when the teacher was removed. Sugar describes subtle emotional and sexual abuse by teachers in an inpatient psychiatric setting and the negative effects on the student-patients. The resolution was unsatisfactory despite the efforts of Child Protection Services, since the teachers relocated to other schools with the blessing of the school board that did not agree with the findings of the hospital. Chase (p. 2), writing as a reporter, recalled that her third-grade arithmetic teacher's "real triumph was to catch you chewing gum. If she did, she made you stick it on your nose. Then she would call on you for the answer to six times seven. Sitting with gum on your nose through an entire math period leaves no marks, but it's an ugly experience for an eight-year-old child." 12

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Case 2 In his early years in an all-white high school, a student was routinely ridiculed and debased by a teacher without basis. The student did nothing about the continued torment, not even telling his family. As a senior, he had the same teacher again for one subject.

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Now, taller and heavier than the teacher, he no longer accepted the teacher's verbal abuse and retorted in kind whenever attacked. H i s grades were average in this one subject but he was an honors student in all others. Neither his parents nor teachers inquired about the reason for this puzzling discrepancy in his performance. T h i s was one of the areas which focused his distrust of authorities and feeling unprotected, and required much attention when in therapy as an adult.

Such abuse is very difficult for parents to discern, and when they become aware of its occurrence, it is even more difficult to confront or resolve satisfactorily. Psychotic teachers may malign, ridicule, or otherwise emotionally abuse children. Case 3 A psychotic, delusional teacher threatened third graders with extinction by God, regaling them all day with details about the peril, and colorful depictions of her hallucinations and delusions.

T h i s disturbed all the children, and their grades were

generally low compared to the previous year. Some of them made fun of her; some were frozen with fear; and others were removed to other schools by angry parents who felt the principal should have given her sick leave. A child who remained in the class felt confused, not knowing what to believe or whom to trust when she was seen for treatment shortly afterward.

Case 4 A college freshman in honors English with excellent grades was ridiculed by the professor who, in the presence of her classmates, said she did not belong in the class. She had been admitted to the honors program after a placement test instead of the usual basis of high school grades. She did not make honors in English that year. I n later years, with other professors, she made honors and received a special award for excellence in writing. However, she continued to have doubts about her abilities, low self-esteem, and extreme anxiety in any meeting with teachers and at exams for years, until she underwent therapy.

Case 5 W h e n a high school student inquired about the answer to a part of the French exam, the teacher confirmed that he was correct. W h e n he asked her for the higher grade he deserved, she derogated him in the presence of the class, which made him appear greedy for wanting the grade he had earned, but she did not change it. T h i s led to feelings of confusion, guilt, discouragement, incompetence, worthlessness, and poor grades in French, which spread to other subjects. These feelings persisted until they were dealt with in treatment as an adult.

illustrate the impunity with which such abuse may be visited on students and cause a sense of inadequacy, confusion, guilt, and incompe-

T h e s e cases helpless tence.

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Physical Abuse by Teachers Dickens wrote about cruelty to children in the 19th century as did Chesser in the 1950s. The latter's clinical account did not lead to the widespread awareness that was evoked ten years later by the report of Kempe et al. Chase (pp. 37, 38) cites some media accounts of blatant physical abuse of students by teachers. Two-thirds of educators condoned physical punishment and more than half of school principals report the use of physical punishment in special education. The survey by Pross indicated that: 41 percent of teachers approved of corporal punishment; and 11 percent had used such, at a time when eleven states had banned it (1985-86) and many were on the way to doing so.

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Case 6 When a student in an all-white junior high school was told to leave the class for talking, he countered with a refutation and refusal to comply. The male teacher tried to physically remove him. The two engaged in a tussle and wrestling match until the student was ejected with a torn shirt before his horrified, shocked, and silent classmates. The student (who had not been the source of the noise) and his family complained to the principal about this abuse, but to no avail. The family placed the student in another school, but his hostility to, and distrust of, authorities continued. An effort at therapy ended in limited improvement. The issue of corporal punishment in the classroom has been disputed without resolution for many years. Recently there has been concern that it has gone too far, and its restriction is now advocated by parental groups. Sometimes teachers are more abusive to a provocative youngster. In some cases there is little or no provocation, and abuse is clear, e.g., caning a child's hands until they bleed. The American Psychiatric Association recently issued an official statement condemning corporal punishment. According to Ammermann et al. disabled children are overrepresented in abused/neglected populations; 9 percent of cerebral palsy children in a children's hospital had been abused or neglected; 39 percent of psychiatrically hospitalized handicapped children were abused/neglected. Does the presence of a handicap also invite teachers to abuse those particular children more than others? 13

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Sexual Abuse by Teachers Sexual abuse of students by teachers is not an uncommon event and may occur at any grade level and in any school setting, even the most devoutly religious. It obviously occurs more frequently than is reported since most of those who bring it up in therapy have never related the experience to others. Case 7 A boy in third grade with an emotionally based learning difficulty was offered extra help after school by his teacher—a nun. He responded eagerly to this extra care and attention since his home provided little of this and no support for his education. Although

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he had been troubled emotionally and was obviously withdrawn, his family had never sought psychiatric treatment for him. Under the guidance of this nun, the youngster blossomed somewhat and improved academically. T h e tutoring continued for some years, even when she was no longer his teacher. H e was very compliant and grateful. I n his pubescence, when she began to fondle him and made him reciprocate, he felt shocked, frightened, confused, and guilty. However, he tolerated this situation for several years until he left to enter high school.

Fearful of not being believed and severe

consequences, he never spoke of this to anyone, not even in confession, until in therapy many years later. H i s sense of betrayal, confused values, guilt, and sexual difficulties were clearly related to this trauma.

Other instances of sexual abuse of youngsters have been broadcast by the media, e.g., sex-abuse rings in nursery schools and elsewhere. The well-known abuse by college professors by demanding sexual favors (homosexual or heterosexual) for an A are continuing threats to students. However, no scientific reports of frequency or effects on emotional development are available. With the high incidence of physical and sexual abuse of girls and boys, ' it should be obvious that a high percentage of teachers (male and female) have been abused physically and sexually at an earlier time in life. Observers have repeatedly pointed to the risk that being abused as a child leads to becoming an abuser as an adult. Thus, it should be no great surprise to consider that teachers may be abusing their students—physically, sexually, or emotionally. 11

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Educational Neglect of Students Children may be neglected in school so that some are barely literate or even illiterate when they leave. Over 25 percent of youngsters drop out of school. Many of these may have been truants, repeaters, or students with multiple problems. Unrealistic academic and development goals have been brought up as incidents of neglect in school. Due to political corruption and mismanagement of the local school board, the State of New Jersey took over the Jersey City public schools on October 4, 1989. Some of the books in use were over thirty years old. This school board and school district may not be the only ones involved in corruption and needing a takeover by a State Board of Education. Educational neglect is a multifactorial issue. It is not based exclusively on one or the other problem of social class, abuse, truancy, uninvolved parents, poverty, teenage pregnancy, geographic location, inner-city race riots, athletics and coaches (especially in college), teachers, administrators, corruption or educational policy. More likely it derives from some, or all, of these features and others in combination. 1,15

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Student-to-Student

Abuse in the Classroom

Abuse between students is so frequent that it almost seems to be the norm and is usually overlooked and uncatalogued. Youngster often tease, berate, and

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ridicule one another about various differences such as physique, clothes, name, origin, race, or religion. Rarely are these reported by the abused youngsters, and even less frequently are the abusing youngsters brought to the attention of the authorities. The stimulus for this type of behavior frequently leads to physical assaults by one student on another. This has been the focus of many media reports on racial violence among adolescents in inner-city schools with the problems of integration. The practice of hazing has been institutionalized as an accepted part of the introduction to college life, clubs, and fraternities. Although college fraternity hazing has caused approximately 42 deaths per year in the U.S.A., it was not discontinued until 1989. Hazing combines physical and emotional abuse such as ridicule and embarrassment. Sometimes it may take the form of forced ingestion of chemicals that have an effect on the body within a day or so. Sexual abuse between students is not a rarity, and juvenile sex offenders constitute the largest group of sex offenders of any age group. However, sex abuse may begin in grammar school years as well, and be heterosexual or homosexual. The latter is frequently in the form of a gang attack on an individual. There is probably more homosexual than heterosexual abuse between students, but it is infrequently or rarely reported due to the shame and embarrassing aspects attached to it. These feelings are greater for the homosexually abused boy than for the girl who is a victim of homosexual or heterosexual abuse. CONSEQUENCES OF ABUSE TO STUDENTS

From Verbal Abuse The effects of verbal abuse (ridicule, excess criticism, humiliation) are long-lasting just as they are from physical or sexual abuse. Feelings such as shame, worthlessness, confusion, incompetence, anger, mixed loyalties and guilt, that come into play do not disappear because the child is silent about it. Although not well documented, nevertheless, adults remember those very clearly, painfully and vividly for many years afterward. The consequences of distrust of the abuser, adult or child, as well as other adults, are significant. When trust is betrayed by abuse, it is followed by confusion, loss of self-esteem, feelings of inferiority and anger and interferences in peer relations. The effects are observable in the victims of abuse who are in psychiatric treatment. From their research Ney et al found that parental verbal abuse was associated with youngsters wanting to hurt themselves or others, tending to blame themselves for the abuse when it was moderate, and to strongly blame themselves when it was severe. Cases 3, 4, and 5 indicate the immediate negative effect on grades, but the long-term developmental or personality effects of verbal classroom abuse on large numbers of youngsters are unknown at the present. 27-29

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From Physical Abuse Although cases 6 and 7 do so, there is little documentation of the effect of classroom physical and sexual abuse despite the many media reports. However, it seems that the data for effects of physical abuse by parents may be applicable to the school situation. From questionnaires completed by a large group of nonclinical female college undergraduates, Briere and Runtz found that: psychological maltreatment by fathers was predictive of symptoms of anxiety, depression, interpersonal sensitivity, and dissociation; and physical maltreatment by mothers was predictive of interpersonal sensitivity, dissociation, and suicide attempts. But they feel that "parental maltreatment of children is a multidimensional phenomenon involving both global and specific relationships between abuse and subsequent symptomatology," and generally all four types of abuse were present in the same families. Their data suggest that these abuses "are associated with substantial psychological difficulties later in life." 6

Ginsburg et al. observed that among late adolescent, nonclinical middleclass male and female students, those who had been abused physically had less concern about physical abuse than those who had not experienced it; and those who had been sexually abused were more likely to have been physically abused too. But Berger et al. noted that although more than 50 percent of their sample of nonpatients met the criteria for physical abuse, most failed to label themselves as abused. Kent documented that parental abuse/neglect shows a direct relationship to academic achievement with 52 percent of the abused and 82 percent of the neglected youngsters having below average or failing grades, compared to 28 percent of the control group. Not surprisingly, in the clinical cases of classroom abuse, most of the youngsters had a drop in grades. Physical abuse may lead to posttraumatic stress disorder, anxiety reaction, depressive disorder, or psychosomatic disorder. Physically abused youngsters have a greater likelihood of violent behavior, juvenile delinquency, central nervous system dysfunction and organic impairment. The latter, along with other factors, leads to increased impulsivity, increased emotional lability, and decreased academic success. Physically abused adolescents have a much poorer self-image, poorer family relationships, particular difficulty with emotional stability and setting future goals about vocation and education. From a study of students from a working-class background at a community college, Bryan and Freed found that educators used corporal punishment; 95 percent of their students had physical punishment at some point in their life; and that males had more corporal punishment than females at home. The major damage was to the self-concept and they reported more negative social interac30

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tions (aggression, lack of friends, and delinquency) and negative psychological reactions such as depression and anxiety. Bandura, Ross, and Ross found that only brief exposure to an aggressive model results in imitation of aggressive behavior by the child. Owens and Straus observed that there were positive correlations between involvement with violence as a child and then approving its use as an adult. This is confirmatory of findings by Steele and Pollock that abusing parents were abused as children. 34

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From Sexual Abuse Although some authors note little, if any, immediate effect of sexual abuse on children, the preponderance of reports indicate various regressive symptoms such as enuresis, encopresis, thumbsucking, insomnia, nightmares, loss of self-esteem, increased guilt, depression, anxiety, posttraumatic stress disorder, or poor sexual adjustment. From my clinical experience, sexual abuse may also be central to dissociative episodes, multiple personality disorder, and psychosis. In a controlled study to assess long-term effects of childhood sexual abuse in females, Briere and Runtz found that the victims were more likely to have: a history of substance addiction; been revictimized in adulthood; made at least one suicide attempt; dissociative experiences; sleep problems; feelings of isolation, anxiety and fearfulness; problems with anger, sexual difficulties and selfdestructiveness; and to be taking psychoactive medication. Sugar observed that adolescent sexual abusers had been sexually abused themselves and were now doing what had been done to them through identification with the aggressor. Thus a cycle of continuing abuse is initiated based on the rage engendered by the original abuser, which is displaced on others by the abused. The next generation then follows suit because this is what they have been taught. From their review, Browne and Finkelhor divided the effects of sexual molestation into initial and long-term. Often among the former are fearfulness, inappropriate sexual behavior, depression, and anger. In addition to these, long-term effects may include: feelings of isolation, low self-esteem, and being stigmatized; self-destructive behavior; substance abuse; sexual maladjustment, and a tendency to revictimization. 36,37

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E F F E C T S ON A B U S E R

When teachers are molested emotionally, physically or sexually by a student, the youngsters I have seen usually have feelings of guilt and fear of retaliation. They manage this often by ridicule of the teacher, denial, projection with further assaults, intrusions, and exploitation. If the teachers try to check it and fail, or if the teachers leave, their position as an authority is further undermined and the limit-setting function of the teachers is greatly reduced. The youngsters then have less implementation of their need for controls. This unconsciously invites

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them sometimes to lesser efforts at control over their impulses, which leads to an escalation of their abuse. In some, this leads to the extremes of violence, and even riots, which is frequent in some schools and occurs even in adolescent inpatient units. When the teacher is the abuser, it may lead the teacher to feel intense guilt over the loss of control. However, there may be a pathological pattern of denial and projection to protect self-esteem by rigidly reinforcing the righteousness of the act against all logic. In some, the confrontation about their deed may lead to self-scrutiny and therapeutic efforts to cease abusing. III. BARRIERS TO REPORTING AND RESEARCH

Parents are usually held in high esteem by their offspring and when they abuse their child the youngster denies, splits, and projects the blame and negative affects onto the self or others, but not the idealized parent, in order to maintain the image of the "good parent." It would appear that parents and their youngsters do the same about the abusing teacher. Their idealized transference to teachers makes it difficult for them to report the physical/sexual/emotional abuse and educational neglect that occurs in school. When there is a negative transference, then the teacher is reported. This would explain the relative paucity of reporting of teachers for incidents of child maltreatment to Child Protection, as well as of scientific studies. It also fits with the findings of Bryan and Freed that "the more a student reported abuse at home, the more likely he or she was to report abuse also at school." The study by Ginsburg and associates showing that those college students who had been physically or sexually abused reported less concern about such abuse compared to a nonabused population would suggest that teachers who have been abused earlier in life may show less concern about its occurrence, i.e., be desensitized and therefore less likely to report it. Perhaps this explains the low rate (10 percent) of reports of parental abuse that come from school personnel despite the mandatory law to report. The barriers to reporting or researching of abuse of teachers by students and administration may be related to this. Possibly teachers do not report abuse by students, parents or administrators since they feel unworthy due to some sense of guilt as if they caused the assault. There probably is considerable fear of parental retaliation for reporting the students, just as there is for reporting parental child abuse. Perhaps this is even greater in connection with losing one's job if the abusing administrator is reported to higher authorities by a teacher. If a youngster is abused by a teacher in one class in one grade and reported, does this mean that it happened only once, or many times by the same perpetrator? or by others as well? Is it possible that some students are abused physically, verbally, or sexually, repeatedly, throughout their 10 to 18 years of schooling? If we suppose the child is simultaneously abused/neglected at home and at school, then the cumulative effect of the abuse is rather awesome to consider. Does the 16

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abuse/neglect at school not reinforce the effects of the trauma at home so that no place seems safe and no adult can be trusted? It is impossible to not consider that even with only sequential instead of simultaneous abuse at school, a school-abused youngster may have some of the, or similar, sequelae that have been noted to follow physical and/or sexual abuse at home. IV. APPROACHES TO MANAGEMENT

Eighty-one percent of teachers said they received no child abuse/neglect information in college, and 66 percent had not received information on the subject in their in-service training. Increased education in college and in-service programs to recognize child abuse should help teachers become more aware of the abused child, as well as their own proclivities for abusing. Teachers with a history of being abused might do well with preventive efforts and help themselves to avoid continuing the abuse cycle by abusing students if they were to deal with their own unacceptable impulses, painful affects, and memories of this abuse with individual or group therapy, or rap groups. When aware of rising impatience due to whatever source of stress, suitable efforts to obtain relief might obviate abuse of the student. Feelings about youngsters with handicaps, or with other major difference from themselves, need to be recognized by the teachers as possible stimuli to abuse in order to prevent the youngsters from becoming targets for their forbidden impulses. 14

Education of students at home and school about abuse, and the need and right to report it to child protection services might help the students to decrease it and help themselves. It has been noted that more male than female children are reported as abused, despite the fact that more girls are abused than boys and, according to some, for a girl to be reported for protection, she has to be more severely abused than a boy. But others found no gender bias in reporting by adult male versus female observers in an experimental study. They felt that there was an absence of sense about what the appropriate response should be when abuse is observed. Teachers would be of more help to the students if they had more information and confidence about the symptoms of child abuse and neglect to recognize and report it. By reporting it, they may be interceding in the cycle of intergenerational transmission of abuse/neglect, as well as potentially avoiding being abused themselves. Administrative support is a sine qua non for the teachers to have more preparation with in-service training; learn about abuse; report abuse; and for support against their fears of reporting. For continued support, the presence of rap groups in schools and school districts would provide a positive preventive and helping arena. Abusive teachers may benefit from Parents Anonymous or start their own Teachers Anonymous to help themselves. 39

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Similarly, students-parents-teachers rap groups might be productive and beneficial. Having student advocate groups in each school beginning at the earliest grade level, would give the youngsters a voice, especially if administration were to strongly support it and also provide outside psychiatric consultation. School-based clinics have provided significant help with teen-pregnancy and venereal diseases and show promise of helping in drug-abuse programs and counseling for emotionally upset youngsters. Perhaps with more research, further similar programs may develop that would lead to less educational neglect. The presence of school-based clinics offers teachers a resource to help abused youngsters and may even provide some support or direction for the abused/ abusing teachers in their time of need. When teachers are abused, it is important for them to report it and obtain immediate help for themselves (medical/psychiatric) and the abusing youngsters, as well as their families. Some of the youngsters need psychiatric hospitalization; others may need outpatient psychiatric treatment and medication; while others need discipline. In the past, students who were caught fighting on school grounds were given warnings, corporal punishment, detention, suspension or expulsion. The punishment did not teach them what to do about disputes, except to avoid being caught. At present, peer-conflict mediation is being taught and peer mediation is available in schools in 48 states from grammar through high school. This teaches children how to manage disagreements in a productive fashion. Sugar suggests: "Parents need to listen and investigate their children's complaints without becoming caught up in a polarized position. Parents should inquire, check with other parents, and, when action is indicated, confront the teacher or principal about the unwarranted behavior." Paulson reported that her findings were helpful to teachers and directors of preschools, who also confirmed her observations. This led to positive efforts by them to change and achieve better understanding and interaction with the children. As clinicians we need to routinely inquire of child and adult patients about their abuse and neglect experiences. This would help identify and enable us to focus our therapeutic efforts more directly on, these trauma. In addition, this might provide some clearer ideas about incidence, developmental and long-term effects. Psychiatric intervention should be considered for: the abused and abusing individuals and families; consultation and advocacy; as well as to help groups of students and teachers. Consultation services, group discussions, and continued in-service training programs should be required for all teachers, particularly for special education teachers in hospitals. 41

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Abuse and Neglect in Schools SUMMARY

Maltreatment in the classroom by students of teachers, and teachers of students, is widespread with emotional, physical, sexual, and neglect aspects. Its frequency and long-term developmental effects are undocumented. We know of the consequences in some who become our patients; but for the others we can only speculate based on reports about parental abuse and neglect. This paper presents these issues about the four types of abuse with representative cases. Idealization and transference feelings seem to contribute to the lack of reporting of abuse by teachers. Perhaps teachers do not report being abused by students for fear of retaliation. Some approaches to management are considered. The seriousness of this problem is underlined even more by the paucity of research and reports despite the obvious need. Hopefully, documentation of incidence and developmental effects will be forthcoming. REFERENCES 1. Neese, L . A. Psychological Maltreatment in Schools: Emerging Issues for Counselors. Element. School Guidance & Counseling, 23:194-202,1989. 2. Titus, R. M . , and DeFrances, C. J . Is There a Pedophile on Your Payroll? Principal, 69:14-16, 1989. 3. Conlee, K . M . Emotional Abuse: The Hidden Crime in the Classroom. Education, 57:66-71,1986.

Contemporary

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