從「體罰」的概念看兒少保護案件： 身體虐待乎？管教不當乎？

Abstract

在目前兒少保護政策下，教育基本法規範強調家外的零體罰政策，但相較於兒少於家內被體罰，囿於民法所示父母的懲戒權利，及兒童權利公約的精神，兒少保社工到底如何去看待因為管教不當或體罰而調查成為保護案件。本研究的目的是想了解兒少經通報調查成為管教不當或身體虐待之案件樣貌，以及兒少保社工如何評估上述兩類案件以及判斷的基準的差異，並整理其所提供之介入服務。本研究勾勒出兒少保社工評估管教不當或身體虐待之兒童保護案件的樣貌，以及分析兒少保社工之介入策略與服務方法。 資料來源為衛生福利部保護資訊系統中，五個直轄縣市政府的兒少保社工撰寫的個案紀錄，研究之案件為2020年12月31日止結案之個案紀錄共計815件。研究結果顯示施虐者大多為父母，且為男性比例較高。兒少被體罰原因依序為日常生活瑣事被處罰、與學校相關問題，如成績不理想及不服從管教，如頂嘴、口角爭執。手段主要以責打或傷害身體為主、並且使用工具或是徒手為之。傷勢種類以淤、挫傷最多；傷勢部位以軀幹、四肢所佔比例最高，其次為臉部及頭部。暴力嚴重程度屬於嚴重暴力較多，已屬於身體虐待範疇。父母或主要照顧者多數認為體罰兒少是合理管教，但又承認教養上有問題，並且多數不認為是兒少問題。兒少保社工在評估管教或是虐待案件，僅在年齡層、傷勢危機狀況、服務區間上有差異，其餘在外顯傷勢、傷勢部位、受傷程度或是是否使用器具、暴力嚴重狀況及性別等因素並沒有差別。且大多數案件在安全評估多屬於「安全」範圍，於風險評估上則較多為「中」或「低」的風險狀態。 以介入服務來看，父母或主要照顧者是願意配合社工的介入，服務時間則以一年內最多。家庭服務以社工訪談服務、一般性親職教育、資源網絡連結及提供福利服務方案為主。兒少服務以就學輔導、兒少心理輔導與治療、醫療服務及陪同服務較多。施虐者服務則為父母的心理治療及治療最多，次為精神疾病治療。 研究建議：(一) 建議兒少保通報案件不要區分成管教不當及身體虐待兩種類型，兒少被體罰實質結果均屬於身體虐待範疇，不因分類不同而在服務上有所區別。(二)社工服務介入成為提供兒少保「基本款」的服務項目，仍需教育單位(學校)與醫療單位(心理輔導治療)協助。(三) 發展兒少保社工對於判斷管教不當及身體虐待的看法，以達一致性評估。最後希望結構化決策工具(SDM)進行本土化研究。

Under the current child protection policy, the Basic Education Law emphasizes the policy of zero corporal punishment outside the home. How do child protective social workers treat investigations due to improper discipline or corporal punishment as protection cases? This study aims to understand the appearance of child protection cases reported and investigated as improper discipline or physical abuse. Furthermore, how do the child protection social workers evaluate the above two types of cases and the differences in judging criteria and sort out the provided information intervention service? This study outlines the appearance of children's social workers evaluating child protection cases of improper discipline or physical abuse. It analyzes the intervention strategies and service methods of children's social workers when they provide treatment services. The source of the data is the case records written by the child and child protection social workers of the governments of five counties and cities directly under the Central Government in the protection information system of the Ministry of Health and Welfare. The cases studied are 815 case records closed as of December 31, 2020. The study results show that most abusers are parents, and the proportion of males is relatively high. The reasons for corporal punishment of children order, being punished for trivial daily life, school-related problems, such as unsatisfactory grades, and disobedience to discipline, such as talking back and quarreling. The means are mainly beating or injuring the body and tools or bare hands. Bruises and contusions were the most common injuries; trunk and limbs accounted for the highest proportion of injuries, followed by the face and head. The severity of violence belongs to serious violence, which falls into the category of physical abuse. Most parents or primary caregivers think corporal punishment is a reasonable discipline for children. However, they admit that there are parenting problems, and most do not think it is a problem for children. There are differences in the evaluation of discipline or abuse, there are significant differences in injury crisis, age groups and period of service, but there are no differences in apparent injuries, injury sites, injury degrees, children's response, violence severity and gender . There was no difference in factors such as whether or not to use appliances. Most of the cases belong to the "safe" range in the safety assessment and the "medium" or "low" risk status in the risk assessment. In terms of intervention services, parents and primary caregivers are willing to cooperate with the intervention of child and child protective social workers, and the service time is at most within one year. Family services include social worker interview services, general parenting education, resource network links, and welfare service programs. Children's services include school counseling, psychological counseling and treatment, medical, and accompanying services. Parents received the most psychotherapy and treatment for abusers, followed by psychiatric treatment. Research suggestions: (1) It is suggested not to differentiate between improper discipline and physical abuse. The substantive results of corporal punishment for children fall under the category of physical abuse, and there is no difference in services due to different classifications. (2) The intervention of social work services has become a service item that provides the "basic fund" of child protection, but assistance from academic units (schools) and medical units (psychological counseling and treatment) is still needed. (3) Develop children's social workers' views on judging improper discipline and physical abuse to achieve consistent evaluation. Finally, academia should research the Structured Decision-making Model (SDM) in future localization research.