Charting the waves of prevention: two steps forward, one step back.

Background: Over the past 30 years, the political response to child maltreatment and its prevention in the US has experienced periods of frantic activity, often followed by long periods of benign neglect. In reflecting on this history, Dick Krugman has referred to this uneven level of attention as a series of "waves" in which apparent progress is often minimized by an inability to sustain political commitment to a given reform or course of action. To an extent, this pattern reflects deep differences among child welfare advocates, researchers, and practitioners on how best to proceed. While most everyone agrees that "it shouldn't hurt to be a child," how to prevent this hurt and at what cost is less clear.

Method: To address this dilemma, prevention advocates, researchers, and practitioners have struggled with a variety of conceptual frameworks and programmatic reforms. This article summarizes the relative gains and limitation of three such efforts and outlines the lessons these efforts offer those formulating future prevention policies and programs.

Results: Specifically, the authors suggest that future prevention efforts will need to take care in avoiding some of the most common mistakes experienced by earlier efforts.

Conclusions: These mistakes or pitfalls include oversimplifying the problem of child abuse; overstating preventions' potential and appropriate target populations; failing to establish a significant partnership with child protective services; compromising depth or quality in an effort to maximize breadth or coverage; and failing to fully engage the public.