In this article, a treatment working model is proposed and applied to two cases of multiproblem families with severe physical child abuse. Stimulus events that directly affect the likelihood of a physically abusive episode and setting factors that play an important indirect role because they increase the number of confrontations and decrease parental competence are considered. The child abuse cases involved major parenting deficits, maternal psychopathology, a major psychosomatic problem (childhood encopresis), and symptoms of childhood conduct disorder, which occurred in a setting of family distress, low income, and sibling distress. This study demonstrates how a two-phase comprehensive parent intervention, paralleling the stimulus versus setting factor distinction, can deal effectively with such multiproblem families. Treatment results and a 7-month follow-up assessment illustrate the utility and validity of the proposed scheme when applied in the real world where the relational character of the problems makes them multidimensional.
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