Defining Institutional Child Abuse In U.S. Social Work: Implications for Recognition, Reporting, and Policy Under CAPTA

Background and Purpose
In the United States, child abuse is primarily defined through frameworks shaped by the Child Abuse Prevention and Treatment Act (CAPTA). While CAPTA guides identification, reporting, and response to maltreatment, its definitions focus on caregiver-based harm and do not explicitly address abuse in institutional settings. As a result, harm in residential treatment, therapeutic boarding schools, and other youth-serving institutions is often categorized as “poor practice” or “program failure,” rather than recognized as abuse. This survivor-led participatory action research study addresses this gap by centering survivor leadership in developing a practice-relevant definition of institutional child abuse. The study aims to (1) develop a definition grounded in lived experience and interdisciplinary evidence, (2) distinguish institutional abuse from individual misconduct and family-based maltreatment, and (3) examine how integrating this definition into CAPTA-aligned frameworks could shape recognition and reporting.

Methods
This study uses a CPAR design in which adult survivors of institutional child abuse led the project and were involved in data collection, analysis, and validation. Data sources included survivor testimonies, advocacy archives, and interdisciplinary literature from social work, psychology, law, and human rights. An iterative analytic process identified definitional gaps and recurring patterns in how institutional harm is experienced. Survivor-led analysis emphasized mechanisms of harm, including coercion, deprivation of autonomy, institutional control, and environmental constraint. These insights were synthesized with existing literature to construct a mechanism-based definition of institutional child abuse. To assess policy relevance, the proposed definition was applied to CAPTA’s statutory language and reporting structures to examine how definitional expansion—without altering CAPTA’s core framework—could influence interpretation and reporting thresholds.

Results
Findings indicate that CAPTA-aligned definitions do not consistently capture harms that are systemic, normalized, or embedded within institutional environments. Practices such as coercive behavioral control, enforced compliance, invasive monitoring, and restricted communication often fall outside reportable categories unless tied to individual misconduct. The study proposes a definition of institutional child abuse as harm arising from the interaction of institutional authority, environmental control, and system-level practices that violate a child’s rights, dignity, or developmental needs, regardless of individual intent. Applying this definition within CAPTA suggests several bounded shifts: institutional practices currently treated as programmatic concerns could become identifiable as reportable harm; mandated reporters could better recognize patterns of harm not tied to a single perpetrator; and state-level interpretations of maltreatment could expand to include environmental and systemic conditions in residential settings.

Conclusions and Implications
Definitional clarity, grounded in survivor-led participatory action research, has direct implications for how abuse is recognized within existing policy frameworks. Integrating this definition into CAPTA would not eliminate harmful practices but could improve recognition, reporting, and oversight. In social work, this approach strengthens alignment among research, policy, and practice by embedding lived expertise within definitional frameworks and supporting more ethically consistent decision-making in referral and oversight processes.