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In this paper I will present some case material which I hope will demonstrate the difficulties child-care professionals encounter in their work with children whose physical and/or mental health is endangered by their home environment. The task of evaluating the potential risks, physical or psychological, of growing up in such a home, against the dangers that may follow removal from the family, is formidable. The authors of Before the Best Interests of the Child (Goldstein et al., 1979) address themselves to these problems and suggest, as a guideline, ‘the least detrimental available alternative for safeguarding the child's growth and development’. They argue that the least detrimental alternative is usually for the’ child to remain with his family and that the law should not enforce the removal of any child unless there is evidence of physical injury, physical neglect or of abandonment.
However, responsibility for taking preventive measures usually rests with the child-caring professions who carry the heavy burden of deciding what is least detrimental. In situations that pose a serious threat for a child's growth and development, the line between needing physical and needing psychological protection is often quite narrow. Even in families where the child is not the primary object of parental violence, he may at any time become so; and in any case he will be adversely affected psychologically by witnessing such scenes. Young children are physically and psychologically at risk when in the care of parents who are drunk or suicidal; and they may be neglected to the point of being physically endangered while in the care of a severely depressed or withdrawn parent. All these conditions applied in the case I am going to describe.
Peggy was 2 years 10 months when she was referred to the