Munchausen Syndrome by Proxy: A Spanish proposal of therapeutic management

This paper provides an analysis to establish a practical guideline in the therapeutic management and subsequent monitoring of Munchausen Syndrome by Proxy (MSP) adapted to the Spanish social and legal context and based on scientific literature published before December 2008. An interdisciplinary team made up of various professionals involved in caring for the child will design a therapeutic strategy and monitoring at different levels. In the field of mental health there must be a triple therapeutic approach: the child as a victim, the agent as abuser and the family as a whole. In terms of social work, the socio-familiar situation should be evaluated using different resources at a health care level. It is important to plan the time to confront the family to obtain their necessary collaboration. The monitoring plan will be collective at the hospital level and the child's primary pediatrician, in the medical and educational fields in those of mental health and social work. A therapeutic strategy and monitoring by an interdisciplinary team at the medical, social and mental health level, is proposed as a useful tool in the management of MSP. In this way, in some cases the removal of child from the family nucleus can be avoided.