Reaching troubled kids

William C. Morse (Editor)
Crisis Intervention in Residential Treatment: The Clinical Innovations of Fritz Redl
1991, The Haworth Press, New York

In his introduction to this book William Morse makes the point that these are not the best of times for a child growing up in the United States. If this is true for children in the United States we can only wonder as to the reality for children in other contexts. Just as children all over the world find themselves in acutely traumatic situations, and the child care profession continues to find its own way, so was Fritz Redl concerned with what he saw as threats to the welfare of children in the early 1960's. His many responses, innovative, creative and very often controversial, have bestowed on him a central position in child care both in the United States and the rest of the world.

This book, rather than being a selection of Redl's original writings, is a collection of essays and articles about his work written by a number of well-known child care practitioners. Morse writes: His (Redl's) genius was to speak on many levels and present a challenge to the child care worker and theoretician in the same description. The purpose of this publication is to encourage others to find the stimulation Redl's original followers found. (Morse, 1991:4) Anyone approaching this book with an eye to finding out substantial information about Redl the man and his biography will be disappointed. Other than a brief outline of his credentials and history in the introduction, this is a book about the work of the man, the academic, the child care worker and the advocate for the rights of children, seen through the eyes of people like Henry W. Maier, Jerome Beker and Thom Garfat.

Still new

The first article in the book by Henry W. Maier is entitled "What's Old -- Is New: Fritz Redl's Teaching Reaches into the Present" and it offers a general overview of much of Redl's work, showing that while many of his insights, revolutionary at the time, could well now be viewed as being 'old hat', the truth is that their re-articulation in the present has never been more vital. Examples are his antipathy towards physical punishment and his emphasis on interactional and situational contexts rather than a preoccupation with intrapsychic phenomena. The principles which Redl developed are widely referred to nowadays but are rarely consciously put into practice. We must follow Redl's dictum and make a "shift from a general preoccupation with the youngsters' psychic development to a pronounced attention to their ongoing life-styles and circumstances, with a search for opportunities for change within their particular life spheres." (Maier, 1991; 27)

David Wineman's contribution to this anthology, "Fritz Redl: Matchmaker to Child and Environment -- A Retrospective", concerns itself with Redl's understanding of delinquent and aggressive behaviour in terms of ego breakdown. It is not within the ambit of this review to discuss in any detail how Redl sees and describes ego breakdown (covered by Wineman) but it must be stressed that his description of an impulse-ridden child serves as the starting point for his important contention "that only total treatment design, in which every phase of the residential setting is involved, could confront the full range of clinical challenges presented". Wineman; 1991: 34) Wineman goes on to discuss Redl's notion of total treatment design including the 'antiseptic handling' of surface behaviour, activity programming as a therapeutic tool, the life space interview, and milieu design.

A way with words

While these terms may appear foreign to many (and Redl had a distinctively folksy way with words) there are elements of them in much of what we already attempt to do. The confusion is one of terminology rather than principle. Wineman's discussion will serve as a concise and yet comprehensive introduction to Redl's work.

"What Fritz Redl Taught Me About Aggression: Understanding the Dynamics of Aggression and counteraggression in Students and Staff" is Nicholas Long's contribution. We hear how this, together with his own experience, led to the development of what has come to be known as the Conflict Cycle paradigm, and Long goes on to outline a number of specific ways of understanding and responding to the onslaught of aggressive behaviour. The practical steps given at the end of the article are not only very useful, but also move the article away from pure theory and 'academia' into the real life sphere of the child and the child care professional -- exactly where Fritz Redl would have it.

Jerome Beker in "Back to the Future: Effective Residential Group Care and Treatment for Children and Youth and the Fritz Red Legacy" attempts a review (using Redl's arguments) of the widely held notion that in-patient units can be ineffective and costly as well as arenas for abuse. He argues that it is not the principle of an in-patient unit which is problematic but rather the manner in which they have often been run in the past, with the theories which came to underpin these units. Quite obviously all attempts should be made to keep families intact, but the magnitude of those needs which are not amenable to in-home services is growing rather than shrinking, and we need to ensure that we do not write off the important potential of residential settings, but rather look at how we can improve the services we offer.

For today

Ralph D. Rabinovitch in "Fritz Redl and Residential Treatment at Hawthorn Center" outlines some of Redl's more potent ideas on milieu treatment. One of the strongest features of this article is that it instils a very strong desire to go back and re-read Redl's original work, as it captures much the essence of the wit, humour and cutting insights which so characterise the work of Fritz Redl.

The final two articles by Ruth G. Newman and Thom Garfat are very much personal responses to the influence of Redl, the man and his writings. Newman's work arises out of a project which she and Redl worked on in Washington, while Garfat attempts an explication of his personal 'dialogue' with the work of Redl as a young child care professional.

This book may in time come to be seen as a catalyst in the rediscovery of Fritz Redl in a new generation. Rather than seeing Redl as an important pioneer with a few useful insights this volume serves to illuminate how relevant his thinking is to present day child care — and how important it is that we rearticulate what he was saying so long ago. The book whets the appetite while offering countless useful insights for child care work in our time.

                                      — Mark Tomlinson