Family Treatment in
Residential Homes – II
Dr. Steen Mogens Lauge Lasson, Consultant in Child Care and
Honorary President of FICE International. This is the second of
See Part I
In many countries, family life is at risk and emotional problems
escalate disturbingly. The number of developmentally threatened
children and families is growing alarmingly. There is a great need
for a supportive network for the modern family to guarantee healthy
mental growth. Residential care may at times be most relevant for
the child and sometimes for the whole family, to build or rebuild
the needed relationships and to secure a healthy family. Therefore
it is important that residential care nowadays includes the family
in the care and treatment of the child. Thus residential care
becomes much more a supplement to modern family life than an
alternative, though the latter might be relevant where no family
exists or can be found able for parenthood.
In 1968 I was appointed by the state as executive director of the
new established Udby Treatment Centre. From the very beginning, in
dealing with so-called problem children we wanted to focus on the
family. Thus we became the first residential home in Denmark to
include the family in our therapeutic programmes. All families
asking for professional help in Udby have to accept the philosophy
of the centre, that parents or parents substitutes are key persons
in their children’s lives. Therefore they are obliged to involve
themselves in the treatment process.
Children referred to Udby are diagnosed to be emotionally disturbed
and their behaviour disorders considered as symptoms of emotional
disturbances in the interpersonal relations between family members.
Therefore the family must cooperate and take part in the daily life
and treatment programmes of the centre, as the goal in sight is the
return of the child for family living in his or her original family.
Responsibility and consequence are key concepts in the work done to
build up the self-esteem and self-confidence in insecure children
and their families. The structure of everyday life is very visible
and exterior order is seen as a psychological aid to inner order and
self-control. Connected to each unit are small houses and flats
furnished for having the children’s families as short-term
Initially, all children attend our internal school. Outside of
school hours the children take part in a very structured group life.
Many formal "training groups" are offered on a therapeutic basis
daily to the children and their families. All groups are based on an
analysis of individual needs. These groups are obligatory parts of
the treatment programmes agreed upon in the assessment phase. Also
many "interests groups" can be attended on a voluntary basis. In
order to train the children for less protected living, at the end of
their residential placement, all of them will, for a minimum of six
months, take part in leisure hour activities in the local village.
The playground of Udby is a special feature. The philosophy is:
"Better a broken arm than a broken psyche". The playground looks
quite dangerous and demands courage, skill and daring. Here are ten-
metre high towers with top platforms and bridges between the towers
from where one can dive five metres down into a safe "spiders web";
here are rope "cars" to drive more than 100 metres, direct into the
jungle! This playground is very important in building the
self-confidence of the child and strengthening their belief in the
social support of people. The playground is an excellent tool when
the staff is working here with the whole family.
All training programmes are action-oriented and challenge the
hyperactive children as well as the passive ones, along with their
very different families.
The family work in Udby is covered in a five-stage programme as
1. A treatment programme
is drawn up individually for each family and each family member.
These programmes are based upon identified needs. The programme
is drawn together with the family members, to ensure maximum
2. The family comes to the centre on specified weekdays. Work is
done with the child and the family. Either taking part in the
common unit activities or special therapeutic sessions such as
role play and video self confrontation. These activities are
called "day projects" and focus specially on the damaged
interpersonal relations in the family.
3. The family move, for weekends, for several days and up to
several weeks, into the family houses or flats. In these periods
the family will be involved in activities specially developed to
meet the needs of their particular family. These activities are
called "residential family work" and focus on the interpersonal
relations in the family.
4. The family comes to the centre once a week for a period of
one to three months in order to participate in a specially
selected activity fit for the general strengthening of the
relations between the child and its family. These activities are
called "week projects".
5. The family comes to participate in group work on family life
with other families in order to gain insight and understanding
in the process of upbringing.
6. The family returns at least every six months for evaluation
of the treatment process.
7. The family comes for participation in social events together
with other families.
The anxiety fields of each
family member are localised and analysed as an important guideline
for building up the proper individualised programmes. Energy is
given to the process of developing new talents and skills, always in
a holistic framework. Counselling and evaluation are currently
offered in order to create insight into the process. The staff has
to pay attention to many personality factors. Among others:
capabilities, knowledge, emotions, desires, fantasies, beliefs,
estimations, ambitions, will, body possibilities, social skills,
autonomy, taboos and traumas. Most training will be oriented towards
interpersonal relations, where severe damage is often seen. Here the
family members receive professional help to face and cope with their
emotional problems. The dangers in denying the troublesome
situations are made visible. Negative energy is transformed to
positive. Convincing success must be found in actions.
Later in this process, following upon actions, words can be most
useful to underline and describe fulfilled actions in order to
stimulate the important process of insight and the feeling of
The Udby Treatment Centre can in a broader sense be described as a
therapeutic community, where the therapy, normally called training,
is placed in everyday situations in order to avoid the clinical,
hospital-like atmosphere found in many psychological therapies. We
do not want children and parents to experience themselves as
patients, but to see themselves as normal families with normal
reactions to normal family problems.
Family therapeutic expertise is found in residential treatment
institutions, but very often uncoordinated with the external
treatment system which brought the families or their children to the
The time has come to break down inefficient and old-fashioned limits
within child and family care. I would propose the establishment of
"Family Life Power Stations", "Family Treatment Centre’s" in the
nearby environment of the family in trouble, the family in pain. In
these locally anchored centres, families can ask for support and
advice. Family work is offered on a preventive and pedagogical scale
as well as on a more therapeutic level. Such centres should offer
choices, from telephone guidance to residential care and treatment
which fits with the needs of each family, each family member.
This feature: Reprinted from Child & Youth Care Vol.18