|
An innovative program partners foster children with
therapists for as long as they're needed, providing a stability
otherwise missing
One Child, One Therapist
When child psychologist Norman Zukowsky first met him,
6 1/2-year-old "William" had already lived through more hardship and
trauma than many people experience in a lifetime. He was born exposed to
drugs and alcohol, one of three children of a drug-addicted mother who
lived in an unheated garage with no cooking or bathroom facilities.
Child welfare reports suggest that the children were physically abused,
exposed to sexual behavior and often went without food or clothing.
Eventually, William was removed from his mother's care only to be placed
with a relative who scarred his chest beating him with a belt.
Then William finally caught some breaks. When he was
5, he and his 7-year-old sister were placed with Mrs. Smith (not her
real name), a loving, attentive foster mother who ran a stable, orderly
home. Under her influence, he began to settle down and shed some of his
wildness and anxiety. One year later, Zukowsky became his volunteer
therapist through an innovative San Francisco program called the
Children's Psychotherapy Project.
For the next two years, Zukowsky and William saw each
other once a week, usually at the therapist's San Francisco office but
sometimes at Smith's tidy blue house. Zukowsky saw in William an
endearing, charming boy who was hungry for adult friendship and
connection. They spent most of their hour-long sessions playing cards,
board games and improvised baseball using paper wads and pencils. "He
made the rules ... he kept score, and he always won ... repeatedly,
inevitably, and -- in my clinical view -- necessarily," Zukowsky wrote
in a chapter of a recent book about the psychotherapy project. William
was playing "developmental catch-up," Zukowsky wrote, seeking and
getting from his therapist the warmth, attention and emotional
nourishment he had missed in his earliest years. Things were going well
for William. He had fallen in love with his foster mother, who was in
the process of adopting William and his sister. He adored Zukowsky. And
he was doing well in school. Then, one horrible night, William's life
crumbled again. Mrs. Smith's husband, a depressed, quiet man who rarely
interacted with the children, shot his wife and himself. William and his
sister found their bodies and lost the only stable, loving home they had
ever known.
Zukowsky was now the key adult in William's life, the
one person he could count on, and who was truly looking out for his
needs. Zukowsky was in that position because 12 years ago San Francisco
psychologist Toni Heineman got mad about the many ways the child welfare
system fails foster children -- and decided to do something about it.
Heineman had worked with foster children for many years and had learned
firsthand how the system sabotages the ability of foster children to
form lasting relationships with caring adults. "We send foster kids from
home to home, community to community and case worker to case worker,"
says Heineman, an associate clinical professor of pediatrics and
psychiatry at UCSF. "It's the biggest problem in the system."
The system's failings take a heavy toll. A recent
report from Casey Family Programs, a foster care agency, found that
former foster youth now in their 20s and early 30s suffer from
staggering rates of post-traumatic stress disorder and other mental
health problems; high rates of unemployment, homelessness and poverty;
and low rates of college and vocational school completion.
Heineman realized that revolving therapists were part
of the problem. Foster children who get therapy usually are seen by
interns who rotate every few months to get diverse experience. Just as a
child forms an attachment with a therapist, she explains, the therapist
leaves and the child is once again abandoned. To address this problem,
Heineman and a group of colleagues founded the Children's Psychotherapy
Project, which recruits therapists to spend one hour a week working with
a foster child. The guiding principle is simple: "One child, one
therapist, for as long as it takes." The project asks for a long-term
commitment from the therapists it recruits, but it also gives something
back: In addition to their one-hour session with a foster youth, each
volunteer therapist also participates in a weekly consultation group led
by a veteran clinician. These groups, which therapists might normally
pay to attend, allow colleagues working with children to come together,
discuss cases and get advice and support from each other.
After Mrs. Smith was murdered, Zukowsky's consultation
group became a crucial source of support for him as he mourned her death
and its impact on William. "I was sustained by the emotional sharing" of
the group, he wrote.
Zukowsky's role in William's life was now more
critical than ever. He comforted William, worked his connections in the
welfare system and strategized with the therapist working with William's
sister, also a project volunteer. When they resumed their sessions, a
subdued William continued to want to play -- and did not want to talk
about his foster mother's death. Zukowsky followed his lead, rarely
bringing up Mrs. Smith's death. William eventually recounted the story
of finding the bodies, the shock and sorrow playing briefly over his
face. Eventually, William brought up the question Zukowsky had been
dreading: Perhaps, the boy asked, they could live together. Zukowsky
awkwardly explained that would be impossible, and William let it go.
Today, two years after Mrs. Smith's death, William and
his sister are again living in a stable home. William is now 10, and he
continues to see Zukowsky once a week for sessions of indoor basketball
mixed with a bit of talk. Zukowsky is guarded and self-effacing when he
talks about William and his impact on one boy's life. But this much, he
will say: "In a psychological sense, I was family. We shared a loss, and
he had someone to lean on."
The Children's Psychotherapy Project, meanwhile, has
gone national. From its start in San Francisco, the project has spawned
12 chapters in cities around the country. More than 100 therapists are
donating their time and more than 200 foster children have been served.
In a system that, on any given day, includes some 500,000 children
nationwide, that number is a drop in the bucket. Heineman keeps on
working to recruit more therapists and serve more children. But whatever
the numbers, she believes the program has an impact beyond the
individual children served.
"When we make a difference in the life of one foster
kid, it also has an impact on the system," she says. "It's small and
it's subtle, but over time, it adds up and people begin to think about
the importance of long-term relationships in the lives of foster youth
in a different way."
Rob Waters
12 February 2006
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/02/12/CMG2BGKO6M1.DTL
home
/
Previous feature
|