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24 September
No 1221
Practice theory
Finally, just as our knowledge of "what to do" has changed, so has our understanding of "who" should do it. A new orientation to the total ecology of the child's world will mean realignment of staff both within and outside of the core treatment program. Where, then, will we find an adequate theory to describe just what a therapeutic milieu is and how it should work? In response to this question, I would offer a fourth guideline for practice:
No single theory or set of practice prescriptions will answer the needs of a program that is geared to the total range of children's development and oriented to the total ecology of their world.
We lack a unified theory for residential treatment and will probably continue to do so for the immediate future. This should not be viewed as particularly problematic, since we are still a field that is developing. It suggests a continued period of experimentation with many different models and an essentially inductive rather than a deductive approach to the development of a theory of intervention. Our theory should be used in the service of our stated program purpose-to provide education for living. Instead, residential treatment programs too often have tried to bend their purposes or objectives to meet preconceived theoretical biases. Thus, some residential programs have suddenly switched from a totally psychodynamic to a totally behaviorist orientation-simply through a change in executive directors. On occasion, even whole service systems, particularly in juvenile corrections, have shifted from one total approach to another-for example, from "casework" to positive peer culture and then back again, as if "truth" lay only on one or the other side of the argument. This either/or approach to the development of a practice theory has been counterproductive in that it has constantly kept alive the spark of hope that somewhere, somehow, we will discover the "answer" in a single approach, theory, or treatment model.
But there is no simple solution to the complex problems that confront us in the child care field. Rather than continuing a search for an encompassing theory of milieu treatment, we should accept the fact that theory development will proceed slowly through a series of experiments and program demonstrations in which the wisdom of clinical practice and the knowledge from clinical research and theory are tested against the real-life problems of children and families in need of care. We must therefore guard against overreliance on a single body of theory, even though there is a need for coherence and a value in commonly held precepts. Perhaps our primary unity should come not so much from commonly accepted and defended theory as from a common commitment to basic purposes: to teach skills for living and to build a powerful environment. Such an open, flexible, and eclectic orientation to a theory of residential treatment demands a program that is data based and capable of being evaluated.
JIM WHITTAKER
Whittaker, J. (1979). Caring for troubled children: Residential treatment in a community context. San Francisco: Joissey-Bass 45-55
