and reach thousands of daily visitors
27 June 2008
NO 1314
Work with families
To understand best how current child-care practice with children's families has evolved into its present form, it is useful to examine its historical evolution.
Families and child-care workers were once excluded from active participation in residential child treatment, an interesting and paradoxical phenomenon, given that both child-care workers and parents are those who traditionally spend the most time directly with children. Given the then-prevailing theories, however, it is easy to understand why. The most prominent theoretical models of human development for a major part of this century conveyed the notion that parents are specifically and directly the cause of the mental health and developmental outcomes of their children. This notion has been effectively termed "the family etiology hypothesis" (Whittaker 1979), or, less formally, "blame and shame" (De Salvatore and Rosenman 1986).
The result of translating this thinking into
residential treatment was the casual removal of children from the
noxious influence of their families so that they could thus be
rehabilitated by benign caregivers and an authoritative clinical staff.
The families were either excluded from involvement altogether or,
possibly, were provided a modicum of therapy or case work so as to make
them "better." Visits between parents and children were carefully
rationed, and parents had little
if any direct contact with their children's daily program and the staff
members who provided their care. Those elements in the family that might
justifiably have been changed to provide a sounder environment in which
to receive the child back were not dealt with. If anything, parental
guilt and isolation were reinforced, and breaches were widened. None of
this boded well, of course, for the postdischarge adjustment of either
children or family.
The bottom of the totem pole
Although the children who were removed from their families spent the
most time with child-care workers, the function of caregiving received
little respect among the clinical disciplines. Child-care workers were
not only excluded from active participation in treatment planning and
implementation, but they also were often forbidden any direct contact
with parents. As was frequently lamented, child-care workers occupied
"the bottom of the totem pole" in the clinical hierarchy. That at this
time many child-care workers were poorly prepared for their work, and
that administrators held only minimal requirements for hiring them
(common sense was often felt to be sufficient), tended to justify that
position.
Recognition and change
Both of these circumstances – practice based on the family etiology
hypothesis and the low status of child-care workers – contributed to
isolating children from their families and to isolation among the
disciplines that served them. As the years went on and inevitable
advances took place, this fragmentation fortunately changed. It became
increasingly recognized that "trying 'to fix' the child apart from the
context of his (sic) family (was) an impossible undertaking" (Ayres et
al. 1987). Although the reasons have already been alluded to, it is
important to specify them.
Parents of various groups of exceptional children have often been even more successful than professionals in achieving passage of crucial legislation allocating much-needed services. For example, parents succeeded in having Public Law 94 142, requiring the delivery of appropriately mainstreamed schooling to exceptional children, enacted and put into effect. The result has been the recognition by professionals working with such children that they might be more effective in the political and legislative front if they were closely aligned with parents.
Within the family itself, the placement of a child out of the home for a period of time inevitably alters the pattern of relationships among the remaining members. They reconfigure themselves around the former influence of the absent person, making it difficult for the child to reenter the family following a period of treatment. If the families are integrally involved in the activities of the children in care, the likelihood of the child's place in the family system being maintained increases.
Just because the child still has a place, however, does not mean that the family structure is ideal. The content and pattern of relationships, including the handling of the child in care, frequently have to change in order to provide a more healthy situation for the child to return to. Excluding families from the treatment process of their children does not necessarily improve their ability to manage their lives in general, or to be more helpful to their children in managing theirs. When parents have participated in the activities that can lead to both learning opportunities and better conditions for their own lives, they become much more able to provide the kind of situation that will sustain children's gains when they return home. This belief accords with that of Garbarino (1982), who states that because "families that produce troubled children appear to be socially isolated from key support systems, they are acutely in need of a family support system." Participation in properly designed family involvement programs is obviously one way of providing a significant support system.
KAREN VANDERVEN
VanderVen, Karen. (1991). Working with families of
children and youths in residential settings. In Beker, Jerome and
Eisikovits, Zvi. (Eds.). Knowledge utilization in residential Child and Youth Care practice. Washington, D.C. Child Welfare League of
America. pp. 173-175.
REFERENCES
Ayres, S.; Coleman, J. and DeSalvatore, G. (1987). Parents: The critical yet overlooked component of effective inpatient/group care child treatment. Paper presented at the Albert E. Treishman Conference, Cambridge, MA.
DeSalvatore, G. and Rosenman, D. (1986). The parent-child activity group: Using activities to work with children and their families in residential treatment. Child Care Quarterly, 15, 4. pp. 213-222.
Garbarino, J. (1982). Children and Families in the Social Environment. New York. Aldine.
Whittaker, J. (1979). Caring for Troubled Children. San Francisco, CA. Jossey-Bass.
