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33 OCTOBER 2001
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work with children and families

Family treatment in residential homes

Dr. Steen Mogens Lauge Lasson

Maladjusted children, troublesome kids, problem children “what is the meaning behind these labels, often used on children who do not fit into adult patterns of living. Some of these children are demonstrating very adequate and healthy reactions considering their insufficient emotional and social living circumstances. In fact these children are often very normal and clever children. Far too often our measuring standards are only set by the adult world. The question of problem children can always be seen from two very different angles:

Often both viewpoints are relevant.

Teachers, psychologists and childcare workers sometimes try to explain these problems of today as a result of “the new character of children”. Here they normally refer to the omnipotent, narcissistic and need fixated children and youth of today. Most of these children have painful experiences of emotional dependence and socially coping, and are indeed troublesome for family, schools, friends, society and most of all themselves. Many such children will be referred to treatment and/or experience extra familiar placements in order to stimulate and develop their personalities and social skills. But unfortunately only a few of these children will get an understanding of how much their own family was a part of their daily problems. Here I am referring to those children from the families where the relations between the family members were damaged seriously and healing them should be the aim of the treatment plan.

So “why do we not talk about “the new character of parents”, and how to prepare modern parents for parenthood? This is the logical beginning of the therapeutic process in order to prevent developmentally threatened children. The characteristics of the child of today are of course the result of a new concept of the family. Too many children have been left in the hands of professional caretakers, with frequently changing, caring adults, who are strangers. Children's personalities are therefore often moulded more from their relationship with other children than from those with responsible, stable, concerned and caring adults. Thus we easily get “video-children” with strong action-oriented needs. Many of these children have not had their needs for being together intimately with closely related adults satisfied ... adults for whom they had strong feelings and whom they would hate to disappoint. Adults who show affection and love for the child, who provide the child with ethical understanding, in the daily demonstration of the difference between right and wrong, beautiful and ugly, safe and unsafe, etc. Adults ready for the possible conflicts necessary for demonstrating the frames for acceptable behaviour.

The upbringing of so-called problem children has often been done by weak, exhausted, and/or immature parents. These parents, as all parents, love their children and wish them the best from life, but for many different reasons are unable to support a positive development of the child's personality. Such parenting is characterised by the assignment of uncontrolled and irrelevant freedom, sometimes with a strong touch of material spoiling, overprotection or laissez-faire instead of planned caring and support of the child's will power in order to counteract anxiety in a safe way. Such an upbringing seldom offers children the opposition and the trouble necessary for demonstrating the boundary posts of the unsociable land.

Among the reasons for this shift in the concept of family life, might be the movement from rural to urban life with its present sharp division between work life and leisure time. This fact causes a split up in everyday life for the modern family. Children especially are taken hostages in this development. Family members often leave early every morning in different directions. Ten hours later the family meets exhausted again. The family has become a rather unproductive spare time community of separated generations, where modern technology ensures the fewest possible demands from family members, and where cosiness and relaxation have become the target in itself.

In developed welfare states the dramatic increase of family income gave possibilities for more consumption and more speculation in the acquisition of material goods. The possibilities for buying certain liberties such as the care and the responsibility for the daily life of children and elderly in the family were obvious. The public service systems in welfare states were ready to take over more and more. Day-care became normal life for many children. More and more elderly people were hospitalised or brought into residential care, not because they were sick but because their own family was not ready for the necessary support and care as they were too busy occupied by other matters. In the same period the family became smaller and smaller in number of persons. Fewer children were born. The rise in divorce rates produced more single parent families. The number of family members was reduced to an absolute minimum. Two or three persons, often make up a nuclear family, and a very vulnerable one. In many countries, family life must be seen as being at risk where emotional problems are disturbingly escalating.

The number of developmentally threatened children and families is growing alarmingly. There is a big 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 relations and to secure a healthy family. Therefore it is important that residential care nowadays include the family in the caring and treatment of the child. This is part of what we today are calling “networking”. Thus residential care becomes much more a supplement to modern family life than an alternative, though the latter might be relevant where no family exist or can be found able for parenthood.

The time has come for establishing enough of good institutions offering “Family Residential Care” ! Too often the treatment of interpersonal problems has been directed toward the individual. It would have been far more professional to focus on the disrupted interpersonal relations in the family. Relation therapies and work will be important tools for the care worker.

This is the first of a two-part article. Part Two (in our November 2001 issue) will cover family treatment services in Udby, Denmark.

Reprinted from Child and Youth Care Vol.18 No.10

The International Child and Youth Care Network

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