Listen to thisOver the last decades there has been a strong discouragement of the therapeutic stance which emphasises pathology and which confirms ‘patients’ as being ‘ill’ and in need of our help. The alternative has been to recognise and encourage strengths, and to build skills and self-respect which allows people to return empowered to their world.
Durrant (1993: 12) reflects on this:
"We have two ways of thinking about the task of residential treatment (or any therapy, for that matter). We can consider it a process in which we therapists act upon the child and/or family in order to change them or to repair damage, or we can consider it a process in which we work with children and families to assist them in changing themselves ... Much residential work has reflected ideas of children being damaged or disturbed, children possessing some problem or pathology, or parents being incompetent or deficient. If we approach our task from this viewpoint, inevitably we will see our role as that of experts who operate upon the clients in order to fix or cure something… however well such interventions may be achieved, they inevitably reinforce a context of family incompetence. Clients may enter treatment experiencing themselves as having the status of failures or people who are deficient. They may leave treatment with the immediate problem solved but with their status confirmed, since they may not have experienced themselves as having had much personal agency or control over the process of change".
Powis, Allsopp and Gannon (1987: 5) refer to ‘bootstrapping’ as a consideration in treatment:
"The saying that a person has ‘pulled himself up by his own bootstraps’ is common enough. In genuinely helpful programmes for children, our job is often to provide the bootstraps. One finds that a child who is unconfident in all areas of his life may need just one area of achievement from which he gains self-confidence, and this can change his attitude to and performance in all the other areas. This emphasises our need to build strengths within children rather than trying to manage and control their life tasks for them. It also highlights the value of identifying strengths as well as weaknesses in the assessment, for it is often these strengths which will provide the ‘bootstraps’ or toe-holds for children in their treatment plan".
The empowerment of children and families is not only one of the principles of treatment – an attitude we want to put into practice – but also one of the methods of treatment which we will deal with in a later theme. Durkin (1988: 356-357) puts it this way:
"A competency-based programme, focused on health and normal development, views the child positively, for example, as a ‘student’ rather than a ‘patient’, and also ecologically in the context of family, school and community. It seeks, through developing positive competencies, to achieve the more realistic goal of helping the child become more acceptable and the environment more accepting. This is in marked contrast to the more abstract and less feasible goal of ‘curing’ the child. The medical psychopathology model, with its negative focus on pathology and dysfunction, stigmatises the child…"
He goes on to sketch a positive cycle which can be easily implemented in treatment:
"Many children requiring professional child care are deeply troubled, but a valid way to treat illness is to promote health. It does not overlook or minimise the problems; it rather seeks to put them in a more treatable context. The more competent an individual feels, the more willing and able that person is to deal with problems. The more competent people are, the less destructive will be their psychopathology".
Empowerment, of course, is not simply helping children and families to see themselves in a positive light and to experience some sense of achievement and competence. It involves our giving them real opportunities to take control over their lives, and to be responsible for their action. We empower a small child when we first take our guiding hand off the saddle of the bicycle they are learning to ride. This gives them a rush of independence, responsibility, self-doubt, trust in their own ability…. a feeling that ‘I am managing to do my own thing.’
Piechura (1992: 22), in talking of the Life Impact Curriculum programme, says that "children should see themselves in relation to their world and understand how they participate in the projection and creation of that world". She goes on:
"The Curriculum stresses that the reality of a child, who is labelled emotionally disturbed, is not right or wrong, but different from that of the consensus of society. Most importantly, the Curriculum teaches every child that they possess the power to change reality. The teacher’s role during the experience takes a non-traditional direction. The teacher is no longer the giver of vast information, but instead, becomes a facilitator of learning, and ultimately learns with the child".
An important empowering technique is to give the child or youth the opportunity to try his own ideas of problem solving. Instead of giving good advice, we ask the child: "What do you think would be the best thing to do now?" – and then allow the child to try just that. Better yet, we then allow the child to evaluate the effectiveness of what he tried. Did it work? Did it solve the problem? Does he feel better? If not, he can try something else. If so, then he learned something about life and people, but more important, he learned to do something for himself.
Durrant (1993: 138) suggests the intriguing idea that we cannot really empower people, since this suggests that we retain the power over them which allows us to do this. He writes:
"Paradoxically this must reinforce that I still have more power than you. All we can do is stop doing those things which disempower people. They will empower themselves as we provide space for them to discover their ability to do so. This is not a trivial matter, for it highlights the issue over who is responsible for change". Durrant means, of course, that it is the client who is responsible for change.
Vorrath and Brendtro (1985: 19), in their concept of Positive Peer Culture (PPC – see Study Unit 14), illustrate the concept of empowerment graphically:
"As adults encounter the challenge of difficult youth, the typical response is to demand conformity and obedience. Elaborate sets of rules are concocted, and then the search for ways to enforce them begins. Rewards are offered to students for behaving, and punishments are applied to keep them from misbehaving; adults send for reinforcements; students are shunted to special programs – but still the problems persist.
Rather than demand obedience, PPC demands that young people become the mature and productive human beings they can be. Unfortunately many adults do not really believe that young people posses the quality of ‘greatness’ which is perhaps not surprising since youth seldom are provided with opportunities to display their true human potentials. PPC is concerned with setting expectations high enough to challenge the young person to do all he is capable of doing. To expect less is to deprive him of the opportunity of feeling as positively about himself as possible".
References
Durkin, R.(1988). Restructuring for
competence: a case for the democratization and communitization of children’s
programs, in Challenging the limits of care edited by Small, R. and
Alwon, F. Needham: Trieschman Centre.
Durrant, M. (1993). Residential Treatment: A co-operative, competency-based approach to therapy and program design. New York: Norton
Powis, P., Allsopp, M. and Gannon, B. (1989). So the treatment plan. The Child Care Worker, 5 (5): 3-4; 5(6): 13-14; 5 (7): 3-6; 5(8): 3-7; 5(9): 5-9.
Piechura, K. (1992) Empowering the Minds of children and Youth. Journal of Emotional and Behavioural Disorders, 1(2): 22-27.
Vorrath, H. and Brendtro, L. (1985). (2nd Edition). Positive peer culture. New York: Aldine De Gruyter
Gannon, B. (1994).Theories, Approaches and Principles of Education and Treatment. Pretoria: University of South Africa pp. 42-45.
