Improper Socialization?

One of the significant problems I see with residential treatment care is the fact that the residents are socialized in a group consisting of dysfunctional children all in various states of mental, emotional, and behavioral crisis. Each new client is thrown into a tempest of "feral" kids, ones who display ineffective and quite destructive social and coping skills, ones who have little to no opportunity to observe and model appropriate interpersonal and internal skills.

And positive results are expected?

If there is a way to integrate children in residential treatment care with other children who possess and exhibit appropriate and effective social and coping skills—without unfair disruption or detriment to the lives of the "normal" kids—I would sure like to know. Perhaps some organization has run an effective program of this type somewhere out there, perhaps in my own back yard. (Perhaps a multi-staged program, the kind that would require several residential units and probably be too cost-prohibitive or complex for most facilities to run?)

Family-based therapy (rehabilitation of the children, retraining of the parents) and foster homes and various sorts of therapy, I know, can provide effective social and coping skills training. But once a child enters a residential treatment care program, it's like she joins a tribe of dysfunction. Though the program structure, rules, and limits—when implemented appropriately—provide a measure of stability and consistency, the peer framework encourages a dysfunctional social milieu, particularly when the residents are kept grouped together for the better part of each day as well as confined together in a restricted space. And especially when the kids are forced to engage in group therapy sessions (often run by professionally unqualified and inadequately trained direct care workers), where they are pushed to air their secrets and shames in front of other children, some who will use their peers' disclosures to maliciously hurt them, as well as others who chronically disrupt the groups so much that they become exercises in behavior management instead of actual therapy.

Who, anyway, could get along in such close quarters with a group of even fully "well-adjusted" people? If you are familiar with any "reality" TV shows in which a number of adults are thrown together into an artificial and confined milieu—not unlike children in residential treatment care—you've seen that the initial good will and smiles soon break down into resentments and fights. So how does anyone expect different results from distressed children?

So, now that we've defined one of the significant shortcomings of residential treatment care, what are the practical solutions? I would sure like to know.

(Another one of the problems, by the way, is a paucity of research and resources on residential treatment care—something we're trying to change through Healing Embrace. Maybe there are programs out there that implement a successful socialization aspect, but finding them is the challenge.)

Anyone out there have any answers? For the sake of children, please share them!

© 2008 David Lee Cummings / Healing Embrace

One Strike for Perpetrators

Regarding sexual abuse, those committing these deviant acts should be dealt with as severely as possible. Too often perpetrators are given slaps on the wrist and are then allowed to re-offend.

I say that until someone finds, or society allows, a biochemical or other effective way to control the impulses of sexual offenders, there should be a one-strike law: One strike, and the offender is in prison for life. This consequence is harsh, but why not let an offender rot away in prison—even if the offender was a victim him or herself at one time? It will prevent several to many more lives from being ruined down the road and break the cycle of perpetrators.

I know there are numerous facets to consider with locking someone away—such as the fact that the incarceration of the perpetrator could mean the loss of a parent for life. But in the greater interest of all children, it's absolutely vital to ensure that one incorrigible life is not allowed to decimate and corrupt many more innocent ones.

© 2008 David Lee Cummings / Healing Embrace

Let's Teach Mandatory Parenting Classes in High School

One of the things I think societies need to do to prevent child abuse is to teach all of its citizens effective parenting skills. We become parents without ever having been trained in the most common and timeless of "jobs."

Parenting simply is not easy for anyone, and many acts of abuse are done because the parent doesn't know how else to manage their child's behavior. Inflicting some form of physical punishment is therefore often levied because the parent doesn't know an alternative intervention that works. We should thus teach high school juniors and seniors, in school, what to expect as parents and how best to be parents themselves (with an emphasis on delaying parenthood until they are emotionally and financially mature enough to effectively handle the responsibility).

In fact, educational systems should also teach other life skills, such as financial aptitude, as part of the core curriculum in addition to the traditional three Rs. Our world would be a better place if we all learned to be better, more responsible people as well as literate ones.

© 2008 David Lee Cummings / Healing Embrace

Is It Ethical for RTC Staff to Subsequently Foster their RTC Clients?

Okay, this one I am absolutely compelled to post. This is an example of the kind of thinking that I believe too oft plagues those in management and clinical positions in residential treatment care (RTC) programs.

I recently had a conversation with someone who is a staff supervisor in an RTC program. We engaged in a minor debate about the appropriateness of direct care staff subsequently fostering any of the children they cared for while in RTC placement.

The super is against staff subsequently fostering their RTC clients because of these reasons:

• It's a conflict of interest within the agency (she did not elaborate on this point).
  
  
• It provides an unfair advantage to the staff, as foster parents, in that they can "pick and choose" who they get to foster instead of having to blindly choose an unknown child as other foster parents must do.

My argument, in stark and passionate contrast, is thus:

• If it's a conflict of interest to provide a continuum of care from RTC into a staff's home, why is it not a conflict of interest to discharge a client from an RTC program and then admit that client directly and immediately into another program (e.g., Day Treatment) run by the same agency? Isn't the "conflict of interest" argument a bit hypocritical when made by a representative of an agency that indeed does just that?
  
  
• Who cares if the staff has an unfair advantage over other foster parents in the choosing of a foster child? What is in the best interest of the child? Isn't it to be placed in a home that we know offers a significant chance for success? Or would it be better to roll the dice and place that child in an unknown commodity—and risk another Marcus Fiesel incident?
  
  
• If we truly have that child's best interest at heart, won't we choose the home we know is very safe and adequately equipped?
  
  
• Foster parents with RTC experience are undoubtedly able to provide superior care compared with foster parents that possess no to moderate fostering experience.
  
  
• Furthermore, the staff knows the child intimately and therefore knows what behaviors to expect and is prepared to address those behaviors with greater proficiency that anyone else.
  
  
• As well, children passing through the revolving door of RTC are not "typical" foster children. They usually have behaviors—often learned or exacerbated during RTC placements—that make them some of the most challenging children in the child welfare system. They usually end up in RTC because they couldn't make it in a foster home. Do we want to send them to yet another foster home very likely ill-prepared to cope with their disruptive and destructive behaviors? Or do we want to increase their chances of success by sending them to a home we know is willing and indeed able to accept, support, and love them unconditionally—flaws and all?
  
  
• Finally, one of the main reasons behind unsuccessful foster care placements is the foster child's inability to bond appropriately with his or her foster family. So, if a staff and an RTC client naturally develop a strong bond (i.e., a "kinship" bond), this should significantly increase the child's ability to adjust to and succeed in foster care if placed in that staff's home.
  
  
• Why prohibit the natural progression into that staff's home and break the bond the child has with an adult yet again, thereby fomenting more grief and loss in that child's life?
  
  
• What could be crueler than saying (even silently), "Sorry, honey, somebody safe and competent, with whom you are closely bonded, actually wants to care for you, and this person is fully capable of addressing your full range of needs and issues ... But too bad, so sad, we're not going to let it happen because that staff's deep concern for your welfare somehow falls within our ambiguous 'conflict of interest' policy" (translation: "I am disguising my own personal bias by hiding it behind a veil of disingenuous quasi-policy").
  

In summary, who gives a flip about some kind of "unfair advantage" over others to do greater good in the world? If cutting in line means no one loses yet a child wins, what's the big deal?

Don't we have a moral obligation to aspire to achieve the best interests of the children we serve? It's inconceivable to me to believe that an "unfair advantage" trumps the best interests of a child in need. What a tragedy it is that this kind of thinking plagues the RTC system and prevents RTC staff from doing further good work in the world.

Anyway ... What are YOUR thoughts on this debate? I welcome any comments.

Thank you.

- David Lee Cummings

© 2008 David Lee Cummings / Healing Embrace