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12. Breakdown and Reconstitution of the Family Circle

Mary Boston and Rolene Szur, Editors Karnac Books ePub

Ronald Britton

In our society the family is the unit in which it is assumed the child!s development will take place. Our imaginative literature as well as an enormous quantity of professional writing testifies to the family being seen as the source of our satisfactions and dissatisfactions : the origins of our strength and security or the hotbed of our neuroses. The children written about in this book, however, have suffered from a lack or loss of family life and I would like to consider the position of such children and the complications of trying to remedy their situation. I would like to do this not comprehensively but from a particular angle, putting aside consideration of the imperative needs of the child for physical care, love, protection and attention, in order to consider the family as the matrix for the child’s development: the ‘locus in quo! of his personal saga. From this point of view the family, however composed, provides a bounded space for the child which, when broken, needs to be restored or replaced. The family seen from this viewpoint is the receptacle into which the child is born. The ability of the family, like a living cell, to maintain its own membrane, its interface with the world, is crucial to its own survival and the functioning of its components. When family breakdown has occurred the child may or may not be homeless but he is psychically unplaced.

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3. Sticking: More Girls in Care

Mary Boston and Rolene Szur, Editors Karnac Books ePub

The little girl described in the previous chapter had suffered traumatic experiences in her early life. Yet she did have some early experience together with her mother in contrast to some other children in the series who had had little or no experience of individual mothering as babies, having spent their earliest months in hospital or residential nursery, where frequent changes of staff were likely to have made significant emotional attachments difficult, Some of these, especially the girls, were quite clinging, craving for affection in a pathetic or appealing way, but there was often a flat, superficial quality to the contact they made with their therapists. Foster and houseparents too sometimes had difficulty in establishing deeper relationships with them.

Katy was just such a little girl. She was in foster-care when she came into psychotherapy but there was a danger of foster breakdown.

Katy started life in an incubator, two months premature, weighing only two pounds. Within four months she had been readmitted twice to hospital, first with gastroenteritis, then with multiple bruising. She was placed in a residential nursery and then a children’s home until foster-parents were found for her when she was 3. She has been able to remain with this couple, who have three children of their own, two born after Katy’s arrival into the family.

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14. Fieldwork: First Visit to a Foster Family Brian

Mary Boston and Rolene Szur, Editors Karnac Books ePub

Brian Truckle

One important aspect of the complex roles of the social worker when working with children is the quality of relationship which he is able to offer a child client. How to get to know and understand the child is often a worrying preoccupation, especially as major decisions have often to be made on his behalf. Hoxter (1977) suggests that with any psychotherapeutic contact with a child the first step is for the worker to have a ‘space’ in his mind for this particular person, freed from the worker:s own preoccupations and prejudices, from the weighty luggage of worries about the last client or the next case conference.

Many professionals in contact with deprived or distressed children have frequent opportunities to offer a child this ‘mental space’ and the experience of being attended to, remembered and valued. At this point the child may feel safe enough to bring his own worries and concerns to the worker in both verbal and non-verbal ways.

An opportunity to do just this is illustrated by the following description of a visit arranged to introduce myself (then a social worker in an area team) to a foster-mother and two children. The previous social worker, Mrs Quest, who was moving, accompanied me on this first occasion to meet the family. Gary, one of the two fostered children, was home from boarding school. The other child, Lucy, who was out visiting a friend when I arrived, had made good progress with these foster-parents.

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CHAPTER SIX Working in a Hospital

Mary Boston Karnac Books ePub

by Rolene Szur

This chapter describes further aspects of work in a hospital setting and returns to the subject of individual therapy with both out-patients and in-patients. The functions of a residen tial psychiatric unit for children are discussed. In hospital, the child psychotherapist may work in close liaison not only with the psychiatric team but also with the staff in other branches of the hospital. M.B., D.D.

A child psychiatric department in a hospital may offer certain facilities not always present in a child guidance clinic. The Day Centre described in the last chapter is an example. In some hospitals there may be a residential psychiatric unit for children or adolescents. The close links with other hospital services are important and interesting for the psychotherapist. Work with out-patients, however, follows very similar lines to that carried out in local clinics. Both see the same wide range of problems - including learning difficulties, school refusal, bed-wetting, conduct disorders and so on. Occasionally, a child is referred specifically to a hospital because the symptoms are very long standing, or are causing severe anxieties.

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CHAPTER THREE The Child Guidance Clinic

Mary Boston Karnac Books ePub

by Dora Lush, B.A., PH.D.

In the previous chapter we were given a glimpse of some of the kinds of children who have difficulty adjusting at school. We saw how some of them can be helped in small groups. These disturbed children are often those who have been deprived of adequate opportunity for an understanding relationship with concerned adults, either because of problems in the home background or because of too large classes in schools. Such children are able to make good use of the extra opportunity which is offered by the groups. There are other children, however, for whom the small groups do not seem enough - and in any case many schools at present do not have such facilities.

Some disturbed children may therefore need to attend a psychiatric clinic. In this chapter a typical setting where child psychotherapists work and where children may receive psychotherapy is described and the details are set out of what happens when children are referred by their schools, or by their parents, or by a doctor. We are introduced to the child guidance team, their methods of assessment and to a sample of the problems the children present. The classified symptoms and backgrounds of one hundred children who were considered suitable for individual psychotherapy are included in the review. Some of these are examined in detail. M.B., D.D.

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