The art of child placement

THE ART OF CHILD PLACEMENT

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The Art of CHILD PLACEMENT by

JEAN CHARNLEY

UNIVERSITY OF MINNESOTA PRESS, Minneapolis

Copyright 1955 by the UNIVERSITY OF MINNESOTA All rights reserved. No part of this book may be reproduced in any form without the written permission of the publisher. Permission is hereby granted to reviewers to quote brief passages in a review to be printed in a magazine or newspaper.

Third Printing, 1966

Library of Congress Catalog Card Number: 55-7693

PUBLISHED IN GREAT BRITAIN, INDIA, AND PAKISTAN BY GEOFFREY CUMBERLEGE: OXFORD UNIVERSITY PRESS, LONDON, BOMBAY, AND KARACHI

To MARGARET LINEHAN WALLACE a teacher who opened doors for children. At thirteen, I sat in her classroom and thought, "Some day I shall dedicate a book to her." Twenty-five years later, here it is. I know Mrs. Wallace will approve its consecration to the belief that the confidence a generous adult offers a child is a gift beyond price.

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Introduction

THIS is a lively book on child placement. Between its covers are incorporated the rich experiences of the author. These are documented by the work and study of many social workers who, also, have dedicated themselves to this field of endeavor. The title of the book is significant. It suggests what is already well known, that child placement compounds scientific theory and its application to practice with an additional ingredient—an easy, creative, and imaginative use of the theory as this is expressed through the personality of the social worker. To have any real potency in the lives of people, the theories of child placement must be expressed through the disciplined emotions of those who practice. It is this creative use of theory which earns this book its title— "The Art of Child Placement." For the reader, Mrs. Charnley unlocks a vast storehouse of material. She covers all the facets of child placement and uncovers their complex network of psychologies. Brought to view through her animated pen is the actual and. fantasied meaning of separation to the child at his various stages of development. The placement worker's "forgotten man," the child's own parent, is born again and realistically pictured in his paradox of being at the same time a parent and a person. Foster parents are portrayed as real people, as parents to other people's children, and as the long strong arm of the agency's service. The price of foster parenthood without ownership of the child is depicted in all its shades vii

The Art of Child Placement of black and white. The role of the placement worker as she guides and steers the process itself is clearly seen. Like the hub of a wheel, she holds together the several radiating bars of placement. To the child, to his natural parent, to the foster parent, she lends her strength, her identifications, and her understanding so that the process can proceed with greater help to all. She makes use of a great fund of knowledge. To this knowledge she adds an individual and creative touch which springs from the wisdom of life experience. She is the true professional in that she blends an objective knowledge of placement with self-knowledge and puts both to use in this business of helping people through foster care. Throughout the chapters of the book controversial questions are dealt with and analyzed. For example, foster home care as over against institutional care; the child's own home as opposed to his care in a foster home; adoption as a goal, or long-time foster care. In addition, the author in light of her experience brings a fresh point of view to old prohibitions, such as placing the adolescent in a foster home or returning a child to his own parents before the community is ready. Such controversial subject matter is embellished with a wealth of case material and thus removed from its academic plane. The disputes of the field melt away before the testimony of the individual case. The reader finds the answers for himself and, as a result, feels nourished. In this book the author has stripped the actors of their social work categories. They are unencumbered and speak for themselves through her to the reader. The dynamics of placement are there to be recognized in their full meaning to the particular child and his parent. Their clinical significance is apparent, but naming the particular form of behavior is less necessary when it is demonstrated so aptly through the living record. This is achieved not only by "telling" case illustrations, but also by the author's informal homespun style which makes the subject matter take on a brisk and spirited quality. In her hands the orthodox and traditional principles of placement achieve a greater freedom in their application to children and adults alike. This is possible because over and beyond her professional knowledge and exVlll

Introduction perience she has a profound faith in the capacity of the child to grow if given needful things. She also has a conviction that both parents and foster parents can collaborate with her as allies for the child. Certain truths are brought out clearly, a few of which are the following: only a positive transference unlocks a child or an adult to our help; there are very few really rejecting mothers, most of them are ambivalent; a child's feeling for his own "neglecting" parent may be very different from what we think it should be; the worker always stands for reality to the child, to the parent, and to the foster parent, and supports them warmly in this reality. Here is a book which makes a case for foster care. More and more, over the past few years, this form of child care has been questioned, especially in the big cities. One hears that foster care is a "dead end" for the child, that he should either be placed for adoption or helped in his own home. One hears that foster care is no solution in itself and should be used only on a temporary basis. Mrs. Charnley's experience disputes this growing trend. Foster care, enriched with casework, stands out not only as "fitting and proper" for selected children and their parents, but in these instances as the only possible and profitable way of helping them. Contrary to what has been said, this trend does not spring primarily from the paucity of good foster homes, nor from the difficulties with natural parents who may destroy these homes, but more from a laissez-faire attitude which denies both our casework opportunities and responsibilities. The case "loafs along" without benefit of diagnosis and planning, and the worker with it. "The Art of Child Placement" comes to grips with knotty case situations. These are studied and thought through. Appropriate goals are set and steps taken to bring these about. Mrs. Charnley has produced a much needed document for the field and one which will be helpful for social workers in all types of agencies and in particular for those working in foster home programs. She has achieved what is hard, if not impossible, for many professional workers, namely, a writing style which makes ix

The Art of Child Placement the book a living event. She has been able to combine accurate theory and method with a universal and human "moving picture" of children, foster parents, and natural parents—thus the technical comes to life for the reader, whoever he may be. DOROTHY HUTCHINSON The New York School of Social Work Columbia University January 195;

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Preface

IN THE coming years, thousands of children will be removed from their own homes and placed in foster homes and institutions. This book is written for all of those who will have a part in helping children to take the terrifying step from the familiar into the unknown. Child welfare workers are practically without exception a group deeply convinced of the importance of doing their job well. They know that children who face separation are suffering children. As the adults who stand nearby, they want to be able to offer as much help as is humanly possible to ease the pain, the bitterness, the aloneness, that children inevitably feel. Many factors enter into the degree of excellence with which child welfare workers do their jobs. An understanding heart, an ability to empathize and communicate with children, a knowledge of the method and philosophies of child placement, are important elements in helping social workers aid children facing placement. A child welfare worker comes equipped with some of these traits, such as the understanding heart. But hearts, like brains, can be educated to greater sensitivity. The knowledge of what happens to the feelings of children in placement has a way of spilling over from the brain into the heart. But mostly, the understanding heart is part of the original equipment of every child welfare worker. It is a part of the force that led her to a school of social work, to a county welfare board to "fill out an application." xi

The Art of Child Placement The ability to empathize with children is partly talent, but it is also a skill that can be acquired and one that becomes more sure with practice and training. In the early history of social work, "the ladies of the parish" who reached out to plan Christmas baskets for poor children in orphanages acted largely out of a sense of sympathy. If they had been equipped with empathy— that fine term of the social worker that means "to feel into"— they would have been quicker to see that growing up in a rigid, overcrowded orphanage was almost as painful and damaging as any hunger or squalor from which a child had been rescued. Communication with children—deep communication that goes beyond the ability to get them to express their superficial feelings or to giggle when their newly skinned knees are still smarting— is perhaps the highest of all skills. Once in a popular magazine for women, I read an article whose purpose was to tell adults how to talk to their friends' children. The article was published, I am sure, because many adults find this a hard assignment. It was richer in don'ts than dos. I wasn't certain that those who read it would come away better able to talk with children. But I had no feeling that I could have written the article better. Learning to communicate with children is much too complicated for a simple how-to-do-it article. It comes from thoughtful practice and improves slowly through the years. It is the flowering of a whole philosophy of life about children and the things, good and bad, that happen to them. I don't think that any article or book can teach just how it should be done. A book can offer enrichment of understanding that may speed the process. Mostly, however, the adult who is able really to communicate with children is one who couples a sound background of knowledge with a sensitive ear. The good child welfare worker learns a great deal about communication with children by being a good listener. How does the social worker or the student begin to be a good listener? Is there no short cut? Must she practice on her first children?

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Preface There are, I believe, different ways of listening. This book is written by a listener. For ten years I have listened to the voices of troubled children—both those who spoke out in sharp, clear, angry tones and those so little or so frightened that their words were barely audible. I have written down many things about how children feel when they face separation. But generalizations come alive only when they are related to freckle-faced Johnny who steals, four-year-old Mary who one day stopped talking. But Johnny can teach something that will help later in understanding Teddy and Jerry and Jack. And four-year-old Mary can show, through her eloquent silence, how Bob and Dorothy feel too. As a listener, I have tried to put down what my foster children have taught me. I have listened to other educating voices as well —those of teachers and other social workers. Their words are here to be used and thought about. This book is based primarily on lessons taught by children placed in foster homes and institutions in Minnesota. My guess is that what they have said is very close to what frightened children have tried to tell adults everywhere, always. But one more prerequisite remains after a worker has begun to have the three important personal traits—the understanding heart, the ability to "feel into" children's secret thoughts, and the power to communicate. That is a sure, unfaltering belief in the philosophy and the techniques supporting child placement. If a social worker thinks of child placement as mere environmental manipulation, or as a resource to be used only when all else has failed, it will be reflected in her work, and parents and children will have subtle confirmation of their this-is-the-end-ofmy-world feeling. Foster placement is something much more positive than this. It should be used as a tool in treatment—a tool whose use is arrived at diagnostically and whose handling involves the utmost thought and care. In the field of social work with children, one of the first truths that a caseworker learns is that there is normally no full satisfaction to a child comparable to a place in his own home with his xiii

The Art of Child Placement own parents. Social workers, profiting by past mistakes, have come to realize that some pretty serious imperfections in a home may not be reason enough for removal. It is not difficult for a social worker to break a family up. Putting it back in working order is a much higher art. But the knowledge of all the pain and inadequacies that may be part of foster placement should not operate in her thinking in such a way as to make placement when it is indicated a negative rather than a positive kind of treatment. Child welfare workers who have had major experiences in agencies where placement is consciously used as a tool in treatment are sometimes accused of being "too quick to place." Actually, it seems that the more thoroughly a worker knows children, the more cautiously she approaches the decision that placement is the best solution. The social worker who has ridden in her car beside a hundred frightened children who are leaving their pasts behind and moving into a threatening new world does not need to have it explained to her that this is terrifying to a small client. And the social worker who has listened to a hundred crying, angry adolescents who are still trying to recapture a place in their own homes that they lost years ago will know that the decision to place a child without a clear and reasonable expectation of how it will all end is a grave one. Most children in placement are there because of major dislocations in family life in which there has been no alternative. But effective placement does not wait this long—it does not wait until the situation has so thoroughly blown up that there is no home left. In many cases organized society, represented by the police or Juvenile Court, has found that children are seriously neglected or abused. Here the social worker begins the placement job robbed of one of the most helpful tools in placement. The rights of parents and child for self-determination are gone. The parents are accepting placement only because a force bigger than their own wills has imposed it upon them. The child too has been robbed. He is going into placement not as a result of a series of

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Preface emotional dislocations that have transpired between him and his parents but because some outside force (perhaps he names it "the dirty cops") is pushing a "cruel" plan on him and his parents. Signs of family breakdown have often been apparent long before the culminating events that lead to court orders. In many instances social workers have had opportunity—but failed—to use placement as a tool in treatment before the crises occurred. If a social worker has failed to use placement in time, it is because she has learned too well not to break up families, and has learned too poorly that child placement can be a tool used to prevent total destruction of what is healthy and sound in a shaky family situation. How does the social worker decide when it is time to break up a family group? Sometimes, if she is fortunate, she will have access to psychiatric consultation for help in evaluating the degree of disturbance in her principal clients. But more often she must go it alone. The answer should not lie in the exact kind or degree of neglect or rejection but rather in the future chances of parents and child to succeed in living together. When she can predict quite clearly that a harmful situation will continue, or almost certainly reach that slightly worse point at which the parents "break," abandon, or are brought to court for their failures, she can be fairly sure that she is .facing a placement situation. When she finds herself working with a child in a home in which it becomes clear that the "dice are loaded" against him, she may confidently decide that placement is the answer. Once a social worker's diagnosis has led her to the belief that placement is indicated, she should use it with conviction. Her plan should envision it as an opportunity for parents and child to come to an understanding of themselves and one another that will make it possible for them to come back together and again to function as a family. The child who faces placement because his parents have requested it as a help toward better understanding is not nearly so damaged as if this were a plan imposed on him and his parents by an outside force. The parent, however disturbed, who has enough mental health and vigor to go to a XV

The Art of Child Placement children's agency and ask for help, has by that very act demonstrated that chances of family rehabilitation exist. At the point at which a parent asks for placement, he has taken a monumental step, as any experienced worker knows. The request for placement is fraught with pain to the self-assurance, the conscience, and the pride of the average parent. One of the skills of the caseworker is the perception to see quickly whether placement is the appropriate answer to the problem. Perhaps there is a simpler, easier, safer solution—homemaker services, parent-child boarding home, or parent-child counseling in the home. When these and all other possibilities offer inadequate help, the caseworker moves carefully and painstakingly toward a soundly conceived placement. The social worker uses her skills in bringing the child and parents to working together with her in the plan for placement. The child needs to feel that the plan arises from his parents, not from his worker. As the worker begins her relationship with the child, she must get across to him what she represents as she stands in the middle of the three forces in his life—the foster parents, his own parents, and his strange new world. She offers him her hand and says, "I'll be right here to help and understand all along the way." The child in placement is in a unique and trying experience that threatens him in ways that are probably deeper than those that threatened his security in his own home. He needs the help of an expert to guide and comfort him in his exile. His foster parents too are experiencing a strange, unnatural kind of experience in which they must adjust to emotional disciplines that life has not often called on them to make. They too need the warm support and help of the expert. And the expert in the center of the circle made up of strangely interrelated humans is the social worker. She holds in her hand a secret without which she could not function. It is a deep belief in the ability of people—adults and children—to change. She has dared to help them to this peculiar mode of living because of this belief. It is this belief and her ability to communicate it to all of them that is the chief source of her power to help. xvi

Preface Child welfare workers find themselves doing placement in many different kinds of settings—protection agencies, large and small public agencies, private agencies. In some, the clients come with court orders; in some, troubled people find their way to agencies to ask for help. In some agencies a worker carries a large and varied caseload so that child placement represents a small segment of her work. In others, she works with the luxury of a small caseload, expert supervision, and easy access to good psychiatric consultation. Whatever the setting, whatever the circumstances of her job, she still needs and must have and use the skills and understanding basic to good child placement. For example, what of the social worker in an agency that assigns large and undifferentiated caseloads? Suppose that among her cases are four or five children in placement. Does she need to develop all these skills? Does she have the time or energy to apply them? The answer is even more ardently affirmative. Because a worker is busy, is she to excuse herself for speaking reproachfully or in an authoritarian fashion to failing parents? May she, because of her heavy caseload, take the short cut of suggesting that naughty children on her caseload be spanked? Can she turn away from foster parents who ask for help? She cannot because of the very fact that she is so busy. Such short cuts are short cuts only to failure, only to more and more work for her. The principles of good child placement are predicated on truth born of experience and study. They are as true for the social worker with the very large caseload as for the one in a small private agency whose load is planned to give her plenty of time for intensive treatment. She faces the knotty problem of selecting what is most urgent, which client needs her most. The kind of help she gives and the philosophy back of the work should be the same wherever children need placement. The impulse to write a book is a strange one. As an author finds himself midway in the project, facing colossal questions of what to put in, what to leave out, whether he has written anyxvii

The Art of Child Placement thing dimly resembling what he actually means, he wonders about his own sanity in undertaking the task. For a social worker to undertake such a task is even stranger. Social workers are essentially doers who find it hard enough to get their dictation done, to say nothing of doing writing that their jobs don't require. (Ask any teacher of social work who tries to get university students to leave their field placements to write their theses!) Nevertheless, social workers may sympathize with the two impulses that have been at the base of the development of this book: the puzzling fact that beginners in the field must go to twenty, or forty or a hundred, sources in libraries to find information merely to begin to get the feeling of this many-faceted work; and the continuing hope of being of help to children's social workers and—more importantly—to the children who need their help. This book grows from a desire to share some of the knowledge foster parents, children, and supervisors have taught me. I must admit that writing such a book has been an excellent experience in humility. Concluding it, I am deeply aware of the many things the book does not say. For example, it skirts completely the current question of the Functional and Diagnostic schools of thought —deliberately, because it is more concerned with ideas which are genuinely useful and less concerned with identifications and differing orientations. My own training and philosophy are Diagnostic, but I have not hesitated at times to learn from Functional thinkers when their contributions seemed helpful. I am aware that this is not a "scholarly" treatise. For this I offer as my explanation the fact that I am a practicing caseworker in the field of child welfare. A scholar in the field would have done quite a different book—but I believe that such a practical one as I have tried to make this may prove equally useful. JEAN CHARNLEY Minneapolis January 1955 xviii

Acknowledgments

I MUST extend thanks and appreciation to three careful and generous critics: Mr. Richard Guilford, professor in the School of Social Work, University of Minnesota; Mrs. Mary Jo Grathwol, supervisor at Children's Service, Inc., St. Paul, Minnesota; and Mrs. Lorena Coates, supervisor at Family and Child Service, Austin, Texas. I must also thank the agencies in St. Paul and Minneapolis which not only opened records to me but also helped in the search for illustrative case history material. And my deep gratitude goes to the executives and board of Children's Service, Inc., St. Paul. Had they not made it possible for me to take time from agency tasks to work on this book, it might never have been written.

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Contents

INTRODUCTION by Dorothy Hutchinson

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PLACEMENT OF THE VERY YOUNG CHILD

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ESTABLISHING A RELATIONSHIP WITH THE GRADESTER

31

FOSTER HOMES AND INSTITUTIONS

69

CASEWORK WITH "OWN" PARENTS

106

CASEWORK WITH FOSTER FAMILIES

144

CASEWORK WITH ADOLESCENTS

205

ADDITIONAL READING

255

INDEX

262

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THE ART OF CHILD PLACEMENT

Timmy, a four-year-old foster child just placed on a farm, stood with me watching Bess, a fine white collie, nurse her pups. When Timmy referred to Bess as "he," I wondered why. "Dogs are he," he said, "and cats are she. Of course, they aren't, not really—but it's easier that way" In the use of the personal pronoun in this book, social workers are she, and children are he. Parents too are mostly he. Of course, they aren't, not really. But it's easier that way.

CHAPTER I

Placement of the Very Young Child

SINS AGAINST THE LITTLEST CLIENTS

THE keynote of success in all child placement is careful preparation. Preparation is aimed at helping the client know, understand, and accept what is happening to him. The social worker recognizes that the need to be separated from one's own family, to be taken to a new family, is a painful reality. She has learned that pain of this kind is more bearable if it conies "in little pieces." The skilled worker comes to sense the tempo at which her child can move from the old to the new and develops ways of helping him to meet this painful change. The placement of a child should have as little of the "being-done-to" flavor as possible. Whatever parts of the process the child can do for himself as a dramatization of his acceptance of what is happening to him will be important in the ultimate success of the plan. A social worker who has children of all ages on her caseload would not think of running out one afternoon to pick up an adolescent whom she had never met, to move him to a home he knew nothing about. And yet, many an agency that is extremely thoughtful in assigning the case of an "acting-out" adolescent will entrust a baby to any worker who has a free hour or two to make a placement. Such casual assignment can lead to care of babies by workers who have thought little about them and whose very physical handling denies any belief that these are the most delicate and sensitive of humans.

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The Art of Child Placement Sometimes it seems as though the littlest of our clients get the least from us. This is in spite of the fact that we completely accept their dependence and are perfectly sure that above all we want to help and protect them. One student social worker asked a puzzled public health nurse, "Show me a couple of good ways to pick up a baby." She was a warm, thoughtful girl who had observed the care and skill with which an experienced mother handles her babies. She wanted a short cut to such skill. Her question was naive; her attention to an important detail was exactly right. This attitude was consistent in all aspects of her work with babies—that is, that this is an important job that can never be done carefully or well enough. She will not belong to the group of social workers who unknowingly sin against babies. Other sins against babies are many. Most seem to arise from thoughtlessness. Social workers do not know enough about babies and therefore cause them unnecessary pain. All workers recognize that babies are miserable when safety pins stick them or when they're cold or hungry, but many a worker does not always feel with the babies the terror of a move into the unfamiliar. Before trying to understand a baby's ability to experience change, it would be well to consider the influences that add up to security for babies. GOOD MENTAL HYGIENE FOR BABIES

Dr. C. Anderson Aldrich has written a clear description of the rights of infants: Every baby, from the moment he comes into the world, is influenced by certain basic needs or drives which are easily recognized by anyone who observes young infants over a long period of time. The most evident are perhaps (i) the need for physical safety, which includes protection from hunger, cold, wetness, and other dangers that threaten the life of a young baby; (2) the deep need for warm affection, which broadens out later into the desire to be an approved member of his own particular family group ... the 'belongingness' spoken of by Lawrence Frank; and (3) the need to grow and develop according to his own habit patterns and rhythms. This last is the device that safeguards individuality, 4

Placement of the Very Young Child produces artist, mechanic, or statesman, and makes each baby different from every other baby.... These needs, so important to a baby, persist under the surface of a child's personality and influence his conduct and happiness from the cradle to the grave. Their great importance to us lies in knowing that when they are unduly thwarted, psychological difficulties, which we call behavior problems, occur. When they are fulfilled, stable personalities are fostered.1 These are not new ideas to caseworkers, and in their way they try to see that the rights of the infants in their care are protected. Perhaps child placement workers have not recognized that when they move babies abruptly to new surroundings, they have, as Dr. Aldrich puts it, "unduly thwarted" them. Many social workers know that change is painful to babies, but as placement workers they know, too, that change is a necessary reality for them. It is not easy to inflict pain on these small, dependent humans. Social workers mistakenly try to do it speedily and get it over, having a memory that the sharp speed of a surgeon's knife is the easier way to have done with an unavoidable pain. They need instead, to understand more of what change means to babies and how best to help them meet it. What in change disturbs babies? Dr. Margaret Ribble has written about some of the details in the changed environment to which they respond: "When a baby is placed in a room where sudden loud noises occur, such as from a streetcar passing at certain intervals, a doorbell ringing, or a sudden clatter of dishes, he reacts sharply to sudden stimulation. On the other hand our study showed that when infants were taken from a hospital nursery where there had been more or less bustle of human sounds and where lights went on and off, they gave an equally strong reaction to the stillness of an entirely quiet room ... the stimulation given to a small baby has to be as carefully regulated as his food intake if the child is to be nervously stable."2 Among the thoughtful experts who have concerned themselves

1 C. Anderson Aldrich, "High Lights on the Psychology of Infancy," Mental Hygiene, 30:590 (October 1946). 2 Margaret A. Ribble, The Rights of Infants (New York: Columbia University Press, 1943), p. 64.

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The Art of Child Placement with the study of infants and their response to emotional trauma is Rene Spitz, whose excellent movie, Grief, graphically depicts the shocking physiological and affectual changes in a group of infants following separation from their mothers and placement in a nursery setting. In the July 1950 issue of the American Journal of Orthopsychiatry, Dr. Spitz wrote an article entitled "Psychiatric Therapy in Infancy." At the conclusion of his article, which describes various psychic disturbances in infancy, Dr. Spitz suggests "preventive psychiatry" for babies. He says that separation from the mother person, such as occurs when a baby is hospitalized, is harmful. If separation must occur because the mother is ill or dead, he recommends that a "substitute mother" should be found. Dr. Spitz feels that the giving of "age-adequate stimuli" (toys) is very important, as is the freedom of a baby to move about in space when he is ready for locomotion. "BRIEF" HOSPITALIZATION OF BABIES The "mother substitute" that Dr. Spitz refers to will not be found in a hospital working an eight-hour shift. Real mother substitutes take the hard, twenty-four-hour shift, a fact that spells security to babies. Social workers seem to forget this easily because the convenience of the ever-ready hospital is tempting. Often while an unmarried mother tries to decide whether to let her baby be adopted, it seems "least complicated" to leave the baby in a hospital. Weeks sometimes become traumatic months, while social workers go about mistakenly serene in the idea that the baby is getting "the best of care."3 It is not uncommon for small children to be hospitalized, for example for a preplacement physical, and left in the pediatric ward for several days "until the clinical findings come up from the lab." Perhaps a court hearing is pending and it saves effort not to move the children to a foster home until afterward. 3 Herman Vollmer, in "Psychosomatic Significance of Body Orifices," American Journal of Orthopsychiatry, 18:345 (April 1948), describes the confusion of the abruptly hospitalized child as follows: "Children admitted

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Placement o] the Very Young Child What does such a baby think and feel? Gone is whatever was familiar and warm and sure in his past. That woman who always met his needs in her own way is gone, that woman whom he would soon have called "Mama." Instead, there is much light, a tighter, firmer bed, and a procession of fast-moving men and women, all starched and white, who sometimes come with needles. There are voices of many children crying. There is a confusion of motion to and fro. Gone is the warm, soft, giving breast. Here are the taut sheets, the bottle with the nipple. The phrase "A hospital is no place for a well baby" has become almost a cliche. Once in the home of a psychiatrist whose fourmonth-old baby was severely ill, I heard the doctor discussing with his wife the advantages of caring for the baby at home because of the importance of the maternal relationship to an infant who is trying to get well. He grinned and said, "A hospital is no place for a sick baby." I wish that social workers would think more of the meaning behind this wry joke and be less fearful to leave sick babies in foster homes. Social workers are as a group too quick to hospitalize for diagnosis, for observation, even for habit training. They trust foster mothers to watch babies through stair climbing and on busy streets, but not as often through high temperatures and diphtheria. Perhaps it is because caseworkers feel so deeply challenged by the helplessness of these littlest clients that they are not able to trust them in illness away from the experts. Inadvertently, they are hard on babies because they do not understand them. It is not difficult to look at the twitching, "near-tears" expression of a four-year-old and know that it is hard for him to leave his mother and go into the unknown. The social worker feels with to a hospital ward without proper preparation frequently show during die first days a well-known pattern of behavior. They cry, refuse to talk, turn their eyes away from every approaching person, or hide their faces in the bedcovers. They have anorexia, refuse to eat, or if they eat they vomit. They are constipated. . . . Sudden separation from home and mother and the fear that this separation might be permanent is obviously the causative psychic trauma. The child reacts with a general negativistic attitude toward the world with which he severs all relations." 7

The Art of Child Placement him; and feeling with him, she instinctively does what she can to ease his pain. Children old enough to tell how they feel are spared many of the errors that child-placement workers make with babies. Food, clothing, and shelter have become an oversimplification of the needs of babies. A proper stress of the needs of babies might well place mothering and a consistent environment ahead of these necessities. The older child, when set down in an unacceptable environment like a hospital, when moved about "like so much luggage," can let fly with a torrent of angry words pungent with hostility; or he can become delinquent, or neurotic. Other children, not blessed with the happy release of angry words, act out their feelings in gestures hard to misunderstand. Babies act out, too. But they are little and new at the business of educating social workers, so that it requires a more delicate eye and ear to understand what they are saying. The greatest mistake in social work with infants is crediting them with too little feeling. EFFECTS OF INSTITUTIONAL CARE

For many different reasons, for many years children who became suddenly dependent on the community were taken to nurseries, hospitals, or orphanages. In some communities this is still a common solution. It is growing more uncommon to leave them in institutional care for protracted periods. In looking back on the reasons for the move away from institutional care one can learn a great deal about babies. Babies have much to tell about themselves and about other babies if one listens with what Theodore Reik has referred to as "the third ear." Denied the power of speech, they act out a mighty drama with the whole of their tiny selves. They stare into space. They do not eat. Their digestive systems are upset. And if we still cannot understand, they die to show us. The idea of foster homes for babies emerged at the turn of the century. America was then devoted to the sterilized, antiseptic, routinized school of infant care. The idea of germs haunted the conscientious mother and the conscientious nurse. It also stultified and stiffened them. The fact that a goodly number of babies sur8

Placement of the Very Young Child vived this epoch and grew to be pleasant, outgoing people could be explained by the strength of the mothering instinct which caused many a woman, in spite of the rules, to be a natural mother —cuddling and rocking her baby, smiling when her crawler gave his puppy a slobbery kiss and got one back. But the people who dealt with children professionally and in large numbers followed the rules conscientiously. Often they put babies in lovely sunny orphanages with excellent physical standards. Most of the experts in the field of infantile development have looked back to these earlier unsuccessful days of congregate infant care in an effort to understand the meaning of mothering to infants. In the history of the now nearly extinct illness marasmus, they have found an important clue. Spock, Spitz, Ribble, and others have described the illness and its implications. Dr. Ribble writes: Not many years ago one of the most baffling problems of child health was a disease known as marasmus. The name comes from the Greek word which means "wasting away." Sometimes it is also called infantile atrophy or debility. It affects particularly children in the first year of life, and less than three decades ago was responsible for more than half the deaths in that age group. To combat this tragic evil a special study of infant care was undertaken by both medical and social agencies, and the most astonishing discovery was that babies in the best homes and hospitals, given the most careful physical attention, often drifted into this condition of slow dying, while infants in the poorest homes, with a good mother, often overcame poverty and unhygienic surroundings and became bouncing babies. It was found that the element lacking in the sterilized lives of the babies of the former class, and generously supplied to those that flourished in spite of hit or miss environmental conditions, was mother-love. In consequence of this new insight, science, without attempting to analyze the life-giving quality of mother-love, came to terms with sense. Hospital authorities began looking around for a "Pharaoh's daughter" to care for unloved children who fell into their hands. A new system of carefully selected foster mothers was developed, and whenever an infant had no suitable person to care for him, he was sent to a foster home rather than to an institution unless the illness was acute. Young infants are now 9

The Art of Child Placement kept in hospitals for as short a time as possible. As a result marasmus is becoming a rare disease.4 When child therapists look to the personalities of children who have experienced institutional life, they agree in their findings that lasting damage is apparent many years later in the personality development of these children. Anna Freud and Dorothy Burlingham made careful observations on small children given congregate care in a thoughtfully run institution during World War II near London. They write: Superficial observations of children of this kind [i.e., children reared in institutions] leaves a conflicting picture. They resemble, so far as outward appearances are concerned, children of middle class families; they are well developed physically, properly nourished, decently dressed, have acquired clean habits and decent table manners, and can adapt themselves to rules and regulations. So far as character development is concerned, they often prove— to everybody's despair and despite many efforts—not far above the standard of destitute or neglected children. This shows up especially after they have left the institutions.5 Dr. Ribble echoes this observation: Sincere and interested people ask: "Does it affect an infant to be placed temporarily in an institution?; is he disturbed by being 'tried out' in one foster home after another?; does it make a difference if several different people care for the baby?" The answer is that it usually makes the difference between a well-adjusted child with a sense of security and the child with behavior problems. . . . A more far-reaching result in children who have had many changes in father, mother, or in nurse or caretaker may be that their ability to form attachments is not possible until much later on. Their capacity to respond may be lessened. Often foster mothers or adoptive parents make the complaint that these children do not respond to love or to gifts or to other things that are done for them. This unresponsiveness is an extremely unfortunate thing and often makes the particularly sensitive child who needs a home incapable of accepting one. Depression and feeling of not being wanted is another response to such changes. Perhaps most serious of all is the child who becomes very auto-erotic in an exaggerated 4 5

Margaret A. Ribble, The Rights of Infants, p. 4. Anna Freud and Dorothy T. Burlingham, Infants without Families (New York: International University Press, 1944), p. 10. IO

Placement of the Very Young Child way and turns to his own body for the satisfactions he should get from the outside. This leads to the problem of masturbation, prolonged thumb-sucking, and many other so-called "habits" of early infancy.6 Dr. Kibble and others see a great deal in common between the often replaced child and the institutional child. In fact, they frequently write of them in an almost interchangeable fashion. This is because these two kinds of children have experiences which, psychically speaking, are similar. It is the fact that the institutionalized baby is cared for by three or more sets of nurses working short shifts—instead of by one person, a mother person, doing the total job—that makes him confused and unable to relate. With the frequently replaced infant there is a similar experience, though the time element varies. No one really knows what time means to an infant. One can be pretty sure, though, that it is not a clear-cut concept to him. It is possible that in an eight-hour shift with a nurse, a baby may experience a "little lifetime." It may not feel very different to him from a six-day placement with a foster mother. Most thoughtful child placement workers find frequent replacements the bitter medicine of their jobs because they recognize that replacements are damaging. Often they will decide that it is better to leave a baby in a hospital for a month or more than to submit him to a temporary placement or two before permanent plans can be worked through. It is their feeling that in this decision they are choosing for the baby the lesser of two evils. Anna Freud and Dorothy Burlingham have given an answer to this dilemma: "When choosing between the two evils of broken and interrupted attachments and an existence of emotional barrenness, the latter is the more harmful solution because it offers less prospect for normal character development."7 That is to say, placement subject to the many uncertainties that lead to replacements is no panacea. A caseworker knows as well as the man who fits a child with an artificial limb that this new leg will not be as 6 Margaret A. Kibble, "Infant Care and Emotional Growth," Bulletin, Child Welfare League of America, 23:1, 3, (October 1044). 7 Anna Freud and Dorothy T. Burlingham, op. cit., p. 63.

II

The Art of Child Placement good as the one he lost. But the caseworker also knows that this is the best substitute she has to offer. She approaches her job with the deep conviction that she is offering him an imperfect but very useful substitute. She has a belief that this is a job requiring high skill, one than can be done badly or well. It is up to her to make it as workable and helpful a remedy as she can. SEPARATION AND PAIN

Once having recognized the fact that separation and pain are intertwined, child placement workers need to sort out their feelings about pain. Since social workers are to live intimately with separating experiences, they can be overwhelmed by them unless they understand them. It is necessary to focus on the ability of all—children and adults alike—to take in pain, to give it recognition and a part in their lives, to grow from it, to go on with it. To protect any child from all pain, physical and emotional, would be a highly questionable way in which to build a sound adult. Beginning with the moment of birth, life is a series of separation experiences, and in each of these there is pain. Once, a vacation companion, at the end of a pleasant two weeks, said to me, "Parting is the price of meeting." We meet, we relate, we separate; we meet, we relate, we separate. Such is the pattern of life until we do not meet again, and this is death. And if we still breathe and meet but do not relate, this, too, is a kind of death. Change and separation are parts of the lives of all babies, but in the lives of the babies on the caseload of a placement worker they are dramatized, sharpened and stark. Change needs to be eased and maneuvered by a gentle expert so that it becomes something that the small clients and she can tolerate. It needs, above all, to be prepared for. One means by which social workers find an understanding of the experiences of their clients is through empathy. Let me tell you how I "feel with" my baby clients in the attempt to know a little of what they are feeling. I am again a little child in my parents' home. I push my memory back as far as it will go. I remember my home through broken 12

Placement of the Very Young Child imagery. An ornate glass lamp with a heavy beaded fringe is the first symbol of my early memory of home. Others begin to crowd in. I try to feel separation again as I felt it then. My mother is going downtown to shop. A gray-haired woman with a mending basket sits on our davenport. She is going to "watch after me." I see my mother in her downtown clothes and my anxiety mounts. When she puts on a fancy hat with feathers on it, I begin to cry. She says to the gray-haired one, "I'll just hurry along. When I'm out of sight, she'll be all right." The door closes and I run to the big window to watch her disappear down the street. There is a fuzzy memory of little streams of water—was it raining or were those my tears? I knew loneliness. And I can remember the pain of separation mixed with rejection in a brief little snatch. "Jean, you ate the frosting off the cake that I wanted to look nice for dinner tonight. Now you may go to your room and stay there." This was more difficult because my own badness was a part of it. But part of me knew that we would make up and that she would still love me. That night I would go to sleep in my own bed and my own mother would tuck me in. And on those days that she went shopping, my grief was tempered by an indefinable knowledge that she would return. But if she had not come home that night? If I could never again sleep in my own bed? If I had become a foster child? Then I would want it to have been this way: I would have wanted a social worker who came to help, a social worker like many I have since come to know. She would have said, whether I were old enough to know the words or not, "This is a really hard thing happening to you, Jean. But I am going to help you find a way to bear it. You may cry if you like, and I will hold you on my lap or let you cry alone if you prefer. I will tell you about how we are going to find a new Mama. It may help if you take your own teddy bear with you to the new Mama." I would know and she would know that the new Mama would not be the same. Nothing is just the same. But there would be parts of the new that would have comforting elements of the old in it, «3

The Art of Child Placement My social worker would have remembered that babies do not like to have things done to them against their wills. When their arms are held down, their faces become red and they cry. (Sometimes, of course, it is really necessary, as when the doctor comes with the offending needle.) So she would have held my hand very gently and said, "Atta girl!" and encouraged me to make whatever part of this change I could for myself. To me and to some other social workers it is easier to understand these things in terms of ourselves. Had a sharp separation happened to me, I know how I hope it would have come. In any separation there is a wound. But it can be treated in such a way that it will leave only a little scar. Babies have within them, as all people do in varying degrees, an ability to take pain and find a way of living with it. They have the wonderful ability to heal and scar. There are perhaps children who have grown up without physical scars. I doubt that there are any adults without psychological scars. It is not so intolerable that babies should have to suffer as that they should not be helped to get well. THE CASE HISTORY OF JERRY JONES

To bring many of these generalizations and principles into a sharper focus, it may help to look closely at a specific case. The child is eighteen-month-old "Jerry Jones" (not, of course, really Jerry Jones—his identity is thoroughly concealed, as is that of the people in all the case histories in this book). Which comes first, the caseworker or the child? In this instance, the caseworker. The problem of selecting a worker for a child is an interesting one. A supervisor tries not to assign cases on a merely alphabetical or geographic basis. A delicate skill needs to be exercised at the point of referral in picking up "the feel of a case" and combining that with a knowledge of the interests and talents of the individual workers. As a case develops, the supervisor may say happily to herself, "I was right. Miss A does have a very special feeling for withdrawn children . . . or guilty parents." Or, on the contrary, she may worry to herself, "Miss B is going to need a lot of help in '4

Placement of the Very Young Child this situation. There's something about Miss B and domineering foster mothers that does not go well together." What a caseworker brings to any individual client is the total warp and woof of her personality made up of a million tiny threads—her life experiences, her training, her reading, the influence of supervisors past and present, to mention only a few. What the client meets is a social worker. But to him she becomes a person. He will soon feel the professional quality of the relationship if it is there, but he will also feel he has met a woman. No one can say whether we are social workers first and people second during the nine-to-five hours of the clock. We are ideally a true compound and not a mixture. What the client meets is the "social worker-person." What he experiences as a client is influenced not only by his ability to respond to treatment, but also by the social worker's ability to give of herself. What Jerry Jones met was Mrs. Arthur. In discussing case histories it is not customary to include a description of the caseworker. But after reading Jerry's case history I was able to spend some time discussing the recording with his worker. This added immeasurably to my interest in, and understanding of, the case. When I explained my purposes to Mrs. Arthur, she was willing for me to include a sketch of her. As I reread Jerry's history now, I picture the casework activities as flowing between a pert, redheaded baby and a small, vivacious woman who told me she had become so fond of Jerry that she suddenly found her eyes filled with tears when he drove off with his adoptive parents. Jerry's Caseworker The sensitivity and skill that have gone into Mrs. Arthur's work with Jerry might make a reader, as they did me, feel suddenly humble. It was interesting to me to learn that though Mrs. Arthur was a warm, intelligent young woman, this kind of work was new to her. Mrs. Arthur was in her late twenties—small, gay, attractive. A nine-year-old foster child had referred to her as "one of them smiling-eyed ladies." At the time she began working with Jerry, she had recently 15

The Art of Child Placement come to a small, private adoption agency on a part-time basis while her own boys, ages three and five, attended nursery school. When I mentioned to Mrs. Arthur that I was planning to refer to her as a mother, she said, "Oh, should you?" She expressed the thought that unmarried social workers sometimes feel keenly—the unfair criticism now and again offered by clients, board members, and even other social workers that "one needs to be a mother in order to understand and work with children effectively." She and I talked about our opinion that this is nonsense. The mere physical acts of conceiving, delivering, and even caring for a baby do not make a woman a mother. Nor do they necessarily make her better able to understand children—her own or others. We agreed that the protest needs to be understood for what it is, an unwillingness to give the stamp of approval to anyone. Those who would classify child placement workers according to such broad rules subject them to double reproach: "If social workers have children, they ought to be home taking care of them. If they haven't they obviously cannot understand them." At the time Mrs. Arthur began her work with Jerry, she had had a good education in social work and a brief experience in a hospital setting, but almost no direct experience in the placement of babies. Her thoughtfulness in relation to her own small boys offered a short cut to her arriving at an "at homeness" with babies. She didn't have to read Arnold Gesell to know that an eighteen-monthold would enjoy taking crayons out of a box and putting them back in. It wasn't necessary that she have been a mother to have moved so smoothly and expertly into a casework relationship with a baby facing a hard new experience, but perhaps in this instance it helped. Mrs. Arthur approached her job with a deep conviction that it was important to do it well. In order to orient her thinking to the adoption work she was about to begin, Mrs. Arthur read what she could find in the literature of the field. She complained that what she found was little, scattered and hard to get at—magazine articles here and there, slim chapters in fat volumes, a few pam16

Placement of the Very Young Child phlets. Mrs. Arthur felt that The Role of the Baby in the Placement Process, an excellent pamphlet published in 1946 by the Pennsylvania School of Social Work, was the most useful and helpful of her references. That is Mrs. Arthur—no sexless, shapeless, colorless form known as "the worker," but a very real person. Background Note Jerry was born three months after the divorce of his parents. His father was in prison on a ten-year sentence for robbery. Jerry was cared for by an alcoholic mother who gave him good physical care and who appeared warm and affectionate when sober. Sometimes, however, he had been left alone for six-hour periods when his mother was drinking. When he was eight months old, his mother placed him in an independent foster home where he received poor care. At ten months, he was replaced by the county welfare board in a licensed boarding home. This foster mother gave him up in one week because he whined constantly and seemed to have an insatiable appetite for attention. He was then placed in the Lowry foster home where Mrs. Arthur became acquainted with him and began to prepare him for adoption. (This home was licensed by the County Welfare Board and "lent" to our agency to avoid another move for Jerry before adoptive placement. The cost of Jerry's care will be met by our agency until Jerry leaves.) Jerry was eighteen months old at the beginning of Mrs. Arthur's record, from which the following pages are excerpts. Interviews with Jerry February 12. Visit to the Lowry boarding home to observe Jerry. Jerry is an appealing child—dark red curly hair, dark brown eyes, and a well-shaped head. His complexion suggests that when he is older he will freckle. He has an engaging grin which breaks through suddenly with little warning. He is sturdily built, about average in height and weight. His frame suggests the word "stocky." '7

The An of Child Placement Mrs. Lowry said that in the three months Jerry had been in her home he had made a remarkable improvement. At first he was timid and withdrawn and seemed anxious. Now all traces of this behavior seem to have disappeared; while I observed Jerry for about half an hour, he seemed unusually outgoing for an eighteenmonth-old, running from Mrs. Lowry to Tommy, her four-yearold, and to me with much "bounciness." Mrs. Lowry said that Jerry is an easy child to look after and offers no problems in handling. He eats very well; in fact, he is something of a "stuffer." He would eat more than is good for him if Mrs. Lowry did not limit him. He goes to bed at a regular hour and sleeps soundly through the night. He acted interested in his toys and I thought he used his hobbyhorse with a good deal of imagination. Mrs. Lowry put a record on the phonograph, saying that both she and her husband felt that he had an unusual musical sense. It was delightful to watch Jerry "dance" to the music—hopping up and down, swaying sideways, changing his rhythm when the music did. The only remaining indication of Jerry's previous tensions is a tic, which takes the form of head-wagging. I noticed three or four times during my stay that he would start to wag his head back and forth in an automatic, compulsive manner. Mrs. Lowry said that this mannerism was much less apparent than when he had first come. Then he was a "head-banger," too; that is, he would suddenly, without any apparent provocation, bang his head against the floor. Mrs. Lowry was afraid he might hurt himself. It was curious, she said, that even when he banged hard, he did not cry. Mrs. Lowry said that the head-banging seems to have disappeared and that he wags his head only when he is in some way troubled. I felt as though perhaps my presence there might be threatening to him and that this might explain the head-wagging during the time of my visit. Mrs. Lowry said that Jerry is not quite as affectionate as some children of this age for whom she has cared, but that there are times when he likes to be cuddled. Just after she said this Jerry climbed onto her lap, gave her a big hug and kiss, smiled, and 18

Placement of the Very Young Child walked away. I was pleased at this because it showed me that Jerry, though his vocabulary is limited to a few baby words, understands a great deal of what is said. Jerry appears to be an attractive, normal child since he has been in a composed, stable household. Mrs. Lowry is the kind of person whom we should seek in an adoptive mother. She is willing to let him proceed at his own pace and has no need to press him. His previous head-banging and head-wagging should be kept in mind. They suggest that he is a sensitive child who responds rather sharply to insecurity. His adoptive home should be one with a minimum of pressures and a similarly relaxed, easy-going manner of handling. March 7. Visit to the Lowry foster home to begin placement preparations for Jerry. After I had settled down on the davenport, Jerry, who had been busily playing with his hobbyhorse and some other toys, began making overtures to me, handing me one of his toys and taking it back. He seemed to be quite cheerful, smiled a great deal, and did not give any evidence of the kind of tension he had exhibited on my first visit. Mrs. Lowry commented that Jerry was no longer stuffing himself but seemed to take only about what he needed now. We discussed this in terms of a child's need to have food as a symbol of security and love, and that frequently overeating is a sign of some kind of inner tension and anxiety. The fact that he now wanted only an appropriate amount was a good sign of adjustment. Mrs. Lowry was pleased that I had indirectly complimented her on the excellent home she had given Jerry. I discussed with Mrs. Lowry my plan to take Jerry on little trips in order to acquaint him with the agency and make placement easier for him. I said that though it might be hard for him to go off with me at first, but that in the end it would be easier for him to leave her if he had had this experience in getting used, with me, to what is new and strange. Mrs. Lowry seemed to understand all the steps involved. However, when I asked her to make a point each time I was coming to tell Jerry about it, she looked puzzled. "But he's just a baby, Mrs. Arthur. He wouldn't under19

The Art of Child Placement stand." I said that no one knows just how much a baby understands. We have seen two-year-olds begin talking in long sentences, which suggested that they understood a great deal before they began to talk. I told her I would like her to say to him in simple sentences, "Mrs. Arthur is coming to take Jerry bye-bye in the car. Then Jerry will come back to Mama." Mrs. Lowry agreed but looked dubious enough so that I didn't know whether she would actually help in this part of preparation for placement. I told Jerry we were going bye-bye in the car for a little ride. "We will come back to Mama," I said. He was pleased at this prospect and got into his wraps eagerly, but when we started to leave the house, he began to whine and cry. Since the snowdrifts were very high, I carried him out to the car while he sobbed all the way. Once we were settled in the car he sighed deeply; he did not cry but closed his eyes. We drove for some time without Jerry's making any sign that he was interested in anything. He merely sat quietly with his eyes closed, sighing deeply. I began to sing a nursery song, "I Love Little Pussy." Jerry gave a wan smile and moved a little closer to me. When we came to the village, we got out at the five-anddime store. At the entrance to the store Jerry trembled so violently that I had a hard time getting his mittens on. "It's all right, Jerry," I said. "We'll be going home to Mama." The trembling stopped as soon as he became interested in looking at some of the toys. I told him he could have one. After fingering several interestedly, he chose a little red truck. Jerry became quite excited at having been given the truck. He began to play actively with it, down the aisles and behind the counters. He made no response to my saying that now we should go see Mama. Finally, as I started slowly toward the door, he picked up his truck and followed me. During the ride home he seemed relaxed and happy, hugging his little truck as though it were a soft toy. When he saw the Lowry home, he gave a big grin and hurried in to show Mrs. Lowry his truck. As he waved good-by to me, I told him I would come again to take him for a ride. 20

Placement of the Very Young Child March 16. Visit to boarding home for the purpose of beginning to acquaint Jerry with the agency. (First part of recording deals with discussion with Mrs. Lowry of signs that Jerry is growing more secure, and Mrs. Arthur's evidence that he understands a great deal of what is said to him. Mrs. Arthur quite easily persuades Mrs. Lowry not to begin toilet training yet.) Jerry greeted me with a big smile today. When I said we were going bye-bye to a place where he would someday meet a new Mommy and Daddy, Jerry asked in baby talk to sit on Mrs. Lowry's lap. She held him for a while and then reached for his outdoor clothes and began to dress him. He made no protest. Mrs. Lowry carried Jerry to the car. When he saw she was not going to get in, he cried bitterly. I spoke comfortingly, saying that we would come back to the house. After we had driven a little while, Jerry settled back and began to play with the red truck I had been careful to bring along. I sang "I Love Little Pussy," which seemed to have a soothing effect on him. By the time we reached the agency Jerry appeared to be in a relaxed, good-natured frame of mind. As we arrived at the door I said, "Jerry, here is where you will some day find your new Mommy and Daddy." He looked at me questioningly, a troubled, anxious look appearing on his face. Once inside he began to wander about, looking in room after room. When Jerry seemed ready, I asked him whether he would like to go upstairs. He took my hand. In the playroom he settled down happily to play with a box of crayons. He wanted me to hold the box while he solemnly took the crayons out and put them back in again. He seemed to enjoy the small chair, the small table. When another worker walked in, he climbed quickly onto my lap and held me tightly. After a bit he wanted to explore the building some more. I followed him from room to room. When he went into the kitchen I poured him a glass of milk and gave him a cooky, which he took back to his little table to eat. The ride back to Lowry's is a long one (twelve miles). Another worker drove while I held Jerry on my lap. There was much less 21

The Art of Child Placement sighing on this trip than on the previous one. As always, Jerry brightened at the sight of the Lowry home. He greeted Mrs. Lowry excitedly and waved me a cheerful good-by. March 25. Appointment with Jerry cancelled because he was sick. April 6. Out to Lowry's to take Jerry to the doctor. Mrs. Lowry was getting Jerry into his wraps when I arrived. He gave me a puzzled look. I said, "Jerry, you and I are going for a ride to see a doctor. The doctor wants to see what a fine, healthy boy you are." He sighed deeply and followed me to the door in a dispirited fashion. Once outside, he began to sob. Because of the high snowdrifts I again carried him to the car. I said, "Jerry doesn't want to go with Mrs. Arthur, does he?" He cried harder. The sound of the motor distracted him from his grief and he began to imitate the sound. I imitated it, too. After he became quiet I sang our usual nursery song, and as always, Jerry moved up closer to me and relaxed. Jerry was pleased and interested by the downtown city sights. He particularly enjoyed the elevator ride, I tried to prepare him for the doctor's visit by saying that I would take off all his clothes so that the doctor could see what a fine, healthy boy he was. The doctor was gentle and considerate. Nevertheless Jerry cried angrily and hard until I had him dressed and we were outside the office. (A detailed doctor's report was included here.) We stopped at a store to buy a little bag of cookies, which Jerry munched in the car on the ride back to the foster home. April 9. Out to Lowry's to bring Jerry in for his psychological examination. Again we repeated much of the routine of our previous rides—singing the nursery song, imitating the motor of the car, pointing out objects along the way. Jerry was showing more signs of liking to go with me, fewer signs of fear. Today he did not cry as we left Lowry's. When we arrived at the agency, I said again, "Jerry, here is where you will someday find your new Mommy and Daddy," Jerry repeated smilingly, "Mommy, Mommy, Mommy." 22

Placement of the Very Young Child Once inside, he again explored the downstairs corridors before he was ready to follow me upstairs to the playroom. He was cooperative as I removed his wraps, and he settled down to play in the playroom where he was to have his psychological. (A detailed psychological report was included here.) On the ride back to Lowry's, I drove while another worker held him on her lap. Jerry has made real progress in relating to people. As long as he could see me, he was willing to be held by someone else. April 22. For some time my supervisor and I had been discussing the best type of home for Jerry. We felt that Jerry had shown us through his previous head-banging and head-wagging that he was a very sensitive child with a low threshold for insecurity. Because a new move would necessarily be frightening, we felt that his new environment should hold as few challenges as possible. I wanted a home with a comfortable, relaxed woman who had already had a successful experience at mothering and one in which sibling rivalry would not immediately be a challenge. We discussed our feelings with the homefinder, who suggested the McAlister family. The McAlisters have an eight-year-old daughter and have said that they did not feel that the child they accepted must be a tiny infant. April 27. Today there was a marked change in Jerry's attitude during our ride to the agency. He came with me without reluctance, happily, joyfully, clutching a big cloth dog. He was so active in the car that I had to stop four times to get him settled again. He tried to grab the windshield wipers; he got the glove compartment open and happily banged a flashlight against the ash tray; he reached for the wheel and tried to steer. He was so exuberant and happy that I had to tell him he must sit more quietly in the car. Twice I said, "No! No!" He looked at me quizzically and stopped briefly, but in a few minutes he would begin again to jump up and down. Once we had reached the agency I said again, "Jerry, here is where you will someday find your new Mommy and Daddy." He nodded knowingly and chanted, "Mommy, Mommy, Mommy." He came upstairs and settled down in the playroom to play again *3

The Art of Child Placement with the crayons and toys. After he had had a glass of milk and a cooky, we started home again. On the return trip Jerry was tired and irritable. This time he was so hard to control in the car that he fell forward and bumped his head on the dashboard. In my efforts to catch him and stop the car, we had a minor accident. As I investigated the damage done to the car, Jerry sensed my anxiety. He began to whimper fearfully and then to cry. The car was not seriously damaged and so we continued homeward. Because I was unhappy about the accident, I overlooked the importance of reassuring Jerry. It was interesting that he, sensing my withdrawal and anxiety, cuddled up close to me and kept smiling up softly from time to time saying, "Hi!" Toward the end of the drive I was less tense and better able to comfort Jerry. I told him he was a good boy and that I liked him very much. I said I liked to be with him. When I said good-by, I said, "I will come soon to take you to a place where you will meet your new Mommy and Daddy." April 50. The McAlisters were in the office to meet Jerry. (The report then gives Mrs. Arthur's interpretation to the McAlisters of Jerry's family background and history to date. Mrs. Arthur liked the McAlisters and felt they would make good parents for Jerry.) I had already brought Jerry in earlier this morning. He was playing in the playroom with another worker. The McAlisters were sitting in the conference room. I went to Jerry and asked, "Jerry, would you like to come with Mrs. Arthur and see your new Mommy and Daddy?" He went willingly. The McAlisters were obviously charmed by his beautiful coloring and his buoyancy of mood. I handed Mrs. McAlister the crayons since that was what Jerry had last been playing with. He immediately went toward her and began to play with her his wellloved game, that of taking crayons out of the box and putting them back in again. I guided the three of them back to the playroom. After I felt that Jerry was comfortable with them, I left the room. Jerry H

Placement of the Very Young Child watched me go but made no move to follow me. I came back in about fifteen minutes to find them happily playing together. Jerry had a little clown with a feathery hat. He was tickling the McAlisters with it and then tickling himself. There seemed to be a free and easy atmosphere. We all sat together for a while. It was obvious that Mr. and Mrs. McAlister were very pleased with Jerry. They mentioned his friendliness, his "nice sturdy legs," and the fact that he resembled certain members of their family. After a brief discussion it was arranged that they would return the next morning to meet Jerry at the agency and take him home. Another worker drove back to Lowry's with us. I held Jerry and talked a little about his new Mommy and Daddy. Though he seemed unduly fatigued, he retained his good humor on the long ride. May i. Out to Lowry's to bring Jerry to the agency for his adoptive placement. Mrs. Lowry had packed a little box of his favorite toys including his hobbyhorse, which he liked best. He was most attractive in a new outfit I had bought for him, and he was practically popping out of his skin with excitement. He took my hand, raced out to the car, and only on the insistence of Mrs. Lowry did he kiss her good-by. The ride to the agency was again marked by a provocative kind of teasing in the car. As we entered the agency, I said, "This is the place where your new Mommy and Daddy are. Now they will take Jerry to his new home." He entered the agency eagerly and went up to the McAlisters with a great deal of assurance and poise. They played with him while I prepared the medical report, the routine of Jerry's day as prepared by Mrs. Lowry, etc. When it was time to leave, Mr. and Mrs. McAlister gathered up some parcels one of which they gave to Jerry to carry, and started out to the car. Mr. McAlister opened the car door for him. After running up and down the boulevard a couple of times, Jerry got in the front seat, looking somewhat puzzled. Mr. and Mrs. McAlister got in beside him. Jerry gave me a quizzical look. I said, "Here are Jerry's new Mommy and Daddy. Jerry will go to a new home with them. Bye-bye, Mama. Bye-bye to Mrs. Arthur." I waved as they drove away. 25

The Art of Child Placement Observations on Mrs. Arthur's Techniques Mrs. Arthur's recording of her activities with Jerry illustrate many principles of good preparation of very young children for placement. She begins with a firm belief that Jerry can understand some of the things she is saying to him. She does not use baby talk in general, though she does often substitute proper nouns for pronouns as she says, "Jerry doesn't want to go bye-bye with Mrs. Arthur." She accepted his terms, "bye-bye" and "mama," for these were his own. She did not complicate their system of communication by creating her own baby talk. Mrs. Arthur offered Jerry two new words. She had noticed that he called the Lowrys "Mama" and "Dada." When she spoke of the McAlisters, they were "Mommy" and "Daddy." Mrs. Arthur felt on the basis of her observations that Jerry understood a good deal of what was being said by those around him. She did not know whether Jerry had any knowledge of what was happening to him in the highly specific sense that we as adults may know, but she did think that he knew almost from the first that a change was coming. At first, he fought against it. Later, he came to accept it. The whole approach she used indicates a recognition that change and strangeness are filled with pain. This was a pain that no one could really take from Jerry or have for him. He was able to experience separation from Mrs. Lowry in little, painful pieces as he went off with Mrs. Arthur on their trips. Presently, he was able to leave Mrs. Lowry without tears. The voyages were not always pure pleasure. There was the trying trip to the doctor. Mrs. Arthur permitted the strange man to frighten the baby, but afterwards she offered him the comfort of her person, her car, the reassuring bag of cookies. Jerry learned, too, through his voyages with his caseworker that strange places are not necessarily menacing. First there was the terrifying dime store. Who will ever know what association from a cloudy past brought on the violent trembling which made it hard to get the mittens on? But the frightening place yielded up a fine 26

Placement of the Very Young Child red truck and the strange woman took him back to his Mama as she had promised. Jerry had repeated pleasant experiences at the agency. At first, he approached it with some distrust. But no one forced him to it. Mrs. Arthur let him explore at will. When he was ready, she suggested going up to the playroom. There were the crayons, the milk and cooky. This was a place Jerry found in a sense for himself. No one carried him up to it and thrust him at it. Repeatedly his association with the woman and the building were comfortable. On his first visit, before he had felt the "safeness" of the place, when a stranger entered the room, Jerry was quick to grab the only familiar object—Mrs. Arthur. Several weeks later, he could comfortably meet the psychologist, later the other caseworker, and finally the McAlisters. The whole approach to the placement of Jerry underlines the belief that change is hard for babies but that if they can take it a little at a time it can be tolerable. Mrs. Arthur eased the pain of the unfamiliar at first by offering Jerry continuity and repeated ceremony in their relationship. There were variations in the patterns of their visits, but underlying all were the same social worker, the same car, the "I Love Little Pussy." Surely things which are so well known and unsurprising cannot be filled with too much danger. There is a principle of social work that Mrs. Arthur has gone to great pains to give obeisance to: "Imposed plans never succeed." How does one avoid imposing plans on babies? In this case it was partly through the innate courtesy of Mrs. Arthur's manner toward Jerry. She writes very naturally, "When Jerry seemed ready, I asked him whether he would like to go upstairs." Mrs. Arthur could not sit down with Jerry and offer him the McAlister home and give him an opportunity to refuse it. She could say, though, "This is where you will find your new Mommy and Daddy." She could let Jerry walk into the room and begin to play with the McAlisters. She could leave the room and give him an opportunity to follow her. When Jerry first saw an unknown caseworker, he climbed on 2

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The Art of Child Placement Mrs. Arthur's lap and clung to her. She permitted him this dependency and reassured him. Later, when he first saw the McAlisters, he went to them and stayed with them, allowing Mrs. Arthur to leave the room. The abridgement of Jerry's case history has minimized the casework with Mrs. Lowry in order to throw a sharp, clear light on a relationship between a baby and a social worker. Some pertinent parts, however, are left in. Mrs. Arthur found Mrs. Lowry a superb foster mother for Jerry's temporary placement. Mrs. Arthur was aware that it was while Jerry was with Mrs. Lowry that Jerry had worked through his most negative feeling against what had happened to him. He began with headbanging, and tapered off with head-wagging until he became so serene that he could go off with a social worker to a new future. Mrs. Lowry was, according to Mrs. Arthur, truly remarkable in that she could let Jerry progress at his own pace. The reason may have been that she was not too immediately caught up in his future. She knew from the first that she would lose him eventually. Mrs. Arthur kept that reality firmly before her as she took Jerry away frequently. Mrs. Lowry, like Jerry, began to experience separation in little pieces. Mrs. Lowry did Jerry a great service in letting him work out his feelings in a nonhostile, nondemanding milieu which, though warm, had the advantage of a certain detachment. The detachment was possible because the Lowrys had no vested interest in the young manhood of this boy. They wished him well, but they would not be there to be a part of his future. Some tomorrow would bring them a new baby which they could help, enjoy, let live—but not keep. This is the magic of the temporary home. It can be a great asset in preparing a child for placement. He can leave behind in it some of the old "badness," which came with him from the ugly past, when he moves into a fresh newness. While Mrs. Arthur did casework with Mrs. Lowry, a feeling of mutual respect grew up between them. It was easy for Mrs. Arthur to persuade Mrs. Lowry to postpone toilet training. Her reason for wanting training delayed grew out of her belief that 28

Placement of the Very Young Child training is a trying experience for a baby and that it should not come at a time that he is coping with another knotty experience. She knew also that the relationship to the mother-person is the primary factor in successful training. When Jerry left Mrs. Lowry, he might regress (an occurrence common among replaced children) and then his new mother would start anew with the problem—one that might be charged with a special emotional tone if it were associated in Jerry's mind with two different motherpersons. The original record shows that Mrs. Arthur called Mrs. Lowry to tell her how Jerry had taken to his new parents and about his initial adjustment. This simple act of human thoughtfulness is often overlooked by social workers. It is as though they forget that when a woman sends out a child whom she has loved, some of herself goes with him. Until she knows that he is all right, a part of her is left floating, unanchored. One foster mother told me that it had seemed as though the child had died and she had failed to provide a funeral, but that when I reminded her that he was well and happy, the process took on meaning for her. She no longer felt as though he were dead; there was no longer the anxious feeling that she "owed" him that last uncompleted service. If one should hold the case of Jerry up to the strictest standards, one might wish that the visits had come closer together. One might wish too that Jerry had had one more experience—a visit to the McAlisters' home. Mrs. Arthur agrees vigorously. But the McAlisters lived three hundred miles away. As to the spread of time between visits, Mrs. Arthur thought it would have been better if they could have been moved closer together, and she would have preferred that the whole preparation had taken longer. She said, "In social work experiences, there is something terribly telescoped in what happens to people." The telescoping of experience is not all bad. The tempo at which a child can move into placement must be delicately estimated. The temptation to move too slowly is as great as that to move too fast. There was certain evidence that Jerry was ready— his ability to leave Mrs. Lowry without crying, his acceptance 29

The Art of Child Placement first of new people in his environment and finally of the McAlisters themselves, even his provocative teasing of Mrs. Arthur. Some day, when our tools are finer, we shall be able to tell more exactly when our clients are ready. No discussion of Jerry's case history could be complete without a reference to the automobile accident. This was clearly an unknown factor that forced its way into the "laboratory experiment." I am struck by the honesty and objectivity with which Mrs. Arthur reported it. Here was the person replacing the social worker. The car was new; the grill was smashed, and the man with whose car she collided was rude. Mrs. Arthur became a worried driver rather than a social worker. Jerry almost immediately sensed the change and responded in a new manner. Up until now he had felt the even, steady tone of the professional relationship. Finding this gone, and perhaps vaguely associating it with his own naughtiness, he became flirtatious in order to win Mrs. Arthur back. She came back to him soon and, recognizing that she had threatened him, gave him rather more assurance than usual. The casework in the adoptive placement of Jerry Jones falls short of perfection. But it is nevertheless a superior professional effort. It is an excellent example of the performance of a social worker who felt that a "small" job was worth doing well. It is an honest piece of work.

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CHAPTER 2

Establishing a Relationship with the Gradester

THE child who is no longer a baby and not yet an adolescent may be a very special placement problem. Any child, of course, finds placement a trying experience. But the child in this age group has his own peculiar characteristics, and his social worker must understand them thoroughly. She needs not only to know the generalized truths about this group but also to appreciate what effects separation will bring. She needs to know those parts of placement which are especially confusing and painful and what she can do to help. She needs a knowledge of the defense mechanisms that children use in order to face their ordeals. Sound preparation for placement, the kind she worked hard to achieve with younger foster children, is still the sine qua non of her job. Following close on its heels is the need for a meaningful relationship with the child. A thoughtful look at this most helpful tool, the relationship, is the core of this examination of the grade school child in placement. WHAT ARE THESE CHILDREN LIKE?

There is no pat name for this age group of children. I have called them gradesters; Benjamin Spock has called them "the 31

The Art of Child Placement middle-aged children;" psychiatrists refer to them as "the latency group." A Mexican mother in John Steinbeck's Tortilla Flat classified the youngest among her large brood as "the creepers" and "the crawlers." One might call this group "the walkers" and "the talkers." Their advanced skills in these areas separate them sharply from the babies. In these skills lies the source of the social worker's highest hopes and greatest despair. Because they are "walkers"—perhaps "runners" would be more apt—they can move toward what they want and away from what they find distasteful. Because they can talk, and talk well, they can use their tongues to disguise true feelings which would be too painful to bear if they were recognized. They can use their tongues as weapons to cause hurt both to those who have hurt them and to those who wish them well but who awaken a memory of a parent who inflicted pain. Nevertheless, in their ability to talk lies the social worker's greatest hope. Through speech the unknown can be shorn of some of its terror; anxiety can be dissolved; bitter, brooding anger can come out instead of staying inside to sicken and fester. Through the words of children it is possible to learn the source of their pain. Through the speaking of the words, the children can become healthier. Through understanding the words of the social worker, the child can begin to accept the relationship that is the most important tool the worker has for the aid of a troubled child. The gradester at the beginning of the road between babyhood and adolescence has much of the baby about him. Shocking experiences like separation may cause some children to back up into babyhood with clinging, dependence, and loss of bladder and bowel control. Others may be pushed into adolescentlike behavior, rebelling against adults, trying ineffectually to ape them before they are ready. When separation from security forces children off the stretch of road that is normal to their age, the social worker needs to recognize clearly that they have strayed. Later, when they find their way back to where they belong, she will know that they are no longer profoundly troubled. 32

Relationships with Gradesters Writing about children in this age group, Helen Ross and Adelaide Johnson say: He [the child between six and ten] is a fairly happy, contented person at this time and he has tremendous energy to turn to learning about things around him; he is usually voracious for information. He has great need for physical activity and he seeks companionship with his own age. He has little interest in the other sex, as such, preferring to play with his own kind, with whom he is usually competitive. Grownups are important to him as providers and protectors, but what he wants most of all is acceptance by his age group . . . the period from nine to ten through twelve is a distinct phase in the life of a child, a transition from easy going, well-balanced latency period to the stormier time of the adolescent period. . . . Girls of eleven and twelve are usually more nearly ready for the boy-girl relationship than the boys. . . . Toward the end of pre-adolescence we observe in boys and girls increasing uneasiness over any display of affection from the parents. Though this is a source of pain to the parents, it is an indication of the normal onset of puberty and the child's need to defend himself against his earlier emotional attachments to the parents.1 Spock, too, has done some thoughtful writing about this period of childhood. He develops in a little more detail Ross and Johnson's theories on the child's need for group life and the pattern of this behavior: This is the age when clubs and gangs begin. A group of boys who are friendly to start with, who feel the same way about things, decide to form a club. They work like beavers electing officers, making badges, drawing up rules, deciding who will be admitted, finding a meeting place, deciding what the secret will be and how they will preserve it. It may superficially appear like a childish pastime, but if we look carefully we can see serious social impulses at work. These kids are proving to themselves that they can run a part of their own life on a cooperative basis without the supervision of adults, that they can decide who is and who is not socially acceptable, on the basis of their own codes of behavior. These codes become very strict indeed. The child who provokes 1 Helen Ross and Adelaide Johnson, A Psychiatric Interpretation of the Growth Process (New York: Family Service Association of America, 1949; pamphlet), p. 9.

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The Art of Child Placement fights unnecessarily or who uses unfair methods is frowned on, also the child who avoids a fight when fighting is the honorable course.2 Spock comments also on the child's feelings of loneliness during this time: There are at least two reasons why the child is particularly affected by loneliness during this period. First, his own unfolding emotional pattern keeps telling him that friendships are his concern; second, his nature is also succeeding in detaching him emotionally, to a degree, from the parents whose closeness to him has always provided nine-tenths of his security. Nature, one might say, expecting him to conform to the normal pattern, counts on the warmth of his outside friendships to make up for the loss of the intimate dependence on parents. But since he lacks for certain reasons the ability to become thick as thieves with his contemporaries, he finds himself in "No Man's Land."3 Secure gradesters appear to be in a period of emotional rest. They have left behind them the enormous emotional involvement typical of the littler child trying to work through a comfortable tie to his parents. They have not yet arrived at the turbulence of adolescence in which they will need with great fanfare to emancipate themselves from these previously acceptable ties. Ideally, they have accepted as suitable their relationship to their parents so that they need no longer "sweat and strain" at it. They are therefore free to look to the rest of the world of people—first people of their own age, later others—and to approach them experimentally. Tentatively they begin to play-act the business of living in the world. They begin with one friend, then add another. Here is an interesting business, "threeness" in friendships! Having mastered this complex experiment, they can move on to the more difficult and fascinating business of group or gang life. The healthy, happy gradester feels secure about his parents. He sees and accepts where he stands in relation to them. This leaves him free to turn his attention outward, away from himself and 2 Benjamin Spock, "The Middle-Aged Child," Pennsylvania Medical Journal, 50:1046 (July 1947). 3 Ibid., 1049.

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Relationships 'with Gradesters them, to the world about him. His curiosity is lively. He is serene when facing little separations, like going to camp, or visiting relatives, because he really wants to know and experience other people, other places. Braveness, curiosity, hard and industrious play are a few of the hallmarks of the secure gradester. If a placement worker is given a well-adjusted gradester to place—which rarely happens—she meets a child chronologically and emotionally better geared to uprooting than she does in the well-adjusted baby or the adolescent. Because such a child has worked through an acceptance of his role as a child who loves and is loved, because he has accepted certain restrictions, and because he is comfortable with these feelings, he can, if gently helped, transplant them successfully to a riew soil. THE EMOTIONALLY DEPRIVED GRADESTER IN PLACEMENT

Unhappily, the social worker who finds herself facing a truly secure gradester needing placement has an atypical experience. Frequently the seeds of family disease which blossomed into the need for placement were sown long ago and have operated to a greater or lesser degree all through a youngster's infancy and early childhood, so that the social worker finds herself facing a child who deviates perhaps sharply, perhaps only a little, from the secure, outgoing pattern ideally characteristic of the gradester. She will need to be aware of these deviations, what has gone into them, and what she can do to help her young client back to the part of the road where he belongs. That is the part between babyhood and adolescence, the stretch in which he feels sufficiently secure in his relationships so that he can swing along much of the time with "the kids in his own gang." Because of the emphasis in the developmental literature on group activities and the eagerness with which gradesters seek out friends, a placement worker might quite logically decide that a group setting in an institution would be best. The question of which child needs institutional rather than foster home care is a complex one which will be dealt with later. But it needs to be said now that the child's normal leaning toward groups at this 35

The Art of Child Placement stage in his development does not necessarily make group living his appropriate modus vivendi. Gradesters still need their parents. They are usually able to turn to their groups because they are secure in the knowledge that their parents are right behind them where they can reach out and touch them if need be. Take away the parents and you take away the foundation of security that frees them to relate to their own age groups. Separation from parents is a painful experience for gradesters as well as for younger children. To them it may mean a kind of punishment for badness, a demonstration of the inadequacy of their own parents, a terrible dramatization of the rejection they have long suspected and sensed. Dorothy Hutchinson has given sensitive expression to the feelings of children about separation. She writes: Under normal conditions separation of the child from a loved parent is usually a maturing experience. Growing up is growing away from home and familiar associations. In child placement, however, separation is something quite different. Here it seldom by itself means growth for a child, but usually the reverse. So humiliating and frightening is the experience to many children that they revert desperately to behavior that is no longer appropriate. It is as though this indulgence was seized on as their only insurance against the hurt. . ., . Separation is a healthy experience when the child is ready for it. The obstacle in child placement is that he is seldom ready. In the normal situation, the child has received emotional satisfactions sufficient to liberate him for new experiences with new people. His affective appetite, in some measure, is appeased. But the foster child has almost never been accorded these satisfactions so essential for his growth, neither the love and admiration of a mother and father happily married nor the assurance of their continuous presence and reliability.4 The gradester facing placement will react negatively in direct proportion to the degree of deprivation he has known in the earlier stages of his development. If a social worker were asked to place a secure, healthy gradester suddenly orphaned she would be given 4 Dorothy Hutchinson, "The Parent Child Relationship as a Factor in Child Placement," Family Journal of Social Casework, 27:47 (April 1946).

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Relationships 'with Gradesters a sharp picture of the meaning of separation as an isolated entity. She would find in this child a kind of "pure" pain not confused by questions of the worth of himself and his family. He would be wounded, but with a reasonably adequate set of foster parents his wound would heal cleanly and quickly. Soon he would be back with his own age group playing hard, vigorously sampling the exciting business of getting ready to grow up. You would not expect him to stay very far away from the typical behavior pattern of other children of his age who were developing normally. There would soon be a marked resemblanc between his relationship to his foster parents and that which he had formerly had to his own parents. The phenomenon is a little like that of a healthy child who is physically injured or who gets a disease. All the good health of his past marshals its forces to bring about his recovery. The well-adjusted orphan can profit to a degree by the help of a social worker in placement. But he does not begin to need her as much as the deprived child does. The deprived child approaches the crisis of placement without a backlog of psychological good health. When he reaches into the past for nourishment and security to see him through this emergency, he finds only a profound psychological deficiency. He approaches the need for sudden strength with psychological rickets, scurvy, and beri-beri. There is no inculcated strength on which he can draw. He is asked to give up what he never has had. He is expected to develop a relationship to new parents when he has not learned from his own parents what this relationship should be. His confusion is pathetic. Perhaps in his mind's eye he has always dreamed of the very thing his social worker is offering him—a nice home, loving, parents, respectability. (In the mind of the gradester respectability and conformity are completely intertwined. They mean his chance to be "like other kids.") But, when faced with this gift he has always wanted, he does not know how to accept it. How can a child react with trust toward adults when adults have always let him down? How can he accept a gift when gifts have never been 37

The Art of Child Placement freely given in his past? "There's a catch to this," he says to himself. Or, as one thirteen-year-old looking back on her placement of a few years ago said, "I wondered what kind of clip joint this [the children's agency] was." The response of the deprived child faced with an offer of placement is one of suspicion, confusion, and pain. He reacts with negativism, with defense mechanisms, in ways which are inappropriate to his situation. In a sense, he is out of touch with his reality. Neither he nor his foster parents nor his teachers nor his own parents can understand why he acts as he does. If he is asked "why," his confusion is aggravated. He gives strange answers and comes to believe them himself. His foster mother, gentle and troubled, asks, "Johnny, why did you hit our baby?" He hesitates. She presses for an answer. He says, "I hit her because she was crying and noisy, because her nose was running, because I hate babies." Johnny cannot say, "I hit her because I'm sure you love her. I hit her because she is having all those things I never had. I hit her because she is your own child and I'm just a boarding child." The naive social worker may carefully dictate into her record, "Johnny hates babies. Perhaps he should be moved to a home where there are no babies." Among the many problems that the deprived gradester in placement has to cope with is the horde of well-intentioned adults who keep saying, "Tell me why?" It's a little like seriously requiring a six-year-old to give you the sum of 97 and 48. Adults expect answers. After all, gradesters can talk. The child is asked an impossibly difficult question. Desperately he will give some answer—a twisted, queer little answer, feeling confused and inadequate as he does it. Pathetically he will come to believe his silly little answer and may come to act as though it were true. This is one reason why children need trained, skilled social workers. If the implications of placement were not so threatening, if children responded in a simple, straightforward, logical way, foster parents and a group of well-intentioned volunteers could run the placement program in America. 38

Relationships with Gradesters But deprived children facing terrifying experiences get jerked off the normal road to healthy adulthood. They have to respond defensively in ununderstandable ways. Their devaluation of themselves and their parents strongly influences their total adjustment. A score of twisted mechanisms hides the potentially healthy child that lies within each young body. A gradester in placement needs his social worker. She can offer him and those around him the understanding which is the main step toward acceptance. She can, through her relationship, help him give up his twisted mechanisms. She can help him to speak the words and do the acts that will heal his wounds. But she cannot help him unless she can understand what is happening to him. THE TRIANGLE OF PLACEMENT

Describing the role of the placement worker, Inez Baker has said, "The worker represents, the link between the foster family unit and the natural parents, and is the balance wheel for the unique triangle of parents, child, and foster parents. The casework role is one of helping the child find and maintain his relationships within the triangle, to the end that he may develop normally. When the unhappiness of any member of the triangle threatens the balance of any other, the potentialities of the placement as a growing experience for the child are also threatened. Hence the worker must be sensitive to the needs and the concerns of all members."6 For a worker to maintain her position in relation to three sets of clients—the foster parents, the own parents, the children—a very high skill is required at times. It is not easy to talk about the social worker's job in relation to any one set of clients without becoming involved with another. Singling out parts of the many-faceted business of child placement for scrutiny is difficult. Whoever tries to pull the problem together is faced by the fact that placement is an unwieldy sort of something to take hold of and explain. Approach it as a unit, and you find that it has twenty or more angles to it. Try to pluck out 5

Inez M. Baker, "The Caseworker Helps the Child Use Boarding Home Experience," Child Welfare, 28:4 (May 1950).

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The Art of Child Placement one angle to examine and you find that angle inextricably interwoven with four others. When a child placement worker tries to integrate the various forces in her triangle and keep them in careful balance, she realizes that a knowledge of child psychology—important as that is—is not enough. She goes back to her generic training in social work to help the parents and foster parents. The child welfare worker is more than a children's specialist. Her skill and specialization, which grow constantly with every thoughtful placement she makes, are in the area of separation and union as they affect adults and children in relation to each other. A social worker explaining her role to a nine-year-old was trying to show him that she stood in the middle. The child, his mother, and his foster mother would all talk with her, she said. She would try to help them to understand each other in a way like—she groped for words. He spoke up sagely, "Like a mechanic who goes around squirting oil here and there, wherever the parts start to rub." This is an oversimplification, but it is important to realize that this is how we may appear to the children with whom we work and perhaps to the interested adults around them. Squirting the oil of casework is a high art. It is needed in all placement situations. No social worker can expect success if she ignores one corner of her triangle. Whenever own parents, foster parents, and a child are concerned with a placement situation, a highly skilled social worker with an ability to focus individually on the parts of the whole is needed. THE CHILD'S TIE TO HIS OWN PARENTS The child's tie to his own parents is the number one problem of placement. It may make placement an impossible way of living for the child. A guilt-filled mother who half gives up her child and half holds onto him, who expresses her ambivalence toward her responsibility by blowing hot and cold, brings to the agency a thoroughly confused, anxious child. Such a child may neither have nor give up his mother; such a child can neither totally accept nor reject substitute parents. 40

Relationships 'with Gradesters The literature of the field puts enormous emphasis on the intake interview with parents and children. It is impossible to stress sufficiently the full importance of the first steps, because they often have within them the seeds of failure or success for months and years to come. An all too common error is to take children from their parents before the children are prepared for placement. The result can be that it will seem to the child that a force outside the control of his parent or himself imposed this monstrous plan upon them. Surely he and they were blameless. The obvious "force" on whom to blame the separation is the social worker and the agency. The child begins his placement with hostility against his worker. As social workers have sharpened their techniques, a pattern has grown up in which, whenever possible, it is the parent who plans and interprets the placement. The social worker thus becomes the agent who carries out the plan made by the parent because the parent has asked this service of her. Jessie Taft wrote in 1940 that the idea that "the parent must initiate and be responsible for accepting and actually taking the steps in the placement process in order to give the agency a sound basis for placing the child is a new concept in child care. In this view, the movement toward placement starts with the parent who applies to an agency for help in making a plan for his child. The agency enters into an exploratory process with him so that he may move step by step, if this is possible at all, into the beginning experience of giving his child into care and relinquishing to a foster home many of the responsibilities that he has previously carried."6 As the child sees his parent taking these steps, he comes to understand that this is the parental plan. The worker should coordinate her work with the child so that he, too, can take some of the steps in placement as his mother moves toward it. Many of the rules for preparing much smaller children for placement hold in work with gradesters. The more the plan can be part of his • Jessie Taft, "Foster Care for Children," Annals of the American Academy of Political and Social Science, November 1940, p. 180. 41

The Art of Child Placement own doing, the less it has in it of "something done to him," the better the chances for success. Situations that arise in child protection sometimes make the cooperation of the parents virtually impossible to get. At these times the social worker will need to give more of herself to her child than in situations where she is clearly acting as the agent for his parent. She may not allow the child to suffer in silence, because to leave unpleasant facts unsaid will mean the child is alone and unsupported when he needs her most. She then makes herself into another ineffectual, nonunderstanding adult. She denies the child help with his suffering, the giving of which is her raison d'etre. Dorothy Hutchinson writes, "To avoid talking with a child about his problems is to deny them. Although at first the child may be unable to discuss these troubles of his own accord, it is reassuring to have a worker talk to him in a realistic, matter-offact, and accepting manner. . . . To leave the child alone with his feelings about what has taken place or to avoid them by just building up a rosy future is to miss the child's real suffering and to lose out on a critical opportunity for forestalling the dangers of denial, fantasy and repression."7 It is early in his placement that a child's feelings about his parents are most accessible to his worker. If she neglects to help him speak of these emotions, if she permits them through silence born of delicacy to become repressed, she will have done him a great disservice. Years later a psychiatrist may have to work hard to bring out what the child was feeling about his parents at the time of placement. If the child's attitude toward his parents is characterized by shame, guilt, ambivalence, or confusion at the time of placement, the placement begins with one important strike against it. OTHER PROBLEMS OF CHILDREN IN PLACEMENT

In the preceding chapter, I suggested that the social worker try, through empathy, to visualize what sudden change means to a 7 Dorothy Hutchinson, "The Request for Placement Has Meaning," Family, 25:130 (June 1944).

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Relationships 'with Gradesters baby. Social workers should make a conscious effort to empathize whenever they are trying to help children through difficult situations. The enormous and terrifying changes that go with placement can easily become almost commonplace to a placement worker with a large caseload unless she stops to empathize. I start such a process with a thought of what uprooting means to adults. Most of us have never experienced a real uprooting. Usually we have taken our families with us when we have moved to strange new settings. As adults we approach change with varying degrees of serenity, depending on our basic security and our appetite for adventure. A great deal depends, too, on whether we are leaving behind some things which have been unsatisfactory. Today we could learn about imposed changes by talking with displaced persons. We have seen their haunted faces in newspaper photographs. We cannot look at them without feeling ashamed that we have so much security and they so little. But seemingly similar experiences are never really similar. Even though one could magically create identical situations, if different individuals experienced them it would not be the same. Still, there are common elements that we can guess and feel. Think for a moment what it would mean to you if you were a gradester in placement. This is not too difficult, for conscious memories carry most of us back into this age period. First, there is the monstrous experience of realizing that your mother and father no longer have a place for you in their lives. All the negative things you have thought and felt about them flash back. Surely they could have taken no more terrible revenge. You have been banished. Or perhaps it is not revenge. Perhaps it is you and your badness that makes it quite impossible that your own parents can continue to live with you. (It is better to think this than that they are bad.) You are to be sent to live with strangers. The terror of the unknown wells up in you. It's better not to think about it. But you must think about it. Day after tomorrow it will happen. The 43

The Art of Child Placement social worker will come. Your things will go into her car. Your parents will talk about the weather, and do you have enough socks, but they will not look at you. And then you will leave. You leave your house, your bed, the kid next door, the school you always went to. You will visit your parents, they have said. Imagine, visiting your own parents. Like a stranger who doesn't belong. Of course, you don't belong. This business makes it all pretty clear. You act brave. You aren't sure whom you're trying to fool— yourself, you guess. And then the social worker says a surprising thing when you are alone in the car with her. She says, "It's hard, terribly hard, isn't it?" For the first time you look up straight at her. The look on her face shows that she really knows. It's funny, the way she is the only one. She says, "It's all right to cry." You know she means it and you do cry and it's still terrifying, but part of the awful feeling of fullness in your stomach, your throat, your cheeks is gone. You begin to think now less about what you have left behind and more about what you are going to. The social worker will answer your questions. Somehow you cannot ask her what you really need to know. You cannot say, "Will they beat me?" Instead you ask lamely, "Is the house big?" But as she talks you realize that she has tried to find people who will not be too hard on you. You recognize that there's something different about her from most people. "She's on my side," you think with surprise. You ask her, "When will you come back?" She smiles and tells you just exactly when, and you feel a little safer. By "feeling through" such a situation, almost any adult can come to a better understanding of the terrors which a child in placement feels. Placement holds many specific problems, all of which grow out of the initial problems of separation and change. The new home has standards that are necessarily different from the standards of the home from which the child came. If they are too strikingly different, they may be the more terrifying. 44

Relationships with Gradesters The child gets the feeling that the privileges which the new home offers him are his only if he behaves. He feels that he is in his foster home on "sufferance." At any moment he may be asked to leave, especially if he does the wrong thing. He may have to prove this suspicion to himself by testing the foster parents. If they're going to throw him out the first time he drops his "company manners," he'd better find out right away and get it over with. Are these people really wanting a boy like him, or would they chuck him out the door if he broke that silly blue vase the woman is so proud of? And how will they feel about his parents when they come to visit? His mother looks pretty messy next to this woman. Will they see that she is really even prettier? And what's all this about always having wanted a boy like him? Don't they know that he's not for sale? He's got parents—he has got parents! There's no way to list the myriad of problems faced by a child in placement. But the basis for the problems is easy to locate. Most children in placement are rejected children. They have faced separation, which was frightening. They are being asked to change themselves, which is dangerous and humiliating. Rejection, separation, and change—these are the bedfellows of the child in placement. Is it any wonder that he wets his bed, cries out in his sleep, wakens looking dragged out? THE RELATIONSHIP—THE CASEWORKER'S WAY OF HELPING

The child's relationship to his caseworker normally begins at the point at which he meets her. I say "normally," because he may already have experienced conditioning factors that will alter his "set" toward her. These may have been remarks of his parents, who have already met her, or biases positive and negative about "welfare workers" picked up from neighbors or schoolmates, or other preconceived impressions received from movies he has seen or stories he has read. The usefulness of the relationship begins at the point at which the child begins to sense that the worker is a truly different kind of adult. When he senses further that she is trustworthy, under45

The Art of Child Placement standing, and eager for his happiness, and that the difference which he feels but could not describe in her is something he likes, a truly helpful relationship has begun. Her differentness means more to the child because of its contrast to the sameness of other adults. So far his contacts with other adults have been with people who represent, in varying degrees, authority—his parents, his teachers, perhaps the neighborhood cop. Even mothers of friends and neighbors into whose yard he wanders have a certain authority about them implicit in their relationship to a child. The successes of these other adults at understanding youngsters' feelings vary widely. Mothers and fathers seem to try especially in times of stress to understand. They try by great and often somewhat stubborn effort to draw the answers out of their children. "Why do you hate school?" "What made you think you could help yourself to the money in the sugar bowl?" "How much candy and pop did you eat that now makes you sick?" The angry, anxious faces trying to understand press upon the guilty child. He begins to have his most uncomfortable time with adults when they are trying to understand. He cannot appreciate that they are anxious and hostile because they have an enormous stake in his behavior. He cannot know that his failures are all intertwined with their feelings about themselves. Probably he has also known times when they sought his reasons more gently, but the chances are that he didn't like that either. Perhaps they found him crying in bed. They were gentle and sympathetic then, but still they asked him to tell them 'why. To put his lonely, nebulous feelings into words is often too difficult. This probing for explanations, whether angrily or gently, is one thing the gradester has come to expect of the adults around him. Another is their way of talking. Mostly they haven't talked to him in just the same way they talk to each other. Mostly a few words to him have sufficed. His mother does not sit and gossip with him for a whole hour the way she does with his father, the neighbors, her friends. If the teacher "keeps him after school," a fifteen-minute discussion constitutes a very long .conversation. 46

Relationships 'with Gradesters It seems as though most adults have little to say to children—a few commands, a few questions, some lectures, a spontaneous laugh at their jokes or mistakes, but no long talk for the comforting pleasure that can lie in talk. Sometimes it seems to the child that he doesn't like talk just for talk's sake, and he wonders at the muffled voices that bumble deep into the night as he lies awake in his bed. Time and talk are given by adults to children in sparing, necessary pieces. Talk involves, "You do this!" "I'm going to do that!" or, "Don't you ever do that again, young man!" This is true unless the adult is a "nagger." In that case she merely repeats her same brief theme with the kind of monotony that drives the child to shut her words out of his consciousness. The gradester has already begun to learn, too, that there is give and take in relationships. He has learned it first from his contemporaries. It is beginning to appear in his relationship to adults. "Johnny, run to the store and get a loaf of bread. While you're gone I'll make you a nice, cool drink." Or, "We could begin to think about a bicycle for you, if we thought you could get home on time for supper each night." Before a social worker knows how to be different to a child, she has to know how other adults have a sameness about them. To a gradester, adults are people of authority primarily interested in talking with each other. There is warmth and coldness in them. They are nice if the child is nice; if he is not, they are angry and punishing. There is give and take in the relationship. They expect things of him—good behavior, conformity, doing things for himself and for them that weren't expected when he was littler. They are somewhat interested in how he feels about things, but this interest has a brief attention span. And they look to him for answers that are hard to give. None of these characteristics seem to fit the social worker who is trying to establish a relationship. She is, or should seem to be, in no hurry. (If a social worker communicates her pressures and busyness to a youngster at the point of establishing a relationship, he will feel rejected.) She will chat with a child at great length. 47

The An of Child Placement Each thing he says interests her. If he chooses to be silent, she can be comfortable being silent with him. She never says things like, "Come on, I haven't got all day." She may say, "We have an hour to spend together. See—that means until the minute hand gets all the way around to here." Setting time limits is acceptable. Rushing a child to speak so that one can get on to other business is destructive. Probably the most interesting thing to the child about the social worker is that she doesn't try to pull answers out of him but seems nevertheless to understand what he is thinking. It's surprising when she says, "You don't like to think about leaving home, I know." Her face is gentle, kindly. She encourages him to talk about his feelings, but doesn't say, "Tell me why." She doesn't exactly tell him why either, but it feels a little as though she has. She helps him to say what he is feeling, and somehow it is easier because miraculously she seems to know before he says it. In expressing his feelings he comes with sharp surprise to a most unadultlike quality in her. If he dares early in his relationship to mention ugly, hateful feelings, it seems to be all right with her. Instead of "What a nasty idea for a little boy to have about his own mother!" he hears, "It make you feel angry and hurt when your mother does these things." Among the emotionally underprivileged children needing placement, few have ever met an adult, have ever dreamed that one existed, who was like this. Bad thoughts—ugly, angry, hostile thoughts—have been "shushed" in children from the time they could speak. Here in the social worker the child finds an adult who encourages him to bring his black thoughts out. She seems neither to condone nor deny them. She accepts with him the fact that they exist and that it is all right to talk about them. This is surprising and intriguing to most children. But what is truly astonishing is that if the child's black thoughts should turn to her, if an angry word against her should slip out, she does not become angry. Actually, she helps him say these words. She may say, "You are really angry with me today. You feel that I'm the one who is going to take you away from home, don't you?" 48

Relationships with Gradesters He begins to feel excited about telling her his feelings. He notices also that even when she is aware that he has done something bad, she never lectures. She helps him talk about his feelings about the bad thing, but does not punish, or tell him not to do it again. Nor does she seem to like him less. He begins to know that here is a truly remarkable and predictable adult. If she makes a promise, she will keep it no matter what. If he talks mean or acts bad, she will still like him. He feels as though she feels that he's important. She listens more thoughtfully than anyone ever has. She can understand how a boy feels about his problems. She wants to help. As time goes by and she passes his tests, he comes to know that she is on his side, that she will "stay by him." With a full understanding that the social worker is a truly different kind of adult comes the beginning of the helpfulness of the relationship. With some children it comes much more slowly than with others. Probably the ease with which it comes is directly related to the kind and quality of his previous relationships with other adults. Sadly, it must be admitted that there are children so damaged that they can never form a relationship to any adult. But to give up trying is like deciding before one is absolutely certain that a child has an incurable disease. Ideally, a social worker should not begin to move into placement with a child until he has achieved a relationship with her. Practically, she may at times find herself in the very act of moving a child before she has had an opportunity to work with him long enough. A child placement worker should resist, in every professional way she knows, being pushed into a series of emergency placements. If a child has been in a bad setting for months and years, no matter how bad it is, the "emergency" necessitating his removal before a relationship is begun actually does not exist. It is better to leave him where he is, however unpleasant that may be, until he is ready for the move. If, however, she does find herself meeting a child who needs placement immediately, the very act of placement is pregnant with opportunities for the beginning of a relationship. The child recog-

49

The Art of Child Placement nizes the social worker as the person who will stand between his past and his future. She knows the home from which he came and the home to which he is going. She will be there to help him bring together his feelings about the two. Anette Garrett describes the caseworker's role as "a delicate one in relation to the child. . . . She often becomes a liaison person attempting to keep the reality factors under control. She is the one person who sees the situation as a whole and attempts to keep the balance between rivalries and anxieties of relatives, child, and foster parents. . . . Particularly when there is no plan of adoption and when the permanence of a placement is uncertain, the agency worker may legitimately become the one secure bulwark in the child's uncertain life, the one person who always stands back of him, attempts to understand him and provide security for him."8 The child going into placement needs by his side a worker in whom he has confidence. He continues to need her long after placement has been achieved. Dorothy Hutchinson, speaking informally to a group of placement workers in 1950 of a child in a foster home, pointed out an episode in the record in which the child through his actions showed his acceptance of his foster home as his true home. She said, "Now he's really placed. He was just living at this house for the first six months." The child especially needs his worker at frequent, regular intervals that he can count on until he is "really placed." Until that time he carries hurt, angry feelings that need to be helped to come out. Esther Brandzel writes, "The child expresses only little bits of emotion at a time, and will bring up only part of his feelings at any one time. By being on the scene frequently, she [the caseworker] helps the child to express as much as possible of his negative feelings about placement, about her, and about the parents, and she lets him feel the agency at least will take care of him even if he is angry."9 8 Anette Garrett, Casework Treatment of a Child (New York: Family Welfare Association of America, 1949; pamphlet), p. 20. 9 Esther S. Brandzel, An Experimental Use of the Temporary Home (New York: Child Welfare League of America, 1946; pamphlet), p. 19.

5°

Relationships 'with Gradesters Many writers in the field are quick to point out that the caseworker should not be fooled by the "company manners period" of what appears initially to be a good adjustment. It is usually a few weeks or even months before the child in placement begins to dare to act out in the foster home. It is then that both he and the foster parents particularly need their social worker. It is then also that the child's repressed feelings are closest to the surface and most easy to get at. It is hard to overemphasize that the child needs his worker intensively and frequently until he is "really placed." It is helpful if the child's appointment times can be scheduled in a regular pattern—for example, at four o'clock every Wednesday. Then, if problems arise, he can say to himself, "I need wait only until Wednesday to talk to Miss Thompson about this." From Wednesday to Wednesday the child can plan his interviews, and progress will often come more smoothly than in the unplanned, unscheduled interviews. Wednesdays may come to be little islands of security in a frightening new life. After the child is "really placed," he will still need his worker, though not as frequently. With a child making a serene, happy adjustment—one who seems to have worked out his major conflicts concerning separation from his parents—interviews could be scheduled at one-month intervals, and in the best examples of successful placements even at three-month intervals. But it is my firm belief that because of the triangle aspects of placement and the unnatural experience of uprooting that every child in placement experiences and re-experiences, he should have access to his worker until he is adopted, returned home, or emancipated as a young adult. EXCERPTS FROM THREE CASE HISTORIES

To try to isolate the essence of a relationship is no mean task. It may be possible to catch it in a framework of words and say, "There! That's what it is!" But it is more understandable if it can be seen as a working, functioning thing. That is the purpose of the excerpts from three case histories 5'

The Art of Child Placement which follow. They show graphically three quite different gradesters in placement. In each the worker and the child are engaged either in forming relationships or in putting relationships to productive work. Many of the problems already discussed—the child's slow acceptance of a worker, his struggle to understand the worker's role, the worker standing behind the child regardless of his behavior, and others—are shown more sharply than many thousands of words of generalities could bring out. The excerpts are included as pictures might have been used in another sort of book. The problems the children present are interesting, as are the techniques their workers employ. The recordings are presented without critical evaluations. Each reader will find himself making his own. Ralph BACKGROUND NOTE

Ralph is a troubled ten-year-old—aggressive, instinct-driven, and full of sharp, mostly unverbalized feelings that his mother rejects him. Because of his behavior and because his mother cannot accept the lack of status implicit for her in foster home placement, he has been placed in an institutional setting. Ralph has recently made sexual overtures to .several of the girls in the institution. His new worker, Mr. Roberts, feels that Ralph needs help in accepting transfer from his former worker, and also that Ralph needs help in his feelings about sex. Mr. Roberts has access to consultation with a psychiatrist. TWO INTERVIEWS

April 28. This was the day that Ralph and I planned to "explore" the capitol. When I stopped for him, I found he was having difficulty with Miss Jones, the counselor. He wanted to go without a sweater but Miss Jones said he had to wear one or else wear his heavy coat. I said we could not go until Miss Jones said we were ready. He became very upset, arguing with everyone in the home, but he finally did put on his sweater. After our shopping we went into a restaurant. Ralph conducted himself very well at first, but soon began spilling water on the 52

Relationships 'with Gradesters tablecloth and chairs. I said he was wondering if I was going to allow him to spill water like this. He said, "Yes!" and continued to do it. I said firmly that he would have to stop spilling the water and wipe it up. I took the glass of water away, gave him some napkins, and helped him. For a while he ate nicely, but after a bit he began spilling his food. I said that I knew that ordinarily he could eat better than that. He agreed and there was no further difficulty with his eating. After we finished our lunch, Ralph and I went to the state capitol. During this period and on the way home Ralph posed several questions about my function. This discussion was spread over a period of an hour and a half. Ralph would interrupt the discussion by various means, but would bring us back to the same subject later on. He began by asking where my office was. Was it in the same place as Miss Line's? (Miss Line was Ralph's last social worker who had left a month earlier.) He wondered where Miss Line had gone and whether she had gone for good and would ever be able to come back. He wondered whether she was still on the earth or had gone to Heaven. He asked what social workers were supposed to do. I explained that I was interested in helping him become happy. I knew that since he had left his mother he had been unhappy and in difficulties. "How come you know so much about me?" he asked belligerently. I explained that Miss Line had told me a great deal about his problems and troubles and that she had also left me a long written note telling about him. He wondered why I had to know all this and why Miss Line had to tell "everything she knew." I commented that maybe he did not want me to know about him. He did not answer so I asked whether he thought I would not like him so well if I knew all about his difficulties. He said Yes to that. Later he began to question how soon I would be leaving. I said I would be leaving sometime, but I would tell him three or four weeks in advance. I also added that I would bring his new worker before I left so that he would get to know her ahead of time. He asked who his new worker would be, and said he thought he 53

The Art of Child Placement would like a woman worker best. He then returned to questioning about how long I would see him and needed reassurance that I would not leave suddenly. Ralph again expressed considerable resentment that the workers and counselors knew all about him. He added that it was Miss Line and Miss Jones whom he did not want knowing about him. This indicated to me that he feels rejected because of his behavior. Although Ralph did not express any hostility toward Miss Line because of her leaving, I sensed that he did feel rejected, and that her sudden withdrawal seemed to him a desertion because of his "badness." I think he was wondering whether he should allow himself to become involved with me if I, too, were to leave suddenly. I feel that when I leave I must be careful to tell him several weeks prior to my going, so that I will be there to handle any feelings of rejection he may have because I had to leave. May 4. Ralph greeted me enthusiastically and wanted me to come with him to his room. I gave him the clay I had brought with me. After he had changed his clothes, he wondered what to do with the clay. He threw it at me rather hard as if he wanted to hit me with it. When I failed to catch it, he said I was rather slow. I said that he could not throw clay at me, and suggested he make something from it. He was unable to do anything with the clay so I made a crude person with body, head, legs, and arms. He then, rather enthusiastically, said he had an idea, and he used the rest of the clay to throw at the model which he named "the man." For the next twenty minutes he mutilated the model which I had made and another which I had formed when he hau totally disfigured the first. He said he was destroying the man. He liked to destroy things, he explained. After saying this, he pounded the figure with his fist and crushed it with his fingers. After Ralph finished playing with "the man," he made the clay into a blocklike shape and jumped on it and battered it. Next he formed it into a doughnut shape and wondered whether I knew what it was. When I asked him what it was, he said that anyone could tell it was a doughnut. He put the "doughnut" to his mouth and stuck his tongue in the hole.

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Relationships 'with Gradesters Ralph said he no longer wanted to play with the clay but wanted to go to the store to buy a comic book. I said that we could go to the store on my way to the streetcar when we were through talking. This was agreeable with him, but he did not know what to do next. I suggested he might like to draw. He thought that was a good idea. He rather deliberately and patiently drew a picture resembling a woman's breast. I asked him if he were interested in talking about the picture, and he said Yes. I said I felt that perhaps he was interested in finding out about the difference between boys and girls and he said, enthusiastically, Yes! When he used one of the more vulgar expressions to refer to the genitals, I interjected the more acceptable term, explaining that we were talking about the same thing. He used his own terms freely, however. During the first part of the discussion I focused my talk upon the development of the baby in the mother. Ralph expressed some feeling about discussing this because it was "dirty." I assured him it was all right for us to discuss this because I knew he was interested in the subject and needed to know about it. He wondered why boys were different from girls and whether boys could have babies. Ralph, who had been very attentive, suddenly said, "I'm going crazy talking about this." He asked whether it was not sinful and whether we should not die from it. I recognized that this strong anxiety came from some previous discussion with someone, possibly one of the youngsters at the home. It might have been in connection with his intimacy with one of the girls in the home. I said, "No, we will not die from talking about sex and the differences between boys and girls." He asked next about the functional purpose of the boy's penis and the part boys played in having babies. I thought that Ralph himself was aware of the sex act by the manner in which he worded his question. I handled the matter by explaining the process of fertilization. Ralph was well aware of copulation and wondered what it was usually called. I said that usually I used the word "intercourse," and he said he knew another word, which he gave. He wondered, 55

The Art of Child Placement using a more vulgar term, whether it was wrong for a boy to have intercourse with a girl. I said that sometimes boys and girls want to find out about one another, and wondered whether he felt it was wrong. He did not feel it would be wrong if the girl were willing. Ralph went on to tell about a girl who lived in the home with whom most of the boys had had sexual relationships. (This was almost certainly fanciful. There may have been some sex play but certainly not what Ralph was claiming.) He told of several girls with whom he had had sex play relationships. He again questioned whether it was sinful and whether he would die from it. I reassured him he would not, and described the normal social process of a boy and girl deciding upon marriage, telling him that after they were married they then planned on having children and having sexual intercourse. He wondered whether they had fun and I assured him it was natural for a man and his wife to have intercourse and to enjoy it. He asked why I did not have a sexual relationship with one of the women counselors in the home, and I explained that I did not do so because I was not the husband of this woman. Ralph speculated as to whether he would marry. He decided he did not want to because it was dirty. He then reconsidered and thought he might because there was a girl living in the next block whom he thought he would like to marry. Ralph turned the discussion to his sister. He said he did not know at first that she was his sister but felt she belonged to a neighbor. He wanted to kill her to get rid of her. He explained that she was born when he was only four and he did not feel she belonged to his mother. He changed the subject abruptly, saying that he was going to go home in three weeks. He was going to help his mother fix up her house so he could go back. He did not like it at the home and was not going to stay. When Ralph indicated his willingness to interrupt the interview, I said the time was about up. On the way downstairs he asked me to tell the other counselors what we had talked about.

5<*

Relationships with Gradesters I felt that Ralph suggested this because he still had some feelings of guilt about having held this discussion with me. It was awkward to follow through on his suggestion at the time. I said I thought it would be fine to tell the counselors about it and suggested that we plan on telling them next week, which was agreeable with him. As Ralph walked to the streetcar with me I reviewed very briefly the general subjects we had talked about, stressing lightly his reference to his sister. I thought this was something we could talk more about next time if he agreed. Eileen BACKGROUND NOTE

Eileen is a fearful six-year-old who is being prepared for a court hearing, permanent separation from an abusive and psychotic mother, and a first placement in a foster home. Hungry, bruised and beaten, and running a high temperature, Eileen was brought to the city hospital by a policewoman. She is a sharply withdrawn child who ate like a starved animal, whimpered at the approach of adults, and appeared to function at about a four-year-old level. Her worker, Mrs. Connolly, has made four daily visits to the hospital, during which the child has made enormous progress in coming to trust her worker as one who likes her and will not harm her. TWO INTERVIEWS

May z. The day of the court hearing. When I telephoned the hospital today, I learned that Eileen was quite well. The doctor was willing to release her for the day so she could attend the court hearing, have lunch with me, and go shopping. However, he wanted her returned for forty-eight hours of additional observation before final release. It was a dark, stormy day when I drove to the hospital. I was reminded of Eileen's persistent statement that she would not go with me if it was raining. When I came to the pediatric ward it was quiet. I walked into Eileen's room. She was still in bed. When she saw me she began to scream and cry hysterically. I was puzzled by this new response, 57

The Art of Child Placement since during our last three "get acquainted" visits I felt she had come to like and trust me. I reached out and tried to stroke her, saying that I was her friend and that I liked her, but she slapped at my hand and looked at me in real terror. I left the room and suggested that the nurse go in to see whether she could find out what was troubling Eileen. I told her to ask specifically whether it was the rain. The nurse came in and set out the new clothes I had brought with me for Eileen. She tried to interest her in them and said that it was going to be fun to go downtown with Mrs. Connolly. Eileen cried and fought more, and the nurse grew impatient. She tried to force her into the clothes and threatened to "get the switch." I came in again and whispered to the nurse, "Try not to frighten her; I think she is very much afraid." I turned to the little girl in the bed next to Eileen's and said, "Tell me why Eileen is crying." The little girl, who was about seven, said, "She's crying because she is afraid you're going to take her to her naughty mommy." I put my arm around Eileen even though she resisted, saying over and over again, "Eileen, we are not going to your naughty mama. You're coming back here to sleep tonight; I'm going to buy you new clothes and a dolly. You're coming back to the hospital to sleep." As I said this, her crying lessened until she was just sniveling a little, and she looked at me as though asking, "Can I trust you?" The nurse repeated to her that the doctor had said that she should come back here tonight. I asked the nurse what time they would have dinner because I wanted to be sure to have Eileen back in time. She quieted down then and reached for the comb which she handed to me. (Each time I had come to the hospital I had combed and brushed her hair and made little pigtails.) This day I made the pigtails and tied bright blue ribbons on them and showed her the result in the mirror. She was quite happy. I looked out the window and said it certainly was raining hard, but I would wrap her in my raincoat and we would run like everything to the car. She looked pleased at this. As we walked through the halls of the hospital, she took my 58

Relationships 'with Gradesters hand and went along quite confidently until a nurse stopped and said, "Well, little girl, are you going home?" The tears started again, and again I said to the nurse, "No, Eileen is coming back here to sleep tonight. She is not going home." When we got to the door of the hospital I picked her up in my arms, put my raincoat over her head, and told her to hold tightly around my neck while we ran to the car. She seemed to enjoy this and giggled as I bumped along with her. When I set her down in the car her eyes were dancing with pleasure. We began to drive slowly away. About a half block from the hospital lightning apparently hit one of the wires that run over a streetcar track. There was an enormous crash and a flash of fire. Eileen blinked her eyes, then looked up at me smiling, and calmly asked, "What was that?" I told her what I thought it was, and when I made a face to show how she had looked when the crash came, she laughed merrily. I was interested that this crash had caused no fear in her at all. When I was satisfied that she was quite serene, I asked, "Did you cry because you thought I would take you to your naughty mama?" She said, "Yes, I got a naughty mommy, a real naughty mommy, I don't want to go to her." I told Eileen that I would not take her to her mommy. I added that I had found a nice new mother for her. Tonight she must go back to the hospital and sleep, but when she was very well I would come and get her in my car, and I would take her to the new mother's house. She smiled happily and said, "Has my new mother got a baby?" I said that the new mother had no little girls, only one big girl, and they wanted a little girl in their house very much because they loved little girls. They would like to dress her up in pretty clothes and play with her and love her and take her for car rides, and sometimes when she was very good, buy her ice cream cones. Softly to herself she repeated over and over what I had said as though she were trying to memorize it. Then, as though trying to understand my role, she asked, "What are you doing right now—working?" I told her that I was a woman who found new mothers for little girls like herself who 59

The Art of Child Placement wanted new mothers. She seemed to understand this perfectly. Then she asked, "Have you got a daddy?" I said that I did have. She then asked a question which she did not especially want to have answered: "Where is he now—at the employment agency?" I said I supposed her daddy went to the employment agency often and she said that he did. She added, "He's a naughty daddy, but not as naughty as my naughty mommy." We parked in the hotel garage. Eileen was enormously interested in driving up the ramp. When we came out she wanted us to go at once to buy the doll I had promised her. I said that we could not do this yet because first we had to go across the street to a big building and ride in an elevator. There we would see a man named Judge Klein. Eileen was to tell Judge Klein that she wanted a new mother, and why she wanted a new mother. Judge Klein would then say, "All right, Eileen, you ask Mrs. Connolly to get you a new mother." Eileen looked a little stormy and said she wanted her dolly right away. There wasn't time before court to go shopping and it was raining so hard I was afraid of getting her wet. Finally she compromised on a dish of ice cream. I discovered quickly, however, that she is a strong-willed youngster. In the courthouse we met Miss Hemsworth, a student in training, who was waiting for us. I had arranged to have Miss Hemsworth there because I needed time before the hearing to see Eileen's parents, and I wanted to avoid a meeting between Eileen and her parents. Miss Hemsworth took Eileen into a separate room and the three of us watched the goldfish for a while and then sat down to look at magazines. I told Eileen I would leave her with Miss Hemsworth for a little while and would come back. About every ten minutes I managed to look in. Miss Hemsworth said that Eileen would play contentedly for about five minutes and then she would look very worried and demand, "Where is my lady?" When the time came I brought Eileen into court. Judge Klein was on the bench. Eileen and T sat on chairs in front of him. She talked very nicely and directly to him. He said, "Do you want to go home, Eileen?" I was afraid this question might release a new

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Relationships 'with Gradesters flood of tears but I guess she had worked that through at the hospital, because she said, "No, I don't want to go to that naughty mommy." He then said, "Do you want to tell me what your mommy does when she's naughty?" She responded this time with a little tremble in her lip, "No, I don't." Judge Klein apparently recognized how difficult the subject was for her. He said that her hair looked very pretty and that he wondered who had fixed it for her. She pointed to me, saying, "My lady." He then asked whether her lady would comb his hair and put ribbons in it in this pretty way, and Eileen laughed an impish little laugh and said, "You haven't got very much hair." Judge Klein, who is quite bald, was very pleased at this comment. He reached into his pocket and gave her a nickel and told her that she would not have to go back to her "naughty mama." Following the court hearing, Eileen and I made a quick trip, still in the driving rain, to the community clothing center where we selected a number of pretty clothes for Eileen. She was absolutely delighted with them. I was torn between the feeling that Eileen had had a very wearing day already and the feeling that she should see her new foster home that day in order to allay her fear that I would take her back to her own home. Since I had prepared Mrs. Tanner, who was to be Eileen's new foster mother, for a preplacement visit, I decided it would be wise to let her have a quick look at her new foster home before returning to the hospital. We stopped briefly to pick up the new doll, which I had promised her from the first day I had met her at the hospital, and then drove on to the foster home. During the drive she asked me querulously, "You're not taking me to my naughty mama?" I assured her I wasn't, and talked with her about the Tanner home and how it would be when she left the hospital permanently and came there to live. Mrs. Tanner greeted Eileen warmly. Eileen allowed herself to be hugged and walked stiffly into the room and looked around. I stood beside her, pointed out where her bed was and how she could lie in bed and look out the window into the tops of the trees, and showed her her dresser where we would put her new 61

The Art of Child Placement clothes. I handed the clothes to Mrs. Tanner, saying, "Eileen has to go back to the hospital to sleep tonight. As soon as she is well she will be coming to live in your house. Why don't you put her new clothes in the drawers now so that they will be there waiting for her when she conies back?" Eileen silently watched Mrs. Tanner start to put things away. It seemed to me that she suddenly looked very weary and a little overwhelmed by all that had happened to her that day. She put her hand on my arm, looked up at me and said, "Now I want to go back to the hospital and go to bed." Mrs. Tanner said good-by to Eileen and reminded her that they would be waiting for her eagerly. She added that they were happy that they were lucky enough to have got her. As though to indicate that she, Eileen, accepted Mrs. Tanner too, she reached a sticky hand into her bag of candy, took out a piece, and gave it to Mrs. Tanner. Mrs. Tanner showed her characteristic sensitivity when she accepted the candy, saying, "Oh, thank you, Eileen!" When we drove back to the hospital and parked, Eileen looked happy. I could see that the place had come to mean a great deal to her in terms of security. She hurried in, almost skipping, tired as she was. At the pediatric ward I put her on her bed, helped her into her pajamas, and told her that when she was well I was coming to get her to take her to her new mother. May 8.1 received word that Eileen could go to her foster home today. I came in with her clothes over my arm, and not seeing a nurse around, I started up to her bed. The children called, "Eileen, your mommy's here." Eileen began to sob at once. When she saw that I was not her mother, she still continued to cry. I suggested that she start to get into her clothes now, that we were going to her new mother's house. She did not want to let me take off her nightgown as she had done previously and I was puzzled, wondering why she was afraid to leave the hospital. Just then a nurse came in and said bluntly, "Her temperature is up again; she can't leave." I tried to hold her on my lap, but she would not let me. I stood beside her, stroking her head and telling her that it would be only 62

Relationships ivith Gradesters a few more days, but she cried very piteously. I said to a little girl nearby, "Why is Eileen crying?" The little girl said, "Because she thought she was going to her new mother today." I was naturally distressed that Eileen had been so sharply disappointed, but I was pleased, too, that this little girl, who less than a week ago had sobbed with fear at the thought of leaving with me, was now crying because she could not go. Johnny BACKGROUND NOTE

Johnny is a ten-year-old in "double trouble." He visits at the home of his mother and step-father and wants to be able to return to them, but they don't want him. Johnny is in his second foster home placement, and his behavior patterns—aggression, def ensiveness, and stealing both within the home and in the community—have caused his second foster parents to ask for his removal, just as his first did. The agency has requested placement for Johnny in a children's institution—a receiving home, not a correctional institution. Johnny and his worker have had a secure relationship for about six months. His worker feels that Johnny needs help in seeing that his behavior causes people to reject him. She wants him to begin to understand that his behavior is tied in with his feelings about his mother. INTERVIEWS April 24. I telephoned Mrs. Kunze, Johnny's foster mother, to tell her that we were hopeful that the children's center would accept Johnny for placement within the next two weeks. Mrs. Kunze was unhappy about the delay because Johnny's delinquencies were coming thick and fast. However, she was relieved to know that the end was in sight. Later in the day I picked up Johnny at school. He was looking depressed. I told him I had come right away because I knew that he would be worried. I had heard about the detective catching him stealing at the five-and-ten. Mrs. Kunze had also told me about his having taken the stamp collection that belonged to her sons.

«3

The Art of Child Placement I told Johnny that I knew he must have been worried about these things. I said I felt that boys found themselves in troubles like these when other things were worrying them. Because I liked him and wanted to be his friend, I hoped that he could talk with me. "I don't want you to have to carry these worries all alone, Johnny," I said. It was hard for Johnny to talk. He told me about the detective's catching him. He spoke in a tearful, whiny way. The emotional tone that I got was that Johnny felt the detective was mean to scold him. Because it was so painful for Johnny to focus on these unpleasant experiences, I had an impulse to comfort him. But I felt it was important for Johnny to relate the rejection that he felt from adults to his own behavior. I thought that it would be healthier for him when he learned he must leave Kunze's if he could feel that he was rejected on the basis of his difficult behavior. Again I tried to get him to talk about the Kunzes' reactions to his having taken the stamps. His response was entirely defensive. It was as though he could not accept the right of the Kunzes to react negatively to his behavior. I said, "Johnny, you made the Kunzes very angry with you." He remained silent and moody. I continued, "They can't understand why you have done this to them when they have been so good to you." Johnny made a real effort to divert my attention. He squirmed about and desperately tried to interest me in a new model of a station wagon passing by. I said, "It's hard for you to talk about this, I know." I told him that I would be a poor friend if I did not tell him that the Kunzes were beginning to wonder whether he and they could live happily together. I found myself talking to an enormously resistant child who wanted no part of what I was saying to him. His whole manner toward those who scolded him for his delinquency was that they were "unfair." He was not accepting any responsibility for his behavior. I put my arm around him. I tried to help him see that I was not just another angry adult, but that I was someone who liked 64

Relationships 'with Gradesters him and wanted to help him avoid the situations which caused him so much pain. April 30. I telephoned Mrs. Kunze who told me that she had been interviewed by the sheriff in regard to some fires deliberately set in the neighborhood. The sheriff, knowing Johnny's history, had thought first of him. In this instance Mrs. Kunze identified with Johnny. She was completely unwilling to accept the sheriffs thinking that because Johnny had set fires in the past, he should be blamed for fires which were occurring now. I sensed a new warmth in Mrs. Kunze today toward Johnny. She was thinking about how hard it would be to have to tell him that he must leave. She knew it would be painful for him. I think she was quite ambivalent about her previous decision that he would have to go. May i. Mrs. Kunze called to say that a card had come for Johnny in the morning mail, advising him to report to the public safety building that afternoon. She was upset at the short notice and did not see how she could plan to take him down. I told her I would be glad to. She said that Johnny had been frightened and anxious. I suggested that she tell him at noon that I would pick him up at school at three o'clock and would go with him. I knew that Mr. Kelly, the store detective, had reported the petty stealing to the Juvenile Police. Actually, I had encouraged him to do this because I felt that if I stood by Johnny in this situation he might be able to bring out some of his feelings. When I picked up Johnny at school later in the day I found him in a somber mood. He was quite relieved to see me. There was a marked difference from our previous interviews in that today he was ready to share his worries with me and to focus consistently on the situation in which he found himself. "Golly, I'm glad you came," he said. He was able to tell me that he was afraid. He wondered what might happen to him. "We're in this together, Johnny," I said. "I'll help you every way I can." Johnny had been to the Juvenile Police Division before. Today's summons worried him because he felt he already had "a bad ^5

The Art of Child Placement record." What he feared most was being sent to the Boys' Home School. Mrs. Hencil, his first foster mother, and his own mother had both warned him that that was where he would end up if he didn't watch out. We had to wait outside the lieutenant's office for some time. Waiting was hard for Johnny. He squirmed about, pulled at his cap, and showed other signs of anxiousness. We could hear a loud-speaker carrying reports to and from squad cars. When I noticed how much this interested him, I said, "Would you like to be a cop when you grow up, Johnny?" "Boy, would I!" he responded. Then his face fell. "But they'd never take me; I've got too bad a record." I told Johnny that he shouldn't feel that way. I said that I was here to help him so that he could stop making a bad record and start making a good one. He and I could work together to understand what made him unhappy and what made him do things that made others angry. "Some day, Johnny, I'm sure that if you really want to enough, you'll make a fine cop," I said. Lieutenant Robbins called us in. I was interested that, frightened and anxious as Johnny was, he had a nice, direct manner. He did, however, continue to show his usual pattern of defensiveness and was far from indicating any feelings of responsibility or guilt. I purposely left Johnny and the lieutenant alone for a few minutes while I went on an errand. When I returned, Johnny was ready and eager to tell me his dramatic version of what had happened. He said the lieutenant had told him he had "one more chance" before being sent to the Boys' Home School. He added excitedly, "There were times when he actually shouted at me." I'm certain that Johnny's account was highly colored but that he was truly impressed by the fact that any further misdemeanors on his part would have serious consequences. He kept repeating that he had "one more chance." Because of Johnny's concern over what was happening, he was better prepared to focus on what I had to say than before. He sat close to me as I talked. I said that certain kinds of behavior make people turn away from us. I guess that was what had happened

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Relationships with Gradesters to Mrs. Hencil, his first foster mother. She had liked Johnny very much, but some of the things he had done while in her home made it too hard for her to live with him. I said that Mrs. Kunze and the Kunze boys all liked Johnny but that Johnny had made them so angry that maybe they, too, wondered whether they could get along well enough together to have him stay there. He was not able to respond verbally but his manner was especially attentive so that I felt as though he knew what I was saying. He mentioned that the last time he had been home on a Sunday his step-father had become angry and had said that he would never again live in the same house with Johnny. "My mother heard him and she didn't say a thing, not a single thing." This was something that made Johnny feel really bad. Now there was none of the usual pattern of defensiveness; this was more nearly a feeling of real grief. "This must have made you feel very bad," I said. He nodded. I asked him what had brought out this remark. He said it was because he had been fighting with his step-brothers. My impulse was to comfort him, but instead I said that I thought this was another example of things a boy might do that would turn others against him. He continued to look somber. "At times like this, Johnny," I said, "maybe you get the feeling that your mother doesn't love you." He nodded and after a silence said, "She tried to adopt me out, you know." When I encouraged him to go further with this he said that he didn't want to be adopted out. I said I could understand that this made him feel unhappy. I said that at other times he must feel as though his mother loved him, too. These two feelings—that she did, and then again that she didn't—would make him feel pretty mixed up. "When things are mixed up and muddled like this," I said, "it's pretty hard to see how they're going to come out." I told him that I'd like to help him with these mixedup feelings. I liked him and wanted to be his friend. I hoped that he would continue to tell me how he felt so that we could try to work his problems out together. This conversation with Johnny was more disconnected than 67

The Art of Child Placement the recording indicates. Johnny was better able to talk today than ever before, but his willingness to focus on his problems was still limited. I was not at all direct about the fact that he would be leaving the Kunzes, partly because it did not seem possible for this to be real to Johnny when he had not sensed it from Mrs. Kunze. I suppose I was still hoping that he might be spared that move. I was worried, too, about how much pain Johnny could take in one day. On the way home Johnny worried out loud because the sheriff had his name on the list in connection with setting the fires. He was afraid this might be the. "one more offense" that would send him to the Boys' Home School. I took plenty of time on the drive home to help Johnny back to a more cheerful mood. We planned our next appointment for five days later. Johnny had been giving me many instructions on how to drive, such as suggesting when I should slow up for a stop light, where I should turn, etc. When I made a mistake, we both laughed spontaneously. I said that I enjoyed being with him and made a number of complimentary remarks about how smart he is in his observations and explanations. Just before I left him, he asked me again about camp. I told him I was quite certain that he could go to camp this summer and that this was something he could count on.

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CHAPTER 3

Foster Homes and Institutions MEN and women who yesterday began the child welfare job as volunteers, and those who do it today as professional social workers, have been remarkably warm and generous groups motivated by the deep belief that children are important—to be cherished, helped, and loved. The child welfare movement in America learned very quickly what it took medicine, law, and other professions a long time to find out—that love is essential to the happiness and well-being of children. Often those who devoted themselves to helping needful children became split up into camps consecrated to one school of thought or another—the "this is the answer" approach, very much as religious groups have fought among themselves as to the specific road to heaven. It happened similarly between the groups aligned with institutional and those aligned with foster home care. Their motivations sprang from the same altruistic impulse—the impulse to help dependent, troubled children. But their behavior was like that of two business competitors who argued, "My patent medicine cures the most children the fastest." In recent years there has been a movement to recognize that the two fields belong together, working hand in hand, not competitively. Organizations like the Rhyther Center in Seattle and the Lakeside Children's Center in Milwaukee are beginning to appear across the nation. In organizations like these, one staff administers both programs. Each child who needs service is considered in the 69

The Art of Child Placement light of his life's experiences and his present needs. The decision as to which type of service will be most helpful is arrived at there as it should be everywhere—on a casework basis. The need for this approach is everywhere apparent. For example, in many states county workers faced with the problem of a child needing placement may decide which of these types of care will be best for him. Every agency which has access to both types of treatment must make this decision almost daily. Every evaluation of a child who is not progressing well in placement reawakens the question. It requires a high skill to know which type of care is best for each child. The child, his social worker, and usually the parents of the child have a part in this aspect of casework planning. The social worker needs a strong basis of knowledge and experience to help her client toward the best choice. A BIT OF HISTORY

A cynic once said, "It is man's greatest tragedy that he cannot learn from history." Perhaps we have not learned well enough the profound political truths like the unsatisfactory solutions of despotism and the futility of war. But it has been through history, through trial and error, that child welfare has learned what it knows today. The story of the rise of substitute-parent care for children in America is old and familiar to social workers. A brief glimpse of its high lights as they shine on the value of the two kinds of care is illuminating. In the early beginnings, the dominant pattern in America was that of each family taking care of its own. Fictional literature made vivid children like Heidi, who found themselves orphaned and had interesting and terrifying adventures in going to live with unknown relatives. In these stories the specter of "an orphanage" hovered in the background—an ugly fearful shadow. Adoptions were arranged within families, or if not that, within neighborhoods. Mrs. Brown, who lived in a shack at the end of town and "had so many children she didn't know what to do," 70

Foster Homes and Institutions would give her babies away to nice families who couldn't have children of their own. Sometimes the impulse to take a baby was the same that motivates childless families today. Sometimes Christian charity caused a good family to take in a waif not because of the adoptive parents' need, but because of the pathos of the child. The wage home too, got an early natural start. Hired girls from poor families, who worked for room and board, often came to help even before they reached their teens. The orphanages, too, cleared out their older children and placed them in homes where they worked for "board and keep." James Whitcomb Riley immortalized the girls in his poem: Little Orphant Annie's come to our house to stay, An' wash the cups and saucers up, an' brush the crumbs away, An' shoo the chickens off the porch, an' dust the hearth, an' sweep, An' make the fire, an' bake the bread, an' earn her boardan'-keep; An' all us other children, when supper things is done, We set around the fire an' has the mostest fun A-list'nin' to the witch tales 'at Annie tells about, An' the Gobble-uns at gits you, Ef you Don't Watch Out! When relatives and community charity failed to meet the problem of dependent children, congregate care was used. Those were the dark middle ages of social work when the aged, the psychotic, the feeble-minded, and children were housed together in crowded, ugly settings. Even with a comforting cloak of past history standing between then and now, it is painful to think of the conditions under which these children lived. One can still find relics of these institutions in America today. Large, ugly buildings are still housing an odd assortment of children who are growing up there. A "good state orphanage" represents an investment in taxpayers' moneys, in human effort, and 71

The Art of Child Placement stands as a symbol of the people's wish to do good. It is not easy to do away with such institutions. Not only their walls, but also their staffs and the people who believe in them, seem to have the same sturdy, red-brick construction. Unfortunately these institutions are usually in no way related to the good treatment centers that are springing up across the country to meet the specialized needs of certain children. An institution today can be classified as "bad" if it exists for no other purpose than to give housing to any child within a community who happens to need care. It can be classified as bad if children are being allowed to grow up within it, staying on for a number of years with no carefully thought out plan for their eventual return to normal life in their communities. The slow movement away from institutional care began in America in a number of ways, in a number of places. In the first chapter, I have already described how the impetus toward foster home care for infants came from the medical profession when the "cure" for marasmus was found in each baby's being given a home and a mother of his own. Placing children in work and wage homes, like the one illustrated in Little Orphant Annie, was more economical than keeping children on in orphanages. In those days children were "let out" at ten and eleven for almost any kind of work in which they could be useful. Laws regulating child labor were unknown; the firm belief in the value of play to children was not established. Perhaps the greatest impetus to foster home care came when Charles Loring Brace began the experiment of sending "destitute children" from the crowded eastern cities by the carload into the middle western farm communities for adoption. Presumably, these were children who otherwise would have grown up in almshouses and orphanages.1 From 1854 to 1875 about twenty thousand children were shipped out to find new homes. Once I talked to an old Iowa farmer who remembered clearly when such a train came to his town. The train stopped and out 1

Justine Wise Polier, Everyone's Children, Nobody's Child (New York: Scribner's, 1941), p. 23. 72

Foster Homes and Institutions walked about twenty-five children clinging together, frightened, many of them crying softly. They were led through the town and instructed to form a circle in the middle of the churchyard. The farmers and the townspeople stood off to one side looking them over carefully as though they were judging cattle. He said it made him think of how it must have been in New Orleans when a ship docked wjth a cargo of slaves. The farmer remembered a lot about which children went where because those children grew up in his town. He himself took a five-year-old boy who "reached the peak" by becoming the town's leading doctor. Strange things happened that day. Two brothers one year apart in age went to separate homes. One went to the home of the most prosperous family in town. The other, one of the last to be chosen, went to a generous but poor family that already had many children of its own. The two boys met from time to time in town and "visited together more like friends than brothers." My friend said they both grew up to be good men, but most folks preferred the farm boy. One pretty little girl was brought up by a prim old maid who had always lived alone. She became "a nice young lady," and as he put it, "made herself a real good marriage." My friend felt that these children had turned out about like other people's children. He summed it up this way: "There were a few real stars, a few bad apples, but mostly they were medium-nice like folks everywhere." A study made in 1884 of 240 of these children by the Minnesota State Board of Charities twenty years after one of these straws-inthe-wind placements pretty well bore out the observations of the old lowan: 23% could not be accounted for 50% were doing well 10% had no complaint [The study doesn't make it clear just who had no complaint] 12% were doing badly 5% were lost track of.2 2 Ibid., p. 24. 73

The Art of Child Placement Charles Loring Brace was the man with the vision to show a way. Many circumstances conspired, some very natural, some economic, to lead America away from the idea of institutional care. Probably none could compare in importance with the new feeling that heredity had been overstressed and environment was "the thing." As the belief that people are products of their environment grew, it followed inevitably that social workers would begin to think in terms of solving children's problems by taking them from "bad" environments and setting them down in "good" environments. Foster home care was a sharp application of this principle. THE SWING TO FOSTER HOME CARE

When social workers picked up the tool of foster home placement, they did it with great enthusiasm but with few of the refinements which they now feel are so essential to the success of placement. Those were, one might say, the red-blooded days of child placement, when a social worker would go out into a scene of squalor and misery, snatch a child out of it much as she might have done from a creek in which he was floundering, and set him down in a nice, clean home. Hastily she would give the foster mother some practical suggestions like starting the placement off with a good hot bath and shampoo. Then she would be off and on her way to "save" another child. There was no evaluation of what the child was feeling about his own parents, no preparation for placement; and the concept of a supportive relationship to help a bewildered child was unknown. The foster mother was given little or no supervision. The child and she were dependent on their own ingenuity and resourcefulness. Today, looking back, one would expect that most of these placements would have failed. But they did not. Remember the early mid-west placement of children by the carload with "50% doing well"? Foster parents and foster children are marvelous ingredients with which to work, as every social worker knows. The successes that social workers saw made them feel that it 74

Foster Homes and Institutions was possible for every child's problem to be met through foster home placement. They began to refine their techniques. When they faced the most difficult children of all, the children who could not seem to make adjustments in foster homes, they still felt that an answer could be found in placement if only they were skillful enough at understanding the child, if only they were fortunate enough to find the perfect foster parents. Because foster home care was so essentially right for so many children, it was understandable that its proponents were unwilling or unable to face its shortcomings. Those who had worked through the days of orphanages into the days of foster care were understandably suspicious of group care. They were afraid to return to the much less healthy form of congregate care that they had known. But for some children needing care away from home, the perfect foster parents have been conceived but never born. They are still gestating in the minds of wistful, hopeful social workers. And so the pioneers who had worked and fought for the new, enlightened foster care program, and who saw no shortcomings in it, became the "vested interest group" who set their minds against admitting that there were children who could not do well in foster homes, children who really needed the more impersonal, more flexible atmosphere of the institution, children who could not use substitute parents. So frightened had social workers become of the "old" institutional care that they feared the new. Had they been able to see ahead they would have been reassured. THE RE-EMERGENCE OF GROUP CARE

Eventually the very real need for a kind of care other than foster homes for certain children had to be reckoned with. The child who will not adjust in foster homes and who may not return to his own home is as difficult a problem as a child welfare worker ever faces. Invariably there are a few such children in every agency. After a series of foster homes have failed—and children, foster families, and social workers too are becoming frantic—it inevitably follows that new approaches must be tried. 75

The Art of Child Placement In agencies across the country a certain kind of foster mother was having better than average success with children who were considered almost impossible to place. Some social workers described her as "the kind landlady," who, though warmly concerned with the success or failure of her children, did not have her own ego bound up with their performance. Nor did she compete for the child's love of his own parents. "Objectivity," "letting a child live his own life," "being able to give without expecting to receive," were some of the terms used to describe her. She seemed to have an innate understanding of the meaning of separation to children. Most remarkable of all, perhaps, was that she could understand "errant parents" with the same kindly objectivity that she brought to their children. Placement workers have always been wary of placing too many disturbed children of a similar age in the same home. But because of the pressure of the need for homes for certain kinds of actingout children, social workers began guiltily bringing such foster mothers a second, a third, and very ashamedly a fourth and fifth child. To their astonishment they were rewarded, it almost seemed, for breaking the rule. The children got along well together. It appeared that there was some magic in the group. The group and the very special kind of foster mother seemed to be the ingredients that went into making up the setting in which these often-replaced children could live comfortably. A careful scrutiny of the foster mother revealed that she had many of the characteristics of the professional worker. Social work raised its head and began to ask, "Could we train people for this job? Could we set them up in big, old houses as professionals specially hired to meet the needs of our 'hard to place* children?" As though miraculously, just at this time certain wealthy people took to leaving big, old houses to children's agencies. The agencies sought those very special foster mothers, and, when they could not find them, hired trained social workers to staff their "big, old houses." In ways something like this, with a thousand little variations,

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Foster Homes and Institutions the good, small, treatment institutions were born. A few cities pioneered. Others watched, evaluated, and copied. The acute shortage of foster homes growing, out of World War II, with its doubling up of families, its general housing shortage, and the changing pattern of family living, hurried the movement. The factors that led to the re-emergence of institutional care for children grew primarily from the sharply delineated needs of some nonconforming youngsters who could not live comfortably in typical foster home settings. What foster mother could live with Mary, who responded to kindness with ever-increasing bitterness until she began to attack the members of the foster family physically? Who could live with Johnny, who day after day, week after week, set different parts of the foster family's house on fire? Or with Teddy, who smeared his feces all over the house about three times a week? Or with Laura, whose mother turned up drunk and abusive toward the child and the foster family at least once a week? Or with Calvin, who was ready for his tenth placement in eight years because there was something about him that people just couldn't like? When group placements were tried for Mary, Johnny, Teddy, Laura, Calvin, and hundreds of children like them, and when these children could find a way of living and even of getting well through group placements, social work began to sharpen its diagnostic tools. The hope was that social workers would be able to determine, before trial and error had pointed the way, which kinds of children need institutional care, which need foster home care. WHICH CHILDREN PROFIT FROM INSTITUTIONAL CARE?

The knotty problem of determining which children can profit from institutional care apparently has a compelling magnetism about it. In the field of child placement, about which comparatively little has been written, there is a cluster of writers on this subject; Burmeister, Selig, Lippman, Deming, Dula, Gardner, and Howard are only a few of the names that come to mind in this connection. It is rewarding to read them all. Though there is an 77

The Art of Child Placement undercurrent of accord in their thinking as to basic types of children who should be tried in institutional settings, there are also some sharp and specific disagreements. Eva Burmeister's classification is attractive because of its flexibility: Some of those for whom a stay in residential institutions can be helpful are: (i) children who have a satisfactory tie to an own parent, a tie which both the child and the parent want to keep close; (2) children of recently divorced parents, youngsters who have become confused and torn in their loyalties, who require a rest away from relatives and who need what is sometimes referre to as the more diluted or impersonal relationships possible in institutions; (3) youngsters who have experienced many moves and replacements, who need, more than anything else, to stay in one place long enough to put down physical roots, and to make emotional ties with an adult or two; and (4) children who, for one reason or another, cannot accept foster care, or whose behavior is such that they are not acceptable to foster parents. This may include rejected children and those who have reacted negatively to the condition of psychological stress and strain between parents and themselves. For many of these children it is a favorable factor that the institution is entirely different from a family home. In the institution, the child can make a completely fresh start, whereas if placed in a foster home, directly or too soon, he may find too many associations with the home life he has left.3 Miss Burmeister's classifications are fluid ones that would or could include several specific categories of children. For example, I would add, "children needing intensive psychiatric care." In some instances, this is possible for a child to obtain while in a foster home; but it is less complex for the child, his worker, and those around him if he can receive intensive psychiatric care while in an institutional setting. If the institution has its own psychiatrist, so much the better. But even if it does not, it seems easier for the child to go from an institution to psychiatric interviews rather than from a home. Another category which I would add would be "children abruptly snatched from their own homes." There is still plenty 3 Eva Burmeister, Forty-five in the Family (New York: Columbia University Press, 1949), p. 211.

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Foster Homes and Institutions of evidence that, for whatever reason, children who face placement still smarting from the wounds of a hasty and brutal separation, will do best if they work through some of their feelings before attempting to relate to parent substitutes. If a child has been carefully prepared for removal from his own home, he will have had an opportunity to work out some of his negative feelings before he leaves. But the child who has been denied this help is in an almost intolerable position when brought to a foster home. He is introduced to his foster mother. There they stand, two human beings, as opposite in intent as people can be. The child is looking back and thinking of the separation he has just suffered. The foster mother is looking ahead to a future with thoughts of union with this child. It would be better if the child had had an opportunity to begin to want at least some of what this woman is ready to give. Several writers mention the use of institutions to keep siblings together. It may be that in some cities in which the foster home supply is especially tight this is really necessary. The agencies with which I have worked have usually been able to solve this problem within the foster home framework when they have wanted to. A Minnesota newspaper carried a feature story about a placement agency which was seeking a home for six siblings under twelve years old. It was able to place the children together in one foster home within two weeks. To the categories already mentioned, one type described by Martha Selig should be added. She says, "Some may question, as indeed they have, the wisdom of sending children who present behavior difficulties, essentially because of emotional insecurity, to an environment where individual attention is 'said' to be limited. The answer is quite simple: affect-hungry children, like starved human beings, must be fed slowly."4 In other words, the rich food of foster home care may be regurgitated. A final group of writers shifts the focus from the child to the parents and tells of the children* whose parents are unable to ac4

Martha Keiser Selig, "Temporary Use of an Institution for Children in Foster Care," American Journal of Orthopsychiatry, 12:472 (July 1942).

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The Art of Child Placement cept foster home care for them but are able to accept institutional care. One of the most common reasons for the inability to accept foster home care is the lack of status implicit for mothers in having "another mother" succeed where they have failed. This is much more threatening to parents than having an institution succeed. They feel that in the eyes of the community, the failure seems to be more that of the child than of the parent when institutional care is at the core of the treatment program. Not infrequently an agency feels so keenly the advisability of separating a neurotic parent and child for the sake of the child that the parent is permitted to control this part of the terms of the treatment. This can and often does happen to a child who really belongs in a foster home. When this occurs, the caseworker will see her job as focusing on her work with the mother. Sometimes the most important thing a caseworker can do for a child is to help his mother "let him go" so that he can begin to form sound relationships. Usually parents who are worked with conscientiously can come in time to accept the treatment plan that is best for their child. INSTITUTIONAL AND FOSTER CARE FOR ADOLESCENTS

When the thinking in child placement began to embrace institutional care, one of the first groups for whom institutions were used was adolescents. In social work journals, articles began to appear under such titles as "Institutional Care Best for Adolescents?" At first there was a firm question mark after the title. Later, as some writers began to express the feeling that institutions were the only place for adolescents, the question mark was dropped. If one thinks of all adolescents as falling within a three- or fouryear group, and of all youngsters within this group as emotionally involved in a revolt against their parents, the thinking is understandable. Obviously a youngster actively engaged in establishing his independence from one set of parents is in no condition to take on another set who wish to possess him as their own child. But the problem here is like that already described for the 80

Foster Homes and Institutions gradester. Certain atypical emotional experiences mean that a child, whether a gradester or an adolescent, is functioning at a level not in keeping with his chronological age. Adolescent revolt for some individuals comes in the twenties, or the thirties—or never. Social workers accept a concept that adolescent revolt is a culmination of a certain kind of parental relationship that has already moved through several stages of development. When a child has not experienced a parental relationship, or when the relationship that he has had has been so unsatisfactory that he has not been able to develop normally, he is in no position to revolt. He cannot revolt against dependence on, and the affection and control of, parents when these qualities have not existed for him. But some adolescents who are clearly in revolt against parental authority still can and will use foster home placement effectively provided that the foster home is sensitive to the needs of the child. For youngsters like these, social workers have often preferred young foster parents in their late twenties or early thirties who remember well their own adolescence and are tender and tolerant toward teen-agers. These foster parents are not parent substitutes in the true sense of the word, but are more like married sister or brother substitutes. Such foster parents need to be secure men and women who are especially flexible. They will not strive to possess foster children as their own. The closeness of ages of the adolescent and foster parent makes this unlikely. So adolescents too must be "classified" as to which should have group placement, which should be tried first in a foster home. Hyman S. Lippman writes that many adolescents will do best if first placed in an institution and later moved into a foster home placement. For some adolescents this is true, but there are others who will be able to tell their workers that they would hate living in a group. A troubled, rebellious sixteen-year-old once said to her worker, "Maybe when I'm twenty I'll feel like trying that. But I want to live in a home with a mother and father and go to school in the neighborhood just like the other kids do. You have to be grown up to want to live in one of those places." 81

The Art of Child Placement Social workers should consult their young clients, keeping, in mind that the decision may be too difficult for some children to make alone. Usually it is best to help the youngster toward the right choice. Lippman speaks of the minority of adolescents who can use foster home care: "We have all seen excellent adjustments made by children placed in foster homes when they are already adolescent. Such adjustments occur when the normal boy or girl has been removed from a home where there has been little maladjustment. We also have instances of adolescents taken from homes with delinquency patterns and neglect who have done very well when removed to suitable homes. Most of those children have formed ties outside of the family and have become emotionally independent of the home. Some of them have been able through their own assets to gain recognition and success. We also know that adolescents who present the most serious emotional difficulties can, under special circumstances, make a satisfactory adjustment in an excellent foster home. These, however, are the exceptions; in the main, adolescents do not tend to adjust well when placed in foster homes."5 Burmeister, on the other hand, feeling that the majority rather than the minority of adolescents belong in foster homes, says, "Children of the adolescent age do better in foster homes where they can enjoy a greater independence than is possible in most institutions, and where they can spend the important teen age years in the setting of a normal family life."6 John E. Dula and Frank M. Howard both express the belief that "the struggling adolescent" or "adolescent in revolt" needs group care. But Julia Deming goes all the way and states, "Today there is a need for more of the small group placements; we have already seen what a foster home can offer. It is preeminently for the 5 Hyman S. Lippman, Foster Home Placement of Older Children (New York: Child Welfare League of America, 1940; pamphlet), p. 4. 6 Eva Burmeister, "Institutional and Foster Home Care as Used by an Agency Offering Both Services," Bulletin, Child Welfare League of America, April 1942, p. 18.

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foster Homes and Institutions young child. For those in or approaching adolescence, the group is a much more normal placement. Rich children go to boarding school; rich and poor go to camps in the summer. Why not have groups where children can be handled in a flexible manner and their needs met?"7 Since the question finds the experts with such varied opinions, the caseworker will be influenced in her choice by the quality of each kind of setting in her community. Her own experiences— failures and successes—will enter in. Some caseworkers are so at home in foster home work that they are able to bring a child and foster family together fairly serene in the idea that they can make this situation work well. Others, who have had their most rewarding experiences with adolescents in institutions, will decide most frequently on institutional placement. Thus the important decision may be a biased one based on the professional experiences of the person who is to be the caseworker. In a sense, there is a peculiar validity to this unscientific approach. But ideally, the social worker-artisan should be comfortable with both kinds of tools. Each social worker should reach her decision with the help of her young clients. She should take into account the life experiences of the children up to the point of placement. She should choose, after careful evaluation, the form of care best suited to the needs of each of her children. In other words, even though the client is an adolescent, this very important decision should be reached on an individual casework basis. WHAT ABOUT DELINQUENTS?

"Delinquency" is a legal term that covers a multitude of emotional maladjustments. From the point of view of the social worker or the therapist it is not too important which form the delinquency takes. The approach must always be governed by an attempt to understand the frustrations, the deprivations, that have led the child to a particular expression of his unhappiness. Though the term is without much diagnostic value, it carries a sharp reality factor with it. When Tommy Thompson is ex7

Julia Deming, "Foster Home and Group Placement," Americal Journal of Orthopsychiatry, 10:593 Uuty X94°)83

The Art of Child Placement pressing his hostility by breaking expensive picture windows up and down the block, the court will step in with a ready-made treatment plan. Tommy will be removed from the community for the protection of the property rights of others. This may not be at all what Tommy's social worker had in mind for him. In the case of Tommy, and other youngsters like him, the result from the point of view of his behavior will be no more broken windows. Or, to generalize, there will be a temporary cessation of the delinquent acts. But unless the Tommys get treatment while at the correctional institution, treatment aimed at uncovering the causes back of the behavior, Tommy will hurl his bricks again when he is released. The job of working with troubled children would be marvelously simple if the locking up of them for a certain period of time would change them into "good citizens." Unfortunately it is more complicated than that. It is necessary first to understand why the Tommys on our caseload feel a hostility that finds brief relief in the throwing of bricks through windows. It is important to understand and to help the Tommys understand too. When a child's behavior arises from guilt coupled with a deep need for punishment, his caseworker may be surprised to find that he is especially happy, serene, and comfortable even in a rather restrictive setting. But when such a child is released, he will return to his pattern of delinquency in order to experience again the guilt-absolving sensation of punishment for his wickedness. The court may feel he is being punished for having stolen cars; the child may feel he is being punished for having wished his baby sister were dead. If a child is sent to a correctional institution, the worker in the placement agency should continue her relationship with the youngster by means of visits, gifts (if possible), and other evidences that he will be returning to the agency and that she has neither deserted him nor forgotten that planning for him is her special concern. Not infrequently the caseworker will discover that the child who was slow to reveal his thinking before is now relaxed, warm and eager to share his worries. 84

Foster Homes and Institutions So far, I have been writing of children sent to correctional institutions by the court as though the social worker had no part in the decision. Mostly she will be reluctant to send a child to an institution where there is no effort made to treat the cause back of his behavior. Sometimes, however, when better opportunities for treatment do not exist, she has no alternative but to ask for this kind of care. A child having a panic reaction to the situation in which he finds himself must be checked for his own sake. I remember a thirteen year-old who had just been rejected by his third foster home in one year. In one week he had committed fourteen delinquent acts, including burglarizing houses and cars, hitting little children, and terrorizing two little girls by dangling them over a railroad bridge. Obviously such a youngster had to be checked whether the checking cured him or not, not only for the safety of the community, but also for his own sake. In dealing with delinquent children, the social worker must be especially careful to let the child know that she feels that there are reasons behind his behavior and that she is concerned in helping him to gQt at them. She will know that rejection is very probably a part of his background. Sometimes the love-starved child will steal things to make up, to himself, for the emotional hunger he feels. Such a child needs warm, positive experiences with adults; parent substitutes are ideal if he can accept what they offer. It is not easy to find foster parents who will live with delinquent children, but neither is it too difficult. There are a surprising number of unprofessional people who see delinquency not as mere wantonness or badness, but actually for what it really is— a natural outcome of an emotionally deprived life. Foster parents are often eager to help children with such problems. One foster parent will be able to accept one form of delinquent behavior; another will be more comfortable with another variety. Once I was asking a foster mother whether she would be interested in caring for a fourteen-year-old boy who stole frequently and compulsively. "Of course," she said. "Poor child! My young brother had that bad habit." As we talked I realized that she was eager to 85

The Art of Child Placement help almost any delinquent child except one kind—the kind who might make sexual advances to little girls. She apologized for this attitude: "I know it's stupid of me. These children are troubled, too, but it would be hard for me to really like a boy who did that." If a social worker trying to choose a placement setting for an adolescent who is frequently in conflict with the Jaw has learned that the community will give the child a chance to succeed, she can then make her decision entirely on the basis of the needs of the child. Where will he be happiest? Where will his needs, that is, his deep emotional needs, best be met? It may be in the small, treatment institution. It may be in a foster home. The important thing for her to remember is that the child who acts out with delinquency may be no sicker, no more troubled, than the child who has night terrors or wets the bed. Delinquent and troubled children can be treated in either an institution or a foster home. Diagnosis of underlying needs will guide the worker in her choice. WHICH CHILDREN NEED FOSTER HOMES?

There appears to be complete accord among social workers and psychiatrists who write on the subject that all children under six need foster home care. The only exceptions are those few and unusual children who have been so severely damaged by their life's experience that around the age of four, five, or six, they need brief stays in institutions for intensive treatment so that they may be made ready to accept what they so desperately need —parent substitutes. Burmeister feels that foster home care answers the needs of the majority of children of all ages. Those who cannot use it are the exceptions. She also makes the point that institutional care should not last more than three years, and preferably less. If children still need care away from home, presumably it would be foster care. Dula emphasizes his feeling that the child with fragile ties to his own family especially needs foster home care. He needs "an 86

Foster Homes and Institutions opportunity to put down deeper roots than he can in an institution even though he is not legally surrendered or available for adoptive placement."8 If child placement workers accept the premise that foster home care is best for most children, it becomes apparent that they will have the majority of their children placed in foster homes. Nevertheless, when a child seems to "fight" placement, when he fails in one or two homes, a social worker may be too quick to decide that this is a child who cannot use foster home placement. Social workers who have worked through a series of placements with deeply disturbed children in a community that does not have good treatment centers will sometimes say that it takes some children several tries before they can accept placement. It appears as though such a child uses the first home to spill out his anger and pain at the fact of placement—that is, the fact that he was so rejected by his parents as to have to suffer this indignity. When he has to move, usually on the basis of "bad" behavior, he approaches his next placement with less resentment. Many writers, especially those from the Pennsylvania School, vigorously recommend for this reason that the first placement be made in a temporary home. Here the child and the foster parent are both aware that this is no more than a temporary plan, one which will lead to something more permanent elsewhere. In the second home, this troubled child usually does somewhat better. Here his struggles may focus on working through his feelings at having to accept parent substitutes. Perhaps he will again have to move. Sometimes in the third or fourth home the child will stop fighting his reality and begin to be able to take what the foster parents want to give. Social workers appropriately have deep feelings against being party to frequent replacements of a child. Sometimes they may feel it is too hard on the child, the foster parents, and—yes—themselves too. It is natural that they may think, "Surely this child would be better off in a treatment center." 8 John E. Dula, "The Child away from Home," Journal of Social Casework, 29:133 (April 1948).

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The Art of Child Placement But even when all the "categories" point to institutional placement, the simple fact that a child may not want it can cause all the rules to go "down the drain." Let me tell you of fifteen-yearold Margy, who, after a preplacement visit to an attractive congregate care center, put her head on her worker's desk and sobbed. "The truth is that in all this city nobody wants me. If you send me to that place, I'll die. I'll crawl into a little black hole and grow smaller and ickier and die.... I want to live like other kids. All I want is a room of my own with nice people who will like me. Those other homes were dopey. No more college graduates! Ish! Find me a butcher or a garbage collector. Don't make me go to that place!" Margy's social worker couldn't find a butcher or a garbage collector. But she found a policeman. Margy's bedroom had blue curtains. Her foster mother thought she was pretty. They got mother-and-daughter dresses. Margy's boy friends stopped roaring up to the house after midnight on motorcycles. Her new boy friends put on neckties and rang the doorbell and brought her home at ten-thirty. Margy was clearly an acting-out adolescent caught in the moment of adolescent revolt not against her parents, for she didn't know where they were, but against all forms of adult authority. She was described in the referral as "predelinquent." Margy blew up four foster homes with her insubordination, her rough talk, her refusal to keep "decent hours." All the rules pointed to care in a small institution. But Margy said, "I'll die if you send me to that place." The social worker tried one more foster home. On Sunday mornings, Margy carries breakfast to the foster parents on a tray. She uses the best silver and dishes. It is her idea. On Margy's seventeenth bkthday, she was adopted by the policeman and his wife. Why did the fifth foster home work? Why did Margy change? Wasn't it partly because in "blowing up" four homes some of her angry feelings were released? Wasn't it also because when she saw the alternative to foster home care, she realized for the first time what she truly wanted. When a child begins to want foster 88

Foster Homes and Institutions placement he can then begin to make an effort to make it succeed. In Margy's case there were a hundred other intangibles, of course —such as the symbolism of acceptance that went into the motherand-daughter dresses, such as the fact that the agency stopped "overplacing" her (an error that they made because of her high intelligence), such as the fact that her social worker accepted Margy's plan instead of imposing her own, such as the fact that Margy was growing older. The healing qualities of placement lie first in the opportunity it gives the child to form a healthy relationship to adults when he has never known this experience. It is, after all, through warm affectional ties and identifications with parents or their substitutes that children grow to healthy adulthood. The second important asset which the foster home offers is that it is a part of the community and therefore a more realistic preparation for life. Many children feel there are few greater horrors in life than to be different from their classmates. It is a hard thing to have to blush crimson every time you give your address because the very address seems to mark you as "different" or "queer." Our older children need foster homes as a place to return to in memory or actuality after they have grown. Many a social worker visiting in a foster home that has given years of service is pleased to see pictures on the piano of foster children's children. The foster mother has become "Grandma." She knits booties for babies as though they were her own grandchildren. The young adults have a place they call home, and two people to whom they refer as "Mom and Dad." SPECIAL QUALITIES OF INSTITUTIONAL CARE

One kind of child that social workers think of first as needing institutional care is the kind who is in acute conflict over his feelings toward his own parents. The conflict which grows frequently from a "now I love you, then I don't" kind of parental behavior results in an almost frantic sort of tie to the parent. As one social worker speculated, "Who receives from her child more graphic 89

The Art of Child Placement proof of love than the ambivalent mother?" Until such a child has come to an understanding of the meaning of his mother's behavior toward him and his toward her, he will find himself confused and unhappy if another woman tries to become a mother substitute. Julia Deming expresses the problem well: If the child loves the foster mother and adopts her standards, as children do from adults they love, he is pushed into further conflict with earlier loyalties and experiences. If the child's ego is strong enough to do this, he can succeed, but only at the expense of tremendous energy output in the repression of earlier difficulties. . . . What if the repression does not succeed? At times resentment of the foster mother's attitude will break through and he will show hate and aggression toward her. Usually, this will not be obvious to the foster mother. There will be no immediate connection between the response to her refusal and the outbreaks of bad behavior, nor will it be clear to the child just why he reacts as he does. Perhaps, if the relationship to her is otherwise good, he will feel shame and remorse over the outbreaks; if the relationship is less satisfactory, he may have no feeling of regret.9 Deming feels that institutional placement offers the only comfortable way of living for such children. Always the social worker will have to have an understanding of the nature of the tie a child feels toward his parents. If the tie is such that a substitute parent will be deeply threatening, the social worker will want to use the treatment center at the beginning. But if the child is to need years of placement away from home, her casework focus with the child and parent will be to free the child from the tie that makes it impossible for him to have a normal life. Already I have discussed some of the kinds of children who will profit by institutional placement. But what are the special qualities of institutional placement which a foster home cannot offer? Lerner sums them up this way: "I believe there are certain things that institutions can offer which cannot be supplied as well by foster homes. They are (a) controlled or semi-controlled environment; (b) the experience of group living and interaction with other youngsters in the same setting; (c) the opportunity 9

Julia Deming, op. cit., p. 592. 90

Foster Homes and Institutions for diluted emotional relationships with cottage parents; (d) greater permissiveness for acting-out or withdrawing in a group setting."10 The quality of the controlled or semicontrolled environment is hard to describe. It is said to offer a more flexible atmosphere, or a setting in which a child's behavior is met with professional (as contrasted with natural) responses. Bettelheim shows by examples in Love Is Not Enough the sensitive, thoughtful reactions of his staff to the behavior of the children in his institution. Only one foster family in a million could be expected to respond in such a controlled, purposeful manner. Selig has caught nicely the flavor of institutional living in her description of Pleasantville: Perhaps the most valuable factor is the so called controlled environment which permits guiding and directing the factors in the life of the child in the interest of treatment. I would indicate that the connotation in "controlled" does not present an accurate picture of the situation. It is not an environment which is controlled in the sense of being rigid, inflexible, and restraining. Rather it is controlled in the sense that it can be modified, within limits, to meet the needs of the child, and that every facet in this environment is directed toward meeting these needs. An environment of this type could perhaps better be called a "conditioning environment" since it presents stimuli directed toward modifying the child's behavior. A therapeutic quality of such a conditioning environment is its daily routine. The child knows what he can expect. Perhaps more than we think, a child thrives on limitations; he can conform or not as he chooses, but at least he knows to what he is reacting. Teaching a child to conform to a certain routine is then not a personal issue. This is one of the essential differences between the experiences of a child in the institution and in the foster home. The issue is not "You obey me," but rather, "This is what is expected of you as of others."u One might sum up the thinking on this subject by taking the germ of the idea from Bettelheim's provocative title; institutional care is indicated for children when "love is not enough." An in10 Samuel Lerner, "The Diagnostic Basis of Institutional Care for Children," Social Casework, 33:106 (March 1952). 11 Martha Keiser Selig, op. cit.

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The Art of Child Placement stitution can tolerate behavior which in almost any other setting will result in rejection. An institution can thoroughly and truly recognize a child as being a sick child, and will not require of him that he behave as a well child until he is ready. An institution will have a knowledgeful appreciation of the deep neurotic forces that pull at the child and will not challenge him to make new emotional involvements, to act out. what he cannot feel, until such behavior is indicated in relation to the treatment he is receiving and the progress he is making. An institution, then, is a place where children's problems will be met on a professional level. It should be used for its own peculiar values and not as a less good substitute than foster home placement for a child who does not need it. THE CASE OF JENNY CARLSON

The case of Jenny Carlson differs from the cases presented earlier in that its recording was done by a psychiatrist working in a psychiatric clinic. The role of the social worker in the placement process is seen only indirectly as the psychiatrist refers briefly to her function. The brief references, however, indicate that this is a psychiatrist who is well aware that Jenny's social worker has an important function even though the major therapy is being done in psychiatric interviews. Background Note Jenny was twelve years old. She was an illegitimate child. Her mother subsequently had seven children. The father of the seven had deserted. Neighbors called the county welfare board with reports that the girl was "insane" and that her mother was "vicious" with her. The social worker from the protection unit became convinced, while she was getting acquainted with Jenny, that the little girl was desperately ill. Among the symptoms reported was a sudden fear of crossing thresholds; it led to a striking incident. One evening Jenny would not come into the house. She had been outdoors all day and had had nothing to eat except 92

Foster Homes and Institutions a few strawberries from the garden and a little food which her step-brother had "sneaked" out to her. Jenny had climbed a tree to spend the night. At midnight the neighbors heard her screaming and making queer, animal-like noises in the tree. She was brought down by two strong neighbor boys and carried forceably into the house. Because she became almost frantically aggressive whenever her mother tried to approach her, two neighbor women closed the mother out of the bedroom, washed Jenny's face, and sat with her until she fell asleep. In the morning Jenny seemed out of touch with reality. She complained that she could not recognize people and did not know what time it was, and she made strange, frightened remarks about color changes in her old familiar clothes during the night. Her social worker, Miss Marshall, requested an emergency interview with a psychiatrist at a psychiatric clinic and brought Jenny to the psychiatrist's office. The following material is made up of a few significant excerpts from his recording during the two-year period that Jenny was under his care. Initial Interview with the Psychiatrist Jenny came in with her social worker, Miss Marshall. The patient stood in a stiff way as she looked at the psychiatrist. In every respect she looked psychotic and somewhat catatonic. The psychiatrist tried to be friendly with her in order to become acquainted. Jenny answered each question very slowly. There was a long, quiet pause followed by a deep inspiration, and she would look anxiously at Miss Marshall before she tried to answer a question. It was surprising that when she did answer the questions, she answered in a rather soft, relaxed voice. This same performance was repeated with every question which was asked. At one point in the interview, Jenny said something about having thoughts that were bothering her. Her imagination, she said, was worrying her. She added, "I'm helpless." The psychiatrist told her that he knew she was and that by herself she could not control these thoughts that were bothering her. The psychiatrist told her that he was her friend and that he was going to help 93

The Art of Child Placement her get all these bad thoughts out of her mind. Then she would feel better and would be able to get along well. At one point, when the psychiatrist asked her how all this trouble had begun, she answered, "Two F's in arithmetic." She added that she had had a number of D's in her other subjects and this meant she would surely fail. This did not come spontaneously, but only in response to many questions. She agreed very slowly to come back the next day, and it took some time before she was able to walk out of the room with Miss Marshall. Ten Interviews and Two Weeks Later The psychiatric diagnosis: The psychiatrist believes that we are not justified in calling this girl schizophrenic, and yet her behavior a few weeks ago was typically that of a blocked schizophrenic with catatonic symptoms. It may be, as so often happens to the adolescent and preadolescent, that a good many unconscious and instinctual drives have come to the surface suddenly, stimulated by something which has happened that is not recognized at the present time. It may be that the sudden fear about failing, plus the harshness of her teacher, was enough to break down her final reserve. Much more likely is the fact that there are some unconscious sexual wishes which are trying to come to the surface in this prepubertal period; since she is in a religious school with much emphasis on a strict religious program, the emergence of these thoughts may have caused a great deal of anxiety and panic and an immobilization of all defense mechanisms to avoid it. The limit having been reached, there was then this breakthrough and the suffering and the symptoms which had come with it. Jenny has a tendency to overreact with emotional explosion and rather bizarre symptoms. This suggests a rather weak ego which cannot meet the demands made upon her. The picture is more like this at the present time than like a psychosis. However, one is unable to give a prognosis at this time to the effect that this girl is not psychotic and that there will not be further explosive episodes of this kind. The fact that there is a history of this kind of bizarre behavior followed by a disap94

Foster Homes and Institutions pearance of this kind of behavior, however, speaks more against than in favor of a psychosis. Later Interviews Tri-weekly interviews continued with the psychiatrist for three months. At one point Jenny came in with a black eye and a broken nose. She was able to tell the psychiatrist in a relaxed, almost cheerful fashion that her mother had become angry with her because she had done a poor job of scrubbing the kitchen floor and had refused to do it again. Her mother had struck her with a little iron frying pan. Jenny said that her nose hurt a great deal and she was glad to accept medical attention, including x-rays, hospitalization, and an anesthetic while her nose was being reset. Miss Marshall immediately took steps, while Jenny was in the hospital, to bring the situation to the attention of the court and to make arrangements for placement in the children's center, a small, treatment institution which worked cooperatively with the clinic. Some time later, Jenny was again brought in by Miss Marshall. They had come directly from the hospital. Jenny would be returning to the hospital for another day or two of observation and treatment of her nose. The mother had visited Jenny daily in the hospital and was holding to her story that Jenny's injury had occurred when she had fallen out of the apple tree. Jenny did not argue with her mother or dispute the statement. She had not yet been prepared for the fact that she would not be returning home. Parts of one of the psychiatrist's interviews with her follow: Jenny came into the office, having left Miss Marshall in the outside office. She began our interview by saying, "You know my mother is plenty disgusted with you and the county and the whole outfit!" The psychiatrist said he knew she was and wondered whether Jenny knew what it was all about. Jenny said she wasn't sure but she thought there was a piece of paper—it was at home now—that said something about Jenny and her mother's having to go to court. Because she was vague and confused, the psychiatrist said that he would try to clear up the matter with Jenny and tell her what was what.

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The Art of Child Placement The psychiatrist explained to Jenny why we were seeing her here and why we wanted to continue with her treatment. He also told Jenny that he thought it was necessary that for the time being she live some place other than at home. The psychiatrist felt that Jenny shouldn't stay on much longer at the hospital but would be much better off in the children's center, which he tried to describe to Jenny in detailed fashion. She seemed interested and said she certainly didn't want to go back to a hospital and have needles stuck in her, but she wouldn't go to the children's center either. She felt her place was at home. Throughout the interview, whenever home or her mother was mentioned, Jenny would seem to cloud up temporarily and become vague. She did say that she wished to goodness all the bickering and fighting around home would stop. Once when Jenny again mentioned that her mother was quite disgusted with the psychiatrist, he suggested that maybe it was better that Mrs. Carlson should be mad at him and then she would not be so hard on Jenny. Jenny didn't think this would make any difference, since her mother would still be mad at her. The psychiatrist wondered if Jenny ever became angry with her mother. Again Jenny clouded up and said that she couldn't, that she had to do her work right. Again, in talking of the children's center, Jenny said that she would not go because then there would be no one at home to see that her little brothers and sisters behaved. The psychiatrist said that even though Jenny went to the children's center, after a while it was entirely possible that she would be able to visit at home and her family would be able to visit her. This was a temporary thing and we had no idea how long it would be. At this point Jenny straightened up very tall. Her blue eyes flashed. She said she wasn't going there and that was that. The psychiatrist reminded Jenny that no matter how all this turned out we were on her side and really had her interest at heart. We were trying our very best to make a plan that would be best for her. No matter what happened in court, the psychiatrist would still be behind her and would continue to see her every other day if that were possible. 96

Foster Homes and Institutions The psychiatrist then reached into his pocket and showed Jenny that he was carrying a handkerchief that she had made for him. She smiled with real pleasure but made no comment. Resume of the Psychiatrist to Date There seems to be no doubt that what we are dealing with now is a case of juvenile schizophrenia in its preliminary stages. A complete picture of the dynamics behind the process is not available at the present time, and it may never be complete. The prognosis in this case must be extremely guarded. No prediction can be made on the eventual outcome. However, if anything can be done to save this girl from a lifetime of repeated hospitalization, it should be started immediately with intensive effort. Shock therapy is definitely contraindicated at the present time. Psychotherapeutic interviews, to be effectual, will of necessity have to be continued over a long period of time at frequent intervals. This is the opinion of this psychiatrist, which is concurred with by members of the psychiatric clinic staff and members of the staff of the county welfare board. There is sufficient pathology in the home situation to vitiate attempts at treatment while the patient remains in the home environment. Hopefully, with the cooperation of the mother, Jenny will be placed in the children's center and will receive intensive therapy at the clinic. Because of the acute nature of her symptoms, because of her conflicting feelings in relation to her mother, and because she will need the flexible atmosphere of an institution, foster home placement is not being considered at this time. It may be necessary later on to hospitalize the patient if her illness takes a downhill course. The Counselor's Comments Jenny was taken by Miss Marshall from the hospital to the center. The placement was made, on the basis of a court order, against the wishes of Jenny and her mother. Many months later, in the course of a treatment conference between the psychiatrist and Mr. Austin, counselor at the children's center, Mr. Austin described the problems the center faces when the mother visits. 97

The Art oj Child Placement Mr. Austin came in today to talk to the psychiatrist about Jenny. What he emphasized was the mother's extreme rejection of this girl and her sadistic efforts to get her to mind. Jenny had discussed these facts with Mr. Austin. The mother had threatened Jenny, for example, that if she didn't come home and take care of the garden, Mrs. Carlson would tell the police and have her put behind bars. The mother said that Jenny would be ridiculed and she would be known as "Mrs. Carlson's stupid daughter." Mrs. Carlson also said that Jenny's name and picture would appear in the paper in the newspaper column, "Believe It or Not." Jenny had asked whether her mother could really do that. She said to Mr. Austin, "She really couldn't, could she?" However, it was obvious that Jenny, partly at least, believed there was this danger. The problem is complicated by the fact that Jenny is a deeply religious girl and believes that she is sinning. She has absorbed some of her mother's suspiciousness and says that people are always watching the Carlsons, always claiming that they are doing things which they aren't. Mr. Austin is confident that Jenny and her mother are incompatible and that if the mother is not treated and does not change, it would be very difficult to think of letting Jenny go back to her. Mr. Austin feels that it is unwise to force himself on Jenny and so only on those occasions when she seems to want to talk, which may be only once a month or so, does Mr. Austin talk with her. It is usually at some quiet time during the day that Jenny will approach Mr. Austin and sit beside him. He thinks Jenny is in a peculiar dilemma. She is not able to reject her mother completely even though she does hate her. But she still has to accept her, perhaps because of some earlier aspect of their relationship but also because she has a genuine fear of what her mother will be able to do to her if she turns against her. On the last visit to the children's center, the mother "hit the ceiling" again and made a tirade against the center and the staff. Jenny told her to "shut up." The mother behaved so badly that the staff did not reprove Jenny. This is the kind of thing that makes the mother furious. She feels that the staff encourages Jenny

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Foster Homes and Institutions to attack her and to show no respect for her. It is for this reason that the mother attacks the center as she does. Mr. Austin understands this and yet he feels that the mother is asking for a kind of negative reaction when she behaves as she does. Mr. Austin wanted the psychiatrist's opinion as to the advisability of totally excluding the mother from her visits to the center. The psychiatrist asked whether Jenny could help Mr. Austin in arriving at the decision. If Mr. Austin would ask Jenny how she feels about her mother's coming to visit and insisting that Jenny do this or that, this would give Jenny an opportunity to express to Mr. Austin some of her negative feelings about her mother without feeling that she is being pushed into interviews. Treatment Conference Two Years Later Jenny is fitting in fairly well at the center. She is not causing any serious difficulty. There have been no emotional outbursts since the time of placement twenty-three months ago. She has a slight tendency to withdraw at times. She is now fourteen years old and has asked how long she would be permitted to remain at the center. She has discovered that she is the oldest child there and that youngsters are not usually kept there after they are fourteen. It appears at this time that it would be advisable for her to remain at the center until the end of the school year and that it might be good for her to know that she can feel certain of this. It seems likely that her asking about leaving the center might be from her anxiety that she will be returned to her mother's home. She has consistently said she did not want to live in her mother's home again, and it seems important that this should be prevented. The mother has moved her family to another state and her contacts with Jenny by mail are very infrequent. Through correspondence the mother has accepted the plan for state guardianship recommended by the county welfare board. Jenny and she will be helped to an understanding that they will not live together again. In looking forward to the court hearing which is scheduled four months hence, the two agencies—the clinic and the county wel-

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The Art of Child Placement fare board—are considering the need for a boarding home placement at the end of the school year. It was decided that Miss Marshall, who first brought Jenny to the clinic and who has continued to work with her—bringing her here for interviews, buying her clothes, etc.—will begin to look for a new home for Jenny. Preparations for the move will be carefully integrated between the social worker and the psychiatrist. It is suggested that the caseworker intensify her relationship to Jenny during this period in order to be able to work more effectively in helping her transfer from the children's center to a boarding home. We have had considerable discussion about the high skills and understanding that will be required from the foster mother who takes on the job of living with this youngster. It was suggested that it would be helpful to her if soon after placement she would have an opportunity to meet the psychiatrist, in the event she ever needs to call him outside of office hours if Jenny should have a repetition of her old patterns of bizarre behavior and withdrawal. Because of the improvement in Jenny's behavior, and because she has arrived at a comfortable feeling in severing her ties with her mother, it is felt that Jenny can now really profit by foster home placement. Some Comments about Jenny Jenny's case illustrates this chapter well because it is rich in many examples which at the beginning of placement, indicate the use of institutional care. First of all, Jenny needed tri-weekly interviews at the onset of her separation from her family. The mere mechanics of working such a plan out within a foster home setting is often awkward and trying. Related to her need for such frequent interviews was the fact that she was acutely ill emotionally. Except in exceedingly rare cases such youngsters can best be handled at the beginning of their treatment by professional workers who have a background of knowledge which will help them to understand and respond thoughtfully to the symptomatic behavior of such very sick children. The controlled environment which can be manipulated to 100

Foster Homes and Institutions meet the child's needs rather than the home environment in which the child must fashion his behavior to fit in with its pattern is definitely indicated for a child as sick as Jenny was. Then too, at the time that removal from home was indicated for Jenny's safety, she was a child suffering acutely from conflicting and confused feelings about her own mother. Though the excerpts chosen show only part of this, aspect of the problem, she was given a great deal of help by the psychiatrist in coming to an understanding of the strange, unnatural relationship that existed between her and her mother. Clearly, she would have been threatened had another motherperson come at her warmly and givingly before she had had an opportunity to sort out her bewildered feelings toward her own mother. Jenny was a child who went reluctantly into placement. She still felt that she should be at home "making her little brothers and sisters behave." She went as a result of a court order, a step necessary for her protection. Though the psychiatrist had an opportunity to discuss the move with her, she was not a child prepared for placement in the full sense of the word, nor was she ready to participate in it. The placement had the quality of something which had been done to her. It is interesting to note the way in which the psychiatrist accepted her saying that she would not go to the center. He reminded Jenny that no matter how this business turned out, he was on her side and really had her best interests at heart. Jenny had to begin her placement with the feeling that she was taken away from her home and her mother against her will. A thoughtful look at the mother revealed to all the professional people who knew her that she was deeply destructive in her relationship to Jenny. The caseworker and psychiatrist as well as the counselor at the center were in accord that Jenny needed to be helped to emancipate herself. In this, Jenny was like thousands of other rejected children in placement. The culmination of this severance took place when the mother moved out of town. Such a move will have a familiar ring to social workers who have fre101

The Art of Child Placement quently seen parents move in situations like these. These decisions to move away are not merely fortuitous circumstances that facilitate treatment by "happening to happen." They are a reminder that parents have needs too and that it is not an easy thing to turn one's back on an anxiety-producing child if the child is nearby. Moves like these are easily explained, as they were by Mrs. Carlson, as an opportunity to be near relatives or to be where jobs are more plentiful. Such moves strongly indicate purposeful, though not always conscious, steps to be rid of children. The picture that Mr. Austin, the counselor, gave of the mother's behavior at the time of her visits shows good reason why the professional staff of the center was sorely tried. An experienced placement worker would shudder at the thought of transplanting one of these scenes into the living room of a foster family. Even if Jenny had worked out her feelings about her mother earlier, the behavior of Mrs. Carlson would have made foster home placement nearly impossible. However, just as it is possible to find people who will put up with very difficult behavior from children, likewise it is possible, even though a little more difficult, to find people who will put up with sick parents for the sake of a child. Foster parents, if carefully prepared, can make the best of very trying parental behavior. The one variety almost impossible for them to deal with is the parent who tries through subtle or obvious means to make the placement fail. Even then exceptional foster home treatment can succeed if the child has emancipated himself emotionally from his parents. Not only Jenny's confusion about her relationship to her mother, not only her mother's destructive behavior, but also the fact that this mother and daughter were unable to see the lack of future in their relationship made foster home placement unworkable. Jenny was a child who was the victim of a really exceptional amount of bad luck. She was illegitimate; she was unwanted; she was persecuted at home and at school. In addition, nature and her experiences had endowed her with the kind of personality that responds to life's indignities not with delinquency or aggression— 102

Foster Homes and Institutions which would have been much healthier—but by holding her pain within herself until it produced a dreadful mental illness. Jenny's luck reversed itself when she met Miss Marshall. Miss Marshall was a social worker who knew the gravity of Jenny's illness, and where and how to turn for help. She knew, too, how to help this terrified child to trust her enough so that even the visit to the unknown doctor could be faced. Jenny's second stroke of good luck came with her referral to the psychiatric clinic—an agency which believed that one impoverished, nearly psychotic little girl was worth several years of very expensive and excellent treatment. Jenny was fortunate in having a good psychiatrist and a social worker who knew how to work together. She was fortunate because they stayed with her and she didn't have to transfer to others. She was fortunate that her town had a children's center. Finally, Jenny was lucky because in spite of her illness she had found her way into the hands of a group of professional people who all believed that she should have, and who dared to offer her, an opportunity to live like other children. At the time of this writing a foster home has been chosen for Jenny and she is painstakingly being prepared for the move by Miss Marshall. The psychiatrist is talking with Jenny, helping her to bring out any fears that she might feel at leaving the center where she has experienced her first happy period of living. Jenny will live in a nice little house in an unpretentious neighborhood. She will live with people who have a good and sympathetic understanding of what life has done to her. They are people who will love her and who will not threaten her or frighten her or drive her fears back in upon herself. Jenny's case is an excellent example of a child who needed institutional care when she first left her own home. While her progress has been dramatic, there can be no absolute certainty that she will remain well. The psychiatrist, the center, and Miss Marshall working together succeeded in helping Jenny up to the point where she is ready to try the frightening but quite necessary step of living in a foster home. Thus Jenny's case began as one of a 103

The Art
Foster Homes and Institutions Jenny could talk with Miss Marshall about "everything." Only Miss Marshall carried the continuous thread of having known Jenny when she lived at home and now when she lived at the center. As all the strange, frightening events occurred in Jenny's life, Miss Marshall stood by, encouraging, approving, showing her concern. As the psychiatrist's role began to taper off, Miss Marshall's became more active. It was she who would help Jenny in the challenging adjustment ahead, that of learning to live in a foster home. In the beginning it was the social worker who took Jenny's hand and led her away from danger to a better way of life. In the end, it will be the social worker who will guide Jenny to adulthood after the psychiatrist and the institution have done all they can for her.

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CHAPTER 4

Casework with fVwn" Parents

WHEN I was about eight years old, I went to a Western movie that I liked well enough to see several times. I cannot remember now what the movie was, but I have never forgotten a song from it. The words were: "Who are you at home? Who are you at home? Only God remembers when you first began to roam. Who are you at home? Who are you at home?" Maybe the tune stayed so long in mind because it puzzled me. I knew so well who I was at home. Children usually do know— they do not have the experience of a "downtown personality." Who social workers are at home has a great deal to do with how and why they behave as they do in relation to their clients. It does not require an extremely tolerant, stable, well-rounded personality to love children or to want to help them. But to identify sensitively and understandingly with inadequate parents who hurt children they ought to be aiding is more difficult. The ability to see and feel that the abusive, intoxicated father who drops in late at night to raise havoc in his son's foster home is as sick, lonely, and frightened as his ingratiating little boy requires real maturity in a social worker. Only as she knows and lives this principle can she reach capacity in the child placement field. And in order to identify so sympathetically with others, there is no one she needs to know as well as herself. She must know why she is a social worker, what she is trying to accomplish— wfcat, in some cases, she herself may be seeking to escape in the 106

Casework with "Own" Parents profession of "helping others out of trouble." In every aspect of child placement—work with foster parents, with children, with courts and clinics and other agencies—this self-understanding is important. But no place is it more vital, I am firmly convinced, than in work with foster children's "own" parents. The theme that the best foster parents are less satisfactory to the vast majority of children than their own parents, however inadequate the latter may be, is a main premise of this chapter. Parents of children placed outside their own homes are usually frightened, inadequate people. The very fact that they have asked for and accepted placement for their children means important things to social workers. A problem is that the parents are usually full of feelings of shame and guilt. But a positive factor is that they have enough health in them to be seeking a solution to their problem. A parent's need for placement of his children, while it has some elements of rejection and even abandonment in it, is not completely either of these things. The parent sees a problem. He does not remain static, nor does he let go and sink under. He hopes that placing his child in a foster home will offer some easing, maybe even a solution, to his problem. He is, in other words, ready for help. There are many different ways in which he can be helped. This chapter deals with some of them. THE VALUE OF HIS OWN PARENTS TO A CHILD

A psychiatrist told me once about seeing a fellow-in-training in psychiatry staggering under the weight of ten books toward an interview room where a patient was waiting. Curious, the psychiatrist asked, "Why all the books?" The student explained that the patient would not believe him when he explained that the patient's fears were irrational. He was going to prove it by showing the patient what the authorities had written! I am not without sympathy for the student in psychiatry. I know that the statement that a child's own parents, however inadequate, have peculiar values for him that even good foster 107

The Art of Child Placement parents rarely offer takes some proving. My impulse is to say, "Look at all the good social workers who have written that this is so—Dorothy Hutchinson, Henrietta Gordon, J. Bowlby, Leon Richman, and a hundred others."1 This is not, unhappily, an axiom that can be algebraically proved. It is an idea that comes hard to young social workers who cannot help being impressed by the many physical and psychological superiorities they see in foster homes over the often grim, harsh, more or less rejecting atmosphere of the child's own home. But as they gain experience, they come to recognize why the concept of the "own" home has such a compelling hold on American mores. It appears, for instance, in the reluctance of some adoptive parents to tell children they are adopted. The fact that the stigma of adoption is considered a nineteenth-century attitude, that nowadays we know good ways to avoid it, doesn't alter the emotional base for it. And of course—as the social psychologists and the social workers point out—there are many other factors that support it. Obviously, there are times when a foster home is better than an "own" home. Otherwise this book would not have been written. Obviously, there are foster parents who are more helpful than "own" parents. But what they have to give is not as essential to the child's sense of well-being as even a grudging acceptance from his own parents. Foster parents should be used as a compliment to own parents. Sometimes they are more dear, more respected, more helpful. But when they are used as a complete substitute for own parents (excepting always, of course, in the case of adoptions) there will be something incomplete, a nagging need in the life of the bereft child. Every children's social worker knows of a hundred cases in1

Dorothy Hutchinson, "The Request for Placement Has Meaning," Family, 25:128 (June 1944). Henrietta L. Gordon, "Discharge: An Integral Aspect of the Placement Process," Family, 22:36 (April 1941). Leon H. Richman, "The Significance of Money in the Child-Placing Agency's Work with the Child, Own Parents, and Foster Parents," Social Service Review, 25:484 (September 1941). J. Bowlby, Maternal Care and Mental Health (Geneva: World Health Organization, 1951). 108

Casework with "Own" Parents volving a hundred children who grew up in foster homes always tenuously tied to parents, always feeling the need to have a part of their own parents in their lives. I could tell frightening stories of what happens to children when agencies or foster families try to kill the images of absent parents in children's minds. I could add stories of children who tried hard to reject and totally repress their pain-giving parents and how in the end they had to yield to the impulse to seek them out for what they could give. There was Catherine, age seventeen, who insisted that he*, mother was a "nice enough woman, but she doesn't interest me." Agency records showed that Catherine's mother had prostituted in front of the child, had beaten her cruelly, had repeatedly locked her out of the house at night. Catherine had pushed the real picture of her mother far, far back in her mind. Her social worker and her foster mother had encouraged her to do it. Catherine had made a good adjustment to school and foster home living and was capable of pleasant, superficial relationships with others. But she often awakened, dragged out and tired, from nightmares with terrible spiders in them. Catherine decided to become a missionary, a vocational decision with obvious, deeply psychological implications for a girl whose mother had "sinned." Before Catherine left America, her social worker helped her make a plan to visit her mother. Catherine found "the woman", as she put it, "poor, lonely, and penitent." She and her mother now correspond regularly across two oceans. Catherine has written that her lifework must be very healthful, for she is no longer troubled by nightmares. The absent parent, like Catherine's, becomes an important part of a child's "fantasy life" and has strong directional influences on what a child will become and how comfortably he can live with himself. When social workers and foster parents ignore the absent parent, it is to the child as though they had killed her. Parents artifically killed in this way will "arise from the dead" and haunt! The parents who live nearby and visit occasionally, sometimes acting "like parents," but mostly more like distant acquaintances, can haunt too. A student social worker in an agency in Minnesota 109

The Art of Child Placement took as the subject for her master's thesis the history of one family of ten children, some of whom had been in placement over a period of sixteen years. The family had been in a state of just about complete social breakdown at the time of the removal of the "first batch of five children." The mother was described as "feeble-minded, totally indifferent to her children, and immoral." The father was described as "brutal, disagreeable, vile in his language, a relief-chiseler, and probably dangerous." The social case history for these children weighed eleven pounds. For the first ten years the parents were considered a necessary evil by most of the caseworkers and foster parents. They were called into the agency about once every six months and scolded for interfering with the placements. The children usually visited at home for a day at Christmas time. Most of the "weight" of the case history dealt with replacements, referrals to psychiatric clinics, long conferences with principals and the juvenile police. But one of the last entries in this record reported the return of the last of these children to her own home. The oldest three were married; though they lived in other states, they visited their parents regularly. Of the seven at home, two had finished high school and were working; the other five were attending the public schools; two had after-school jobs; none had been in serious trouble with the school principal for a year; only one had been seen by the juvenile police and that was for a minor matter. The answer? A social worker who believed that parents could change and that home situations should be re-evaluated; a social worker who really believed that children do best with their own parents when such an arrangement is at all possible; a social worker who made a "three-year plan" and sent the children home one by one as their parents felt "up to taking on another," and who gave warm, accepting support to the family as it adjusted to the business of being a family again. Only one child in that family longs for her foster home. That little girl spent her years from one to five in a foster home and accepted the foster parents as an adopted baby would her adoptive parents. She is making progress with her problem. The others no

Casework with "Own" Parents all have an intense feeling of family solidarity; and the family is now a going concern. This eleven-pound case has a thousand lessons for caseworkers. Here is the one that stands out for me: For a good many years the use of foster homes for these children was an absolute necessity. Agencies and foster parents, for these years, saw little hope of reviving the family as a unit. Yet the spark of family unity was there; and eventually the right kind of social work put the family back together, to the advantage of every member of it. When child welfare workers have not only seen but genuinely understood the innumerable evidences that children want whatever part of their parents the parents are able to give, and when they can accept this principle not as a handicap in their work but as a strength, they will begin to help the children as well as the children's parents. This is hard for some child placement workers. Not long ago I heard someone ask a child placement worker what was the hardest part of her job. Without hesitation she answered, "Coping with the tie children have to their parents!" As long as social workers feel they are "coping with" the tie, parents and children will sense it and the workers will have trouble "coping with" their cases. Once social workers recognize the tie for what it is—a lifeline to self-respect, good mental health, and a sense of security—they'll nourish, treasure, and respect it. The children will sense it. And the parents, so full of guilt and shame at having had to accept the label "failure" because they have asked that their children be placed, will sense it too. The inadequate mother will feel, "This social worker understands. She thinks it's important that I go right on being a mother to Frankie even though I can't live with him now." Because someone thinks she's valuable, she acquires value in her own eyes; and she has taken the first small step toward becoming a more adequate person— perhaps, someday, even a full-time mother. WHY PARENTS NEED PLACEMENT SERVICES

The fact that a parent may need a long-time placement plan for his child can be explained in terms of many external and fre-

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The Art of Child Placement quently socially acceptable factors. It is well that this is so, for parents of children in placement are too full of guilt and apologias as it is. Most guilt is likely to be an incapacitating rather than a helpful attitude. A social worker in the children's field quickly learns to see such apologies for what they are—superficial rationalizations to cover the real emotions that underlie the need for separation from their children.2 She sympathizes with the parents' need for rationalizations and does not try to take them away. No one likes to be stripped of his clothing and left naked for the world to see him just exactly as he is. A social worker's first step in understanding a parent involves the assumption that the parent rejects the child and wants to be rid of him. But, she reminds herself, the parent wants this release with only a part of his personality. If this were not so, it would be reasonable for the parent to do a wholehearted job of abandonment, like the cases that appear at long intervals in the newspapers as examples of most peculiar oddities in human behavior. Most parents do not say, "Take this child off my hands and out of my life for keeps!" Most parents do not even want to say that. They want only to be relieved of the part of responsibility for the child which they believe is interfering with their own "pursuit of happiness." The social worker in trying to understand the parent will constantly be testing the depth of rejection in the parent, asking herself to what degree the parent can bring satisfaction to his child while the child is in placement. The fact that rejection is present means that there is a serious 2 Says Leontine R. Young, "In most cases the parent's stated reasons described specific environmental situations—the mother who is temporarily not well or the child who is getting out of parental control—and usually the request is for temporary, not permanent, placement. That these stated reasons are often in themselves correct should not blind us to the fact that they can also serve as rationalizations and are not the fundamental and real causes for the request. . . . The fact is, as we have learned put of long experience, that most requests for placement grow out of a deeply rooted rejection of the child. To expect parents to say this or even to recognize it is asking them to be almost superhuman." (Planning for Child Placement," Btilletm, Child Welfare League of America, 27:9-12 [January 1948]).

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Casework with "Own" Parents dislocation in the life of the parent and the child. Dislocations arise from many causes. Sometimes there are ways of easing these causes so that parent and child can again live together; sometimes only a slight improvement can be hoped for, sometimes none. As a social worker tries to understand the causes operating in a particular situation she moves slowly, delicately. She knows that people resist being changed and that the parent will fear that the social worker will try to make him "into somebody else." Since a good social worker will approach a parent with a belief in the potential integrity of the parent as a person, some of the parent's fears will be dispelled. He will begin to want to share some of his feelings in regard to his child and to talk about some of life's forces that have molded him into the troubled person he is. The troubled parent will want to talk about his past. I have never said to a parent, "Tell me about your past," but I have never worked with a parent who did not choose to do so. I am one who believes that the past will furnish clues to the present, that social workers need to know something—perhaps a good deal—of clients' histories. This is not a universally accepted view among social workers today; some point out that a social worker cannot "treat" or change the past. But knowledge of it will help her to see the unmet needs in her client's life. And talking about the past to a sympathetic and skilled interviewer will help the client to gain insight which may be a vital step in his own treatment. As the parent talks about his life experiences—his feelings about the present in relation to his child, himself, his job, his other relationships—the social worker will come to understand why this parent and this child find themselves at their present impasse. In most parents the social worker will find one common trait: that they were unloved children themselves. Bowlby, who has brilliantly studied the problems of children in placement in Europe and America, writes, "Social workers have again and again emphasized the importance of the emotional problems in the parents as being a major cause of children being in care and have emphasized, too, the extent to which deprivation and unhappiness in "3

The Art of Child Placement the parents' own childhoods have been the cause of their present problems. The psychopathic and unstable parent met as the cause of child neglect is clearly as often as not the grownup affectionless, psychopathic child, who had been discussed at length as being the typical product of maternal deprivation."3 When social workers become aware that the parents with whom they work are, for the most part, enlarged editions of foster children—unloved, frightened, guilty, self-devaluating—they will have gained a most useful tool. And social workers sorely need all the tools they can find to show the patience, warmth, and understanding that an obstructionist parent needs. It cannot be said too often that social workers are people too —and that try as they will to discipline deep-set emotions into a professional mold, old experiences and impulses will burst through at inappropriate times. Once a social worker has succeeded in really understanding the parent with whom she works, it will not be as difficult for her. Understanding and tolerance are twin sisters. The love-starved parents on caseloads are as entitled to compassion as are love-starved children. Just as the mother holds her baby daughter to her breast to give her the milk of life so that she in turn may become a woman to give milk to another human being, so it is with love. Because parents have generously given love, the life-giving milk of the soul, children grow up having within them that same love to pass along to another generation. And if there is no milk in the breast of the mother? Science has shown us that it is not necessary for children to sicken and die for lack of it; science has found the substitute in other milk from other mothers. Science has also shown that the sickly, weak young woman can be strengthened so that she may become, in the physical sense of the word, a mother; and the psychologically sick young woman can sometimes become healthier so that she too can become a helpful mother. Since these generations of emotionally sick people go on as though caught in a relentless hereditary chain (whereas actually * J. Bowlby, op. cit., p. 78.

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Casework with "Own" Parents it is an emotional chain), its rupture, whether at the point of the parent or of the child who will one day become a parent, is of inestimable value to future society. There are those who do not see eye to eye with the social workers who believe that these consecutive generations of rejected, affectionless misfits are products of emotional deprivation in the relationship of the parent to the child—but this is not the place to attack the intricate question of heredity and environment. It remains the responsibility of social workers to try to alleviate the unfortunate manifestations, whatever the causes. Evaluating the capacity of a person for parenthood is one of the jobs of the social worker. The child in placement and the placement agency make certain demands of parents. These demands are sometimes referred to as "the framework of placement." The framework is made up of such requirements as visits in the foster home by appointment; providing the child with clothing, allowance, and other necessities; support of the child through payments to the agency; and maintenance of a working relationship with the social worker in charge of his child. The manner in which the parent responds to these requirements will help the parent come to realize how much or how little he wishes to be a parent at the same time that his response is showing the social worker the stuff of which this particular parent is made. The careful and minute examination of a parent's responses to any one of these requirements would fill a book. Essentially each of them is a yardstick against which the social worker can measure to a degree the stature of a person's ability to be a parent. Since at this point the emphasis is on understanding rather than treatment, the treatment value of gaining insight through such measuring will be passed over lightly. It is most important to remember that the parent is being measured not so that he can be condemned or praised, but rather so that the social worker will have some knowledge of what is involved in working with him. It is also important to remember that the evaluation is a measure of the parent as he is at the moment. In social work, it is axiomatic that we are concerned with the past, we are working toward the "5

The Art of Child Placement future, but our business is that of taking hold of the client and his situation where they are at the moment, in the present. HOW CAN CASEWORKERS HELP PARENTS?

During the time that a social worker is engrossed in the steps of understanding the quality of parent with whom she is dealing, treatment has been going on. When I was a beginning student in social work, I had the idea that maybe that was all there was to it. It seemed to me as though all our textbooks and lectures were concerned with arriving at diagnosis and that once you had really labeled a problem it was as good as licked. I think that some of this same danger exists in practice among many social workers today. At interagency conferences, I am distressed that the emphasis is often more on getting a situation labeled than on focusing on what to do about it. This would be understandable in brand new situations, but on old cases social workers should put more emphasis on what to do about a situation and a little less on naming it. I am reminded of a skit the students in a school of social work put on for a state conference of social workers. There was a scene in which the student, case in hand, listened earnestly while his supervisor talked. She said something like this, "It's a simple case of mother fixation with strong paranoid trends complicated by a homosexual response to the therapist, so now, of course, you know what to do." The student jigged off the stage singing, "So, of course, I know just what to do!" That we don't know just what to do is not the only danger of labeling. Parents are often labeled "psychopathic," "paranoid," or "not able to respond to casework." Assuming that the labels have been given by a person competent to make diagnoses of this kind, such labels can still be more of a handicap than a help because they may seem to mean "hopeless" to inexperienced minds. Whether the labels are accurate or not, the fact remains that parents have a part in the lives of their children and it is the social worker's obligation to try to help them, whatever the prognosis. 116

Casework 'with "Own" Parents Sometimes a parent with a "bad" label can be helped to become genuinely useful to his children. I am reminded of one parent who behaved in a paranoid fashion and muttered vociferous imprecations against "the social workers who had taken his children away from him." His children's worker was a warm, understanding young woman; his own worker was a man, the agency having some feeling that a man was better equipped to defend himself against a "dangerous client." It appeared that any progress with this father was impossible. His ability to keep his children and their foster parents in a state of terror and confusion amounted to genius. The young man social worker spent six months in a close relationship to the father. The father poured out insults, anger, and a healthy expression of his feelings of impotence at the outrageous fact that his children had been removed from his home. Meanwhile the children, whom the father really loved, had become devoted to their social worker. The father began to be able to like the young woman from a distance because she supported the children in whatever positive feelings they had toward their father and because he could like her as long as he had another social worker to hate. When the young man left the agency, the children's social worker asked to be allowed to work with the father. With some trepidation she was permitted to. The agency feared that this father needed an outlet for his rage and that when the young man was gone, the father's rage would shift to the children's worker. But the young man continued, even though in another city, to meet the father's needs. The father grew more serene and accepting of placement. When he felt frustrated, he would tell his worker about that first "terrible" young man who had taken his children away and had bullied him. Both of these caseworkers did good jobs with the paranoid parent. Neither expected to cure him. They did what they could for him because he was related to his children. The case shows how clients, even the sickest, change and have changing needs. This frightened father is now able to share his children with their 117

The Art of Child Placement foster parents. His present social worker, though half his age, successfully uses a warm, supportive, maternal role in relation to him. In one interview, when she expressed worry over a bad bronchial cough and urged him to see a doctor, he wept. "Not since my mother died," he said, "has anybody ever fussed over me!" Any good agency has many similar cases showing ways that parents who bear the most ominous labels can be worked with successfully in relation to their children. If a social worker will begin only with the related part of the parent's personality, the parent will not usually be threatened. If, on the other hand, the social worker approaches the whole problem of the father's paranoia, she is likely to find herself in serious—and unnecessary —trouble. The woman social worker in this case was supportive with the father. If there is any one tool most useful in relationship to work with parents, I would say that supportive therapy is it. Jeanette Axelrode has defined supportive therapy as "the conscious attempt to mitigate the child's affect-hunger through a strong emotional tie to the caseworker; a deliberate giving of affection and interest which is not a means of strengthening the therapy, but is in itself a therapy."4 Dr. Axelrode's definition concerns supportive therapy with children, but it applies equally to adults—especially the adults who are so very similar to the love-starved children of the placement agency. The supportive therapy with parents begins with the worker's initial meeting with the parents, whether it be at the point of intake or at the point of transfer from another worker. The outstanding quality of the relationship from the parent's point of view will be the nonjudgemental attitude with which the social worker meets him. This may be a unique experience in the life of the parent whose hidden belief of his own lack of value has been all too well re-enforced by other people in his life. Here, for perhaps the first time, is a person—a children's social * Jeanette Axelrode, "Some Indications for Supportive Therapy," American Journal of Orthopsychiatry, Vol. 20, April 1940. Il8

Casework with "Own" Parents worker at that—who sees it hasn't been easy, that the parent has done some things well, and that the parent was wise and courageous in turning to an agency for help with a real problem. The worker does not think of the parent only as a failing parent, but as a human being with many wishes and desires other than those imposed on him by parenthood. Her recognition that he has needs and wishes of his own is one way in which she can be supportive, if she takes care that he is aware of her sympathetic concern. I have never forgotten a series of superb interviews I read in a case history that had taken place between a social worker and an extremely shallow, egotistical, vain young mother. There were ten interviews at two-week intervals. They began with a young widow, the mother of two babies, who wanted to be a model and have lots of pretty clothes and boy friends, and ended with a woman who still wanted many of these things but who had found that she wanted even more to be a mother. She remarried shortly and took her babies out of foster homes to bring them up herself. The caseworker, recognizing the young woman as similar to many mothers she had known, remembered Anna Freud's wise words about what love-starved children grow up to be: "The ability to love—like other human faculties—has to be learned and practiced. Whenever, through the absence or the interruption of personal ties, this opportunity is missing in childhood, all later relationships will develop weakly, will remain shallow. The opposite of this ability to love is not hate but egoism. The feelings which should go to outside objects remain inside the individual and are used up in self-love."5 The social worker recognized the narcissism of this young woman as stemming from a deprived childhood, a fact which the interviews confirmed. The social worker gave affection, warmth, and acceptance. She encouraged the young woman to express her own self-love and accepted her need for having it—since no one else had loved her. But each personality has in it along with the diseased tissues some healthy ones. There was a maternal part of 5 Anna Freud and Dorothy T. Burlingham, War and Children, (New York: Medical War Books, 1943), p. 191.

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The Art of Child Placement this young mother; there was a part that still wanted those "pretty babies," who were in a sense possible outlets for her narcissism. She was able to discover as she talked with the warm caseworker that some of the satisfactions of life as a model might be questionable and when she arrived at the point of choosing whether to be a mother or a model, she chose to be a mother. I believe this choice was made possible because someone had liked her, had considered her worth time and thought, had found her pretty, and had given her affection even though she was incapable of giving back affection herself. An interesting "aside" from the treatment aspects of the case insinuates itself at this point. Was it "good" that this shallow, narcissistic mother chose to take her children home? The alternative for these babies was not adoption, but foster home living. Remembering the earlier arguments of the superlative value to a child of his own home and parents, even though the home has serious shortcomings, the answer in my mind, is a sharp Yes. Sometimes a social worker will use supportive therapy for its own value; at other times it will be used in connection with other forms of treatment. A social worker is safe in assuming that the parent of a child in placement has some recognition of the fact that a problem exists and that having his child in placement is one of the steps he has taken in hope of finding a solution to the situation in which he finds himself. Henrietta Gordon has written, "We must certainly understand the meaning of a parent's behavior in relation to his child, if we are to help him with the problem that has brought him to us, his conflict about his responsibility for rearing his child. He and we must know whether he does or does not want to assume his parental responsibility and to what extent. In testing this out it is helpful to recognize that although emotional ill health underlies the difficulties in the parent-child relationship, it is insight and determination to help himself that motivated the parent's coming to us. We must respect and challenge that determination."8 6

Henrietta L. Gordon, op. cit., p. 37.

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Casework with "Own* Parents The usefulness of the mechanics of placement as a yardstick for measuring the degree of parental impulse arises here in a different context from that mentioned earlier. And if, with the guidance of the social worker, the parent is able to see these mechanics as a means of understanding his feelings toward his child, he will have gained insight. To help a parent toward insight in relation to his ambivalent feelings about his child is another important phase of helping parents of children in placement. When a parent is able to evaluate those parts of himself that want his child, and those that don't, at the same time knowing that the person who is helping him undeistands and accepts the fact that he has both negative and positive strivings, he will become free to act. He will be freed from the grip of indecision that has made it impossible for him to follow any course comfortably. It would be an oversimplification if a social worker were to say, or even think, "Mrs. Hamford, you were supposed to visit Bobby on Tuesday at three o'clock and bring him three sets of winter underwear. Instead, you spent the money that you should have used for underwear on drinks and arrived at the foster home at seven o'clock drunk. Obviously, you would rather drink than visit Bobby. Therefore, since you prefer 'fun' to Bobby, you'd better recognize that what you really want is to give him up." I've never known of a social worker who would respond like this. I have created the illustration merely to show by sharp negatives some truths. It is important to remember that people like Mrs. Hamford drink because they are frightened. Facing subtly critical foster parents who are doing the job she feels she should be doing is a most frightening experience to a person like Mrs. Hamford. One little drink, she thinks, will give her the courage. But she needs another and another. The hour of the appointment is a source of annoyance to her. It reminds her of the parental rights she has given up. Who is to say at what hour a mother may see her own son? And there is another terribly painful aspect. Bobby will cry when she leaves. He always does. And his tears will make her feel 121

The Art of Child Placement more guilty than ever. He will try to make her promise when she will come again, when she will take him for keeps. What can she say to him that will not be an addition to the string of lies she has already told him? The good mother in her is trying hard not to make false promises. So what does the social worker do to help Mrs. Hamford see where she wants to stand in relation to Bobby in the years ahead? She says, "It's hard for you, I know. But when a child is in a foster family, we do have to think of the foster family too. That's why we have appointments. The mothers of children in foster homes often find planning ahead hard. But it's the only way, I'm afraid. Is there any way I could make it easier for you?" Mrs. Hamford eventually sees three possibilities:—she will give Bobby up entirely; she will make a home for him; or she will try to find the strength to continue to face the ordeal of "visits." The social worker is warmly ^supportive as Mrs. Hamford carries her thinking through these three painful possibilities. Often it is a time-consuming task. With some parents it can go on for the span of a youngster's childhood. But the parent and Bobby cannot afford that much time. The time that one little boy is caught in the no man's land of not knowing whose little boy he is to be, and the time that a mother tortures herself to examine what she wants to be, must not be wasted or dragged out. I know of no words that can be written that will tell a social worker how to measure the tempo at which a client can move. There will be signs to show her when she is moving too fast. (Sometimes the withdrawal of a parent from appointments will be a sign.) But as she practices her art, the knowledge will come more surely. Many social workers like to use time limits. They suggest to the parent that together they will aim for an answer in two months, six months, a year. Juvenile court judges often use this technique in custody cases. Because people's lives do not move in clocklike fashion, and because outside factors—jobs, boy friends, an increase or decrease in mental stability—cannot always fall within the limits arrived at, a certain flexibility must, of course, characterize their use. 122

Casework with "Own" Parents But though these various external factors do not follow the clock or the calendar, neither are they completely the tricks of a capricious fate. The parent working within a time scope has an influence, though often unrecognized, on the appearance of jobs, boy friends, and mental stability. Accidents of luck, good or bad, are often not accidents at all and need always to be regarded thoughtfully as evidences of what a client wants to have happen to him—especially those "accidents" that influence the ability of a parent to be a parent. Sometimes, in the interest of helping a parent to gain insight, a social worker will help a mother see that the accidents are part of her own making. At other times the social worker will recognize them as the necessary defense of a weak ego and the worker will say philosophically, "Accidents will happen." Skillful work with parents is, I believe, the most important part of the child placement worker's job. Several social workers have written that it is the parent, and not the child, who is the client. I have seen situations in which it is first one, then the other; sometimes it is only the one or the other. The parents who will not come in for interviews, who will not accept the help the social worker wants to give, are most frustrating. But I believe it is the solemn duty of the social worker to keep trying. I believe no social worker may ever abandon a parent. And when a parent has been worked with, studied, evaluated, and found to have nothing positive to give his child, I feel that his personality and his situation should even then be reevaluated sympathetically and frequently. WORK WITH PARENTS WHO ARE GIVING UP THEIR CHILDREN

It may well be specious to entitle a section as I have entitled this one. Actually, whether a parent, as a result of his relationship with a social worker while his child is in placement, concludes that he wishes to give up his child or live with him makes no difference in the process. The social worker's job is to stand close and lend a hand while the parent takes the steps that let him know whether he wants or does not want this role that nature and 123

The Art of Child Placement circumstances have thrust on him. The decision does not belong to the social worker; she is not a god to give or withhold the privileges and penalties of parenthood. In social work it is always easiest to work in the situations that have some possibilities for a "happy ending." Whether the release of the child seems a happy ending to the social worker or not will depend to some degree on whether she thinks the client has arrived at the decision with the "best prognosis." More than one social worker has shed tears as a mother has given up her child, however right the decision may be. It is equally hard to see a child parting from his parent. One day I sat in my office where a mother was explaining to her five-year-old twin daughters that she wasn't going to be their mother any more. The mother, Mrs. Campbell, was dressed in the uniform of her trade, that of a prostitute. Her face was heavily made up. (She never should have used that much mascara on a day when she would surely cry!) Her clothes, flashy in color, were too tight and she wore the inevitable imitation silver fox fur. Her four-inch high-heeled black pumps were decorated with butterflies which Jean and Joan, the twins, loved. This day she had dressed up for her daughters so that they would remember her as a pretty lady. She had planned her speech carefully, and she wanted me there to "give her the guts to go through with it." She explained why she had decided to send the little girls to another state far away to live with their paternal grandmother. Mrs. Campbell said she had to go to a hospital for a while and after that she would have to take a job and work to support herself. The doctor had said she was frail and must sleep after work and couldn't take care of her daughters too. Joan found her voice first: "But won't you mind it—the hospital and us being so far away?" She patted her daughter's hand. "Of course, my sweets. But I won't worry about you the way I would if you was in a foster home and nobody comin' to visit you Sundays. Your grandma will bring you up to be real ladies. She'll do a better job than I could, sick and weak as I am." 124

Casework with "Own" Parents A look of apprehension came into Jean's eyes. "And will you die?" Mrs. Campbell said—almost a little wearily, I thought—"This is a disease from which people almost never die. Sometime I'll be well and we can be pals again." "But we'll be growed up then!" one of the twins protested. "I sure hope it won't be that long, but it just might!" said Mrs. Campbell. Then she told the twins warm appealing stories about the grandmother they had never seen, the little house near the sea, the country where it never snowed. Plans were made so that letters would be sent and snapshots exchanged. When the twins left, Mrs. Campbell looked up at me. Now she could let the tears go, let the mascara run. "Jesus!" she said, "they was the nicest, cleanest thing that ever happened to me and I had to let them go." Three years of hard work with that mother, years full of watching the girl (for she was little more than that, having had the twins when she was seventeen) try to make herself into a mother, had led up to this moment. I remembered her disappearances. One had run through the Christmas holidays. Another time, she had failed to show up for the girls' fourth birthday party. I remembered the little girl voices saying, "If you could find our mother, tell her we still have a present waiting for her." Soon I had to leave her to drive the twins home. They needed me then. She needed me too. My own emotions were not as steady as they should have been. As I looked at Mrs. Campbell's tearstained face, I remembered Sydney Carton in A Tale of Two Cities-, when he was contemplating his decision to die so that another man might live, he said it was the best thing that he had ever done with his life. Sydney Carton was willing his own death. This mother was willing the death of the mother part of herself. Sometimes, I thought, the most wonderful thing a parent can do for his child is to give him up. Jessie Taft writes of separation: "But the fact remains that human beings are not passive victims of trauma from birth to death. They do find fulfillment in experiences that arc hard to leave. 125

The Art of Child Placement They can overcome the traumatic aspects of painful parting by the discovery of unused strengths for living in the self. True, man is a suffering being, but he is also a powerful creative force, with a capacity for molding the outside world into something he can claim as his own. What man resists above all is internal interference with any phase of his living before he is ready to abandon it. It is not the leaving but the lack of control over the leaving that he fears. If he can possess to some degree the ending phase of even the deepest relationship, so that he feels as part of himself the movement toward the new, then he can not only bear the growth process, however painful, but can accept it with positive affirmation."7 THE FLANNIGAN CASE

A Word of Introduction Condensation of a case history inevitably alters its flavor. This is true of the resume of the "Flannigan case," as it is of others in this book. The reader is sure to find some of his questions about the Flannigans and their treatment unanswered—details of the thinking of the psychiatrist, for instance, and many of the specifics of the casework with Michael and Patricia. But in this case, and in the others in other chapters, the purpose is to throw a spotlight on one aspect only—to bring into full focus, in the Flannigan case, the relationship between Miss English, the caseworker, and Mrs. Flannigan. The reader will understand why other facets of the story are left veiled. Mrs. Flannigan is a "type," if humans can ever be types. I find Miss English's work with her superb in many ways. The facet I like best is that Miss English has found a way of keeping a light but necessary hold on her relationship to this running-away parent. In social work, one is taught early not to force casework on a client who does not want it—and conversely, in child placement, that one must not lose his contact with parents. Miss English has handled this difficult problem with the delicacy of an artist. 7

Jessie Taft, "Some Specific Differences in Current Theory and Practice," The Role of the Baby in the Placement Process (Philadelphia: Pennsylvania School of Social Work, 1946; pamphlet), p. 105.

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Casework with "Own" Parents In rereading my condensation, I miss a little of the warmth that Miss English expressed toward lonely Mrs. Flannigan, to whom life had given so little. It was not easy to identify one day with the rejected children and just as fully the next with the rejecting mother. Some agencies would have used separate workers. Children's Aid did not because the agency felt that Mrs. Flannigan would have been all the more frustrated if she could not have talked to the person who she knew was her children's caseworker. A score of suggestions made in this chapter on casework with parents are illustrated in this piece of work; I shan't point them out. I'm thinking of the caseworker who, moving a very bright boy to a foster home which she felt had remarkable possibilities for him, purposely refrained from telling him about several details of the household. For example, she did not mention that the foster father was a "ham" radio operator, though she knew that tinkering with radios was the boy's major interest. In her recording she wrote, "Some things a boy like Kenneth likes to discover for himself." This, I hope will be true of the readers of the Flannigan case. Background Note Placement of the Flannigan children—Patricia, 9, and Michael, 10—was made at the children's center on the recommendation of the psychiatric clinic. Referral to the clinic came as a result of the school's pressure on Mrs. Flannigan to do "something drastic," as she put it, about the behavior of the children in school. Patricia and Michael were sent to different schools, both within walking distance of the center. Schools were selected because of special skills of their respective third and fourth grade teachers. The behavior of the children in placement at the center showed them to be very troubled. There was a sharp improvement in their school adjustment, which both children explained as being caused by their liking for their teachers. This suggests that they are able to modify their behavior as a result of relationships.

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The Art of Child Placement Development of the Case Michael. In his first eight months at the center, Michael made a poor adjustment. He is hyperactive, highly distracted, cranky, and whiny. He is slow and dreamy in doing his duties and never manages to get anything done on time. From December through February he had four or five screaming temper tantrums a day. He did not relate to any of the counselors and complained, "The kids pick on me and they don't like me" (which was true). He would never discuss his behavior and only infrequently would he answer a question. During the first three months of Michael's placement, he was seen weekly by Dr. Hudson, psychiatrist, at the clinic* Dr. Hudson decided to discontinue appointments because he felt that Michael was not making any progress. Patricia. The initial adjustment of Patricia to the center was as stormy as Michael's. She was even more aggressive in her stubbornness and anger than Michael. Whereas Michael seems to turn his rage inward on himself, Patricia strikes out at those around her. Michael is dreamy about not getting his duties done; Patricia screams that she is nobody's slave. She will set her own place at the table but nobody else's. She lies almost constantly and with great skill. Three times she has caused a great deal of excitement in the neighborhood by telling romantic stories about how she is beaten, starved, and generally abused at the center. But Patricia is devoted to her third grade teacher and will do almost anything she can to please her. The teacher reports that she is a child of very superior ability. Dr. Hudson also tried having interviews with Patricia without success. It was his feeling that she was a little less heavily defended than Michael, but that until the children have lived a little longer at the center and have showed more willingness to accept a psychiatric relationship, he should discontinue his contacts with her also. Patricia is a squarely built, large-for-her-age, tomboy sort of girl. Her features give promise of handsomeness later on, but at present she seems to make a fetish of looking as messy as possible. This is in sharp contrast to Michael, who is neat, pretty, delicate —an almost feminine little boy. 128

Casework with "Own" Parents Relationship between Siblings. There are moments of marked antagonism between the two children when Patricia, who is stronger, bullies Michael and when Michael makes fun of Patricia's appearance and points out her failures rather brutally. Still, underneath there is a kind of loyalty between them. One counselor at the center said, "When they fight each other, they don't put the same verve into it that they do when they are striking out against others." They seem to assume that they constitute "a little family" and that if they ever leave the center to go to a foster home, they will go together. There is little apparent rivalry over their mother, Mrs. Flannigan. They have both received so little acceptance from her that they seem not to be jealous of each other in relation to her. Dr. Hudson felt that Michael and Patricia shared confidences and that they aided and abetted each other in resisting psychiatric help, and formerly in being insubordinate at school. Mrs. Flannigan. Born Madeline LaRue, Mrs. Flannigan, age 31, is a strikingly rejecting parent. She was born in France and came to America with her parents when she was five years old. She speaks with a French accent and thinks of France as "home." It is a source of wonderment to her that she ever married a man named Flannigan and it is a source of distress whenever she is called Mrs. Flannigan. Her own mother died when she was ten years old and her father was excessively strict and often cruel in his discipline. She eloped with Mr. Flannigan to escape her tyrannous father. Michael was born nine months after the marriage, and Patricia followed Michael ten months later. Mrs. Flannigan had phlebitis following Patricia's birth which, as she puts it, "ruined my beautiful legs!" (Her ankles are swollen and shapeless. She wears heavy orthopedic shoes.) The marriage was a brief and unhappy one. Mrs. Flannigan feels that having her babies so soon after her marriage and so close together was entirely Mr. Flannigan's fault and that she was greatly misused. When Patricia was five months old, Mrs. Flannigan awakened one morning to find that Mr. Flannigan had died in his sleep. She describes this experience with no visible signs of 129

The Art of Child Placement distress. It appears that she was glad to be free of a future with too many babies, which she had begun to foresee. The Irish names for the children were chosen on the insistence of Mr. Flannigan. Mrs. Flannigan does not like them but once said, "Oh, they're all right. With a last name like Flannigan, what can you do? The children even look Irish!" The clinic made an enormous effort to work with Mrs. Flannigan, but she is such a highly defended person that they found it impossible. Nothing they could do would persuade her to come in for interviews. The psychiatrist, who saw her twice, felt that she had identified the children strongly with her husband, whom she detested. Her need for respectability made the necessity for placement of the children very hard for her to face, but her need to be free of them has been even greater. The children's center has found her difficult to work with. They are grateful for her job at the library, which keeps her occupied at least eight hours a day. She frequently marches into the center and criticizes everything it does. The children are not taught to behave "like ladies and gentlemen," the food is "common," the games in the yard are "too rough." While she comes on the pretext of visiting Michael and Patricia, she is capable of ignoring them and making a great fuss over some other child. Her manner is usually that of "the great lady." She is supercilious and elegant. Once she said in front of the children, "Gracious —what is a French lady like me doing with two little Irish monsters?" The first four months that the children were at the center, she took them home every Sunday for four hours. The children disliked the visits and said so quite frankly. Slowly these visits have been tapering off until they now occur about once a month. Mrs. Flannigan is very controlling in relation to her plans for her children. She insists on making all the rules and will not adapt her plans in any way to the convenience of the center. One counselor said that she treats the staff as though they were servants whom she had hired to take care of her children. 130

Casework 'with "Own" Parents Michael and Patricia's Attitude toward Their Mother. The attitude of the children toward their mother is hard to describe. If these children have learned anything from their mother, it is a reluctance to admit that "things are not perfectly well-bred and nice." They speak of her rather pleasantly and acceptingly, for the most part. When other children at the center brag about their parents, Michael and Patricia brag about their mother. They brag that she has a good job and is paying every cent for their keep at the center; they say she is pretty (which she is); they say she can speak French. When she makes subtly rejecting remarks about them they both look embarrassed, but Michael especially has picked up her trick of trying to pass unpleasantnesses off with a high little nervous laugh. Mrs. Flannigan calls the children "behavior problems" to their faces and says that as soon as the center and "that Miss English" gets them "straightened out" she will take them home again. Patricia, in a burst of rare candor, told her teacher that while she hated living at the center with "all those mean kids," she preferred it to home and was going to continue to be a "behavior problem." Improved Adjustment of Children. The last two months of placement have seen a steady diminution in the temper outbursts of both children. One might almost say it is the quantity rather than the quality of their outbursts that has tapered off. There seem to be several factors causing this. The first seems to be the much less frequent contact with Mrs. Flannigan. There are times when she visits only once in two weeks. She explains this on the basis of having had trouble with her legs. Always before, the staff was aware that outbursts on the part of both children followed as an aftermath of Mrs. Flannigan's visits. The second factor seems to be their much more serene school adjustment. Previously school was a place of turmoil. Both children are now finding satisfaction there and have learned to take pleasure in reading. They each spend several hours a day curled up with books. They seem to use reading as an escape. Consequently, there are more hours of peace in their lives. J

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The Art of Child Placement The third factor is that they have begun to form a relationship to a social worker. Almost every child at the center has a social worker whom he refers to possessively as "my worker." Workers appear once a week to talk with children, take them out on excursions, buy them little presents. Michael and Patricia had not been assigned a regular worker because the agency felt that the children should not be given a worker until they asked for one, so that there would not be a repetition of their rejection of a worker as they had rejected Dr. Hudson. When the clinic decided that neither Mrs. Flannigan nor the children were amenable to treatment, they referred the entire case to Children's Aid. The clinic makes no further effort to see either the children or Mrs. Flannigan. It has, however, kept the case open so that Children's Aid may come to the clinic for consultation. The children have begun slowly but surely to relate to their worker, who sees them separately each week. Patricia will especially need this relationship when the school year ends and she loses her "beloved teacher." Michael is reaching out toward his worker, shyly and cautiously. He has twice given her little presents he has made, and each time he sees her he compliments her on some article of clothing she is wearing. Michael, not having quite such a tie to his teacher, is relating a little more quickly than Patricia, but she too has made a few cautious overtures. Psychiatric Treatment Conference (April). In the first conference at the psychiatric clinic, it was pretty generally agreed that these were children who would face many years in placement and who might respond quite well to foster home rather than institutional care. There was, however, strong doubt that the mother, because of her guilt and pride, could be persuaded to accept foster home care for them. (A teacher, two years ago, recognizing the extent of this mother's rejection, had told her bluntly it was quite possible to give them outright to the state for adoption. Mrs. Flannigan had flown into a rage that was a fair imitation of one of Patricia's best.) The fact that the children have made progress away from their 13*

Casework with "Own" Parents mother indicates that every effort should be made to keep them in placement. Their response to the caseworker seems very hopeful. Several of the members of the staff of the children's center have heard both children say they would like to go into a foster home as so many of the children at the center have done this year, but they suppose they'll have to grow up in the center. The difficulty of working with Mrs. Flannigan was discussed. The staff at the center has been firmly referring Mrs. Flannigan, whenever she wants to discuss the children or complain, to Miss English. Miss English was urged to make every effort not to threaten Mrs. Flannigan and to be especially careful never to appear to identify with the children against her. The reluctant decision reached by the group was that there was no way to try these children in a foster home unless their mother could accept it, and that acceptance was unlikely. Members of the children's center staff presented their observations of the improved behavior of both children, especially Michael, at this time. They felt that his ability to relate to Miss English is the most significant thing that has happened to him in placement. There was considerable discussion of the fact that Mrs. Flannigan has been less interfering of late and some speculation as to whether she will begin gradually to withdraw. Miss English reported that though she has some contact with Mrs. Flannigan by telephone and through Mrs. Flannigan's occasional visits to the agency, she does not believe this woman is capable of a fruitful casework relationship. Miss English does not feel that the mother has gained any insight. She is not able to discuss her own situation coherently, and she goes into illogical outpourings of hostility whenever she feels she is losing in any way her right to control the children. One member of the center's staff pointed out that Patricia has a morbid fascination with death. She likes to visit cemeteries and said, after reading Little Women, that she, like Beth, would die young. Her sense of "impending doom," as one counselor described it, is acted out by behaving everytime she scratches her 133

The Art of Child Placement finger as if she will bleed to death; every little cold she diagnoses as "double pneumonia." The psychiatrist felt that Patricia may have been acting out some death wishes that her mother had communicated to her. Miss English agreed, saying that more than once Mrs. Flannigan, by slips of the tongue, has indicated that she wishes the children were dead. She seems particularly hostile to Patricia and explains it in terms of Patricia's coming "so terribly soon" after Michael and giving her that terrible disease that ruined her "pretty legs." Her manner suggests that Patricia maliciously and willfully chose the date of her own birth and then inflicted an illness upon her mother soon after her birth. Miss English's Summary of Contacts ivith Mrs. Flannigan. In the seven-month period following the psychiatric treatment conference, I have seen Mrs. Flannigan very few times, and my telephone calls with her have been infrequent. I have tried to let her reach out to me rather than the other way around, since I feel that nothing is accomplished with her unless she initiates the interview. When she telephones it is always to ask how "little Patricia and Michael" are getting along. When she is especially relaxed, she pronounces their first names in French. She seems to have less need of late to complain about the treatment of the children at the center, nor does she misquote me as often when she calls at the center. She called me once in May and wanted to know how much she owed. (She had fallen behind in her payments.) She had been hospitalized, she said, and it just hadn't been possible to keep up, what with doctor bills and all. I sent her an itemized account, saying I knew the amount was overwhelming but that she was not to be worried about immediate payments. I said I knew it was easy when you were ill and missing work to fall behind. I told her I had often marveled at how she could manage to support two children at the center—that it was a great financial burden and she had been most conscientious. This seemed to relieve her, since she is almost compulsive about keeping up her payments for the children. It is apparently one way that she satisfies herself that J34

Casework with "Own" Parents she is being a "respectable mother." I worry sometimes as to whether she has enough left for herself. Whenever I talk with Mrs. Flannigan, I think of the desirability of placing Mickey and Patty in a foster home; but I have never felt I dared mention it because of fear that this would produce a strong negative response in Mrs. Flannigan from which she would later find it hard to back down. She is aware that many children leave the center to go into foster homes. She once told a staff member at the center that, that was, she supposed, all right for children whose parents were "riffraff" and couldn't be depended on to make them a proper home. One night in January, Mrs. Flannigan telephoned me at my home. She said she was sick and tired of the children's center. It seemed to her that each new batch of children that moved in was more vulgar than the last. Had I noticed that Michael and Patricia were losing their manners? And that Michael had picked up some very bad words? She spent about ten minutes telling me how bad the words were, but "if her life depended on it" she couldn't bring herself to repeat them. I told her I was sure this was distressing, since she had such a sharp sense of the "nice" way to do things. This pleased her. Suddenly she asked me what I thought of putting the children in a "private home." I told Mrs. Flannigan I thought this was an interesting idea and might be quite good for the children. I wondered whether she would like to come into my office sometime to talk more about it. She agreed, and a week later she arrived on time for her appointment. When she came in, she asked me what I thought of the foster home idea. I said I had been thinking of it since our last conversation—that I thought it might be very good. Mrs. Flannigan said that I must not think of separating the children, for she would not hear of it. I told her I always wanted to know what she thought was best for the children. At the end of the discussion, I said I would look for a home where they could be together. Very hesitantly she said that she thought the children needed a '35

The Art of Child Placement man in their lives. There would be, of course, a foster father. She went on to tell how affectionate Mr. Flannigan had been with the children; sometimes she thought they misbehaved because they missed having a father. I said I thought it was nice if children who had no fathers of their own could enjoy foster fathers. This was the first time Mrs. Flannigan had ever spoken acceptingly of her husband. I had the feeling that she was being lonely for him. Then, very anxiously, she said, "I don't really want a foster home for the children. I want them home with me. I'm lonely." She began to cry. As she cried, she kept saying, "I don't know what you must be thinking of me." I told her that I knew she was lonely—that it was natural that she would be. I encouraged her to cry and talk it out. I wondered aloud whether she had ever thought of finding someone to live in the apartment with her, so that she wouldn't be alone so much. She described a "very ladylike" young girl about twenty years old, very shy and retiring, who had just started to work at the library. The girl lived in a boardinghouse and disliked it. Mrs. Flannigan felt maternal toward this sweet young girl and had often thought of asking her to come and stay with her, but she didn't like to "push herself at anyone"—and then it was so awkward, going into finances and all. Mrs. Flannigan outstayed her hour. The interview that had begun with a discussion of foster home placement ended with a plan for her to find a roommate. I gave Mrs. Flannigan a great deal of support and agreed that she should, if she liked, come back and talk more about it. As she left she said, "Oh, dear—I forgot about the children. You can't be spending your time worrying about me." I assured her that I liked her and wanted to help her. If we wanted to talk again about her roommate, we could. The foster home plan was an idea of hers that could wait if she wanted to solve this other problem first. After all, the two problems were related. If she was lonely, it was hard to make good plans for the children. She thanked me all the way down the hall and promised to come back next week—which she did not do. About three weeks later, 136

Casework with "Own" Parents she "dropped in" and found me at the agency with an hour of free time. She told me very excitedly that her plans had worked out. The girl, Miss Swithers, had moved in—and she was "such a lovely girl." Mixed in with her pleasure at describing her roommate was a steady undertone that life was hard for her; she was too tired at night; and she had no insurance to live on like other "widow ladies." Mrs. Flannigan seemed suddenly to straighten in her chair and become very tense before she said, "Frankly, Miss English, I know I shouldn't say this, but I feel that Michael and Patricia are my cross in life." She became pale. "They're problem children. I feel it's really unfair to be saddled with them." She went on to say that she knew it wasn't a Christian thing to say but she felt they were more Mr. Flannigan's children than her own. Sh added that she never got anything out of that marriage but eighteen months of pregnancy in a row, two problem children, and no insurance. Sometimes she felt she could not go on any longer. I told her I could readily understand her feelings. She certainly had had a hard life. It wasn't easy to work all day with aching legs and come home and have to worry about two problem children. With a mixture of apprehension and hostility she said, "I'm not sure they wouldn't be a burden even if they weren't behavior problems." Again I said I could sympathize. She had had a very hard life. She was working and supporting herself and now she would like a little peace. It was a shame Mr. Flannigan hadn't left insurance. I could see it would be just awful for her to try to bring the children back home again. She said emphatically, "I just can't take it." I brought the subject back to foster homes and found her ready to talk about them. I asked how she would feel about visiting the children in a foster home. She said, "I would feel just fine. I would know they were being taken care of and would have love and security." 137

The Art of Child Placement I told her I thought that was a generous response and that I knew we both wanted the children to have security so she wouldn't have to worry so much about them. Sometimes, I said, I thought she might feel "strange" seeing the children living in another home when she went to visit. Sometimes she might be afraid that they would grow away from her. And it wouldn't be easy to share responsibility for the children with a foster mother She shook her head negatively, but I urged her to think it over. If she felt differently later, she should talk to me about it some more. I asked her what kind of home she had in mind for the children, and she responded, "Good, clean, and Christian. I'd like it to be a home with people who have some refinement about them." I said that I would talk with the children about a foster home but I did not feel that there was any hurry. Perhaps in June, after school was out, would be the best time. She agreed. I asked her whether sometime she would talk to the children about it. I did not want to mention it until she had because I wanted the children to feel that this was her plan for them. I said I had often talked with Patty and Mickey about the fact that she was working, that she was not strong, and therefore could not care for them. At the end of the interview Mrs. Flannigan followed her usual pattern and began complimenting me about how nice I was to the children and how much progress she thought they had made. She thought it was wonderful to be a social worker—very Christian. I smiled and said that I liked social work and I liked people. She said, "It's wonderful to help people when they're in bad situations." I replied that there were times when most of us needed help from others. I said I knew she was in a difficult situation, being a widow, having to work, and also having the worry of two such difficult children. She nodded in agreement and thanked me profusely as she was going down the hall. After this interview I had a few more telephone conversations with Mrs. Flannigan about the children's acceptance of the foster home idea. Then in May the children's center informed me that Mrs. Flannigan had taken a large apartment on the outskirts of 138

Casework with "Ouw" Parents town and was planning to take the children home after school was out. The counselor urged her to call me but she seemed very resistant. It took her a month to telephone, and I think the reason she phoned was that I had written her a letter reporting on a minor health problem of Patricia's and asking her what she wanted me to do about it. She called me at home rather late in the evening and spoke in a lilting tone which I have come to recognize as a sign that she is especially defensive. "Hello there," she said. "This is the little French mother of those wild Irishmen. Guess what! I'm going to take the children home with me this summer. Won't that be lovely?" She went on to tell me that her young lady friend was going to work short hours this summer because of a heart condition, and they each had separate vacations coming, and there was a charming landlady who would feed the children their lunch and look after them from time to time when no one else was at home. I asked whether she would come into my office and talk about it and she said she would. We made an appointment for the following Monday, which she broke. She called later to say that she hadn't been able to come because she was expecting a C.O.D. package. She broke two more appointments, using the same excuse. I asked whether I might come out to see her then and she said that would be "just lovely." Mrs. Flannigan served an elaborate tea, with French pastries on French china. Her apartment was nicely furnished. There were evidences of frugality combined with great ingenuity and taste. When I complimented her, she was delighted. After we had finished tea and I began to bring the conversation around to summer plans, she flushed and said it was "too horrid" but that she had a doctor's appointment and we could talk for only fifteen minutes. I told her I knew it was hard for her to talk to me about the plan. I was very interested in her and the children but that if she preferred, we need not talk about it. "Oh, but I do want to," she said smiling artificially. "You've been so kind and helpful. It's amazing the way you've straightened 139

The Art of Child Placement out the children. Now you tell me what you think. I'll do absolutely anything you say." I said I'd like to have her thinking on it, but her quick answer was, "No, I want to hear yours first." I told Mrs. Flannigan that I thought her idea was a very generous one but that I wondered whether it would not be too much for her insofar as we both knew she was very tired at night after working long hours. She said it would not be too much because her landlady would look after the children during the day and they had promised to stay in the yard. She felt there had been so much progress in the children that she believed they could now pretty much look after themselves this summer. I said I hoped they could but that, though they had made progress, there were still many areas in which they needed help and guidance. With a great deal of hostility she said, "I don't know why they never tell me any of the problems about the children." I said perhaps the counselors at the center did not want to worry her. They dealt with so many everyday problems with so many children that they could not always take time out to discuss them with the parents. That was one of the reasons children had social workers. She said, "Just what are these problems?" I told Mrs. Flannigan that both children were oversensitive to any kind of criticism, whether it was on important or unimportant matters. They tended to try to blame the other children. Sometimes they became very angry and would show a good bit of temper. "Just like Mr. Flannigan," she said. She went on to say that if she hurt his feelings, he would fly into a rage. "I don't get furious like that," she said, "but I do get my feelings hurt easily." I said it was hard to be so sensitive. She said, "Yes, at times I get so down in the dumps I don't know what I'm going to do. I think I'll quit and then I pray to God for guidance and pray very hard and it keeps me going for a few weeks more." I said it was nice that she got help from prayer. Mrs. Flannigan straightened in her chair—always a signal that she is going to say something that is hard for her. "Now about les enfants—if they're going to get into trouble I'm not sure that 140

Casework with "Own" Parents I can have them here." I said that I did not know that they would get into trouble, but that I thought we should both think about that possibility. I said I would like to share the problems when they arose and I wondered if she would be willing to come in about once every two weeks this summer to tell me how things were going. I said that at times everything would go smoothly but that I needed to hear about that too. "Would it be all right," I asked, "if I visited the children?" If this suggestion threatened her, I could not detect it. She seemed genuinely pleased. I wondered whether she had been thinking more about foster home placement for the children. I said, when I heard she was going to take them this summer, that I was thinking in terms of a foster home for them in the fall. Mrs. Flannigan was enthusiastic about this. I said that I had not mentioned this to Patricia or Michael because I wanted to talk to her first. I wondered if she could talk with them about it a little this summer so that they could understand why they were to live with their mother in the summer but not in the fall. Both Patricia and Michael, I said, were sensitive, intelligent children who could understand about a parent's working and being tired out at night and needing some time for herself. She was sure they would understand and agreed to discuss it with them. I told Mrs. Flannigan that I had been thinking about a camping experience for the children. It meant that they would have to live in a supervised group with some pretty rigid routine and that this would be good for them. Mrs. Flannigan liked the idea. I described St. Anne's Camp to her and explained that the period for which Mickey and Patty would be eligible was the first two weeks in August. She was willing to go along with this plan, which would be followed by an early placement in the fall so that the children could get "the feel" of their new home before having to adjust to a new school. I made arrangements for Mrs. Flannigan to come in two weeks after she had taken the children home, which would be about the first of July. They went to her as scheduled; but when her appointment with me was due, she phoned to say that she could not 141

The Art of Child Placement come because she had "shooting pains" in her legs. She went on talking very rapidly about her problems with her roommate, who was out till all hours of the night with her boy friend and then was too tired the next day to do her share of the housework. After a hostile tirade against the girl, she said, "I'll have to take steps to get rid of that one in the fall. I'm just about fed up." Almost as an afterthought she added, "Les enfants are just fine!" I asked whether she would come in the following Monday and she said that she would. I felt that everything about the summer had been overwhelming for Mrs. Flannigan. She sounded at the point of exhaustion. My suspicion that the children had been very difficult was borne out by their own account when I saw them, and I knew it was hard for their mother to come in and tell me about what was really happening. Her plan for the summer could not have been much more unrealistic for two such violent, acting-out youngsters. It seems to me that Mrs. Flannigan had a need to make a plan that would surely fail. Her "shooting pains," which made it impossible for her to come to appointments with me but did not keep her from work, movies, and her church, may have been caused by an unwillingness to face with me the realities of the failure of the summer plan. The plan of placing the children in a foster home in June as she had originally made it, must have produced a great deal of guilt in Mrs. Flannigan. She had to make one more effort at living with the children in the mother role before she could lower the last barrier and let them begin, in part at least, to belong "to a private family." Author's Note For readers who are as tortured by a case that "ends in the middle" as by missing the last installment to a story, here in brief is the last news on Michael and Patricia. Despite Miss English's pains, the first placement failed. The failure appeared to be caused by a combination of the rigors of living with Michael and Patricia and by the constant, nagging, critical interference of Mrs. Flannigan. 142

Casework with "Own" Parents The second placement is five months old and off to a good start. The homefinder has succeeded in finding a foster mother with the same steady, even, sympathetic tolerance that Miss English has displayed in her work with Mrs. Flannigan. The children's progress is slow but steady. Michael has three loves: the cocker spaniel puppy which the foster family got for him, Miss English, and his foster father—in that order. Patricia has related nicely to both foster parents and Miss English. She has asked Miss English whether for Christmas she can have a permanent wave, and she has decided to be a social worker when she grows up.

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CHAPTER 5

Casework with Foster Families

WHAT KIND OF PEOPLE BECOME FOSTER PARENTS?

ONE hot summer afternoon I drove into a small town from a nearby farm to buy an eight-year-old foster boy an ice cream cone. We passed a lodge marked "B.P.O.E." He asked whether I knew what the initials stood for, and then supplied the answer: " 'Best People On Earth.' Dad Carlson's an officer," he added proudly. I thought to myself that if ever there were a fraternity for the best people on earth, foster parents should certainly be honored members. Social workers, writing of the problems of child placement, are warm in references to the exacting demands made on foster parents, and to the skill with which many perform. But they seem reluctant to describe what goes into the make-up of these exceptional people. Carl R. Rogers has, I believe, made a useful synthesis of his own observations and those of social workers. He writes: It seems clear that the suitability of a foster home for the care of problem children depends more upon certain types of attitudes than on any external factor. These attitudes may be summarized as follows: (i) An attitude of intelligent understanding. This involves the ability to look at the child's behavior as a natural result of his makeup and experience, rather than as an infraction of moral rules, or a deviation from adult convention. It also requires the creative 144

Casework ivith Foster Families imagination to understand the way the child feels and the motives for his acts. (2)A consistency of viewpoint and discipline. This element of stability in management gives the child the comfortable feeling of knowing where he stands with reference to some standard. The consistency of viewpoint seems more important than the actual discipline itself, since every clinic or child-placing agency can point to successful homes with very diverse views on discipline. (3) An attitude of interested affection. It is the moderate type of affection which seems most helpful, not the glowing enthusiasm of the emotionally starved parent. 'Fundamental interest and affection' is perhaps the best descriptive phrase. It is a primary factor in the child's security. (4) Satisfaction in the child's developing abilities. Only if the foster parents find this satisfaction will they wisely reward the youngster for achievement, and permit the child more and more freedom to grow in independence.1 Here we are not concerned with the difficult task of finding foster parents with these right attitudes. Nevertheless, in order to work successfully with foster parents, it is necessary for a caseworker to do some thinking about the kinds of people who become foster parents and the reasons why they are drawn to this hard, challenging, satisfying work. Foster parents approaching an agency to make an application are almost always people with some unmet need in their lives. This statement: need not be viewed with alarm. It does not imply that they are frustrated, maladjusted, or unhappy, but only that they are seeking answers to some lack which they feel. It takes years of experience before a placement worker stops looking among her friends for foster families when a specific kind of home is needed for a specific child. Eventually, after years of turndowns, she begins to realize that her friends are not made of the stuff from which foster families come. Sometimes her friends come to her to inquire about becoming foster parents— but this is quite a different thing from her approaching them.) What she needs to recognize is that for the most part the friends 1 Carl R. Rogers, The Clinical Treatment of the Problem Child (Boston: Houghton Mifflin, 1939), p. 74.

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The Art of Child Placement she had thought of are stable, serene, secure people—the kind it is natural to call on—but they are not families with the special necessities that seem to produce foster parents. What are some of these unmet needs that provide the matrix for foster parenthood? I remember one woman—a vigorous, warm, lusty, seemingly inexhaustible farmer's wife—who, when the social worker marveled because she always had energy to mother "one more child," had a ready answer. "Why," she said, "I'm like so many sterile women you must have known—I've got more energy than I know what to do with." She may have been sterile in the technical sense of the word, in not being able to have a child of her own. But the mothering she had done in restoring seven children in that many years to normal living was the act of a deeply creative, productive woman. Her mothering extended to the lambs on the farm, the invalids in town, to every person and creature in the county that needed a spot of special love and care. Everybody knew her. Everybody felt free to call on her for help. All agencies know her sort, but she is not truly typical. For many foster parents are lonely people. Often they live deep in the country, where in rough weather about the only cars that get through are their own model A's, the milk trucks, and—heaven guide them through the spring mud —the social workers. These foster parents, with their socially uncomplicated lives, have not only an excess of emotional energy to give a foster child, but an eagerness to give it. Or perhaps they live in the heart of the city, but keep to themselves and live apart from their neighbors. Perhaps I should not call them "lonely," for they would never describe themselves as that. Perhaps I should have said they seem lonely because of the limited number of friends and acquaintances they appear to have. A homefinder spots them quickly. Their references are often people who shared a duplex with them five years ago and who, when called on, say, "They seemed awfully nice. They sort of kept to themselves, you know. We never knew them well. But yes, I think they'd be very kind to a child." Sometimes these "lonely" ones have had children of their own 146

Casework with Foster Families who are now grown and out of the home. Sometimes they are childless. Their separation from society seems to grow out of a sort of self-sufficiency coupled with shyness, sometimes—but not always—touched with feelings of inadequacy. What about the families that become foster parents originally because they want to supplement their incomes? One foster mother, when asked her reason for taking children, wrote, "At first it was to help pay off the mortgage on our new home. But gradually it was to fill a void as our own children left home." There is a certain unfortunate tendency among some social workers, lay people, and even foster parents themselves to apologize for financial incentive. It's one I rather like. If a family looks on having a child as a business (instead of a luxury) in which it can do a little better than "break even," it is all to the good. I think the general concern over the money motive goes back to the era when almshouse keepers fed the children bread and water and pocketed the "profits." In fifteen years of foster home work, I have rarely come across an instance in which I suspected that a foster family was misusing a child or underfeeding him in order to show a larger cash balance at the end of the month. If, as a repayment for laundering mountains of sheets cheerfully and without complaint for a child who wets the bed every night, a farmer's wife can swell her egg money to the point at which the family can have a television set before the snows set in, my only concern is that she has had to work so long and hard to save so little money. I believe that doubling the allowances to foster families would still make the payment they receive inadequate. To answer the critics who complain that foster families sometimes go into it "for the money only," I like to point out that anyone interested in "money only" could make a lot more with half the effort in the humblest and least demanding of jobs. When did it become objectionable that people should choose the work they do well and be paid for it? I'm afraid I've digressed. I should only have said, "Most foster parents are interested in some financial gain, a fact that is understandable and healthy." H7

The Art of Child Placement There is another kind of "practical" gain that sometimes prompts foster families: the "need" for a certain kind of child who will pay his way in more than cash. The young mother who wants an adolescent girl to assist with the care of the children is one example; the farmer who wants a boy to help with the chores is another. There are problems inherent in this kind of situation; in general, it takes a rather mature, steady youngster, whose problems are well under control, to be of much real help. A disturbed child will be much more trouble than help. But agencies need applications like these to use for youngsters who are approaching the age of "graduation" both from school and the agency. The home may furnish the youngster his first opportunity to earn some money of his own. (I believe that children who are sent to homes because they are needed should be paid directly for their services by the foster family. On first jobs, they should be paid in cash and not in a reduction of the board rate.) In general, as I've said, these homes are best for the most secure youngsters. But in situations with acute foster home shortages, a skillful homefinder may be able to cull from the many applicants (who usually far exceed the demand) a few homes that can work with rather deeply troubled youngsters. If the fact that the foster family has applied to an agency not exclusively because of a shortage of domestic help, but rather because, for example, it feels a genuine liking and acceptance of adolescent children, the family may have more of the stuff of which really strong foster families are made than can be seen at first glance. Effective foster parents are people with a special ability to identify with the problems of children. This ability stems from various experiences in the foster parents' own backgrounds. Among foster parents are always some who have been foster children or orphans themselves. If their placement experiences were satisfying, they will often be good foster parents. If they were not, caution should be used; for the person who helps a troubled child must be reasonably secure and emotionally healthy 148

Casework with Foster Families himself. Unsatisfactory foster home experiences rarely produce healthy adults. Sometimes foster parents' ability to identify seems to arise from the fact that they have been concerned, warmly concerned, over a child who has had "a rough time of it"—a brother "who got into trouble with the police," a neighbor's child whom they have watched being neglected, abused, left alone, rejected. I have been speaking of foster families whose identification with the rejected children of the world springs from their own experience or the experience of someone close to them. There is another kind whose deep concern about the ills of society finds satisfaction in helping one or two children. These people are political philosophers. Dissatisfaction with the pattern of society may lead them to concern themselves with the unemployed, the underpaid, the unhappy. Or they may feel simply that it's everybody's job to help needful people. They are often exceptionally tolerant in working with delinquents, for example, for they see delinquency arising from evils in society and they hold society, not the child, responsible. They tend to be rather more vocal and more aggressive than the typical foster family. They are not cranks. They are not Communists. But they see and feel the sufferings not only of individuals but of humanity as a whole. High intelligence is a common characteristic of the men and women in this group; often they are able to discipline their emotions in a truly professional way in following treatment plans for foster children. There are always among would-be foster parents families that would like to adopt a child and who perhaps have waited until "too late" to try. Great caution needs to be exercised in using such applicants because in most instances foster children are merely on loan and not "for keeps." But among these applicants will be some who can meet requirements well—even that hardest task, the sharing of the foster child with own parents. Once during World War II, when the shortage of foster homes was most acute, I was working with an agency which persuaded an adoptive agency to discuss with some of its 149

The Art of Child Placement applicants their interests in working with foster children on a temporary basis while awaiting their own child. The adoptive agency used discretion in selecting its applicants. The results were very good. Ten years later, one foster family still has it's "temporary" boy—one who needed a long-time placement but was not available for adoption. They also have their own adoptive nine-year-old daughter. The boy is in college. He and his little foster sister are devoted to each other. Sometimes families feel they are "too little." This is especially likely to happen when foster parents come from big families. One foster family with a five-year-old boy and a fifteen-year-old girl asked for one or two children to "fit in the middle." The foster mother explained, "These were the children we missed having because of dislocations arising out of the war." Small families like this that wish they were bigger often provide excellent foster homes. Should the child become available for adoption, he is usually wanted. Should another plan be better, parents who have already had satisfaction from their own children do not need to hang on to the foster child. In general, people who want to adopt children do not make good foster parents. Nor do people who are over sixty. Nor do people who are not married. Nor do people with histories of delinquency. But even among these types are found many useful parents by agencies that believe that stereotypes are not laws. Though men and women beyond sixty have serious shortcomings as foster parents, it is often true that families well into their fifties constitute one of the most useful types. One applicant of fifty-seven said that his youngest daughter had recently married and that he and his wife couldn't stand the quiet at home. These people become in the eyes of children still tied to their own parents, not "parent substitutes," but "grandparent substitutes." In much the same way, foster parents in their late twenties and early thirties can become "married sister substitutes" for adolescents. Because foster parents at either age extreme do not seem like parent substitutes, they may be less threatening to some children. 150

Casework with Foster Families Finally, there are people who become foster parents for reasons arising from deep religious convictions. They may, and probably do, fit into other "types" I have already described. Priests, ministers, and rabbis have long been excellent sources to direct homefinders to those members of their congregation who find the care of a homeless child a true expression of their belief that of all virtues the greatest is charity. THE ROLE OF FOSTER PARENTS IN THE CASEWORK PROCESS

Foster parents are not clients. This seems a simple and obvious statement; yet there are times when it is hard for social workers to remember it. Sometimes, as the problems that arise in their new role press in upon them heavily, foster parents "act like clients" and the social worker responds to them as she does to any person in need who is asking for help. A client is a person who comes to an agency for help with a problem of his own or the problem of someone so closely related to him that it "feels like" his own. A foster parent is one who comes to the agency with a solution to an unmet need in his life clearly in mind. His solution is to work with foster children. He, like the client, wants help. But the help he wants and chooses is in relation to the child, not in relation to his own problems. When a foster parent and a child come together, certain changes occur in both of them. Problems arise in which help, interpretation, and a relationship with a social worker will be helpful. Foster parents have been described as staff workers of an agency who share with the social worker the job of rehabilitating children. There are both dignity and veracity in this description. But there is also the inherent danger of expecting foster parents to behave in the same disciplined, unemotional fashion that is expected of the social or institutional worker. Whether foster parents should, ideally, respond like caseworkers to children and their parents is debatable. The fact is that usually they don't. To a degree, because of the education in thinking about foster children which they began with the home151

The Art of Child Placement finder and continued with the social worker, they are capable of somewhat more disciplined emotional responses than "average" parents. A few of them have really striking talents in this area; but when this is true, the social worker considers it remarkable rather than typical. I am reminded of a case conference attended by staff members of a child placement agency, a child guidance clinic, and a family service agency. The family worker, on learning that the foster mother had become rivalrous toward the own mother and had lost her temper and scolded her, was deeply shocked. "It was most unprofessional of her," said the family worker. The psychiatrist saw that life had been hard on the foster mother too, and that her frustrations at not having had a child of her own had risen up at this moment and had been too strong to hold in. He questioned the advisability of continuing to use the home. The child placement worker could agree in part with both attitudes, but had additional understanding. "Foster parents are people," she said. "We try to help them so that they will not need to 'blow up' at own parents. This woman can do many of the things required of foster parents well, and the agency, is fortunate to have her help. This one thing she did badly. I wish she hadn't. But this is the stuff of which a child placement worker's job is made up." The fact that foster parents will often react quite unprofessionally does not necessarily mean that they behave badly. When an agency decides that a child belongs in a foster home rather than an institution, it decides that he is ready for the natural, human relationships which are more unpredictable but a better preparation for life than the disciplined, contrived relationships of the institution. A child who is ready to live in a foster home needs normal, natural experiences. It is not an unhealthful experience to have a parent, or a parent substitute, become genuinely angry with a child who has done wrong. It is not bad for the child to see and learn that his behavior brings responses from those around him which are sharp and clear-cut. It will stand him in good stead 152

Casework with Foster Families when in the future his boss fires him, or the girl he wants to marry turns him down. The art of working with foster parents involves helping them to control natural responses so that overwhelming doses are not fed to the child too fast. But natural responses will come, and any social worker who feels that her child is unready to take them had better hold him in institutional placement a little longer. Foster parents, for the most part, will become genuinely angry when a little boy with muddy feet tracks across their clean floors. The child will feel their anger, and this is not bad. Foster parents will cry when a child they have loved leaves. And it is not a bad thing for a child to see that he has been loved enough to produce tears. Foster parents may show temper when excessively imposed upon by own parents. This is more difficult; but parents and children can learn that a certain kind of thoughtless, selfish behavior produces a certain kind of negative response. Occasionally a steady, even-tempered response baffles a child when the stimulus should, he feels, produce anger. Sometimes foster parents have to change in order to continue in the job that they have chosen to do. The social worker will realize that just as a change of oneself is threatening to a client, so is it to a foster parent. She may have to help the foster parent see that if he is to continue to work for her agency, he must learn not to smother the child with love, not to threaten him, not to take sides with him against his teacher, not to reject his parents. The foster parent may then decide whether the satisfactions he gains in his role as foster parent make it worth the effort of disciplining his behavior. Most foster parents want to do their job well. And they want all the help and advice that a social worker can give them. (Offering advice freely, frequently, and with an assurance that her special education and experience qualify her for the task is a main distinction between the social worker's technique with foster parents and her work with clients.) There will be in the experience of many social workers times when her foster parents cease to act like co-workers and become '53

The Art 0f Child Placement a great deal like clients. Their demands for help are no longer related primarily to helping them to do the best job they can with the foster child. The goal has shifted to something within themselves that is primary, urgent, pressing, even frightening. Sometimes a worker will be able to shift her focus and help them through a temporary dislocation. At other times, she will find the problem so deep and compelling that she will have to conclude that she is no longer able to work with them as foster parents. In these instances, she will use her relationship to help them to transfer to other workers in agencies geared to meet their particular problems. I am remembering a foster father whose response to a pretty, bubbling, vivacious—though often noisy and thoughtless—adolescent girl was a profound personality disturbance. He first noticed that when she came racing into the room, slamming doors and making a clatter, the hairs on his hands and arms stood up. He couldn't determine whether his emotion was anger or fear. It seemed to be some of each. Because he was ashamed of himself, he held the information back from everyone, including his wife. Four months later he was taken to the hospital with a serious case of ulcers. He asked the social worker to use his hospitalization for an excuse to move the girl. When she agreed, having been aware of subtly disturbed relationships that seemed to spread throughout the home following the placement, he was able to tell her about his real feelings. She, in turn, was able to interest him in obtaining psychiatric help aimed at helping him to see what the introduction of the girl into their home had meant to him. He and his doctor had been inclined to feel the noisy girl had made him "nervous." Seven months later, the foster father stopped in at the agency to describe how helpful the psychiatric interviews had been and to thank the placement worker for showing him the value of having them. Every social worker could tell of times when her foster parents have become clients and it has been necessary to treat them as such. Sometimes the result is ultimately to close the home; but usually the dislocation is temporary, and agency, child, and foster parents can go on together for many years. 154

Casework with Foster Families WAYS IN WHICH SOCIAL WORKERS HELP FOSTER PARENTS

The social worker's primary tools in her work with foster parents are education and interpretation. The education is strongly re-enforced by a relationship of shared responsibility. Education begins, as has been said, with the home study and continues all the time the child is in placement. Education is carried out in many ways, but most obviously through the giving of advice. When a social worker gives advice she does not say, "This, my way, is the way to do it." Instead she says, for example, "A child like Johnny needs an opportunity to talk about his mother and keep her memory alive. Perhaps you can find some way to help him with this." If a social worker's advice is specific, dogmatic, or restricting, the foster parents will appropriately become resistive; or if they try to follow it specifically and placidly, the results will have a dull, flat, unconvincing quality. I remember a student social worker's being shocked to hear her eight-year-old foster boy, who had identified strongly with his foster father, swearing with every third word he uttered. When the foster father told her that was a "damn nice kid" she had brought, she thought she knew just what to do. She explained the problem to the foster father and wondered whether he could stop swearing when the child was around. The man scratched his head thoughtfully. "Hell, Miss," he said, "I dunno. My wife and mother both gave up on me. You better ask my wife how she taught our kids not to cuss at birthday parties. There's some easier way. Hell, I'd have to keep my damn mouth shut all the time!" The student went humbly to the foster mother for a little advice and education. The student had given advice to the foster father which involved a change in himself which he did not want to make. Foster parents have a right to expect to go on living much as they always have. They're usually ready to make changes vital to their success with the child, but a social worker must be careful not to require of them changes that threaten their freedom, such as the right of a good-natured man to cuss. 155

The Art of Child Placement As the social worker goes along in her job with foster parents and children, she works at keeping in balance the triangle of foster parents, own parents, and child. Sometimes, one arm of the triangle has to accede briefly or thoroughly to the needs and wishes of the others. Mostly the foster parent has to be the one to yield, since he is employed in the services of child, own parent, and agency. He is better able, for the most part, than the parent or child, because he has the greater stability and security. But he has his needs too. The social worker should never lose track of the original motivation that brought the foster parent to the agency. If he is not gaining satisfaction from his job, he will quit. If the demands of parents, agency, and children are greater than the satisfaction he receives, there is no value to him in continuing. It is the job of the social worker to keep her foster parents happy too. Even the most disturbed parents and children can be helped to see that foster parents are people who have "rights" too. The social worker will protect these "rights," remembering that "rights" vary with the differing values of individuals. To one foster mother, it will be her "right" to have one free Sunday a month to go alone with her husband for a long ride in the country. The rights of another may involve extra money for extra laundry. The rights of a third may involve serving cocktails to her friends before dinner parties. It is the social worker's job to support the foster family warmly in preserving those parts of its life intact that seem important to them and in helping them to gain the satisfactions they were originally seeking. The warmth of her support is shown in a hundred ways. She remembers that all people who are doing a hard job like to be congratulated. Usually she will give her congratulations directly. Many foster mothers like concrete expressions of other kinds— through agency parties in honor of foster parents, awards of merit for ten years of service, pictures in newspapers in relation to agency publicity. A good child placement worker gives warm support to her 156

Casework with Foster Families foster parents because she genuinely likes them and thinks they are doing an important job. It would be difficult for her not to let them feel it. Once a homefmder telephoned a foster mother to ask whether she could come out to discuss placing a disturbed child in her home. The woman hesitated, "Well," she said, "it's a bad time for me. Dotty's graduating this spring; and we're expecting relatives in July; and our house needs painting. I don't feel up to taking on another child right now unless Miss Lennon is going to be the worker. She gives such a lot of help, you know." Miss Lennon did not baby sit, or help with the spring cleaning, or make a pie when the relatives came. Butcher warm, steady acceptance and her quick ability to see ways in which she and the agency could help gave this foster mother the feeling that the worker was beside her "pitching right in." Miss Lennon was a worker who never lost track of the fact that foster parents have needs of their own distinct from those of the foster child. She would be in the audience on Dotty's graduation night; and she might find it possible to have the foster child spend a long week end with his grandparents when the "company came in July." In the warm relationship which the caseworker has to the foster parents, she often wisely offers herself as an escape valve for steamy emotions and encourages foster parents to pour out their irritations and frustrations to her. The social worker calls on the foster parents and is told how badly "Nancy" is doing. She may come away feeling she's doing pretty badly herself if she hasn't realized that these particular foster parents have loyally sealed their lips in talking with Nancy's mother and the neighbors, and that they have been secure in their knowledge that she is a really safe person to tell their trials to. "Of course you were furious," the social worker says understandingly. "Well, it did make us pretty mad at the time," the foster mother says, and her manner indicates that having had acceptance in her right to feel angry, she does not have to feel quite so angry any more. 157

The Art of Child Placement It is sometimes a mistake, when foster parents are bringing out negative feelings about children and parents, for a social worker to be too ready to come in with her interpretations. Almost always the interpretation belongs in the interview, but not until the foster parent has had a sound opportunity to get rid of some of his angry feelings. While the feelings are being poured out, the social worker must make it clear that she expects these feelings, is interested in hearing about them, and is not made uneasy by them. Otherwise, following the interview, the foster parents may feel that they showed themselves falling short of the serene steadiness they would like the social worker to find in them. They may feel they were indiscreet and next time they'll hold their tongues. Social workers should urge foster parents to share their angry thoughts, also their thoughts of discouragement, frustration, and futility. Most foster parents enjoy sharing their happy moments too. One night at five o'clock I paused with a social worker as she picked up her telephone messages. It was interesting to watch her face as she went through them—a look of annoyance, one of genuine worry followed by a quick glance at her watch (too late to catch the doctor?), and then a happy smile. She handed the last note to me—"2:00. Mrs. J. called. Nothing important. Just wanted you to know that Terry has had a dry bed six nights running this week." A certain kind of teamwork often grows up between the foster mother and social worker, a teamwork that is built on mutual respect, a genuine, shared interest in the progress of the child, and a recognition of mutual interdependence. The shared responsibility is especially felt at times when foster children are having crises in their lives—the night a little girl's temperature goes to 105°, the time a little boy runs away to look for the mother he can't remember, the night the sixteen-year-old stays out all night. The social worker's home phone number is shared with the foster mother when it is feasible to do so. Some foster mothers need help in not using it too often. But they do like to have it. And when problems become frightening, the social worker may stay close to the foster mother even though it is long after office hours. 158

Casework with Foster Families I have never known a placement worker who did not think the job of being a foster parent was a hard one. I've known many who said quite frankly that they could never do it themselves. Accepting the fact that the job is hard, social workers will often turn to the resources of the community to ease the foster mother's load. One adoptive agency hired diaper service for the foster mothers who cared for babies awaiting adoption. One agency enrolled many of its preschoolers in nursery schools and furnished transportation so that foster mothers could have free hours. Special group-recreation centers such as the "Y's" and neighborhood and community houses offer supervised recreation periods for youngsters. Specialized psychiatric care for deeply disturbed youngsters offers reassurance to the foster parents, as does interpretation directly from the psychiatrist. Foster families, like social workers", sometimes need vacations. If a child is pushed out of his home so that his foster parents can take a vacation, he'll feel rejected. If, on the other hand, while he goes to camp or has a "vacation on a farm," his foster parents take a vacation too, he is not likely to be threatened. Usually a social worker does not have time to do all the shopping, to take all the waiting in clinics and at doctor's offices involved in a busy caseload. She cannot do much of this solely for the purpose of relieving a busy foster mother. But doing some of it, especially as it is related to the casework plan for the child, will again remind the foster mother that this child is a responsibility not only of hers, but also of the social worker. The fact that a child does not totally belong to a foster family is something which must always be kept foremost in the thinking of the foster family and the worker. Often the reminder may seem harsh and pain-producing when parents slip into the background and children begin to turn their primary affection to their foster families. Once in a while a child will come into a foster family which may have successfully helped and returned to their own homes a dozen foster children previously. Something in the peculiar and ultimately unpredictable chemical reaction involved 159

The Art of Child Placement in bringing human beings together may produce a wish in the foster parents to make this child their very own. When a social worker, by a hundred direct and indirect actions and remarks, forces them to remember that this child is not theirs "for keeps," she may get a hostile reaction. The foster parent may feel that she is "not on their side." But the constant reminder of the painful fact is a way of being "on their side" even though it is not in tune with their wishes. And, however unwelcome that frequent, steady reminder may be in some instances, it remains a way of helping foster parents. For this is insurance against the ultimate pain of giving a child up. It would be natural to wonder, "Must it always end like this?" Certainly there must be situations in which a child may and should elect to choose his foster parents over his own parents—situations in which own parents literally abandon children. Of course this is true, but it becomes part of such a different kind of process that it belongs under a different name. In situations like these, it is work with adoptive parents, not work with foster parents. SOME PROBLEMS OF TELLING THE TRUTH

A major problem that a social worker faces in preparing many foster homes is that of confidentiality. She may, for example, know a great deal about the own parents and even about the child that she does not feel at liberty to share with foster parents. Unless this problem is faced realistically, she and the foster parents may start off on a basis of distrust. Most parents—and most children, too—can be persuaded that foster parents must know "just about everything" before they undertake the work. Certain aspects of a parent's past often need not be divulged; current history often must be shared. Alcoholism ten years ago may be irrelevant; alcoholism today is likely to be a vital force, knowledge of which the foster parents must have. I can remember half a dozen situations in child placement in which it was felt that there were "superconfidential aspects." (Not infrequently this label is applied snobbishly, I have observed, where parents are socially or politically prominent.) The foster 160

Casework with Foster Families parents were asked to work in the dark. In every instance, the child and his parent eventually talked freely with the foster mother; and this left her with the feeling that the client trusted her, but the agency did not! Sometimes social workers have made the egregious error of trying to "sell" a child to a prospective foster parent by not honestly describing the extent of his problems. A foster mother may be understandably furious when the child who was described to her as "disturbed and insecure" begins his placement by soiling the bed, beating up little children in the neighborhood, and starting a fire in the basement. Social workers sometimes forget when working with children with whom they are deeply identified that behavior does not often change overnight; and when they yield to the impulse to give a child such a well-meant, though false, "fresh start," they are unduly handicapping the person who might be of greatest help in achieving that very thing. In order to do intelligent jobs, foster parents need to know as much as possible about the forces that have molded the child. The problem of truth not only does not end with an honest description of the child; it becomes more intricate as the case situation progresses. Interviews between social worker and child can be deeply threatening to most foster parents unless they are skillfully and regularly interpreted. The public has not entirely forgotten that social workers were once called "investigators," and the feeling is bound to continue in a foster parent's mind that a prime purpose of the interview is to check up on the foster home. A placement worker should always keep in mind that the "investigative" aspects of her job constitute a continuing threat to the security of her foster parents. An extremely effective practice of many social workers is that of calling a foster mother before an interview with a child to indicate the purpose of the interview. Later another call should interpret the pattern the interview followed. These calls give the foster mother the feeling that she is truly a partner, that nothing secretive is going on between the child and the worker. They give her an opportunity too to understand what the worker is trying 161

The Art of Child Placement to accomplish. She may suggest—if she is typical, she often will— that the social worker give the youngster a "good talking to" about some f ailing. Gradually, through these before-and-after calls, a foster mother becomes educated to the purpose of the interviews, and her understanding of the child with whom she lives grows along with that of the social worker. When the content of the interview is truly something secret or the client has sworn the social worker to secrecy, the problem becomes more delicate. For example, the child who hates a foster parent and is using interview time to spill out angry feelings cannot be let down. The social worker still needs to make her calls to the foster parent after such interviews. She tells all she can. Usually, she can interpret the mood of the child, without giving the content of the interview. Sometimes she may have to explain that children—even children in their own homes—need at times confidants who will not share their secrets. As long as the social worker's manner reflects security in her dealings with the foster family, the fact that she does not share all secrets should not be too troubling. The art of social work becomes an art of diplomacy when a child is expressing such strong negative attitudes toward his foster home that the social worker knows that eventually the child will have to move to another home. In most such cases, it is best to persuade the child that some of his feeling should be shared with the foster family. A practical reason is that the family is almost sure to learn of the prospective move even though child and social worker seal their lips. When any member of a family "wants out," it is very difficult to keep his wish a secret; he dramatizes it with a hundred little gestures. In any case, these situations are charged with dynamite, and generalizations are extremely dangerous. Some foster families, whether they intend it or not, become very punishing to the child who has rejected them. Confidences in casework must be respected by the social worker. She is like the hub of a windmill into which propelling winds come from many directions. She shares confidences of 162

Casework with Foster Families parents, foster parents, teachers, and children. She accepts "secrets" reluctantly, whenever possible persuading confidants to let her use at least parts of what she knows. But when there must be secrets, she respects them religiously. To protect a confidence, whether it be from child, own parent, or foster parent, is sometimes exceedingly difficult. Lies are never solutions. Forced against a wall, a social worker may have to explain that there are some confidences she may not share. WHAT SOCIAL WORKERS WANT FROM FOSTER PARENTS

Social workers want and expect a great deal from foster parents. When the list of "qualifications" is lined up, it appears that the workers are looking for a species of saint such as the twentieth century has rarely produced. Foster parents are asked not only to live with a child, but to love and discipline him—not simply for mutual comfort, but rather for the purpose of meeting the child's highly individualized needs. They are asked to maintain objective, understanding relationships with the parents, but not to give the parents advice, not to scold them, and not to express the irritations that might naturally arise in a relationship of this kind. Their relationship toward the parents should contain acceptance, understanding, and a willingness to see aberrations in conduct not as immoral or even unnatural, but as a normal outcome of the parents' life experiences. Foster parents are asked to respect the child's love for his parents even when it seems that the own parents may have only negative values for the child. They are asked to be scrupulous in not accepting from the child the love that belongs to the parents. They are asked, except in rare cases, to accept a secondary role. If the child seems to begin to reject his own parents in favor of them, more often than not they must feel that they have failed. What social workers ask of foster parents in relation to the child's own parents is hard, but not nearly as hard, I think, as what is asked of them in relation to the child. Henrietta Gordon has said that foster children "live in one place and love in another." The role left for the person who shares 163

The Art of Child Placement a home with such strange little exiles is often full of pain and self-sacrifice, often lacking in many of the satisfactions that should go along with mothering. It might not be too difficult if one could insulate oneself against such a child. But foster parents are expected to love their children, even if in a thermostatic way—to love them enough to help the children, but not enough to hurt themselves too badly. They should be able to accept love from the child, but not the kind of love that should go to his parents. They need to be able to share the child not only with his parents, but also with his social worker and the agency. This sharing is expressed in many ways. Occasionally, before a transfer has been achieved, a child will love his social worker better than he loves his foster family. He will look to her for decisions of greatest importance that normally are made primarily by parents or parent substitutes. The social worker will have a part of the disciplining of the child too. She or a psychiatrist may ask the foster family to follow treatment plans or new ways of disciplining that may seem, from the foster parents' point of view, unnatural and unlikely to work. A foster mother who has successfully brought up her own children with liberal use of spankings in the early years may feel that one hand has been tied behind her back if, for treatment reasons, she is asked not to spank her foster child. The fact that the social worker is to have a share in the disciplining of the child and in his affection too may not seem nearly as difficult for foster parents to accept as the fact that the child must be allowed to bring out his negative feelings to his worker about his life in the foster home. Foster families must be able to accept this freedom as a peculiar right of the foster child. For some foster families this is deeply threatening. Those that feel secure with their workers are able to take it in stride. I'm remembering one ten-year-old disciplinarian who, whenever she felt she had been misused, would say, "Where's my writing paper? I'm goin' to tell my worker on you!" Fortunately her foster family wasn't threatened. They furnished the stamps and helped her spell her angry words. More times than not the child 164

Casework with Foster Families decided not to send the letter, but she felt better after she had painstakingly written out her grievances. When she did mail the letters, the social worker handled them in a way that was acceptable to both the foster parents and the child. But the threat of being "tattled on," as foster parents sometimes express it, is challenging. Children's identification with their own parents, and their wish for their parents to appear respectable, normally will prevent children from attacking them. Not so with foster parents; they are "fair game." Foster parents are expected to accept a child at the level at which he is brought to them, however primitive it may be, and to take satisfaction in the progress the child elects to make at his own speed. Most social workers have memories of really destitute children who seemed like little animals when they were first brought to foster families for mothering. The kind of mothering required in these cases becomes a fine art. Foster parents should know this art well and take pleasure in it, for mothering must be mutually enjoyed to be successful.2 The healing qualities of mothering, when administered to truly destitute children, are remarkable to see. This kind of treatment is dramatic, creative work. And the hardest part of it is often that the child at first does not want and is not willing to accept the warmth the foster parents are willing to give. It takes a while for new foster parents to discover that gratitude from the child is not to be one of their rewards. Occasionally, a foster child, after he is grown, will seek out a foster family to offer a tardy "thank you." But this is adult stuff. Children can be taught easily to say their "thank yous" for gifts and favors; but it rarely occurs to them that they need to thank anyone for offering them a roof over their heads, mothering, or the right to live. This is good. It is healthy and sound that this much of life they should take for granted as a basic right. 2

In this respect, J. Bowlby says, "The provision of a proper diet calls for more than calories and vitamins; we need to enjoy our food if it is to do us good. In the same way, the provision of mothering cannot be considered in terms of hours per day but only in terms of the enjoyment of each other's company which mother and child obtain." (Maternal Care and Mental Health [Geneva: World Health Organization, 1951], p. 67.) 165

The Art of Child Placement But it is equally natural that the foster family that has done a hard job might expect to be thanked. The foster family must be content with thanks from the agency and a conviction that it has done a fine job whether anyone else is aware of it or not. Not infrequently a child is cold, unresponsive, and—most annoying of all—openly critical of foster parent behavior and standards. He may insist that "things" were done much better in his own home. The fact that the foster family knows this to be false offers only a little comfort. Julia Anne Bishop has described the problem well: "The placed child must work out his problem on and with people with whom it did not originate. Through an act not of his own will, the objects on and through whom he has expressed his problem, have removed themselves from his reach. . . . The child separates himself from his attachments, ambivalent as they often are, with difficulty, often trying to recreate the old situation in the new, to put on the new all the bad of the old, leaving the good unrealistically in the old. This is a familiar phenomenon of placement. It is, of course, not wholly a matter of separation, but of incorporating this experience and of rifting in himself the change incident on such an incorporation."3 What this all adds up to is that social workers are constantly searching for foster homes that exist only in Utopia. "Foster parents should be able to succeed or fail without excessive involvement of their own security; foster parents should be willing to accept a secondary role and to remember always that their task is to serve children, not to find satisfactions of their own." To set down neat rules like these and expect always to have them govern is vain, and to realize how often a placement is short of meeting all requirements is frightening. But it need not be too frightening, for experience shows every social worker that foster families falling short of the ideal are still doing magnificent things for children. Day after day, year after year, a worker stops to catch her breath at the realization that 3

Julia Anne Bishop, "The Child's Part in Adoption Placement," Adoption Practice: Casework with Parent, Child and Foster Parent (New York: Child Welfare League of America, December 1941), p. 17.

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Casework with Foster Families another set of foster parents, with her help, has accomplished the impossible. SOME CHARACTERISTICS OF FOSTER MOTHERS

When Eugene Field declaimed that little girls are made of "sugar and spice and everything nice" and little boys of "frogs and snails and puppy-dog tails," he was guilty of some pretty serious errors—the kind of errors, both physical and psychic, that grow out of generalizations. Perhaps, as so often happens, he could find no "body of authoritative literature" on the subject, yet felt that even without footnotes somebody should say something to describe such interesting and common phenomena. Anybody describing the characteristics of foster mothers and fathers as individuals can be little more scientific. Empirical observations have to provide the material for such descriptions. Yet one generalization about foster mothers is repeated again and again in what little literature there is, and the comments of many child placement workers I know, as well as my own experience, bear it out: Foster mothers tend to be the dominant members of their families* In recent years the word "dominant" in reference to women has taken on a kind of disrepute which I do not believe it deserves. Is it perhaps due to sloppy thinking that it has become confused with the word "domineering"? To my way of thinking, these words are not even second cousins by marriage. The dominant foster mother is the member of the family who most often makes its decisions. This does not mean that she is domineering and overrides everybody's wishes, but that she is her family's leader. That kind of family has been described by sociologists as a matriarchy. One evening, returning from a long day of foster home calls in the country, I was switching my radio dial about when I suddenly caught a small part of a speech. The speaker, whose name * O. B. Markey and Helen Noble, "An Evaluation of the Masculinity Factor in Boarding Home Situations," American Journal of Orthopsychiatry, 6:258-267 (April 1936); Anette Garrett, Casework and Treatment of a Child (New York: Family Welfare Association of America, 1941; pamphlet).

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The Art of Child Placement I never learned, appeared to be a social psychologist of some prominence. He was speaking on the subject of matriarchal and patriarchal homes that had been studied in postwar Germany. A surprising fact had emerged from the study. Children from patriarchal families had been pro-Nazi; those of the matriarchal had been anti-Nazi. The speaker explained it this way: Women have traditionally stood for the values that stress peace, love, and values of the home. Men have been more ambitious and daring and have found excitement and interest in military and imperialistic ideas. A snatch from a speech like this doesn't prove anything. But it led me to some new thoughts on the "dominant woman." The dominant woman of Germany had influenced her children toward most undomineering goals. I think social workers find a high degree of dominance in foster mothers because they are the kind of women with excess energy who take steps to channelize it. Walking into an agency to fill out a form to take in foster children is one form of expression for it. I once asked a foster mother who was past the two-and-a-halfyear point with a youngster whom she had expected to have for only a few months whether she would take another foster child when hers was ready to return home. She gave me the easy, relaxed grin which young Tom had found so easy to take. "Who knows?" she said with a little shrug. "The first thing I took on was running a boarding house. Next, it was assisting a nursery school teacher. After Tom goes, maybe I'll take a little girl, or a baby, or maybe I'll go in for politics." Her response showed clearly the typical pattern of the foster mother with more than enough energy and that extra energy always finding its outlet in helping human beings. Since the foster mother is to do most of the job of caring for the child, the fact that she makes the application that sets the wheels in motion is a selective factor operating to bring "dominant" women to the doors of placement agencies. The adjective, of course, applies in varying degrees. I have known some foster mothers so dominant in their own homes that 168

Casework with Foster Families the word "domineering" unquestionably also applies. And conversely, I have known some who lead their families with so fine a filament that their leadership is almost invisible. Like any character trait, its intensity will need evaluation for specific uses, specific cases, specific children. Foster mothers couple with the strength of personality that makes them dominant a higher degree of energy and drive than most women. They get their housework done more quickly; they give abundantly to their own children; and yet they have something left over for the "extra" child. Their drive is also shown by the fact that when their own children have married and left home, they feel young enough and energetic enough to start in on another family. They like to be busy and occupied. Some of them are excellent housekeepers; others, impatient with routine, give their houses "a lick and a promise." Foster children usually prefer the latter type—especially little boys. One day I was taking a nine-year-old to his third foster home. He said, "Will this home be all neat and clean like the Daily's, or nice and messy like the Murphy's?" Adolescent girls, on the other hand, can be quite upset by a foster home with casual housekeeping standards; no matter how messy their own dresser drawers may be, they are often exacting about cleanliness in the kitchen. Regardless of what children want, however, more foster mothers are casual housekeepers than "neat as a pin." I once heard a homefinder tell a student, "Beware of the nasty-neat house." Nor is the casual housekeeper-foster mother much concerned if the social worker or the minister drops in to find her sewing doll clothes with the children before the vacuum has been used. She is not apologetic about being seen in an apron, or for the way she lives and works with her family. Foster mothers fortunately have very little sense of family privacy. They are quite willing to reveal areas of their family life that many women consider "personal." Without being asked, they may tell their social worker what their family income is; that they "flunked out" of high school; that they can't stand their mothers169

The Art of Child Placement in-law; that they quarrel with their husbands over bridge, budgets, or radio programs. They are able to discuss their own behavior and that of the members of their family without reticence. One social worker told me that a foster mother said to her, "I've got two adolescents in my home fighting like banty roosters over who gets the newspaper first. You brought me one, and I picked out the other myself twenty-nine years ago!" It is well that the sense of privacy is not acute because the foster child would make it hard for foster mothers if it were. I've seen several foster families who had a need for privacy give up because they couldn't stand "living in a goldfish bowl." I remember overhearing the executive of an agency talking with such a foster mother. He said, "You and I are alike that way. I wouldn't like a social worker talking our private affairs over with me or my wife. I suspect most people are like that. But it's fortunate for us social workers whose business it is to find homes for children that there are a few who don't mind a bit." The typical foster mother is proud of her role as a foster mother, but doesn't like to be called a "boarding mother." She likes to be known as a woman whose home has been formally licensed and approved by the state. She takes pride in telling her friends and neighbors how much the agency appreciates her work. When state licenses are renewed each year, the social worker may think of it as a pretty routine piece of red tape, but many a foster mother takes it to be a renewed vote of confidence. Her pride in her job is often shown by the fact that if she is asked to appear in a promotion picture in the paper, she is glad to do it. The typical foster mother has some imperviousness to"what the neighbors think." One foster mother advised a woman who was thinking of applying to an agency, "Never ask your family's advice. [She had reference to grandparents, uncles, and aunts.] They'll think you ought to see a psychiatrist. And your closest friends will start looking for the newly sprouting wings." The foster mother makes her decision rather independently, without much regard for what the neighbors think, and she spends little time worrying about their views afterwards. When a foster 170

Casework with Foster Families girl of seventeen had a "date" who brought her home in a "clunk without a muffler" after midnight, the foster mother was annoyed with her not because the neighbors would be shocked, but because they would be awakened. This, she explained, wasn't f air "because they had to get up in the morning and go to work." Foster parents often somewhat unrealistically expect others to have the same warm understanding and acceptance of pathos back of a sick child's behavior that they do. One foster mother was puzzled because a neighbor was deeply shocked by the behavior of her child. Each day when he went out to play he built a little mountain of snow on which he carefully deposited his feces. The foster mother (who was unhappy because it was one more sign of the child's deep disturbance) was totally unable to understand why the neighbor should act "as though there were something immoral about it." But if the typical foster mother lacks ability to sympathize with the conservative attitudes of her neighbors, she has a real talent in empathizing with her foster children and often with their parents. The stories of foster parents' ability to empathize with children are legion. I remember one instance that showed a social worker that her new foster mother was going to be a good one. She said, "Remember when you brought Sally with all her belongings in that little paper bag? The only thing she had that you might call a toy was a dirty little lump of clay. Well, I've had the worst time taking care of that clay! I knew there would be times when she'd feel lonely and want to have it and so I tried to put it in a safe place. But someone was always finding it and trying to throw it away. She doesn't ask for it often any more." And another episode showed the great motherly warmth that will guide a foster mother. This one came in a letter from a foster mother who lived in the country. A mother who had had psychotic episodes had visited her baby in the farm foster home that day and had, the foster family thought, taken the bus back to the city. The foster mother wrote: "About midnight a neighbor telephoned and said a crazy-acting woman was wandering in his orchard. Somehow he got the idea that it might be Janie's mother. 171

The Art of Child Placement Well, Ted and I hopped right in the car and went over. When 1 found her, I just kept talking to her softly and saying, 'Ida, wouldn't you like to come back with me to see your baby again?' Poor thing, she was so dazed, but she seemed to understand and trust me. We got her home easily enough and I gave her a hot bath and a strong sedative—I was afraid to, but I was afraider not to—and she let me tuck her into bed just like a little kid. Then I remembered my promise and lay Janie beside her until she fell asleep. I tried to reach you, but your phone didn't answer. Ted put through a call to the state hospital. They were ready to come and get her that night, but Ted persuaded them to let her sleep until morning. It would have frightened her so, and we never wanted her to get the idea she couldn't trust us." Fortunately, this is hardly a typical problem. Few foster mothers have to face as challenging an emergency as Janie's foster mother did. But the steady thinking, the warmth and gentleness are quite typical. Janie's foster mother was of the "motherly" type. She, like most others, could mother a troubled child (or parent) as easily as she could whip up a batch of biscuits for lunch. She would have made a good nurse; but she made an even better housewife. For like most foster mothers, she was really wedded to her home. If the fact that a foster mother is the dominant member of her family suggests to some people a strain of masculinity in her makeup, her love of homemaking denies it. No matter how big the laundry, how many hours she sits up with a sick child, how many people turn up at her table for a meal, she takes it in stride. She rarely complains about the amount of work she has to do. She assumes that this is part of her role and she likes it. The foster mother is not a career woman. It rarely occurs to her, for example, to solve her financial problems by taking a job outside home. In fact, when financial problems become so acute that a foster mother has to "give up" and "work out," she often shows signs of vocational maladjustment. Nevertheless, she is a good business woman. She is a much better shopper than the average social worker. She knows how to cook 172

Casework with Foster Families nutritious meals on a careful budget. She is concerned about lights needlessly left on. And she takes marked interest in her check from the agency at the end of the month. More than one foster mother has the habit of coming to the agency to get the check, especially if it is to be mailed on a Friday and might not arrive until Monday. In general, foster mothers are much more concerned about their financial remuneration than are their husbands. Foster mothers are not entirely "born that way;" like everyone else, they are a product of their life experiences. But they need a great deal of help and they grow into their jobs as they practice them. Some of the faults that social workers often find in new foster mothers are related to their strong identification with the child against what they consider to be a hostile world. The identification may show itself in impatience with teachers, in an almost childlike intolerance at the complaints of "crabby neighbors," or —if a child is involved in delinquency—in sharp criticism of the police. It is important for a child to feel that his foster mother is strongly on his side. But since the healthy child should have an acceptance of sound authority as represented by schools and police, he may be confused by the fact that his foster mother seems to reject them. Here is an area demanding real help from the worker. One aspect of the new foster mother's identification with the child against the world that social workers often see with some amusement is the foster mother's wish to "protect the child from the agency." I have said "amusement" because the problem can be worked through rather easily as the foster mother comes to trust the agency and the worker. A foster mother will often, for a time, hold back evidences of the child's failures. When they become frightening and she decides to share them with the worker, and when she sees that the worker is as much on the child's side as she is, the problem is half licked. The average foster mother, once she has learned that she can trust her worker, takes real enjoyment out of the teamwork between them in helping the foster child. She especially enjoys 173

The An of Child Placement sharing evidences of progress. And the typical foster mother gets a sharp feeling of progress even when it comes in millimeters. The fact that Harry's mark in conduct went from F-plus to D-minus is often worth a happy telephone call. The fact that one angry litde girl forgot herself enough to say, "Gee, thanks!" merits rejoicing. Foster mothers are clearly made of sugar and spice and something much more positive as well. The qualities that make a really good natural mother have always been revered in our society. And these are part of the foster mother too. But the woman whose motherliness reaches out to children not her own and takes them in to love, nourish, and heal has about her a kind of Olympian goodness that defies description. Those who are privileged to work with such women can only feel very humble. SOME CHARACTERISTICS OF FOSTER FATHERS

In the literature of social work, the foster father is truly the forgotten man. A reader might almost get the impression that foster homes were usually fatherless homes. The typical foster father is a warm, giving, likeable man who makes an important contribution to the lives of foster children. Since the foster mother is usually dominant, it follows that he is usually somewhat retiring. He is not what youngsters call a "mouse" or a weakling, but he is a man who has found it most comfortable to let his wife make many of the major decisions of the family. Such a foster father is often employed in some line of work that does not bring full financial security to his family. More often than not, he has worked for the same large firm for years and years. He feels satisfaction and pride in his work and has a loyalty to his employers and a feeling that his company is doing "important" work. The fact that he makes not quite enough money to meet his family's standards (which are usually simple) leaves him with no bitterness or unrest. He is likely to be more aware that he is much better off than many people and to feel himself lucky. He gives the impression of being very well adjusted to his role 174

Casework with Foster Families in his family and in society. He is rarely aggressive or a fighter. (There is more unrest in his wife.) He has little defensiveness in his make-up. Whereas many men might be threatened if their wives say in front of them that they need more money, he tends to nod in agreement, draw on his pipe, and listen passively as she and the homefinder discuss the financial aspects of child placement. Foster fathers, for the most part, are happy family men. They love their wives and their children. They take an active interest in their home and its appearance. Most of them I've known have made things for their homes, ranging from simple shelves in the kitchen to truly handsome furniture. Most foster fathers have hobbies that involve working with their hands in their own homes in the evenings. Many of them enjoy teaching their hobbies to foster children, especially boys. Their work is careful, accurate. They may find little pleasure in working with a boy who likes to "slap a bird house together any old way." The foster father may be a man with a shade of femininity in his make-up. He talks unashamedly of "beauty." He likes his home to look well and will listen with interest, or even participate, when a discussion of color of the new kitchen curtains is under way. More often than not, a foster father gardens. He usually raises both flowers and vegetables, but he is proudest of his flower garden. Unlike his wife, he is not a fluent talker. He is a man of quiet. He rarely raises his voice excitedly. In an interview, the social worker has to make a special effort to draw him in. She needs to know his ideas because they are usually good ideas. He is a "thinking man" and respected in his family as such. His wife may make many of the decisions, but what her husband says counts heavily with her. He reads more than most men. He quietly turns ideas over and over in his mind before he brings them out. His ideas about foster children tend to be gentle, sensitive ideas. His wife will be able to "act out" what the child wants to have her do. The foster father, sensitively, may be the first to "figure out" what the child wants. 175

The Art of Child Placement Foster fathers spend many hours a day with foster children— some, of course, a great many more than others. The child and the foster father may work side by side, or may on Sunday fish in the same boat. Some children give more of their confidences to these quiet men than they do to their bustling wives. The foster father is a very valuable person to the social worker. It is he who teaches the boys how to be men and shows the girls what good men can be like. His opinions have a great deal to do with how the foster mother carries out her mothering. In most case histories, one finds only snatches here and there in regard to foster fathers. This is probably largely because of the mechanics of the social worker's day—she works roughly from nine to five, as he does. Therefore when she telephones, or visits, he is not at home. His opinions come to her secondhand from the foster child or the foster mother. Actually, he is much too important to be worked with in this fashion. He is worth an evening or a week-end call. (Child placement agencies, probably more than any other organization, need some way of compensating their workers for overtime. It's an essential part of the work and shouldn't be left to the generosity of the worker.) So far, I have described what seem to me the traits of "typical" foster fathers. But another type that is numerically significant among foster fathers is almost the direct opposite of the kind I have just described. This type makes the application at the agency. More often than not, he is asking for a boy who can give some help—with chores on a farm, errands at the store, or perhaps no more than with snow in the winter and the lawn in summer. It is quite clear from the first that this foster father is planning to take the responsibility for the boy and that he will actually assume what is usually thought of as the foster mother's role. This kind of foster father can be useful with certain kinds of boys— for example, the psychopath-like boy who needs a firm hand and some consistent habit-training, or a secure boy who is really eager to learn a trade. The dominant foster father is challenging to the worker. He 176

Casework with Foster Families seems to feel a little defensive about his role and to bluster a bit. Most workers find it hard to achieve a teamwork relationship with him. He tends to be somewhat harder on the children, somewhat more domineering than dominant. While I do not wish to sell these foster fathers short, for every agency has many very helpful ones among its foster families, for the most part they are less well adjusted, less generally helpful to children than the more typical, quiet, gentle man in the matriarchal home. In between the two types, who hit both ends on the "passivitydominance scale," are, of course, many other kinds of foster fathers. But these are the two that stand out in my thinking as most typical, and the first type is much more usual than the second. "OWN"

CHILDREN IN THE FOSTER FAMILY

The foster family's own children can be a most important part of the family from the foster child's point of view. Too often they are overlooked in the home study, and only after a child has been placed do they begin to come to life in the record—sometimes to the vast advantage of the foster child, sometimes to his great sorrow. One homefinder I knew always had separate office interviews with the children of each family she was studying. It was her theory that children, like their parents, need education in how it feels to be a foster child. She also believed that the "own" child's response to the coming of a foster child was likely to be romanticized and that the reality might be pretty disappointing. It is a common fantasy among children who are members of one- or two-child families to dream of adopting a perfect companion. The companion, usually of their own sex, will always be on their side. They will have a regular Damon-and-Pythias relationship, they think. When the foster child arrives, rebellious, sullen, perhaps unattractive and unfriendly, they are likely to feel they have been "gypped." For the truth is that foster children rarely prove to be, at least during the first months or even years, good companions to own children. I have learned to shy away from placing small 177

The Art of Child Placement children in foster homes with own children of similar ages and sexes. The inevitable rivalries are too threatening for the foster child, and the disappointment to the own child in the unsatisfactory companionship can be too severe. (This rule can sometimes be safely broken with adolescents.) Big brothers or big sisters have often been most important influences for foster children. And a baby—who accepts new children as puppies do—can be one more loving and accepting person in the foster child's life. A firm look at the own children, whatever their ages, will tell a social worker a great deal about the kind of family she is working with. A social worker should not be too surprised to find minor signs of maladjustment in the children. Very often the fact that parents are frightened or baffled by their own children will lead them to apply for a foster child. Sometimes their idea is a simple one—their child is "lonely" or "selfish" and will benefit by the presence of another child in the home. More often, it is that they expect to learn something that will help them with their own child. This is especially true while their own children are in the stages of acting-out adolescence. If the maladjustment is deep, the home probably should not be used, for it goes without saying that most foster children do not make very good disciplinarians or therapists. If it is minor, the social worker will lend an ear and a hand to the problem of the own child, not being overconcerned that she has strayed a little from the basic structure of her role. I remember a foster home in which a woman who took superb care of agency babies became so concerned about her own sixteenyear-old son's sudden and almost violent interest in girls that she could hardly continue to work with the agency. The foster mother was the kind of mother who did beautifully the work of mothering babies but found helping her own child to grow up a tougher assignment. Her social worker gave her a great deal of support and help so that the boy was eventually able to take his girl a corsage that his mother had made from her own garden flowers, and the agency's babies went on getting expert care. 178

Casework with Foster Families Sometimes it doesn't turn out so well. Occasionally the placement of a foster child is deeply threatening to an own child and the social worker sees to her dismay that in trying to help one child she has hurt another. In this instance, she has a solemn obligation to do what she can to heal any wounds the foster child's presence has made, and if it is a situation without easy solution, not to use the home again. Not infrequently, there is in the make-up of the social worker something that especially identifies with the sad, rejected children of the world and that is bored or indifferent toward relatively secure children. This attitude can result in indifference toward the own children in the home that may express itself mildly by disinterest or sometimes by thoughtlessness. A social worker cannot ignore own children. If she does, she cuts off one facet of her relationship to the foster mother, for mothers do not take warmly to people who ignore their children. What does a social worker do to her happy foster home if the agency child gets a bigger allowance, has nicer clothes, goes to the circus, and has many advantages over the own child in the family? What has she accomplished if through placement she has made other children insecure? It is not complicated or difficult to be thoughtful of own children—but it is important. A homefinder I know has a nice story about an own child. The family had four adolescent girls in it. It had applied for a foster child of about kindergarten age. The homefinder, in her office interview, asked one of the girls whether the home wanted a boy or a girl. The girl answered, "Honestly, I've thought and thought about it and I don't know. All us girls would like a girl because we're girls and—well, I don't know how to say it—but girls like little girls, like dressing 'em up, making doll clothes, and all that stuff. But we think that's not fair to Daddy. He's never had a boy and a boy sure would be nice for him. But we're not sure four girls would be good for a boy. We might make a sissy of him! And then there's that business of having to give him back to his mother. Having to give up a girl in our family might be easier than having to give up a boy. Gee, I don't know. You must 179

The Art of Child Placement know best about stuff like that—you're the one that's supposed to be the expert!" Any social worker who overlooks the ideas of a thinker like that young lady is missing a bet. PROBLEMS IN WORK WITH FOSTER PARENTS

Probably more problems arise in foster home work in relation to work with own parents than in any other area. It seems intrinsic in child placement that the hard core of the problem lies here. Almost without exception, for a variety of reasons already discussed, the kind of person who needs placement for his child will not be the kind who will be thoughtful, appreciative, or helpful in his relationship to the foster parents who are caring for his child. The most common problem that arises is that the foster parents cannot really like the own parents. This difficulty is aggravated by the fact that own parents often behave thoughtlessly. A foster parent may feel quite appropriately that he has agreed to take in a child, but that having one or two extra adults on his davenport for many hours each week is quite another thing. The problem of competition for the affection of the child, whether it is real or imaginary, is another manifestation of the lack of real warmth that exists between two sets of adults. A social worker does what she can to discourage the own parents from long visits in the foster home, especially when the foster parents object to them. Since the purpose of having the parents visit is to let them see the children, the worker often suggests that it would be best to take them away from the foster home. But there are many times when this is not feasible. Foster parents are urged not to involve themselves in discussions with the parents about the disciplining and handling of the children. Nor should they discuss the casework plan as to how, if, and when a child is to begin again to live with his parents. Foster parents should recognize this as the social worker's job, but often they don't. Partly this is because they become so involved in the future of the child that they cannot resist pointing out to the parents what they should be doing. When foster parents assume this 180

Casework with Foster Families role in relation to parents, the parents may become defensive, and the caseworker's wish that they should arrive at their own decision independently is frustrated. But even when foster parents accept and try to live up to this passive attitude with parents, the situation is still very difficult. The subjects the social worker would like them to avoid are precisely the ones that the own parents want to discuss—and this is quite natural. Actually the role of the foster parent in relation to the own parents is an unnatural one that calls for a rare brand of disciplined emotions. Foster parents need all the warmth and support that their worker can give them. Interpretation is helpful, but sometimes sympathy is more helpful. Once a foster mother said, "At first I felt as though we could have had a little more sympathy as we faced the problems Larry's mother brought us. That is, that all her undisciplined behavior did not need to be explained and excused as evidences of insecurity, or her need for affection and so forth. This was unfair of me, doubtless, but it is the way I felt." This warm, intelligent woman gave an important message to social workers when she said that sometimes—especially when the going is roughest—too much interpretation can be irksome. Second to sharing the child with the parents is the problem of sharing it with the agency. The foster family may feel that the life with the child would be simpler if there were no social worker in the picture. Important among the areas of "sharing with the agency" which some foster parents have found difficult are the following: the interviews with the caseworker (which more than one set of foster parents has found to be upsetting to the child); the acceptance of the social worker's feelings about discipline (in the broad sense of the word); and anxiety over psychiatric treatment that the child is receiving. Psychiatric treatment, with its release of repressed feelings, may cause the child to behave worse rather than better, especially early in treatment. Then, too, there is still a great deal of superstition about, and resistance to, psychiatry. The meaning and purpose of psychiatric treatment should always be carefully explained to foster parents. Sometimes, when 181

The Art of Child Placement their resistance is strong, it is helpful to have them meet the psychiatrist. These areas of sharing, which are understandably difficult, can result in behavior on the part of the foster family that really creates new problems for the social worker. The most extreme response is to try to shut the social worker out of the child's life entirely. Of course, foster parents should not be allowed to do this; but there have been times when it has happened, and a new worker trying to find a re-entry will have to work long and hard and may in the end have to resort to the use of the authority of the agency. This is the kind of problem that needs to be prevented before it arises. Fortunately, the rejection of the agency is usually much milder. A foster mother who feels annoyed by her tie to the agency may punish the agency in subtle, little ways. One foster mother of whom I heard was always "too busy" to see her worker and would break appointments, or insist on the worker's coming in the evenings. Another refused to submit her statements for extra expenditures monthly, insisting that she operated on a six-month budget. Others found it impossible to keep sales receipts. All of these forms of negativism should suggest to the social worker that something is unsatisfactory from the foster parent's point of view in his relationship to the agency. The problems should not be solved on the surface—for example, by refusing to pay if bills are not submitted on time—but should be regarded as symptoms of a disturbed relationship to the agency or worker. There are many kinds of problems in handling agency money. There are as many foster parents who feel that the agency is too liberal as who think it is too "stingy." Whenever possible, the agency should try to adjust the child's clothing expense, allowance, and so on to the standards of the foster home. If the foster mother has a hand in these decisions, she will be best able to accept them. But the extravagant foster mother who casually submits a ten-dollar dry cleaning bill month after month is probably as much a problem to her husband as to her agency. She, like the extravagant child, will have to be given a budget and a set of 182

Casework with Foster Families limits. For the most part, though, foster mothers are real experts at budgeting and it's an unusual social worker who has much to teach them. The opposite of the foster parent who expressed her troubled feelings about sharing the child with the agency by "pushing the social worker out" is the one who is overdependent on the worker. Usually one discovers this to some extent in most new foster mothers. I remember a puzzled social worker bringing a telephone message to me that read, "Mrs. Kline would like to sun-bathe the baby this morning. She wonders whether you think it's warm enough." Mrs. Kline had brought up two children of her own and had had no trouble with such decisions. The social worker was right to feel puzzled. I once knew a social worker who busied herself answering such questions and even making suggestions. Her reward for her pains was hostility from the foster mothers. If a social worker's manner suggests that she feels that the foster mother is incapable of making minor decisions, she is denying that woman's ability to be a foster mother. When such questions arise, it is sometimes because the foster mother really wants to talk about something else, or perhaps that she has an excessive sense of responsibility for a child not her own. Foster parents need help in the definition of the extent of their responsibility. Their fears of certain kinds of acting-out behavior, such as is sometimes found in adolescents, may be much greater in relation to foster children than it would be in relation to their own. The fear that "the girl will become pregnant" or that "the boy will get into trouble with the police" is a very real concern to many own parents. But some foster parents may fear that they will somehow be legally or morally responsible to an even greater extent with foster children than they would be with their own children. This can result in too much restriction and a feeling on the part of the child not only that he is not trusted but that perhaps he is really expected to "go wrong." It cannot be said too often to foster parents that they are not and cannot be held responsible for the behavior of foster children. The behavior problems of foster children arose in another setting 183

The Art of Child Placement in which the foster parents had no part. In giving the child a chance to become well, the foster parents are making a contribution to him and to society. The thought that society could turn around and punish them if they did not succeed would certainly be an excessive burden to carry. Often foster parents say, "If he were my child . . ." The implication is that then they would be better able to cope with the problem. These sentences should not be allowed to trail off unfinished. It is important for the social worker to know what the foster parents would have done and, if possible, to give them support in doing it. Not infrequently the answer would be, ". . . give him a good spanking." The "need to spank" is an interesting manifestation of our culture. Social workers as a group are a little more "against" than "for" spankings, I believe. They were probably spanked when they were children and may have almost as deep an emotional respect for the old adage "Spare the rod and spoil the child" as foster parents do. And yet, their experiences as social workers may lead them to question whether spanking really works. The majority of delinquent children are rejected children. The majority of rejected children are often-spanked children. It took a great deal more, the social worker has seen, than the liberal use of "the rod" to make these children "mind." Spankings, she may conclude, are all very well for some well-loved, secure children, but not for frightened, insecure children. But what can a social worker do when a foster mother really believes that she herself is a good woman largely because when she deserved a spanking, she got it? What can a social worker do when foster parents feel that their own children turned out well because they got a "paddling" on appropriate occasions? My feeling is that when spanking is a family tradition, the unspanked child may feel himself an outsider until he has been initiated. And the foster parents may invest too much energy in not spanking. The spanking probably won't be effective, but it may make the foster parents feel that they have tried what they had believed would work, and this will free them to go on to more creative 184

Casework 'with Foster Families types of disciplining. Most young foster children I've known have tasted some kind of corporal punishment in their foster homes because this is the American pattern of child rearing. Except in extraordinary situations, the decision of whether or not to spank no more belongs to the social worker than the decision of whether or not to sun-bathe. The chief difference is that one decision is "emotionally loaded" and the other is not. The need to spank may very well be the foster parent's need to act out one more gesture that shows that decisions concerning the specifics of disciplining the child are his to make. The specifics of discipline cannot depend on the social worker. The large scheme of discipline is hers rightfully as an expression of her diagnosis of what the foster child's deep needs are. But not the little details. These belong to the foster parents. Problems raised by foster parents in relation to the agency or the social worker can usually be met through sympathy and education. When they cannot, there is a strong suggestion that the problem lies within the original motivation of the family. The possibility should always be considered that the family really wanted to "have" a child in the adoptive sense of the word, and that therefore sharing with parents and agency is too difficult. The agency has made a serious error in this case and if it cannot be corrected, the home should not be relicensed. The opposite of the wish to have a child is a startling indifference toward, and lack of insight into, the feelings of the foster child in giving him up. A most common problem that child placement workers face is the willingness of foster parents to give up too easily. Few foster parents have been deeply rewarded by their efforts during the first three months of placement. And yet many a foster family has felt willing to quit after a few weeks. Social workers can sympathize, because they know that a few weeks with certain children can be physically and emotionally exhaust ing. At the same time, their primary sympathy must go to the child, who has been asked to try a hard thing and has put a great deal of himself into the effort. (Incidentally, foster parents must be helped to see that even the child who seems to be almost 185

The Art of Child Placement completely negative is nevertheless investing heavily in the effort of becoming part of a new situation. Many children must "fight" a new home before they can begin to accept it.) Another form of willingness to give up that is even more distressing appears in the act of some foster parents in pushing a child out of the foster home before he is ready to go—often for trivial reasons. Sometimes he is told that if he doesn't behave in a specified way, he must leave. Every effort should be made to teach foster parents before crises arise not to use what social workers call "the threat of removal." No own child faces that. He knows that no matter how recalcitrant he is, he still has rights as a member of the family—one of them the right not to be sent to find another home. The threat of removal is tacit in foster home placement. Each foster child knows deep inside of himself that it exists. Sometimes at the beginning of placement, he will cautiously test his foster parents to see how quickly they will throw him out. If they are going to be like that, he reasons, there's no use putting forth much effort in getting along with them. The fact that children will very often be asked to leave a home because of their behavior is one difficult aspect of the job of a social worker. But even harder, I think, is the fact that they may be asked to leave so that a visiting relative can have their bedroom, or because the foster mother is going to have a baby. The family who gives up a child for superficial reasons, of course, never had a very deep tie to him. But the child's tie to them may have been as deep as he was capable of making it, and the inability of the family to see the pain they cause him is frustrating. Sometimes I think this is the terrible price exacted by the fact that some children cannot belong totally to their own parents or to their foster parents. It is obvious, of course, that the superficial reason may cover a deeper one, like a basic rejection of the child. But every agency has known women who are always eager to take a child, but quite casual in presenting a weak excuse for giving him up a short while later. Occasionally, a good foster home may cease to be useful be186

Casework with Foster Families cause of a factor external to agency and child—a private, family problem such as financial reverses, marital discord, illness, the arrival of an aged dependent. In these instances, it will usually be the foster family itself which will see the problem as too big and will ask to be relieved of the responsibility. The ultimate in problems of work with foster homes is reached, I believe, when a child has to be taken from a home against the wishes of the foster parents and the home is not to be relicensed. The home that wants to be relicensed and shouldn't be almost invariably has come to this pass through an agency failure. Perhaps the home should not have been licensed in the first place. Perhaps through the neglect or carelessness of the social worker, a bad situation has been allowed to worsen until it has achieved incurable proportions. When it is the agency and not the home itself which wishes to remove the child and revoke the license, the problem is really difficult. Fortunately, it happens rarely. But I, like other social workers, have some painful memories. I remember an old man who had been given an award for twenty-five years of service to the agency (and, most unwisely, shortly thereafter another child). He felt crushed and bitter a few years later when a six-year-old child was removed from his home to be placed in another. I remember a foster mother and father in their thirties whose home was being closed because the foster mother would not cooperate with the agency in the simplest requirements, and the child, who was unhappy, had been threatened with punishment if she told her social worker her real feelings. The foster father said, "If you say we are not 'good enough' to care for foster children, we ask ourselves whether we are 'good enough' to care for our own children. Who are you to set yourselves up to name this family 'good' and that family 'bad'?" I remember a foster mother whose love of gossip was stronger than her wish to be a foster parent. Reports came to the agency of stories heard on streetcars, at card parties, and many other places of the intimate and painful details in the life of the foster boy and his parents. The problem had been discussed with her 187

The Art of Child Placement several times, but she seemed unwilling or unable to give up entertaining her acquaintances with confidential material. There is no one simple clear rule that can be given to social workers to meet these problems, because they have a thousand different kinds of roots. The only rule should be that of sympathy and gentleness, helping the foster family to save face in every reasonable way that lies within the realm of honesty. In some instances a situation reaches a point where a social worker must choose what is best for the child. And when that choice involves pain to the foster family, this is the point at which she remembers that the child is her client and that she and the foster family alike are working, not for their own satisfaction, but in the service of children. WHICH HOME FOR WHICH CHILD?

Chemistry has always seemed to me a very pleasant science. You mix, I have been told, two parts hydrogen and one part oxygen and you get water. You bring together two elements and you get a compound. But foster home placement is not a science. It is an art, and a very unpredictable one at times. You bring together a family that wants a foster child and a child that wants a foster home and what you get may be not water but nitric acid. The chemistry of mixing human beings together is most delicate. Social workers have turned eagerly and hungrily to the social sciences to help them sharpen their tools so that they will know better what kind of humans to bring together. There are some rules of varying degrees of helpfulness; but in the last analysis, the decision is reached by a blending of human intelligence, intuition, experience, courage, and luck. The first rule, and a sound rule it is, is against sharp changes for the child in standards of living. I remember once, during a period of foster home shortage, bringing a young adolescent to his new foster home which was of the upper middle class level. To me it seemed "nice" but unpretentious. The boy, who had always lived in a run-down fourplex in a low-income district, 188

Casework with Foster Families stared at it with real concern. "Jeepers," he said, "am I goin' to live in that mansion?" He looked afraid. Anna Freud and Dorothy Burlingham have expressed these dangers well in writing of the problems of varying standards arising out of the billeting of children in the country during World War II in England: Children who are billeted on householders who are either above or below the social and financial status of their parents will be very conscious of the difference. If urged to adapt themselves to a higher level of cleanliness, speech, manners, social behavior or moral ideals, they will resent these demands as criticisms directed against their own parents and may oppose them as such. . . . With young children this may be just an expression of love and a desire to cling to memories; with older children it is an expression of their refusal to be unfaithful to the standard of their homes. Their reaction may, of course, also be of the opposite kind. The quickness with which they drop their own standards may be an expression of hostility against their own parents. When, on the other hand, children are billeted on families who are poorer than their own, they easily interpret the fact as punishment for former ungratefulness shown at home.5 In general, a social worker ought to try to avoid sharp changes in economic setting in either direction. And she should avoid mixing other kinds of extremes, too. For example, extremely bright, dull, rich, poor, neat, or sloppy foster parents will do best with children who, like them, belong generally in the same category of extremes. Because I believe that foster parents grow in their skill through experiences with children and through relationships with social workers, I do not like to try extremely difficult children in new homes. It is helpful to foster families to "try out" this new kind of experience with rather simple situations involving short-time care. A foster family whose skills have been proved by adequate experience is the most likely choice for troubled children. There are, of course, a hundred other factors that run up and down the scale in importance. The nature, skill, and experience 5 Anna Freud and Dorothy T. Burlingham, War <mrf Children (New York: Medical War Books, 1943), P- 37-

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The Art of Child Placement of the foster family and the problems of the particular child are not, in other words, the only things the social worker needs to examine. She must think at times of the relationship between own parents and foster parents; not infrequently the attitudes of "foster relatives" and neighbors must be taken into account. Transportation to school has in some cases I have known been so difficult that an otherwise ideal placement had to be abandoned. And what if a troubled youngster whose only affection has come from his fox terrier is assigned to a fine family that happens to despise dogs? Finally, there are times when following all the rules yields failure—and others when breaking them brings success. A social worker may balance all the factors into a neat equation, only to find that the child and the foster family don't belong together at all. And she may, in desperation, break some of the rules and discover that she has made a successful placement. Whenever possible, a social worker will follow the few simple rules she knows. But her reality often brings her up sharp against the foster home shortage and she is forced to risk some pretty unpredictable chances. Some of the most fruitful placements I have known have broken all the rules. For example, a distinguished scientist and his cultured wife showed special warmth and understanding for troubled, unhappy, rather ordinary little boys. A retired schoolteacher in her early fifties, who had never married, spent five happy years with a formerly delinquent girl who had "fought her way out" of a dozen homes. Three loveable old Swedish brothers who lived alone on a farm took fine care of a ten-year-old when his foster mother from a nearby farm was called away to another state for a few weeks to a dying mother. One excellent foster home had an alcoholic father in it. He was the kind of man who went to work each day, then came home and drank for three hours until he fell into bed exhausted. His wife and the social worker both understood the psychodynamics underlying his drinking and were sympathetic to him and his problem. He was steady and sweet with the foster children. Most of his drinking went on after they were in bed. Truly, it was a 190

Casework ivith Foster Families shocking disregard for rules, but there is no measuring what that family did for a dozen deeply troubled children. In no other area of her work is the child placement worker more aware that this is an art she is practicing—not a science. One envies the exactness of chemistry; but chemists, for all their miracles, cannot make gold. And yet the social worker who succeeds in making a good placement is a real alchemist, for to a troubled child a good foster home placement is pure gold. THE DU MONT FOSTER FAMILY (Susan Scott, child in placement) Scott Family History The Scott family is made up of five children: Sara, Janet, Susan, and Roger and Douglas (twins). All of the children were removed from their home on court order, with temporary custody given to Children's Aid, when Susan was three years old. This decision of the court grew out of a series of episodes in which policewomen were called to the home to find the children living in filth and squalor and left alone at night, with Mr. and Mrs. Scott intoxicated at a nearby tavern. The three girls were placed in separate homes. The twins were placed together. Mr. and Mrs. Scott were bitter against the court and insisted they wanted their children back. They continued to drink, however, and to become involved in fights with themselves and others. Mr. Scott did manage to hold his job as a painter and was rigidly careful to make his payments of a hundred dollars per month for the children's care. He considered this a guarantee that sometime he could have his family back. Mrs. Scott, one year after the placement of the children, was found to have an advanced case of tuberculosis and was hospitalized for three years at a sanitorium. She was a most difficult and uncooperative patient and the doctors were surprised when she made a recovery. Mr. Scott visited the children sporadically, especially at birthdays and Christmas. He was frequently intoxicated and objectionable in the foster homes, so that foster parents and children alike came to dread his visits. Mrs. Scott seemed to lose all interest in the children while she was hospitalized, but following her release 191

The Art of Child Placement she would frequently join her husband on his occasional visits to the foster homes. The agency found it impossible to work with the parents, who remained bitter, aggressive, and generally uncooperative. Mr. Scott was called to juvenile court annually for a review of the case. Children's Aid made repeated efforts to gain permanent custody of the children, but Mr. Scott and his attorney countered with passionate pleas about the cruelty of "a country that would steal children from a mother while she was fighting for her life." Efforts to prevent the visits of Mr. Scott to the foster homes were unsuccessful. The agency concluded that the only possible way to prevent the visits would be to turn to the police for help, an expedient which seemed worse for the foster parents and children alike than putting up with the infrequent visits. All of the children made fair adjustments to placement, but all showed troubled behavior and confusion following visits of the parents. Background History of Susan since Placement Susan was three years old when she was removed from her own home and placed in the foster home of Mr. and Mrs. Charles Du Mont. At the time she was brought to the home, she presented an almost classical picture of the neglected child. Though it was a chilly fall day, she had nothing on but a filthy cotton dress and a blanket in which she had been wrapped by the social worker. She was covered from head to foot with scabies. She was not toilet trained and she talked very little. The foster parents did one of those miraculous jobs of changing a little animal into a delightful, pretty child in a few months. The social worker was fascinated by the sensitivity with which this was accomplished. Susan loved her foster parents and made remarkable strides in placement. About a year after placement, shortly before Mrs. Scott was hospitalized, the parents "dropped in" on Christmas Eve. It was a deeply troubling experience to all concerned. The parents were 192

Casework with Foster Families both intoxicated and very defensive when they saw what the Du Monts had been able to do for Susan. They proposed taking her out visiting with them. The Du Monts thought the Scotts were in no condition to drive. A bitter argument followed that ended only when Mr. Du Mont called for a squad car, and the parents were taken to jail for the night. Within a week, the social worker was asked to call at the foster home. The Du Monts presented a plan. Mrs. Du Mont had inherited a farm a hundred miles away. For a long time the Du Monts had been toying with the idea of going back to farming. They asked permission to take Susan with them and to be given a guarantee that the parents would not be allowed to visit. The agency agreed to the plan. Susan was to visit with her parents at the agency in the future. The question of adoption was raised, but the Du Monts, in spite of their great affection for Susan, did not seem able to decide on adoption at this time. (The social worker had hoped that on the basis of the Christmas Eve episode, the judge might be prepared to act on the question of custody of Susan.) It was agreed that the move was to be made without knowledge of the Scotts. Children's Aid would continue to pay board and to supervise the case, though because of the distance involved, home visits would be infrequent. The agency was convinced that Susan was very well placed in a superb home and that both of the Du Monts were so conscientious that a great deal of the supervision could be handled by mail. The move to the farm seemed very successful. It was almost a year before Mr. Scott asked about Susan. He was told that he might visit with her in the agency if he would make an appointment a week ahead. Mrs. Scott meanwhile was hospitalized. Mr. Scott made two such requests a year apart but at neither time did he appear at the agency. It seemed as though the Scotts had almost forgotten Susan. The other children received Christmas gifts, but not Susan. Mr. Scott seemed to be drinking less. He had developed a rather pleasant relationship with the twin boys at the Sidney foster home. Mr. Sidney described him as "a diamond in the rough." 193

The Art of Child Placement Susan and the Du Mont foster family had one social worker until Susan was six years old. Then the worker left the agency and a new worker, Miss Fitzgerald, was assigned to the case. The Du Mont Foster Family The foster home study showed Mrs. Du Mont to be 45 and Mr. Du Mont 47 at the time Susan was placed. Both are high school graduates. Mr. Du Mont's work history showed that he worked on farms as a hired man until he was thirty, came to St. Paul where he got a job in the business office at the stock yards, and finally returned to farming. Mrs. Du Mont, before her marriage, worked as a governess for seven years for a wealthy family in Minneapolis. She is still the adored "Nana" of the children, now grown, who keep in touch with her. In the first five years of marriage the Du Monts had three stillborn children. Various medical explanations were given to them. It was a source of great sorrow to them, for they loved children. Both reached out to children through various volunteer organizations, but did not look upon adoption as a solution. Susan was their first foster child. The social worker talked to them on several occasions about adopting Susan but found them curiously blocked. They never completely rejected the idea, but usually asked for more time to make the decision. The social worker felt that they were frightened by the behavior of the Scotts and believed that heredity might cause Susan to become the same kind of person in adolescence. The following summary covers a two-year period of Susan in placement. It was written by Miss Fitzgerald, the new social worker appointed to handle the case, and was based on two home visits, in April and June. Evaluation of the home: The Du Monts are excellent foster parents in most respects. They give superb physical care. They are thoughtful and intelligent about most psychological matters. The two work together cooperatively, often discussing Susan and the most intelligent manner of handling her. They have done a fine job of anticipating many of her questions and problems. The 194

Casework with Foster Families fact that she is just barely bright enough to pass in school seems not to bother them. She is disciplined with firmness and consistency but is never threatened in the area of affection. Susan: Susan appears to be a healthy, outgoing, exceptionally secure child. School adjustment socially is very good, and her teachers have felt that she works up to the limit of her capacity. She has had limited and even false interpretation of the reasons for being in placement. She understands only that her mother is hospitalized and that her father is unable to care for her and her siblings. She has never known a working relationship with a social worker since the day of placement. Problems inherent in the situation: The glaring problem is that this is a case that goes along on a day-to-day basis with no plan for Susan's future. Neither social worker nor foster parents have given this child adequate opportunity to express her feelings about her parents. The ambivalence of the foster parents toward adoption should be worked through to a definite decision. A plan should be made to bring again to the attention of the court the aimless drifting of the Scott children toward maturity. Either the parents should be helped to make a plan for Susan and her siblings to live at home, or Susan should be helped toward adoption in another home if the Du Monts do not want her on an adoptive basis. The solutions are not easy, but they are vital to Susan's welfare. Both the foster parents and Susan must be helped to see that a plan with no future is unfair to the child. Foster Home Visits August 5. Both foster parents were present; Susan, by prearrangement, was visiting at a neighbor's. Mr. Du Mont quite directly expressed concern over the frequency of my visits. The previous worker had called only about once a year. Did this mean that either the agency or I was concerned about the adequacy of the home? Was something going on that the Du Monts did not know about? I outlined the problems as follows: (i) the Scotts' future relationship with their children was an unknown quantity—at any 195

The Art of Child Placement point they could demand the return of their children and the court might support them; (2) Susan was living in a vacuum, with no past and no future (interpretation of the danger of this manner of living for foster children was given); and (3) the Du Monts' wish to go along under the present setup, with Susan living with them on a temporary basis, gave inadequate security to Susan. The Du Monts seemed pleased by my frankness. They asked how they could cooperate. They too were concerned by some of the problems I had outlined. Sometimes they had discussed them together, they said. Mrs. Du Mont added with a laugh that more often they tried to pretend they didn't exist. The discussion of these problems with Mr. and Mrs. Du Mont had lasted over an hour. They were quick to agree that monthly interviews were indicated until we had arrived at some workable plan for Susan. An appointment was made for September 15. I suggested that we plan to focus on just one problem in that interview—how the Du Monts felt about adopting Susan if she ever became available for adoption. They agreed. September /j. Susan was at school when I arrived. I had indicated by letter that I hoped to see her after school and begin establishing a relationship with her. Mr. and Mrs. Du Mont began by saying they had talked in circles since our last interview and were afraid they were no nearer to an answer than before. I suggested that I might be able to help them. I raised questions and directed the interview along these lines: When their third child had been born dead, had they discussed adoption or thought of it as a solution? When they first took Susan, why had they done it? How had they seen their future in relation to her? I asked them to retell the story of the Christmas Eve quarrel with the Scotts. How had it affected their feeling toward Susan? What were their feelings about heredity and environment as they referred to Susan? The Du Monts are intelligent, cooperative people who genuinely tried to come to grips with the problem. They made remarkable strides. The talk about adoption and their childlessness was painful 196

Casework with Foster Families for them. This is more or less where they seemed to emerge in their thinking. Originally, they had firmly rejected the idea of adoption. No one else's child could take the place in their hearts of the three they had lost. They apologized for the attitude. I assured them that it was a perfectly healthy one and quite typical of the majority of people. The important thing was to understand how you felt about adoption before you got into it, I said. In taking Susan, they decided before they ever saw her that she would offer a test of what they believed to be their attitude toward adoption. Susan, in her pathetic, abused state, aroused deeply protective instincts in them. They wanted to protect her from future hurts. They hated her parents. With the beginning of affection for Susan came a feeling of responsibility. The Christmas Eve episode had accentuated their hatred of the Scotts, and their wish to protect Susan from her parents had led to attempts to try to help her to forget them. In regard to adopting Susan now, they felt that they really loved her and would be willing to do it if it were the only way to protect her from returning to "those awful parents." But—and this came out only with much help from me—they really didn't want to. What they did want was to continue with her just as they had been doing until I came along. I tried to help them bring out why they didn't want to adopt Susan. This came hard, but the following seemed to be their main reasons: (i) They felt a curious emotional disloyalty to their dead children when they put another child in their place. (2) They were beginning to plan toward old age and retirement in some southern state that would be warm in winter. A vivacious (and expensive) adolescent girl didn't fit in with their mental picture. (3) They were fearful of how Susan would turn out. They had heard some frightening stories about adolescence and didn't like the feeling of facing it without the agency standing behind them. When they considered the possibility that our talk might lead eventually to Susan's removal, Mrs. Du Mont shed some tears. 197

The Art of Child Placement She apologized for her inconsistency. Mr. Du Mont said, "Maybe we like kittens, but we're a little afraid of cats." I helped the Du Monts to see why they were excellent foster parents but not good adoptive parents. I talked through with them my plan of beginning to reintroduce Susan to her siblings and finally moving from her siblings to her parents. Regardless of whether Susan was to go on to adoption elsewhere, or whether she was to return to her parents, she needed to know them. Some of her secret feelings about them needed to be brought out. I talked about the dangers of repression, especially those of a foster child's feelings about his own parents. They verbalized an intellectual acceptance of this idea, though the application to Susan came hard to them, I know. I told them I'd like to see them in a month. If they'd put Susan on a bus on October ifth, I'd meet her, take her to visit her sisters in their foster homes and bring her home. Then I'd like to talk with them. We had covered a lot of ground today. Maybe after they had thought about it, they might feel differently. Then I had an interview with Susan regarding memories of her parents, the chance to meet her sisters, etc. (Part of Susan's record, not included here.) October 15. The Du Monts were threatened by what they had shared with me in the previous interview, as I had anticipated they might be. They asked, did they sound heartless? bigoted? selfish? They had forgotten to ask what I thought would be best for Susan. If I recommended adoption, they would like to reconsider. I talked to them about the special qualities that go into making good foster parents and how clearly they fitted the pattern. I tried to show how the impulse to help and protect a child without needing to "own" her made them able to give vital services to needful children. I said I hoped if Susan ever left, they'd take other children for Children's Aid. Mr. Du Mont said good-naturedly that in view of what they were going through at the mere idea of parting with Susan, this was certainly a "radical" idea. But it was obvious they were both pleased by the vote of confidence. 198

Casework with Foster Families I described Susan's happiness at "finding her sisters." They listened eagerly and Mrs. Du Mont suggested having Sara and Janet out next month for Susan's birthday. I said I thought it would mean a lot to Susan but that it would be hard for me to arrange transportation. Mr. Du Mont said they would "make a day of it" and do the drive both ways. Mrs. Du Mont said it would be interesting to meet the girls and their foster parents. I felt that the Du Monts' actually doing all this themselves would be a healthful dramatization to themselves and to Susan of the fact that Susan had a past. November 20. The Du Monts were eager to tell me of Susan's birthday party. Because of all the driving involved, Janet and Sara had stayed all night. Janet, Sara, and their foster parents spoke quite acceptingly of the Scotts, who were now visiting in their homes fairly regularly. (I commented that Janet's and Sara's foster parents were relatively new ones who had not known the Scotts during the time they were most difficult to get along with. Now, they were much better behaved.) The girls' foster mothers told Mrs. Du Mont that Mrs. Scott had "got religion" and was trying to be a better mother. They understood that though Mr. Scott still drank a good bit, he too was much easier to get along with. Susan was now excited at the prospect of meeting her twin brothers, and the Du Monts had promised to ask me about arranging a visit at Christmas vacation time. I took this opportunity to describe the intensive casework I had been doing with the Scotts to try to help them come to a definite decision—either that they were or were not going to establish a home for their children. I described the marked improvement in Mrs. Scott and told how she had swung far in the direction opposite to her old personality with her new religious zeal. I shared with them my theory that at the time the children were removed, Mrs. Scott had been suffering from some fairly acute mental illness that had been incorrectly described as alcoholism. 199

The Art of Child Placement I told them of the close tie between Mr. Scott and the twins and my expectation that Mr. Scott would request at the next annual court hearing that he and Mrs. Scott be allowed to try to re-establish a home with the twins. The Du Monts were startled. They said it seemed "criminal" to send two little boys into a home with "parents like those." I suggested that maybe the Du Monts were picturing the Scotts as they had appeared four years ago on Christmas Eve. They agreed that this was so, but wondered how much people could change. I asked them how much Susan had changed. They said, "But that's different." The Du Monts, after years of not having to share Susan, were seeing her slip back into her own family. It was an uncomfortable experience for them. I told them I knew it was being painful and helped them to express some of their fears and doubts. My interview with Susan showed an excited and happy child. She was thrilled to be finding her family again. She was full of questions about her parents, which I answered. I felt that Susan's major identification at present was with her new-found family. She was beginning to dissociate herself from the Du Monts. January 5. The Du Monts had written asking for this appointment. After meeting her brothers, Susan had been bubbling with questions about her parents. Why couldn't she know them as her brothers and sisters did? Why did the parents want her brothers and not her? Sometimes she was very close—even clinging—to the Du Monts. At other times they thought she was yearning to be with her own family. The Du Monts were hurt. They were also puzzled about the best way to interpret her parents' behavior to Susan after their long silence. I spent a lot of time in giving the Du Monts the first full, sympathetic portrait of the Scotts they had ever had—the forces that had pushed in on them to make them behave as they did, the live spark of family cohesiveness that had kept Mr. Scott paying his hundred dollars every month, the passion and paternalism with which he had fought annually for the custody of his children, the changes in both of them in the last years. 200

Casework with Foster Families Mr. Du Mont's eyes twinkled and he said, "You know, you're arousing our sympathy. Don't you know we don't want to like or even understand these people?" I acknowledged this feeling and ,we talked about its meaning. I said that while it was hard to guess about people like the Scotts, it certainly appeared as though it would be a very long time before they would bring Susan home. After all, they knew her least of all the children. Dougie and Roger were two lively youngsters, and if the court let the Scotts take the twins home, they might find that they had bitten off all they could chew. I felt that the movement in the Scott case was so rapid that it was leaving the Du Monts breathless. However, they were making a great effort to keep pace with it. I had confidence they would make the grade. February 15. Mrs. Du Mont complained about the length of time since my last visit. I reminded them that they had felt challenged at first by the frequency of my visits. We reviewed the many changes that had taken place since then and I encouraged them to express some of the negative attitudes that they must have felt when I came in and began to be the agent for so many changes in their peaceful style of living with Susan. They said that at first they had resented me, and at times they still looked back a little wistfully on their old relationship with Susan. Mr. Du Mont finished the review with the statement, "But it's all for the best. Now we've stopped playing ostrich. I think we all feel more comfortable." I told them that the court had sent the twins home on "six months' trial." There were rough spots in the adjustment, but actually it was going surprisingly well. They asked many penetrating questions about the Scotts in the full-time role of parents. Though they were still dubious, I felt they had made progress in their acceptance of the idea of the Scotts as "decent parents." Somewhat apprehensively I told them of the Scotts' request to see "our long-lost daughter, Susan," and that I had made a tentative appointment for March 13, in my office. 201

The Art of Child Placement Mr. Du Mont accepted the necessity of honoring the request, but said quite frankly that he hated it. Mrs. Du Mont said nothing^ but a few tears rolled down her cheeks. She blew her nose vigorously and said with characteristic humor, "You'll have to excuse me. My bladder always was too close to my eyes." I spent some time talking with them, regretting aloud that events had moved so fast for them. Then I went to tell a delighted Susan that plans had been made for her to meet her parents. March 13. The meeting of Susan and the Scotts was a very nice one, handled with great restraint by all three of them. Susan, on the ride home, was bursting with questions about her future relationship to her parents. I was happy to be able to drain some of this off, for I knew these questions would be uncomfortable for the Du Monts. Susan rushed excitedly into the house, kissed the Du Monts warmly, and proudly showed off the new blouse Mrs. Scott had given her. She asked whether she might put it on and show it to her best friend, Janie. This gave the Du Monts and me a good opportunity to talk alone. I described the meeting fully. They in turn were eager to tell me something puzzling that they had been observing in Susan. She kept telling them she loved them, almost as though she were insisting on it. I said, "Susan feels guilty because she thinks she's unfaithful to you. She doesn't know that she can love her parents and you too." They were quick with their sympathy. They were going to show her that it was all right with them if she loved her own parents too. Summary of visits from March 75 to January 15. During the next ten months Susan made a steady transfer from her foster home to her own home. Susan reminded Mr. Scott of his sister, now dead, who had always been his favorite relative. The Scotts said that Susan was the child for whom they had done the least. At the annual court hearing, Judge Olson congratulated them on their success with the twins and agreed with 202

Casework with Foster Families their request that they should now try to absorb Susan into their home. The Du Monts had some months of very real pain as they helped Susan prepare to leave them. She made a number of brief visits home before making the final permanent move. They gave lip service to understanding my description of the strength of the tie that binds a child like Susan to her own family, but I think they never quite understood why she should prefer her own family to them. Other things were hard too. For example, the Scotts' standards of physical cleanliness were much lower than those of the Du Monts. The fact that Susan would come back from weekend visits looking unkempt and even a little dirty was hard to take. As a social worker, I felt the Du Monts had more need of my help than did Susan or her parents. Fortunately they are people with great integrity, strength, and humor—a fact that made my efforts very rewarding. For the most part, I was struck by the "togetherness" of this couple in facing the loss of Susan and in all their thinking about it. One day, however, I had an interview alone with Mrs. Du Mont in which she expressed deep bitterness that she had never been able to deliver for her husband a live baby. Losing Susan now seemed to reactivate this old pain for her. During the last two months before Susan went home, I put my best efforts into getting a workable relationship going between the Scotts and the Du Monts. I wanted Susan to be free to visit the Du Monts often, for separation from them could be very troubling. After all, her placement with them had closely resembled an adoptive one. Of course, the Du Monts never came to really accept the Scotts. But they came to understand with less hurt to themselves why her own parents meant so much to Susan. When they saw how much Susan wanted a part in her own family they came to want this for her too. I was quite moved when I heard that Mrs. Du Mont had carried home a basket of mending to do for Mrs. Scott. "I like to mend while I watch television," she had said. "Besides, there's 203

The Art of Child Placement so little work for me to do, and you have more than you can possibly do." The Scotts, on the other hand, thoroughly accepted the Du Monts and were perfectly willing to have Susan visit them as often as she chose. About two months before Susan went home to stay permanently, I asked the Du Monts whether they would be willing to take, for a six months' placement, two brothers, four and six years old, who were recuperating from polio. They needed lots of specialized care including diet, exercise of diseased muscles, and a quiet, restful setting. The Du Monts refused unhesitatingly at first, but three days later wrote saying they'd be willing. Mr. Du Mont ended his letter, "We thought this was a trick of yours to keep our minds off Susan. At first we were going to concentrate on our misery. But we kept thinking of how those two poor little tykes needed us, and so, we're going to let you play your trick on us. ... I wrote the mail-order house for an extra bed today." Report of Two Years Later The Du Monts did a fine job of getting the little boys back on the road to health. All the Scott children eventually went home. None of them was ever as clean or as delicately handled as he had been in his foster home, but none would have given up his place in his own home for one in a foster home at a higher socioeconomic level. Susan visited with the Du Monts for a whole month the first summer after she went home and many weekends the following year. The Du Monts felt that she was not the same child they had known, but they could accept her changing. It hurt the first time she began spontaneously calling them "Uncle Chuck" and "Aunt Ellen," but they got used to that too.

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CHAPTER 6

Casework with Adolescents

THE RIVER OF ADOLESCENCE

A PARABLE

IN A far-off, ideal land that is neither here nor there, but is, in a sense, everywhere, there are two villages built near each other. One is called the Village of Childhood, the other the Village of Adulthood. Between them flows a river—wide, treacherous, difficult to swim. It is called the River of Adolescence. For the most part, there exist only good feelings between the peoples of the two villages and they live harmoniously and cooperatively. There is no bridge between the towns and there probably never will be. Communion between the peoples can be accomplished only by swimming. The very old, the weak, the fainthearted, and the lazy never cross, but live out their lives on one side or the other. Mostly it is the youth from the Village of Childhood who are to be seen crossing and recrossing the river—boys and girls alike. From early childhood they have practiced their swimming, each year daring to venture further and further into the treacherous waters. At last, sometime late in their teens, they are able to complete the crossing. Their motivation is keen, for there is a taboo against marrying a mate and remaining in the Village of Childhood. All through their childhood, they have looked to the opposite shore knowing that their mates and their futures were there. The manners of the young people while they are engaged in swimming the river are a source of interest and concern to their

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The Art of Child Placement families and their friends. It is a well-accepted fact that the youths may be overtired and irritable during the period of the frequent swimmings. Their parents need to show warmth, tolerance, and understanding. For it is not an easy thing—this crossing and recrossing the river, this choosing a mate, this decision to put behind oneself parents, home, and the town of one's childhood. The variations in the conduct of the swimmers of the River of Adolescence are great and a source of deep interest and concern to the watchers. Some swim out boldly and confidently, and after a very few trips announce unwaveringly that they have chosen a mate and are prepared to leave. Some who can make the swim easily enough cannot make the decision to stay. A few crippled or sickly youth who want to make the swim but are unable or fearful are helped by strong swimmers, sometimes a youth who is a friend, sometimes a friendly adult whose job it is to help the weak swimmers. There is no disgrace in needing help. But there is real worry about the unusual youths who do not wish to make the swim at all. Whenever a youth swims home to announce that he has found his mate, and has chosen the site for the home of his adulthood, there is usually great rejoicing, feasting, and celebration in his family. For though it is a hard thing to have a child grow up and leave his parents, it is a much more terrible thing to have him fail ever to do so. Mostly the parents are proud and pleased, and they heal their lonely thoughts with happy anticipation of the visits they will have when their son and new daughter swim back for visits—someday, perhaps, with grandchildren strapped to their backs! A boy or girl is considered a great treasure to these people, but a happy adult is even more precious. A few unfortunate parents behave ignobly when the time for their children to learn to swim approaches. Perhaps from early childhood they have taught their girl or boy to fear the water, to distrust the distant shore. Many of them believe that someday they will want their children to make the swim, but no matter how strong and tall their children become they are still considered too young. Some children accept the wish of their, parents that they 206

Casework with Adolescents remain children, but this is not a happy solution for it is apparent to them and to the rest of the village that they are too tall to remain in the land of their childhood. Sometimes an angry youth will swim out boldly in defiance of his parents' wishes. This too is sad, for the festivities at the farewell are clouded by cold hearts between the youth and his family and it requires many visits home before all hearts have thawed. One day there came to one of the villages a traveler and adventurer who had followed the river all the way to its source. Many and wonderful were the tales he told of the exotic lands through which the river flowed and the customs and manners of other people who lived along its shores. Of all the stories he told, there was one that interested them most. It was a story about two villages built far, far upriver. These villages were located exactly as theirs were on either side of the river. The strange part of the story was that at this point the River of Adolescence was invisible. Though it twisted and fumed between the villages, the people could not see it. Not being able to see it, most of them did not know it existed. Only a few of the very wisest people believed in it and understood it. Nevertheless, something within the youths still drove them to swim it. But they swam as though blindfolded, not knowing why it was so difficult or what they were swimming toward. The time for swimming the River of Adolescence in that foreign land where it was invisible and little understood was quite different, the traveler said. The youths who were making their first swims were tired, frightened, and confused. Their parents, who had no understanding of the invisible river, were angry, hurt, and unkind. A bitterness grew between parents and youth which made the swim through the invisible river in quest of the unknown goal much harder than it needed to be. It was a strange tale to think about, and the parents and the children remembered it long after the stranger had left. They counted themselves as blessed to live in a land where they could see and understand the river as they prepared to make the big swim. 207

The Art of Child Placement ADOLESCENTS ARE NOT "ALL ALIKE"

The social worker who would like to do successful casework with adolescents should be one who is well acquainted with the currents and eddies and shoals of "the River of Adolescence," as well as with the characteristics of its struggling swimmers. She should be a strong swimmer herself, and her eagerness to lend a hand should grow out of a genuine liking for, and understanding of, these youngsters. What are adolescents really like? Ask a thousand people and you'll get a thousand answers. I once overheard a mother chuckling fondly over something her eight- and ten-year-olds had done. Her companion, a woman in her fifties, nodded approvingly. "Go ahead and enjoy them now," she said. "They'll soon be adolescents and then you'll hardly be able to stand them. You won't like them a bit! Then all you can do is love them because they're yours." This woman's attitude was not atypical. Actually, she softened it more than many commentators would. Listen to some happily retired high school teachers, talk to librarians or druggists who have daily contact with groups of adolescents, read some magazine and newspaper articles, and you may come away with the feeling that adolescence is a dreadful disease of the personality through which most children (except a few very nice ones) pass in their late teens. You might also conclude that any free agent who chooses to work with them is a saint, a masochist, or a fool. Look to American literature for classical pictures of adolescents and you will find wide variations in types. There is no such thing as a sharp, clear picture of a "typical" adolescent. What do Meg, Jo, Amy, and Beth of Little Women have in common with Farrell's young Studs Lonigan, or Booth Tarkington's Willie Baxter and Alice Adams? And what in the personality of J. D. Salinger's Holden Caulfield in Catcher in the Rye would remind anyone of Henry Aldrich of radio fame? All these literary adolescents have one thing in common—the struggle to take the decisive step from childhood into adulthood. The authors who have written about adolescents truly, accurately, 208

Casework 'with Adolescents and skillfully have presented a varicolored group of humans; for adolescents are people (half child, half adult) and they can no more be successfully stereotyped than can their elders. Adolescents differ one from another in many ways. In personality, some are outgoing, some are withdrawn; some are generous, others selfish; some are eager and excited at the prospect of life ahead of them, others are fearful and troubled. The chronological age of adolescents varies widely. Usually, it is true, they are teen-agers. But adolescence is more a physiological and psychological state of development than a chronological one. Physiologically, a child becomes an adolescent upon reaching puberty. His physiological maturity is marked by changes which make him uncomfortably aware of a heightened capacity for love and hate and other feelings that want expression more fully than the mores of his society approves. The adolescent may find he is noisier than politeness permits. He may be subject to fits of giggling and raucous laughter and a few hours later to deepest despair. If he is a boy, he may express his depression through being grumpy and generally uncommunicative and "owly." A girl may express her unhappiness in the same way, or she may give way to sudden floods of tears. Ask the adolescent to explain the grumpiness or the tears; if there is any answer, it is likely to be an honest, "I don't know," or a painful search for some episode in the day to which the mood may be arbitrarily ascribed. But though these are common manifestations of the sudden baffling rush of maturation in some adolescents, there will be others to whom this behavior is as atypical as it would be to the "average" group of grandmothers. For some adolescents, the physiological and psychological manifestations do not keep pace. A caseworker, during the day's work, may find herself buying hair ribbons to tie on the pigtails of a tall, fully developed fifteen-year-old who thinks boys are "nasty" and all the girls in her school are "wild." A few hours later she may be interviewing a twelve-year-old with a real emergency—she has lost her lipstick! The same unevenness will 209

The Art of Child Placement occur in her adolescent boys. One day my work schedule took me from a solemn, freckle-faced little boy who told me he was a "scientific atheist," to a boy nearing six feet who drank three quarts of milk a day and who was yearning for a fancy horn for his bike. And if the caseworker is also a supervisor, she may find herself at the end of the day discussing with a caseworker the problem of getting home from a professional meeting at night because "mother fusses so if I come home alone after dark, you know." Adolescents also vary widely in their immediate and distant goals. One pretty sixteen-year-old will say with a theatrical toss of her head, "I'm going to be a ballerina. I'm not interested in love!" One immature seventeen-year-old boy will aspire to a good newspaper route, another to an immediate opportunity to drive in a hot rod race. Some adolescents in placement want a chance to live again with their own families; others want to escape from them. Some can live only in institutions; others consider institutional living as a sign of being queer. Many adolescents go through a "wild stage" as they approach adulthood. Their behavior suggests a strong identification with gangsters and their molls. If they have to be adults, they seem to say, this is the kind they are going to be. A variation on the same general pattern, I believe, is the adolescent who becomes a "terrible prude." Both kinds of youngsters are demonstrating a rejection of adulthood. Most likely the rejection arises from adults who in the course of their lives have disappointed them. Actually, however, the behavior of many adolescents is a direct contradiction to their professed beliefs. Thus the boy who talks the philosophy of a hardened criminal may live the life of a model citizen. The prude finds life as most adults live it to be wicked. Such a youngster is fair game for various fanatical religious sects. The inevitable unpopularity that results from the "holier than thou" attitude is easily rationalized. Both roles—that of the thoroughgoing saint and that of the thoroughgoing sinner—are unhappy ones. I think the sinners are a little healthier because their role offers more opportunity for rebellion, more release for pent-up 210

Casework with Adolescents feelings, more opportunity to spit out their angry thoughts, while the saints tighten, withdraw, hold in, and deny their turbulent feelings. Between the saint and sinner adolescents lie the in-betweeners who are playing a more moderate role. One of the most confusing of these is the youngster who is a saint on Monday and a sinner on Tuesday. (The director of an institution for girls told me there is no more confusing kind of youngster to work with, because you never know until too late to whom you are talking.) Fortunately most adolescents differ mostly in relation to one another and not quite so much in relation to their yesterday's selves. Adolescents, like anybody else, do not fit well into pigeonholes. They too are products of the potentials they brought with them at birth played upon by the thousand influences called environment. IN MANY IMPORTANT WAYS, ADOLESCENTS ARE ALIKE

Anyone who works closely with adolescents will find many ways in which they are alike too. If the caseworker accepts their right to be different as all people are different, she may also be allowed to clarify her thinking by isolating ways in which they have similarities. Such knowledge is a short cut to understanding her young clients. Dumpson describes the likenesses of adolescents in terms of their problems: "The major problems of adolescence are to loosen the emotional ties of the family, to become self-supporting, to develop a heterosexual attitude, and to form a definite policy toward life. This crucial period is usually accompanied by parentchild conflict in varying degrees. The adolescent's demand for self-assertion is in conflict with the parent's need and demand for dutifulness and submission. Adolescence is a process that calls for establishing of new patterns of relationships within the family, a reorientation of the parent-child relationship on a new and more independent basis."1 It is, then, the similarity of the goals more than the manner of 1

James R. Dumpson, "Placement of Adolescents in a Foster Care Agency," Journal of Social Casework, 29:171 (May 1948). 211

The Art of Child Placement the striving toward the goals that brings adolescents into a group. It is a group with homogeneous strivings rather than a group with homogeneous behavior and manners. But there are some types of adolescent behavior that have come to be known as typical too. An adolescent struggling toward maturity can be likened to a mountain climber. To climb a given mountain there are a limited number of successful approaches, and they come to be known to the people in the valley and those on the top who watch the climbers. Every now and then some especially inventive genius may find a new approach, but for the most part, the climbers will end up using the familiar trails. The same is true of adolescents. There are just so many ways to climb to adulthood. If the person who tries to help can remember that there is a definite goal and the young person is not just out for an aimless stroll, it will not be difficult to understand why he acts as he does and to know when to point out the trail and when he's doing all right in figuring it out by himself. The helpfulness of the caseworker in lending a hand or pointing out the trail requires more than a willingness to assist. She will need real skill to make her help acceptable, for most adolescents are quite antiadult. Marilynn Manning comments that older girls look upon a new caseworker with real suspicion: "The world about them is changing; they cannot trust the solidarity of any relationship. Everything must be challenged and thoroughly tested."2 But hand in glove with the initial resistance to trust oneself to a new relationship, there is, I believe, a special capacity to use a relationship deeply once it is begun. Adolescence is, as many writers on the subject have remarked, a period of extremes of feelings, especially in the area of love and hate. The adolescent youngster, boy or girl, who overcomes his initial distrust to form a relationship to a worker can often put more depth into it and move more quickly with it than can most younger children or most adults. 2 Marilynn Manning, "Casework in a Child-Placing Agency with the Older Girl," Bulletin, Child Welfare League of America, 2:2 (January 1943).

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Casework with Adolescents In their jerky, ambivalent movement toward adulthood, it is quite common for adolescents to reject temporarily all the adults who have previously played important roles in their lives. This is especially true of any adult who has in any way represented authority to them. Thus innocent teachers, parents, foster parents, and even the friendly neighborhood cop find themselves in disfavor. The throwing out of these adults leaves a gap and a special spot for a warm, new adult of a nonauthoritarian type. If the caseworker can win this role, she can use it to help the young person find his identification with a "good adult." Most adolescents test their workers pretty thoroughly before they come to accept them. One of the testing grounds may be the social worker's integrity. She may be requested to write false excuses for school, to tell white lies to parents and foster parents alike. To pass this test, she must tread the tight rope of refusing and at the same time appearing to be uncritical of the child for asking that she lie, in no way prudish in her refusal, and unhesitating and sure in her decision not to lie. No matter how habitual the pattern of lying may be in the child with whom she is dealing, no matter how thorough and natural a response to everyday living it may have been in his home, his foster home, or his best friend, the adolescent can't brook it in his caseworker. For adolescents—even those who are actively delinquent, even those whose expressed goals in life are antisocial—have deeply idealistic spots in their make-up. In some the idealism is expressed in reading heroic literature, whether it be good poetry or sentimental "True Stories" (in which virtue invariably triumphs). It is often latent to the point of invisibility; but it is there, and it is the part of the adolescent that demands that his caseworker be honest and good. The adolescent who has not been too deeply deprived in earlier relationships can also gain a great deal of comfort and pleasure from another kind of relationship. With boys, it's "my buddy," and with girls, it's "my very best friend." Ross and Johnson describe these friendships as a natural step toward heterosexuality: "To find his way to the opposite sex, he often seeks first friend213

The Art of Child Placement liness, confidence and closeness to members of his own sex. This bond, this realization of loving and being loved by a dear friend of one's own sex, is a boon to the adolescent."3 The caseworker will very soon become aware of these closest friends. Very often her young clients will bring their friends with them to the agency. If they arrive early, there may be much giggling and many loud squeals of laughter coming from the outside office, if they are two girls. Or they may demonstrate their new adultness by being soft-spoken and sophisticated, the only interruption to the receptionist's work being when she is asked for an ash tray. Boys, when they arrive in twos, are much harder on the secretarial staff. Their noise consists of very loud, very deep guffaws. They like to "horse around" in the office. If there's a pretty, young secretary, they may flirt with her, brag about their exploits with "women," and try to date her. (I've never known a secretary silly enough to accept a date, but I'm sure if one ever did, the boys would be covered with confusion.) Any conscientious office manager and any caseworker might come to blows over this problem. My feeling is that unless the youngsters are really actively destructive or a real "menace," as one of them might put it, it is unwise to clamp down on them before they have had a chance to prove what they are trying to prove through this behavior. An adolescent can have a lot of feeling toward the agency that houses "his worker." The secretaries, the files, the office equipment, and the other social workers give him a feeling of security about his immediate future. He may not have a home of his own to take his friends to, but he has a regular downtown office where he is welcome and liked. He can say and do pretty much what he feels like there. Part of him knows, however, that the office represents an authoritarian kind of adult too. For example, the agency won't let its boys set pins in bowling alleys, and the agency sets his allowance and requires quite parentally that he go to the dentist and have regular physical examinations. In spite of 3

Helen Ross and Adelaide M. Johnson, Psychiatric Interpretation of the Growth Process (N§w York; Family Service Association of America, 1949; pamphlet), p. 10, 214

Casework with Adolescents his negative responses, however, it is deeply important to him to be able to show his friend he can rebel a little against this authority without being "sat on" or rejected. If it gets too noisy in the outside office, the caseworker can always hurry to the interview—split up the twosome and automatic quiet results. Sometimes, youngsters want their buddies to be present during the interview, insisting they have no secrets. The wise caseworker will express pleasure that they have good friends whom they can trust, but will hold firm to having the interview a deux. Sometimes a caseworker may become confused in regard to these "alter egos." Though she excludes them from the interviewing room, they seem to be still with her because the nature of the friendship is all her young client wants to talk about. (This is legitimate business, incidentally, for it is through these best friends that the youngster is practicing for future give-and-take relationships.) Most adolescents are fairly constant to one or two best friends. Some—the flighty ones—have a new best friend each week. (This suggests fear of intimate relationships.) But almost all of them are ardent members of a clique. The majority of adolescents are happiest when they're with their own age group. (This is one of many reasons why some social workers feel almost all adolescents should be in group placements.) Preadolescent children, they feel, are "dopey" or "dumb"; adults are even more vigorously avoided as "bossy," "always beefing about something." But if you watch an adolescent in the group of his choosing, you will note there's much competition for the center of the stage, much shouting, scuffling, and verbal cruelty. I hold to the belief that if an adolescent can take a foster home, he will need it to rest up physically and emotionally between his violent experiences in group associations. The adolescent is much concerned about the uniform of his gang, which usually varies little from the uniform of his whole high school. Whether it's sloppy joe sweaters, combat boots, or very dirty white saddle shoes, the adolescent is a desolate fish out of water until he is dressed like the others. Fortunately, most 215

The Art of Child Placement "fad" clothes are not expensive; with careful budgeting, a way can be found to furnish the youngster at least some of the most noticeable badges of his tribe. The amount of emotional tone that can go into having the clothes with which to conform can be alarming. But so, too, can the amount of emotional tone that goes into almost everything else. In the ups and downs of emotions, the downs have the supremacy. This is a period when everything is bad, and everything bad is terrible. It would be an easy mistake to write off the depressions of adolescence as unimportant because they are so frequent, melodramatic, and mercurial. A fourteen-year-old boy came back into my office one day a few minutes after the conclusion of our interview. With a great effort he said, "I'm having a terrible time to keep from killing myself." A quick referral to the agency psychiatrist and some intensive work was necessary at once to check this self-destructive impulse. A fifteen-year-old girl wept over her last trip to the dental clinic. "I know my teeth are terrible," she sobbed. "But this big oaf calls in three other dentists and they all stand around making faces like they were looking at garbage." The fact that the same girl may be full of joy a few hours later because of a good date or a chance to go swimming doesn't make her pain any less real at the time that she feels it. The dentists at the clinic who made the girl feel so repulsive quite unthinkingly violated an important rule in working with adolescents. In their interest in the pathology of one patient's teeth, they forgot they were dissecting a sensitive adolescent. Criticize an adolescent's teeth or feet or clothes, and the effect is often as though you had damned his whole appearance and personality. It is like the proverbial pebble dropped in the water— the ripples move out to the very edges of the pool. Hypersensitivity to criticism is only one aspect of the sensitivity of adolescents. It shows itself in many delightful ways too. Though adolescents while playing the role of "one of the gang" 216

Casework with Adolescents are slow to reveal their gentle, dreamy side, it is still an integral part of their makeup. Their approach toward finding a "policy toward life," as Dumpson describes it, draws on the basic sensitivity not only in relation to their feelings about themselves but also toward how other people feel. Most adolescents stand for right, idealism, and integrity. They are genuinely (not just theoretically) angry at injustice, whether it is expressed through racial prejudice or a teacher who keeps picking on "some poor kid who can't help it he was born kind of dumb." Politically and philosophically they are often on the side of the angels, however much their stormy conduct may deny it. I don't mean to deny their sins. They can be and often are thoroughly selfish. (This selfishness comes often, I think, from their enormous preoccupation with what's going on inside themselves rather than a calculated selfishness toward others.) The tongues of adolescents can be sharp and cutting, their laughter terribly cruel. But mostly they are unkind when they are really angry, or they laugh because an adolescent responds with a loud uncontrollable guffaw to the same stimulus that may produce a fleeting smile in an adult. When they escape briefly the egocentricity that the pressures of adolescence force on them, they can be almost frenziedly generous. One adolescent boy gave his life's savings ($8.75) to "a kid whose Pa was in the hospital and his Ma didn't have any money." An adolescent girl split her Christmas savings money exactly in halves in order to share it with her little sister who lost her purse the day they went shopping together. Goodness, idealism, generosity, warm responsiveness to beauty, and even heroism are part of the make-up of most adolescents. Probably never again in their lives will this be quite as true. This "good" sensitivity, this warm responsiveness, so often hidden under bluster and superficial brass, is too often forgotten. The remark, "He's reacting like an adolescent," could be a compliment! It was, it seems to me, totally appropriate that it was an adolescent who wrote: 217

The Art of Child Placement The world stands out on either side No wider than the heart is wide; Above the earth is stretched the sky,— No higher than the soul is high. The heart can push the sea and land Farther away on either hand; The soul can split the sky in two And let the face of God shine through.4 PROBLEMS OF ADOLESCENTS IN PLACEMENT

Whether an adolescent will succeed in foster placement is dependent on a number of factors in the make-up of the specific youngster and on his particular life history at the time of placement. It seems a pretty well accepted generalization among social workers that whether the placement is in a foster home or an institution, real success is hard but not impossible to achieve. If the social worker reminds herself that placement is a crutch, a less than ideal way of living for all children, and bases her thinking on the fact that adolescence is perhaps the most difficult step of all in the psychological maturation process, she will see that it must be true that successful placement of adolescents is one of the toughest assignments she will face in her job. In most thoughtful child placement agencies a recognition of this fact is the practice of giving the worker who has a number of adolescents assigned to her a smaller caseload than the one who has mostly younger children. The difficulty of taking the forward step in any phase of psychological progression—whether it is leaving behind two-yearold negativism for the sweet imitative conformity of the threeand four-year-old, or whether it is taking the harder step from childhood into adulthood—is related to the degree of security the youngster has previously had and the thoroughness with which he met other stages of development. The adolescent who has already made a really sound adjustment in foster home placement for some time previous to his adolescence can often work through this step with about the same 4 Edna St. Vincent Millay, "Renascence," Edna St. Vincent Millay's Poems Selected for Young People (New York: Harper, 1929), p. 69. 2l8

Casework with Adolescents degree of success as any other healthy youngster. But the adolescent who has never known a real tie to a parent or a parent substitute will seem to be shadowboxing as he struggles to cut the tie he has never had. This is also the time to expect trouble—perhaps even fireworks —from a certain kind of child whose earlier placement has been characterized by repression in contrast to expression. I am thinking of a very common type of child who has had an uneventful period of years in placement from the agency's point of view. The foster parents are almost always described as "strict." The children are well behaved, neatly dressed, do well in school. The social worker may feel in her visits that she doesn't get far beneath the surface, but she is not sufficiently troubled because the surface really seems so very good. A careful study at the time would reveal that the children have chosen to mind in a totally unquestioning fashion. They have learned that it is easier for them not to talk about their yearning for their parents, their anger at having to "swallow everything" that's said to them. They are thinking, perhaps, "When I grow up .. ." But when adolescence comes, they cannot wait to grow up, and social worker and foster parents alike see overnight all the hidden, angry, rebellious feelings that may have been piling up for a number of conforming years. Another important ingredient in the make-up of the specific adolescent that will have a great deal to do with his ability to find a comfortable way of living in placement depends on which phases of adolescent problems he takes in stride and which he really comes to grips with. The youngster who is putting his most passionate energy into forming a policy toward life or developing a healthy heterosexual attitude will probably be fairly comfortable in a placement with understanding, flexible foster parents. But the one who gives his best energy to denying adults any right to have any authority over him will find foster home placement very stormy. (Incidentally, these youngsters almost invariably panic when no limits are set on their behavior.) In general, the adolescent who has already been successfully 219

The Art of Child Placement placed will have a good prognosis. So will the youngster who has had in his previous development one or more successful relationships to parent figures. Much less likely to succeed is the adolescent who approaches placement from a psychological void of relationships—the "boarding-home hopper" who has lived in a dozen foster homes and taken root in none, the child with a history of many years of institutional placement, or the child who has lived for years with rejecting parents or relatives who have given him nothing but a heritage of bitterness and criticism. There are in the typical make-up of even the healthy adolescent some factors which make placement more difficult for him than for younger children. For example, adolescents are strict conformists to the pattern of their gangs. If it is painful for them to be different in their manner of clothing, how much more difficult it is to be different in their manner of living. The fact that they don't live with their own parents, the fact that their support often comes from an agency, the fact that they may be "wards of the state" or may live in an institution, are all sources of shame to them. Children of most ages feel this to a degree at least. It appears to be especially painful to adolescents. Another difficult problem of the adolescent in placement, perhaps the most difficult of all, is that he must work through his rebellion against parental authority on and with people who have had no part in its beginnings. Sometimes he will give his innocent foster mother all the hostility that his own mother has earned. The average rebelling adolescent in his own home can hold fast to memories of a sustaining parental relationship going back to earliest infancy when he begins to strike out against the part of his parents' authority that seems to be interfering with his reaching adulthood. This memory includes the progress they have made toward recognizing his new status. He remembers when bedtime was "eight o'clock sharp!" then nine, then ten, then "Don't stay up too late tonight, dear. Remember how tired you were this morning." These memories are not part of the base of rebellion for a child in placement. If he is to have his pseudo rebellion against these 220

Casework with Adolescents pseudo parents, he starts to build his anger against a pretty reasonable set of rules that recognize that they deal with an adult in embryo. Not only does the adolescent in placement lack a memory of increasing relaxation of rules and regulations which in healthy families suggests a progress toward maturity; he lacks too the memories of wholesome, demonstrative affection. The average adolescent stops nearly all demonstrative affection toward his parents as he approaches adolescence. Such a youngster is even less able to take that kind of show of affection from new parent substitutes. But the adolescent in his own home has a clear memory of having been loved, petted, tucked into bed, and kissed goodnight. The adolescent in placement has no such wealthy store of memories to draw from, and helpless foster parents have no way to give him either such memories or replacements for them. The adolescent in placement is facing a double-barreled set of problems. Whenever life's stresses and strains become especially acute, old unresolved conflicts are likely to reappear. Being placed in a foster home or an institution is an especially challenging experience in life. So also, is adolescence. It is small wonder that many youngsters show signs of severe trauma and that the problems they present are often grave. But the adolescent's caseworker should remember that some of her client's most frightening symptoms arise from understandable developmental urges and that during treatment the youngster is moving toward a more comfortable phase. Eighteenth birthdays—all by themselves—have cured a lot of "problem adolescents." It is probably a fair guess that among adolescents in placement in the United States nearly fifty per cent could be classified as delinquent, predelinquent, or semidelinquent. It would be easy to make the mistake of thinking that youngsters are delinquent because they are in placement. Actually, it is more likely to be true that they are in placement because someone became concerned about their actions or the directions in which their actions seemed to be leading. A large number of referrals come to agencies through juvenile 221

The Art of Child Placement courts. This is a natural outgrowth of the judges' realization, on looking carefully into the background of young offenders, that many never had a chance in their own families. Schools, too, are instrumental in sending to the agency doors an ever-increasing number of parents of adolescents who are incorrigible at school. And parents come by themselves too, for some parents of rebellious adolescents are frightened people. Most parents have hopes that their children will ascend to richer and fuller lives than they themselves have achieved. When they discover that their nearly grown children are tending toward delinquency, they are terrified. They come to the agency often acting angry, but really being deeply worried. They want "the experts" to salvage their boy or girl before it is too late. While it is often possible or thoroughly advisable to work out the problem of the delinquent adolescent in his own home, it is not always practical for a number of reasons, the most common of which may be the parents' total unwillingness, or in some instances, incapacity to struggle direcdy with the problem any more. The main reason, then, that the average placement agency has so many delinquents among its adolescents is that the delinquents are referred to it. Another reason is that adolescence is a point of development at which delinquent behavior very often makes its first firm appearance. Couple this with the fact that delinquency arises most commonly among emotionally deprived children and you have the reason for the large number of delinquent children in placement. Treatment of the delinquent adolescent in placement is a subject more suitable to a shelf of books than the few paragraphs for which there is space here. The important thing to remember is that a delinquent is a child in need of exactly the same kind of casework as any other child with any other problem. Delinquency is rarely cured by a change of environment or a change of foster homes alone. The delinquent adolescent is not infrequently a member of a gang. This membership in a gang or clique is normal adolescent 222

Casework •with Adolescents behavior. The selection of an antisocial gang that is expressing its rebellion against authority by identifying with criminals is not an aspect of healthy, normal adolescence. Many a young caseworker has felt that the first step in treatment was to move her youngster far away from his delinquent gang. She has been surprised to find how quickly in a new environment he has found another gang like the one he was taken away from. "Honestly!" a student social worker once exclaimed, "it's uncanny the speed with which they find kids like themselves in a new community!" One form of delinquency that is often the problem of the delinquent adolescent girl is sexual promiscuity. Just as joining a delinquent gang is a warped form of the normal adolescent impulse toward group association, so are sexual experiences for which a youngster isn't ready an unhealthy response to the awakening sex drive which is a part of all adolescent experience. In referring to sexual promiscuity, I put the emphasis on the adolescent girl rather than the boy, thereby showing myself to be a true product of my own culture. The problem with boys is equally acute, equally disturbing and unhealthy. The one lesser threat to the boy is that he is less likely to "get caught." If he is caught, his behavior will be viewed with less anxiety and outrage by those around him. As one angry sixteen-year-old girl put it, "Boys don't get pregnant." Working with youngsters who are coping with this problem requires maturity in the caseworker. It requires understanding, not moralizing. A special problem in foster home placement is that many foster mothers who forgive a girl who steals or lies or cheats will not continue to offer a home to one who has had sexual experience. The result can be that just when a girl has demonstrated her need for help in making a sound heterosexual adjustment, she is locked up in a correctional institution with her own sex. This often is merely an interruption of her sexual life, but it is not treatment. (I am not forgetting that there are some very confused girls whose sexual behavior is so unrestricted and atypical that they really must be institutionalized to protect them, against themselves for months and even years.) "3

The Art of Child Placement Among nondeliquent adolescents, there are many other severe problems which may fill the caseworker with as much or more concern, though as a rule the community is less troubled by nonacting-out adolescents. The dreaminess that characterizes many normal adolescents may be elaborated until it approaches a withdrawal from reality. Immediate referral for psychiatric help is then indicated. Related to withdrawal from reality, but a variant of it, is the refusal of a youngster to enter into the adolescent phase of development at all. This happens largely with deprived children who have had inadequate experiences in living through their earlier stages of development. The superficial symptoms are the withdrawal of boys and girls from their own age groups, They won't "date"; they stay aloof from both boys and girls at school; they want no part of earning money; and the thought of giving up their dependency on the agency in a few years produces marked signs of anxiety. Almost equally alarming is the boy or girl who tries to take the step from childhood to adulthood all in one day and much too early. One month a gangling boy is in his social worker's office talking about baseball and Roy Rogers. A month later he returns with a young fiancee and ill-conceived plans for leaving school, getting a job, renting an apartment. The social worker's task is to help the boy apply the brakes—and to help him also to understand why high speed is unwise. Another problem, one most classically that of the adolescent in placement, is a resurgence of interest in, and feeling about, missing parents. It's a common experience in adoption agencies to have youngsters who were placed as babies turn up as adolescents wanting to know more about their natural parents. I knew a blustering "tough guy" adolescent who let me in on a favorite daydream of his. He knew that his mother, who had deserted him when he was a baby, was living somewhere in Texas. He had heard that she was still pretty and that she had lots of boy friends. The boy recited with great excitement his well-polished, much-rehearsed daydream. He would bum his way to Texas and 224

Casework with Adolescents walk in on her and surprise her some day. He wasn't going to knock. That was an important part of the plan. He was just going to walk in, the way a kid would at his own home. He would walk up to her and grin and say, "Hi, Mother! Your little Tommy's come home to take care of you." And when her boy friends turned up, he'd answer the door and say, tough-like, "My Mom's decided to be a good little girl. No more time for jerks like you. Beat it!" In some detail he outlined how thoroughly he'd beat up "the guys that were chumps enough to argue." Tom probably had an unconscious wish to make a "good" mother out of his parent by force if necessary. However, the chief impression I got was one of cold, sadistic hatred and a wish to make her suffer. And Alice, a fragile, lovely adolescent, who was more ambivalent, sharply expressed this ambivalence. She too was going to find her errant mother. "And when I find her, I'm going to hit her as hard as I can. Later maybe I'll forgive her and try to help her, but first, I'm going to hit her." Jolowicz describes a little girl in placement who has to love her deserted mother in secret because she was "bad" and the social worker and the foster mother never spoke of her. Jolowicz writes: "However, her yearning to love and be loved by her mother continues. She condemns her own resentment and is aware only of her loyalty and a strong need to defend her mother. Love and hatred then are both repressed, which simply means they have gone underground, where, unknown to both the child and the people around her, they continue to be active in forming her personality. The little girl, as she grows up, seems to get her mother back by becoming like her. At adolescence, boy-crazy behavior shows up, and now everyone says, "Isn't it too bad, she's become just like her mother? And after all we've done for her!" ... Someone should have acknowledged to her that of course she loved her mother. Almost everyone loves his mother; there's something wrong if you don't, not if you do. Once the child learned that no one would condemn her for loving her mother, and that she no longer had to defend her against criticism, she would have been encouraged to talk freely, even to tell of her resentment and anger that her mother had let her down, had failed to be the kind of 225

The Art of Child Placement mother that she should have been. Talking would have released some of the child's tensions and left her freer to pattern her life after that of the foster mother's.5 The problem of the child described by Jolowicz will appear less frequently as child placement agencies remember to keep alive the memory of the "hidden parent." Another problem related to an adolescent's resurgent feelings about his parents (parents who are nearby but who fall far short of the adjective "good") is a confused, unrealistic expression about them. If the parents are divorced, he may keep them, his foster parents, and his worker muddled by deciding that one parent is "all good" and the other "all bad." Six months later, he may reverse his loyalty. This keeps everyone, but especially the youngster himself, in a confused emotional state. The sudden resurgence of feeling about parents, with its hot emotional tones and the child's often unconscious impulses to act out an identification with the undesirable aspects of the parents' personality, is just one more characteristic of adolescence that makes life in foster placement hard. A PLACE FOR AN ADOLESCENT TO LIVE

Whether an adolescent is to live in a foster home or an institution is a decision that must be made on a casework basis. Some social workers and psychologists who have studied adolescents in foster home placement have discovered quite a turbulent picture, and there is a wide body of authority that holds out for institutional placement. I have not been able to find that this conclusion has been based on an equally careful study of adolescents who have made sound adjustments in institutions. It is a little as though social workers were saying, "Because a dose of sulfur and molasses does not give much help in curing acne, it follows that sulfathiazole is what we should use." Institutional Living Institutional living for not too long a period may be a genuine • Almeda R. Jolowicz, "A Foster Child Needs His Own Parents," Child, August 1947, p. 19.

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Casework imth Adolescents aid in planning for adolescents. The danger is that adolescents who do not belong in institutions may be placed there against their wishes only because of the ill-considered stereotype that it is "best" for them. The psychological principle that "imposed plans do not succeed" is never more sharply illustrated than in cases like these! When institutional care is strongly indicated but the adolescent, for apparently superficial reasons, makes it clear that he wants none of it, the social worker is not totally defeated. One of the codes of many adolescents is that they are "good sports" and they'll try anything once. Frequently the adolescent who has demonstrated his inability to get along in foster homes can be helped to an acceptance of institutional placement by persuading him to give it a brief try. A "brief try," however, is not a meal and a tour of the institution that lasts only a few hours. Such tours only sharpen the impression of how different the place is from a home, and they give the youngster no chance to relate to the staff or to the curious, critical young faces that size him up. I think a *preplacement visit should last at least a weekend, preferably longer. If the decision to "look the place over" can arise naturally, as in providing a place to stay while the foster family is out of town, so much the better. After such a stay, the adolescent will be much better able to tell his caseworker that this kind of living is, or is not, for him. Work Homes For the adolescent who needs an impersonal setting where foster parents are not trying to make him "their own child," the work home is often a good answer. In a work home, an adolescent should earn something a lot more tangible than his board and room at first. Realistically, very few adolescents who need placement are worth board, room, and a salary to the family who takes them in. I like the first work home to be paid full or part board by the agency so that the child may have the experience of receiving weekly from his employer a pay check which makes up his allowance and his clothing budget. As a means of motivat227

The Art of Child Placement ing a youngster toward maturity and self-support, that allowance should make him a little richer than he has ever been before. This gives incentive to the child and yet keeps the foster mother aware that she has a special kind of arrangement with both the caseworker and the child that is quite different from what she might have with an adult in her employ. The caseworker may wish, for example, to consult with her frequently, or to remind her that even though this is a wage home arrangement, the client is still a youngster who needs both time with his friends and the right to make mistakes while learning. Some agencies have been forced to put nearly all of their adolescents into wage homes in return for board and room, in order to make inadequate budgets stretch. It is a short-sighted community that withdraws funds for support from adolescent children who need it so badly and for such a relatively little time longer. Some agency children who need help in working toward selfsupport find the wage home and the role of "mother's helper" hard to take. With one girl, it may be a question of the difficulty of accepting "bossing" from a woman who reminds her of the mother figure. Another may feel that being "a maid" is associated strongly with an unfortunate social status. For youngsters like these, some other kind of work needs to be found. Boardinghouses Some mature adolescents, boys and girls alike, find after-school jobs in drugstores, filling stations, neighbors' farms, grocery stores, and department stores. These jobs often provide adolescents with greater social prestige among their friends and seem to the youngsters to pay more money. These adolescents still need a place to live. They feel their new independence and do not want a home where some well-meaning woman tells them when it's time to brush their teeth. They need a boardinghouse with an understanding landlady. Such a woman may have one or two adult boarders. She will probably like the feeling that she can call the agency when she's troubled about late hours, or the hack228

Casework iwth Adolescents ing cough she has noticed at night. She will supply a warm, "Good morning," or a "My, that's a pretty dress, dear. Turn around and let me see the back." And some days when she's making cookies, the girl will find a plate of warm cookies and a glass of milk in her room when she comes home from school to change before going to work. Every city has a number of homes like this. The trick is not so much for the homefinder to locate them as to persuade the landlady to take on an adolescent boy or girl when she is accustomed to the simpler needs of employed adults. It can be done; but the landlady needs to be reassured that these are youngsters who really do not want a lot of mothering and that the agency, not she, is responsible for them. More Typical Foster Homes Many adolescents who are more chronologically than emotionally adolescents still need and deeply want the more typical kind of foster home. The foster mother who does a fine job with a five-year-old may do just as well with an adolescent whose fiveyear-old needs have not been satisfied. But she must be a woman prepared to give, and with less need to receive. Probably the worst placement I ever made was of a delightful, love-hungry fifteen-year-old boy in a home where I later learned the people really wanted to adopt a child and make him their heir. The boy eagerly took the love for a while because he needed it; but when he began to show healthy signs of adolescent independence, the foster parents were not ready because they had not nearly begun to satisfy their appetite for a little boy whom they could love. The boy lost his foster home and "inheritance" (fortunately he never knew about that) overnight. His next placement was with an understanding "landlady" and it lasted until he finished high school and enlisted in the marines. Big-Sister-Substitute Homes Another kind of foster home I have liked for adolescents is the "married sister substitute" in contrast to the "mother substitute" 229

The Art of Child Placement home. Young married couples in their late twenties or early thirties can often seem much closer and more in tune with the thinking of the adolescent than somewhat older couples. If the home is used for girls, the strongest part of the relationship must be carried by the foster mother. If it is used for boys, the foster father must be willing to hand out the allowance, the rules, and a good bit of companionship. One reason is, of course, that the adolescent needs an identification with an adult member of his own sex. Another is the danger that the sixteen-year-old boy may confuse his already tangled emotions further by falling in love with his young foster mother! Older Parent Foster Home For some adolescents, I also like the family who has already brought up its own children and in retrospect may have found their adolescences "a little rough" but nevertheless enjoyable. It may be that one or two of their own children are still in the home. Sometimes a home of this kin4 will have been found by the youngster himself who came one night to dinner with his buddy and decided with everybody's approval to stay forever. The rules about not having children of an age in the same foster home do not seem to hold quite as rigidly in adolescence. Some adolescents enjoy each other's company and are not as rivalrous over the mother or father figure as are younger children. The most important general characteristics of the foster home for adolescents are that the foster parents are not expecting to receive in proportion to what they give; that they are "young in spirit"; and perhaps most important of all, that they have a sense of humor. They'll need it! THE CASEWORKER OF THE ADOLESCENT IN PLACEMENT

Of the important role the social worker plays in dealing with adolescents, Helen Ross writes: A caseworker who worked chiefly with delinquent adolescents used to say that the child who lacks the parent of his own sex is the most unfortunate and the most likely to become delinquent. 230

Casework imth Adolescents A normal identification with the parent makes the formation of new attachments easy. These, however, are not the cases that reach social agencies and need our guidance. . . . Herein lies the importance of the social worker who, in order to do effective work, must become a new vehicle of identification. A new relationship to an adult is necessary to undo the harm or make up the lacks of the old. Only with such a corrected relationship can we expect a boy or girl to reach satisfactory affiliations with the other sex. Emotional development is animated by its own ghost which returns to look after unfinished business. The unfinished business in the life of the child is the concern of those who are trying to help him get on his way to the concerns of adulthood.6 What is the nature of the "corrected relationship" that Helen Ross writes of? One might start by describing it as a disciplined, calculated, professional relationship, in order to point out some of the differences between it and a more spontaneous natural relationship that might arise between a child and, let us say, a favorite aunt. Its purposefulness is based on the caseworker's knowledge that an adolescent who has rejected or been rejected by the adults of his childhood is a lost soul when he tries to become an adult without having found any adult he'd like to resemble. The relationship is warmly supportive and not criticizing or disciplinary in character. The warmth and supportiveness grow out of a deep understanding, without which such a relationship cannot exist. It has the dignity befitting the status of the new adult. In this respect, it differs from the relationship the caseworker offers a little child. A four-year-old may need at times to sit on her caseworker's lap, to be rocked and stroked. A sixteen-year-old is embarrassed and confused by demonstrative affection. Her caseworker offers her a tissue, expresses verbally her sympathy and understanding, and assures her it's all right for a young lady to cry, but she does not put an arm around the girl. The relationship that is offered is strongly supportive. The caseworker makes it clear that she likes and values the adolescent. She accepts his right to be angry—even at her—and his right to 6

Helen Ross, "The Caseworker and the Adolescent," Family, 20:233 (November 1941). 231

The Art of Child Placement make mistakes. The caseworker avoids criticizing, scolding, and obvious efforts at reforming. She recognizes that the role the adolescent chooses to assign to her may symbolize an important lack in his life. Some days the caseworker may find that in the adolescent's thinking she has become the loving mother the child never had; another day she may be made to represent oppressive authority; still another day she may be the father who can give or withhold the money for a new suit or evening dress for the junior-senior prom. The caseworker may know that she is being helpful when the adolescent uses her as a symbol in this way; but she also knows that this requires great delicacy of handling. A caseworker may utilize a child's fantasies for understanding and treatment, but she must not enter into them without pointing out eventually what reality is. She may end her interview by saying, "You were really angry with me today because I could not give you money for a new suit. The feeling must have been a lot like what you felt toward your Dad when he wouldn't give you money for things you had to have. I don't blame you for being angry. It's hard to find a way to get along without things you really want." No matter how angry or hostile the young client may be, he should be able to count on his caseworker's not becoming angry or defensive. He must know too that she still likes him even though he is angry. The caseworker must be a person whom the adolescent can count on. She must be meticulous in keeping her word. She must demonstrate in sharp, clear lines how much she values the boy or girl. She must keep her appointments promptly. She must even take great pains to respect what may be irrational, painful prejudices. For example, an adolescent girl protested that she couldn't go to a "man doctor." She expressed it with the typical humor that adolescents often use to cover up deep feelings. "If I should get appendicitis some night and you send a man doctor, I'll say to him, 'Go away and send an undertaker instead.' " When an agency has its own arrangement with a clinic or doctor, it is often timeconsuming and expensive to get another doctor. But the thought232

Casework 'with Adolescents ful caseworker of such an adolescent may often think it worth while to find a way. ' The caseworker of adolescent children should be able to give gifts, thoughtfully chosen, for birthdays and at Christmas. She will try to attend class plays and graduation exercises (even though they invariably fall on Saturday nights at the end of particularly difficult weeks). Though the adolescent and the caseworker both know that she has other clients, other obligations, she gives her undivided attention to her client while she is with him. She does not take phone calls or cut short her interviews with him. If there's a real emergency, she explains it clearly. It is interesting that the adolescent has a clear picture of the professional aspects of the relationship. The little child may say, "When Sunday comes and you don't have to work at the office, why don't you come over and play all day instead of for just an hour?" Most adolescents have some awareness that the hour a week is not just "visiting" or play. It is business. One aspect of the "business" is holding the adolescent to reality and gently urging him to move ahead a little. The caseworker for adolescents will usually have several who want to talk at great length about their deprived past, their wretched present, and their hopeless future. There comes a point at which the interviews must move beyond this. One caseworker said to an adolescent girl, "I know, Margaret. You hoped that your foster parents would adopt you and take you along when they moved away. But they didn't. And it hurt so much that now you don't feel like trying to live anywhere. You and I have to say to ourselves, 'Margaret had a big disappointment but it's over and done. How can we make a new plan for her?' I can understand that right now you don't want anything. I want to help you, but you'll have to help me, too. Maybe we could start by talking about what you especially don't want in your future " And a man caseworker was talking to a fifteen-year-old boy whose father was a prominent but somewhat alcoholic lawyer who couldn't keep promises or remember to send checks for the boy's 233

The Art of Child Placement care. The caseworker said, "I see what you're driving at, Ted. You really want to punish your Dad, and I'm sure I can understand that. Let's look at your plan. You rob a filling station and get caught. Maybe he says to himself, 'I should have been a better father.' Now let's play fortune teller. You tell me what you think he'd do next and what you'd do next and how it would all work out. Start by telling me what he'd do next." The caseworker who works with adolescents will hear a lot of angry, negative feelings against parents. She can understand her young client's need to express these feelings and she can feel safer about letting them come out freely than she could with younger children. The younger child is going to want his parents back soon after his angry outbursts. The adolescent is on his way to giving up his old relationship to his parents. He is en route to a new interadult relationship that need not be damaged because he has been angry at his parents in adolescence. The caseworker also feels more secure in accepting the adolescent's drive for independence of adults than she could with a younger client. In fact, she is cheered by these signs in her client and she aids and abets him in his drive for independence. Her role gives her a unique opportunity to be the good adult who joins with him in helping him gain independence that the other authoritarian adults seem to be more reluctant to give him. The caseworker knows that adolescents need limits, that they panic when they find themselves without them, that they can't fight for independence if they already have complete independence. But the caseworker should not be the authoritarian person in his life. Authority should come from schools, foster homes, the institutions in which a child lives, the laws of the city, the rules of the agency—but not from the caseworker herself. Foster parents must understand this clearly so that adolescents do not come to their worker asking for permission to do this or that. (This requires a great deal of interpretation. Many foster parents will try hard to maneuver the caseworker into the "boss" role. Only when they understand the reason why she cannot function helpfully if she has that role can they respect her wishes.) 234

Casework with Adolescents The caseworker's part in the adolescent's movement toward independence is one of being the agent who helps him get it. She may say she will ask the foster mother whether the girl or boy can stay out till twelve on the night of the high school dance if he is willing to promise the foster mother (not the caseworker) to be in by eleven on other date nights for the next month. The caseworker may agree to plead the cause of an adolescent who wants to quit school and get a work permit a few months before he reaches the legal age. A caseworker may offer to take up with the agency a boy's request for a larger allowance. In all these instances, the caseworker is on the side of the adolescent in his demands for more independence as he seems ready for it. His feelings toward her as an adult with whom he can identify will be strengthened by these overt actions to help him toward his goal. If, on the other hand, she were to stand in loco parentis and say, "This you may do; that you may not!" her job would be made more difficult. What does the caseworker do when her adolescent demands privileges for which he is in no way ready? Then she helps him see that she can't plead for this privilege because she knows they haven't got a chance to get it from any reasonable adult. She may help him see what he needs to do, how he needs to change to persuade the adult world around him that he is ready for the request he is making. She is still on his side, but she is holding him to reality. The caseworker with whom the adolescent identifies has a grave responsibility to stay with him and not let him down. One young caseworker told me that she found the responsibility frightening. She had just finished an interview with a fourteenyear-old who felt quite realistically that the whole world had let her down. Her older brother had come to school with "liquor on his breath," her foster father had refused to put up any longer with the puppy who left puddles in the living room, and her mother had not written to her in seven months. "It must seem to you today," said the social worker, "as though the people you love most always let you down!" 235

The Art 0f Child Placement "It isn't that bad," said the girl. "First in the world, I love my mother, and then, usually my brother—the big lunk—and third, you. When they both louse things up I love you best. Whether I love you first or third best, you never let me down!" The girl was on the young side of adolescence and was better able to express her love than she would be a little later on. But she was saying what any number of adolescents in treatment feel but cannot say: "When everybody else lets me down, you never do." It's no wonder that the young social worker felt this to be a grave responsibility. I can think of none greater. SIGNE ANDERSON—A CASE STUDY

Descriptive Summary from Psychiatric Clinic Record Because there has been concern over the type of depression Signe sometimes displays, a psychiatric clinic has been used on a consultative basis for several years. The following material is made up of excerpts from a summary of her clinical record. Signe Anderson is thirteen years old. She is a tall, slim, exceptionally beautiful child of classic blond Scandinavian type. In the past year, she has grown five inches and gained twenty-five pounds. She began menstruating about six months ago. Signe's beauty is marred by a sullen, discontented look and by a light case of acne on her nose. Intelligence tests at school and at the clinic have placed her I.Q. in the 125-130 range. School achievement, while superior, is not as good as her potential would make possible. Signe is an acutely conflicted adolescent girl who has lived under extremely unfavorable conditions all her life. There was always quarreling between her parents. When Signe was eight years old, her mother died of pneumonia. Signe, her fourteen-yearold brother, Thor, and her father made an abortive attempt at maintaining the home for ten months; but eventually, in response to pressure from the school, a foster home placement was arranged for Signe when she was almost ten. In three years, she has been in four unsuccessful foster home placements and is now 236

Casework with Adolescents living in the girls' club, where she is the youngest member by two years. Signe is a typically unstable adolescent girl whose emotional expressions and moods change rapidly. She is capable of applying strong likes and dislikes to the same objects or people in quick succession. She has a need to call attention to her misery as a means of getting the kind of affection and attention she has lacked through the years. This is expressed through alarming floods of tears that many people—caseworkers, teachers, foster parents, and friends—see regularly. Her statements are often unreliable. Her caseworkers have felt that this is more a reflection of instability of her feelings than a conscious attempt at misrepresentation. Signe seems incapable of forming a relationship of any depth with anyone. Foster parents have requested her removal on the basis of her acute mood swings, her constant irritability and demandingness, her hysterical, almost suicidal sounding depressions. They find her "totally exhausting." But it seems possible that if any of them had felt that Signe had related to them at all, they might have been able to hold back on the request for removal. Caseworkers—Signe has had four—feel too that they have never approached a meaningful relationship with Signe. She uses her caseworkers to express her constant neurotic demands for "things" —clothes, allowances, and privileges. Every interview begins and ends with Signe in tears. Signe has just been assigned to a new worker, Miss Dawlin. At present Signe is as discontented with her placement at the girls' club as she has been everywhere eke. She is begging to be given another opportunity at foster home living. What she probably really wants is another opportunity to live with her father, but he says quite bluntly and in her presence that he is not up to living with her. Twelve Interviews between Signe and Miss Dawlin The material that follows is not a summary. Rather it is a selection of a few remarks from Miss Dawlin's report of each inter237

The Art of Child Placement view, presented in order to sketch a picture of the nature of Signe's resistance and her worker's attempt to break it down. First interview. In my first interview with Signe, I attempted to lay the groundwork of what I hoped our relationship would be. I wanted it to be supportive and warm; but at the same time, I hoped it would be characterized by a certain kind of firmness. Particularly, I wanted to avoid a certain kind of "soft" sympathy. After reading Signe's record, I became convinced that this response caused her to "dissolve in tears." Once she began her weeping, any hope for progress during the interview had to be abandoned. It seemed to me this was a very effective defense Signe used to avoid having to talk about her real feelings. We began our interview by talking about Miss Carl and Signe. I said that when Signe used to come in to see Miss Carl, I had noticed her and had liked her. When I heard Miss Carl was leaving the agency, I had asked whether I might become Signe's worker because I had felt drawn to her. This remark drew a small, appealing smile from Signe. Before Miss Carl had left, I said, I had talked with her about Signe and she had told me some things I needed to know, but mostly I needed to know things from Signe if I were to help her. Signe took a deep breath and began to tell me how she hated the girls' club. She hated the counselors, hated the girls, and hated the school she attended where all the teachers "picked on" the girls from the club. Her strongest complaint focused on the contention that all her clothes had been borrowed, ruined, or stolen at the club and now she had "nothing to wear." The tears began to flow as she talked. I said it sounded as though she really disliked the club. I wondered why Signe wasn't living in a foster home. She gave a strong rush of negative feelings toward foster homes she had lived in in the past. I then asked why she wasn't living in her own home. She looked angry. "Didn't Miss Carl tell you?" she asked. I said Miss Carl had told me a little about it but I needed to know it from Signe's point of view. 238

Casework with Adolescents She began to sob as she told the story of what she described as "her miserable existence." I handed her some tissues, but made a real effort to ignore her tears. Her story followed the case history material. It was told with many melodramatic expressions and in a rotelike manner so that I was certain this was a story Signe had told over and over again. I commented that all of this must leave Signe with pretty mixed up feelings about her father. She must feel angry with him at times. But at other times she must feel as though he's all the family she has left and that there are good parts about him too. I changed the subject purposely. I said that Signe was helping me to understand. The first problem right now was that she was unhappy at the girls' club. Could I help with that? Signe wanted me to find a foster home. She told me how unsuccessful the others had been and ended by saying it was hopeless. She would always be unhappy. I wondered aloud why Signe should move if she were certain she'd be unhappy anyway. She hesitated and said she'd like a change. She'd only stay in her new home a year or so. She said after that she'd always get restless and keep moving. She guessed she'd keep moving till she got married. I said it looked as though there would be quite a bit of time between now and then. I could find her foster homes, help her buy her clothes, and see that she got to the dentist. But was that enough? Wasn't the thing we both needed to think about that Signe was unhappy? I asked her whether she wanted to go on this way. She responded tearfully, "Of course not!" I then suggested she think about the girls' club, the new foster home, and right in the middle of these thoughts her own unhappiness. How did they tie up together? What did Signe want to do about her immediate future? Would she think about these things and come to my office next Thursday to talk with me? Second interview. In this interview, Signe was resistant and attacking. She tried to focus the interview on clothing, which I would not let her do. She wept a great deal; beyond handing her a box of tissues, I made no comment about her tears. 239

The Art of Child Placement I kept bringing the focus back to Signe's saying that she would be unhappy wherever she was. At the same time that I was saying this, I assured her I was looking for a foster home so that she wouldn't think I was withholding this help because she wouldn't talk. Finally, Signe rose to her feet very angrily, saying, "I hate it at the club and that's all." I said that Signe didn't seem to feel much like talking today. Perhaps she didn't have confidence in me. After all, she didn't know me very well. She gave me a startled look and said, "Sure I do!" Third, fourth, and fifth interviews. These three interviews were markedly short. I tried to hold Signe to the essential problem— why she was unhappy, why she felt she would always be unhappy, and what we could do to change that. She made a careful effort to make me angry. Her request for high-heeled shoes was an example. When I explained why the agency could not get them for her, she began to cry. "Why do I have to be under the Welfare?" she sobbed. "Why do social workers make you go down on your knees and grovel and beg for every little thing?" Her anger spilled out toward others—the school, the club, her roommates. I thought I saw some change in Signe. Before she had been only "weepy" and self-pitying. Now she was becoming angry. I thought this was healthier. During these interviews I was able to let Signe know that I liked her and that I didn't blame her for being angry. It was good, I let her know, to let your angry feelings out. Sixth interview. It appeared to me that our interviews were sliding into a rut, so I arranged to meet Signe at the club, go through her wardrobe with her, and plan a spring clothing budget. She resisted this a little because with a plan of this kind she would no longer be free to ask for extras and would lose her chance of using clothing needs for "changing the subject." In spite of her resistance, her mood soon changed and she became a new Signe—gay, provocative, and teasing. I commented that she got a good feeling when I was giving her "things." Some240

Casework with Adolescents times, I said, girls who had missed parents they could count on, a home of their own, and a safe feeling about their future got a false feeling that they could find happiness in clothes and money. Signe gave me a thoughtful look but made no comment. Seventh interview. In this interview, I felt that Signe had shifted her defenses but was still testing me. Now she was charming and loquacious, filling the hour with rapid, excited talk about her new clothes, parties, and uncharacteristically positive remarks about her friends. She spoke warmly of a visit with her father. She said she had spent two hours with him on Friday. "He gave me this!" she exclaimed, showing me a cigarette case. I said pleasantly that I hadn't known she smoked. "Oh, yes," she said airily, "I've been smoking for about two years." Signe said her father hadn't known that she smoked either. She told the story of how she got the case. She picked it up saying, "Oh Daddy! Can I have this?" He said Yes sort of absent-mindedly and then, "What do you want with it? Do you smoke?" She told him that she did and that she intended to hold him to his word and keep the case. He pretended to be angry, but he let her keep it. She held the little gift in her hand, smiling affectionately at it. I said, "Signe, you looked so happy just now talking about your father and the fun you had with him about the case. You must really have enjoyed your visit with him." She nodded smilingly. I went on to say she must wish it could always be that way between them. She nodded again. I said that Signe had told me that she hated him and yet she did like him and wanted to be with him. I said that many of us felt like this toward the people near us. We loved and hated them at the same time. I said that Signe had these mixed-up feelings toward her father and while it was natural that she should, still I thought she must be confused by them at times. She nodded again, very softly and acceptingly. When she changed the subject, it seemed to me it was not the defensive kind of switching of subject that she usually employs. I was encouraged. I felt she had let me come quite close to her. 241

The Art of Child Placement Toward the end of this interview, I said that one thing had been bothering me. Signe had said that she didn't like to be under the care of the agency. I asked why. She was gentle as she said, "I don't know. I just don't." I said I suspected that she didn't like what had happened long ago that made it necessary for her to be under agency care. "That's it," she said, "I want a home of my own where I really belong." Eighth interview. Signe stormed into my office. "Can I change my name legally?" she demanded. She had been called a dumb Swede just once too often, she said. The real impulse seemed to be a fresh disillusionment with her family. She had had a most unpleasant Easter Sunday dinner with them and she knew that I had arranged it. "What made me maddest," she said, "was having people ask other people to invite me over." I told her I was sorry. The club was to be without staff on Easter, and caseworkers had been asked to make plans for children to be away for the day. When I called her sister-in-law, she was already planning to invite Signe for the day. "Oh, it's not your fault that Daddy got drunk and that he and Thor hollered at each other and that Margie started to cry," she said. I again said I was sorry that I had engineered such a bad plan without first talking it over with Signe. She grinned. "I guess," she said, "I was trying to take it out on you for the way us dumb Andersons behave." Ninth interview. Signe opened the interview with an excited exclamation: "I know where I want to live! The foster home where Lorraine moved last month has room for another girl and I want to go there." In the discussion that followed, it turned out that Lorraine and Peggy had been plotting that Peggy was to get her worker to move her in. Signe wanted to beat Peggy to it. I laughed and asked whether she wanted to go to that foster home to be happy or just to beat Peggy to it. She said she wanted to get ahead of Peggy. I said I could understand this, but I won242

Casework with Adolescents dered what the people were like. She made a face and said she didn't know or care because she had just decided that she wanted to stay on at the club after all. I said with a smile, "You mean, now that you know you can go, you don't want to?" She said, "I just decided that it's not so bad after all." Tenth interview. Signe wanted to talk today about the advisability of being married in shell pink instead of white. She thought she was such a "washed-out blond" that she looked terrible in white. The wedding was to be in two years and I was invited. But later I became uninvited because she thought it was simplest for a girl with no mother to just run away. She was able to discuss the fact she had no mother calmly and without self-pity. She looked forward to marriage as the one way to get a home of her own. Eleventh interview. This interview was begun with a superficial display of anger that played itself out in a few minutes. "Do I," she demanded, "have to ask your permission every single time I want to see my own father?" I said, "Of course not." I asked whether she had asked permission of her workers in the past. She said that the counselor at the club was requiring this of her. (I knew that this was not true, or at least that Signe was misrepresenting some statement. I felt, however, that she was wanting her foster home, was "fed up" with the girls' club, and wanted a reason to express her anger at it. Therefore, I let her accusation pass.) I told Signe that as far as I was concerned, I thought it was good when she wanted to see her father. I remembered that there had been times when she said she hated him and never wanted to see him again. It was natural that sometimes when he was unreasonable she would feel that way. It was equally natural that sometimes she would want to be with him. She made no comment, but wore a look of agreement on her face. I said that if the counselors wanted her to call me, it was quite simple to ring me up. I always enjoyed hearing from her. But she and I would know that when Signe wanted to see her father, I would be in favor of it. 2

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The Art of Child Placement Feeling some rapport between us, I tentatively brought the subject back to Signe's unhappiness. When she became resistant I said that I didn't keep bringing this subject up just to be mean. I now knew and liked Signe so much that I wanted to help her. I wanted her to be able to look forward to happiness, not hopelessness. I knew Signe didn't talk because the subject was painful. I also knew that someday she was going to talk about these things with me because a part of her already wanted to let me help her. Signe was embarrassed, I believe, by her own inability to talk with me. She covered this with a smirking smile. When I was driving her home, her smile had become more bemused. I told Signe I had been studying her face and I suspected she was laughing at me because she was winning the "not-talking battle." She sobered at once. "Oh, I'm not, Miss Dawlin. I wouldn't laugh at you." She said this with real feeling, but then lapsed again into silence. Later, the counselor told me that Signe had come back in rare good spirits. She said that at dinner Signe had carefully and admiringly described some Mexican jewelry I had been wearing. Twelfth interview. Signe brought in a picture of her boy friend, Joe. I said he was very attractive. "He's adorable," she corrected me. She said they planned to marry in two years. However, she was not going steady, because if they should quarrel between now and then, she didn't want to be "out of circulation." Signe had, I think, decided to prevent me from getting back to "that old subject" by a barrage of chatter about less emotionally charged questions. I permitted her to do this today. As she talked, her face was animated and very attractive. Finally, when she paused, I was able to say, "I have good news, Signe." I told her about the foster home I had found for her. She was excited and pleased. I described the home in detail and found her responding quite positively to the other children, the school district, the fact that she would have her own room, and so on. Signe asked a number of good and pertinent questions and then began to focus on the number of nights she could go out. I asked 244

Casework with Adolescents her how often she thought would be right. She said she would like three nights a week until nine and one night until eleven. I said I couldn't answer this. Perhaps the three of us should talk it over— Signe, Mrs. James, and I. Signe said, "I want her to be strict." I asked Signe when she wanted to visit, and she responded, "Tomorrow." I asked when she would like to move in if she liked the home and she said, "As soon as possible." An Interview Two Years Later The following interview took place two years after the series of twelve. One might say, "Same caseworker, same child, two years later." This, however, would not be true. For though the child was still Signe Anderson, she was not the same child. Signe had spent the two years in the Robert S. James foster home. Her continuing close relationship to Miss Dawlin had been characterized by real movement. One rarely saw tears from Signe any more. She had made progress in the James home, although it was a rather rigid one with some genuine shortcomings. Miss Dawlin and Signe agreed that another move was desirable. Miss Dawlin felt that an exceptionally detailed recording of this interview was called for because of its interesting nature. The following is her account of the interview. Signe came in, in her usual ebullient mood. She asked whether I had found a new foster home yet. When I said I hadn't, she made a little face. I asked her how things had been going and she said, "Terrible as always." She gave a detailed description of the marital problems between the foster parents and how uncomfortable she and the other foster children were when they not only witnessed the quarrels but were urged to take sides. Signe said that when Mrs. James was not quarreling with her husband, she kept Signe and the other girls busy from morning till night cleaning the house. She didn't know which was worse. Signe said Mrs. James accused her of being "oversexed." Signe explained this was because five different boys had asked her to the prom and she didn't know which one to go with. We talked at some length about the meaning of the term "oversexed" and only *45

The Art of Child Placement when I was sure that Signe was not uneasy about the remark did we go on to the subject of her father. I reminded Signe that when we last talked, it looked as though her father might have to be hospitalized. I had felt concerned because I knew Signe was. She said he was quite a little better. Suddenly she said, "Maybe I should go live with him." I asked whether she would like to and she said, "Yes. But he wouldn't have me. I make him nervous." I asked what she meant by nervous and she couldn't say. I said that maybe she was thinking that he had problems of his own and when she came over with her problems too, it was too much for him. One is able to help another only when his own problems are not too pressing. She said she guessed that would describe her Dad. "If he would have you, Signe, would you go?" I asked. She shrugged her shoulders expressively. Then she said that it wouldn't work—it wouldn't help either of them. I added, "But you wish it were different and he were different so you could live with him?" She smiled and nodded. Signe returned to the inadequacies of the James home. She said that in other homes she had been encouraged to bring her friends in after school. Here it was forbidden. Every night she was supposed to come right home, change into work clothes, come down stairs, and say, "Mrs. James, what would you like me to do?" I sympathized. Signe said that Mrs. James disliked her. I said that Mrs. James was an unusual woman, one who couldn't show her feelings easily, but I knew she really was fond of Signe. Signe disagreed with me lightly. She brought up her school worries. (Signe carries a B average but is still worried.) Arithmetic was her chief worry. While talking about it, she suddenly became quite excited. "Miss Dawlin," she said, "I've been doing a lot of thinking. My arithmetic is poor because I've missed so much school. I used to love my brother. We had such good times together. On nice days when I didn't feel like going to school, he'd write fake excuses and we'd go biking around all day. He was wonderful to me. You'll never know how I looked up to him." There were unshed tears in her 246

Casework 'with Adolescents eyes. "And yet, he was mean too. Now I understand. He's really Dad." I said, "You mean, he's just like your father, Signe?" She began to reminisce about the times when she and her father and brother lived together. While she was doing the housework, her father was "mean." He'd hit her and say "nasty" things to her. But in the end, he would give her a reward. I said it was terrible to have someone mean to you when it was someone you needed to have be nice to you. I said she must have had an awful lot of work to do when she was just a little girl. She said she had. I asked whether this began right after her mother died and she said, "Yes, my father and brother made me work all the time." I said sometimes fathers and older brothers expect too much of little girls. Maybe they expected her to take her mother's place. She said that was just it. I said, "That was hard—and yet I'll bet you were sometimes flattered and pleased to be treated as an older girl" Then Signe said, "Miss Dawlin, there's something I want to talk about. It sounds funny, but I've thought about it a lot." I said, "What is it, Signe? I'm very interested." Signe said she was not making anything of herself moving from foster home to foster home. She had been thinking that when she lived with her father and her brother perhaps it was largely her fault that they didn't get along. She used to tattle on her brother and lose her temper at her father. She said, "Now I know it was all my fault." I told Signe that in situations like this everybody has a part in the failure. Maybe Signe had not been an angel, but she had had more burdens than a little girl can carry. I knew that both her father and brother were much too hard on her. I knew how her father was when he was drinking, too. I felt that if Signe had been a complete angel, it wouldn't have worked. She listened eagerly and seemed to need a lot of reassurance that the failure of their family wasn't her fault. She again said, "I know this sounds funny, but I have been thinking of this a lot and I do want to make something of myself. H7

The Art of Child Placement Especially now when I'll be trying a new home. This one has got to work." I said it didn't sound funny at all. It was a good sensible thing to do—trying to figure out what made you the way you were, like why you were having trouble in arithmetic. Signe talked about how she had had to grow up too fast. First trying to keep house, then going to a series of foster homes, and to the girls' club where she was the youngest girl and tried to compete with the older girls. She tried to dress like them and act like them. She said, "I look old, act old; kids my own age bore me. Yet I missed growing up. I'm awfully young underneath—just a little kid, really." I smiled at Signe and said that this was true. She had certainly drawn a sharp analysis of herself. "You know," she said, "I've always said I didn't like little kids. But really, I'm jealous of them because they're having what I missed." Suddenly Signe said, "How much does the past dominate?" Before I could respond she said that she had been thinking how like her father her brother was becoming. And Mrs. James is always criticizing her father, and she's really a lot like him. "What will I be like?" she asked. I asked whether Signe meant, "Will I be like my father?" She nodded. She said she didn't want to be, but sometimes she found herself acting like him and was afraid of this. I told Signe I had always been struck by how unlike her brother and father she was. I said it was important to go on feeling that in certain ways she did not want to be like her father. I said that the past does not dominate, but our feelings about it often do. It is the way we think and feel about the past that can influence what we become. Signe was acting just right—talking about the past and how she felt about it. She was right in thinking about it to help her in her determination to understand herself so that she could be different. She said, "Is it worth it—the fighting to make something of myself? Maybe what I decide is right isn't right at all." I told Signe that making mistakes wasn't important. It was the trying that counted. But it just happened that Signe was right. Of 248

Casework with Adolescents course, I knew her well and liked her so much that I might be prejudiced. But others were noticing it too. The agency doctor had commented that there had been a remarkable change in Signe in the four years he had known her. He said, "Signe is really getting along with people now." She beamed. "Oh," she said, "did he really say that?" I said he had, and that I knew it was true. Signe then said that she knew it, too. She felt differently toward people. Not so hateful, not so jealous, not so sure that they thought she was dirt under their feet. Then she added sadly, "But look at my background!" I said, "All right, let's look at your background. You start out with good health, a really superior brain, and better looks than most of the girls in your class. That's part of your background too, you know. In addition, you have something in you quite honest and courageous and wonderful that's making it possible for us to have this conversation right now." I continued. "Now let's look at what you consider the bad part of your background. You weren't lucky enough to draw a father who was the kind of father you wanted to have. And though you liked your mother, you weren't lucky enough to have her around for very long." I agreed with Signe that her father had some serious shortcomings not only as a father, but also from his own point of view. He wasn't a happy person. He didn't feel secure about himself. He hadn't had help, when he was her age, with his feelings about his background. Neither had her brother. I said, "Signe, the past doesn't dominate if you don't want it to." Signe listened very attentively. She said she didn't want to criticize others for not trying, and she wanted to go right on trying herself. But sometimes, she said, she got the feeling that it was hopeless. Now she would remember what I had said—that it wasn't your past, it was how you felt about it that counted. Signe said she had been thinking about a lot of things, such as how she would raise her own kids. She looked at other girls who were not like herself—girls who were not still little girls underneath, girls who could run things and were popular and sure of 249

The Art of Child Placement themselves. Once at school she thought she had found an ideal girl, but the girl confided in her that she quarreled with her mother over the housework. Until last year this girl had never had to do any. Now that she was learning, she and her mother fought about it all the time. Signe thought she had done too much work, but she didn't want her kids to grow up never doing anything for themselves. I said that Signe used to feel that other girls were ahead of her but that I believed that she was going to be ahead of them pretty soon. She had something very important that they didn't have. I asked her how many girls she knew who really looked at themselves as she was doing today and tried to figure out why they acted as they do. Signe smiled. I said that Signe was going to end up with more understanding of herself than any of these girls. And when she understood herself, she would understand others better, too, and this would make her able to get along more comfortably with them. Signe looked pleased. "I feel a little silly talking this way," she said. I said that I knew perhaps she would but that I thought she felt good about it at the same time. Signe said, "For some reason, I can let you see me as I really am." I told Signe I thought this was wonderful and that I certainly liked what I saw. I liked all the progress in Signe and I liked her wanting to make more progress. Signe went back to talking about how controlling Mrs. James was. I said I had known that Mrs. James was a somewhat controlling person when I placed Signe there. I had felt that Signe needed this at the time she went there. I knew she was all mixed up, couldn't trust people, and wanted to be her own boss, but that she was unable really to decide anything for herself. Maybe if someone could control her and make her decisions for a while, it would give her a chance to get on her feet. Signe listened intently and seemed to look approving. Finally she said, "I want to move now, but I'm not saying I didn't learn anything. I've learned a lot. You get out of life what you put into it. I used to think the world owed me a living." I said it was fine that Signe was feeling 250

Casework imth Adolescents this way. I hoped that she would go on trying to put a lot into the world. Signe said, "I want to go on trying, but the world gets so black!" I said, "Because of your background?" "Not just that," she said. "I'm so dumb in arithmetic." I told Signe that when I was her age, I wasn't able to do foreign languages and I thought I was dumb too. It was wrong, I said, to feel "dumb" because of just one subject. Pretty soon you realize that there are some things you do well, others not so well. I could arrange for some outside help in arithmetic, if Signe wanted it, but the fact remained that she got a B last month in that subject. Maybe some of Signe's worries about the past spilled over when she felt she wasn't understanding everything in arithmetic. I'd like her to keep on trying alone a little longer and not to care if she did get a C or even a D. We'd talk about it again soon, and if she really wanted help, all she'd have to say was "Uncle." I'd like to see her do it alone if she could, though, because I thought she'd be able to manage it herself. Our interview led back to Mrs. James, who once said that "welfare kids are spoiled. They get everything they ask for." Mr. James, on the other hand, says, "Get all you can out of them before you're eighteen, baby. After that they cheerfully let you get pretty hungry." Signe laughed and said that she was criticized for being on the welfare, criticized for being spoiled by the welfare, and yet advised to take advantage of the welfare. I said it looked as though they had her over a barrel. Signe said she didn't mind being on the welfare any more. The things that caused her to be here were things over which she had no control. I said, "Like things that happened to your father a long time ago and made him the way he is now?" I said maybe he could have changed if he had been able to use the kind of help that Signe was using now. "Yes," said Signe thoughtfully, "I guess he could have changed if he had had someone like you when he was my age. But now he won't. He'll never change." 251

The Art of Child Placement I said, "He's not like you. You could change a lot. Like the big change in you in the past two years." I paused and added, "And some of the other changes you're planning to make." Signe laughed. I offered to drive her home, and we enjoyed the ride. Getting into the car now is a signal to Signe to talk about light subjects. She brought me up to date on the latest successes of the football team.

252

ADDITIONAL READING AND INDEX

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Additional Reading

Chapter i. Placement of the Very Young Child 1. Aldrich, C. Anderson, and Aldrich, Mary M., Babies Are Human Beings. New York: Macmillan, 1938. 2. Bishop, Julia Anne, "The GhikTs Part in the Adoption Placement," in Adoption Practice—Casework with Parent, Child and Foster Parent (pamphlet). New York: Child Welfare League of America, 1941, pp. 17-34. 3. Goldfarb, William, "Infant Rearing as a Factor in Foster Home Replacement." American Journal of Orthopsy chiatry, 14: 162-166 (January 1944). 4. Hunt, Frederick C., "Boarding Care for Babies." Child Welfare, 30:16 (May 1951). 5. Leatherland, Louise, "Helping the Baby through the Temporary Foster Home," in The Role of the Baby in the Placement Process (pamphlet). Philadelphia: Pennsylvania School of Social Work, 1946, pp. 42-66. 6. Philbrick, Norma, "The Interrelation of Parents and Agency in Child Placement." Journal of Social Work Process, 3:17-28 (December 1939). 7. Pile, Florence M., "Helping the Baby Move into an Adoption Home," in The Role of the Baby in the Placement Process (pamphlet). Philadelphia: Pennsylvania School of Social Work, 1946, pp. 67-100. 8. Rathbun, Constance, "Psycho-physical Reactions to Placement." Journal of Social Casework, vol. 28, no. 2, pp. 61-67. 9. Ridenour, Nina, and Johnson, Isabel, Some Special Problems of Children, Ages 2 to 5 Years (pamphlet). Philadelphia: National Mental Health Foundation, 1947. 255

The Art of Child Placement 10. Ross, Helen, and Johnson, Adelaide, Psychiatric Interpretation of the Growth Process (pamphlet). New York: Family Service Association of America, 1949. 11. Smith, Mary Frances, "The Integration of Agency Services in the Placement of Babies," in The Role of the Baby in the Placement Process (pamphlet). Philadelphia: Pennsylvania School of Social Work, 1946, pp. 7-41. 12. Spitz, Rene A., "Psychiatric Therapy in Infancy." The American Journal of Orthopsychiatry, 20:623-633 (July 1950). 13. Taft, Jessie, "Some Specific Differences in Current Theory and Practice," in The Role of the Baby in the Placement Process. Philadelphia: Pennsylvania School of Social Work, 1946, pp. IOO-IIO.

Chapter 2. Establishing a Relationship with the Gradester 1. Allen, Fredrick H., Psychotherapy with Children. New York: W. W. Norton, 1942. 2. Baker, Inez M., "Special Needs of Children." Public Welfare, 4:170-181 (August 1946). 3. Bettelheim, Bruno, Love Is Not Enough. Glencoe, 111.: The Free Press, 1950. 4. Bowen, Janice, "Responsibilities in Placement of Children." Proceedings, National Conference of Social Work, 1947, pp. 301310' 5. Cowan, Edwina A., "Some Emotional Problems Besetting the Lives of Foster Children." Mental Hygiene, 22:454-458 (July 1938). 6. Deming, Julia, "Foster Home and Group Placement." American Journal of Orthopsychiatry, 10:587-593 (July 1940). 7. Dula, John E., "The Child Away from Home." Journal of Social Casework, 29:130-135 (April 1948). 8. Josselyn, Irene M., in Psychosocial Development of Children (pamphlet). New York: Family Service Association of America, 1948, chaps. 8 and 9. 9. Gardner, George E., "Ambivalence as a Factor in Foster Home Failure." American Journal of Orthopsychiatry, 3:135-139 (January 1942). 10. Gordon, Eleanor W., "There Is a Time in the Affairs of Children." Bulletin, Child Welfare League of America, 24:4-15 (February 1945). 11. Gordon, Henrietta L., "Discharge: An Integral Aspect of the Placement Process." Family, 20:35-42 (April 1941). 256

Additional Reading 12. Luehrs, Leslie, Foreword to Adoption Practice—Casework with Parent, Child and Foster Parent (pamphlet). New York: Child Welfare League of America, 1941. 13. Silberpfennig, Judith, and Thornton, Frances E., "Preparation of Children for Placement." Family, 23:146-152 (June 1942). 14. Weisenbarger, Ruth, "Direct Casework with the Child in Foster Home Placement." Child Welfare, 30:3-6 (April 1951). 15. Weissman, Irving, "Children in Long Time Foster Care." Child Welfare, 29:3-5 (June 1950). 16. Wires, Emily Mitchell, "The Foster Child and Separation." Mental Hygiene, 30:250-256 (April 1946). 17. Young, Leontine, "Placement from the Child's Viewpoint." Social Casework, June 1950, pp. 250-255. 18. , "Planning for Child Placement." Bulletin, Child Welfare League of America, 27:9-12 (January 1948). Chapter 3. Foster Homes and Institutions 1. Bettelheim, Bruno, Love Is Not Enough. Glencoe, 111.: The Free Press, 1950. 2. Dumpson, James R., "New Developments in Child Welfare." Bulletin, Child Welfare League of America, 27:1-6 (May 1948). 3. , "Placement of Adolescents in a Foster Care Agency." Journal of Social Casework, 29:170-176 (May 1948). 4. Fredricksen, Hazel, The Child and His Welfare. San Francisco: W. H. Freeman, 1948, chaps. 13, 14, 15, 16, and 18. 5. Freud, Anna, and Burlingham, Dorothy T., Infants without Families. New York: International University Press, 1944. 6. Gardner, George E., "Ambivalence as a Factor in Foster Home Failure." American Journal of Orthopsychiatry, 3:135-139 (January 1942). 7. Goldfarb, William, "Infant Rearing as a Factor in Foster Home Replacement." American Journal of Orthopsy chiatry, 14: 162-166 (January 1944). 8. Gula, Martin, "Study and Treatment Homes for Troubled Children." Proceedings, National Conference of Social Work, 1947, pp. 331-343. 9. Howard, Frank M., "Institution or Foster Home?" Mental Hygiene, 30:92-104 (January 1946). 10. Lippman, Hyman S., "Newer Trends in Child Placement." Family, 21:323-328 (February 1941). 11. Milner, John G., "Some Determinants in the Differential 257

The Art of Child Placement Treatment of Adolescents." Child Welfare, 29:3-8 (October 1950). 12. Richman, Leon H., "New Needs and New Approaches in Foster Care." Child, 23:8-14 (July 1948). 13. Schumacher, Fred A., "What Service Does the Institution Give, What May We Expect of It?" Bulletin, Child Welfare League of America, 27:5 (April 1948). Chapter 4. Casework with "Oivn" Parents 1. Allen, Fredrick H., Psychotherapy with Children. New York: W. W. Norton, 1942. 2. Baker, Inez M., "The Caseworker Helps the Child Use Boarding Home Experience." Child Welfare, 28:3-5 (May 1950). 3. , "Special Needs of Children." Public Welfare, 4:179181 (August 1946). 4. Baum, Helen, "Function in Child Placement." Journal of Social Work Process, 1:45-47 (November 1937). 5. Brandzel, Esther S., An Experimental Use of the Temporary Home (pamphlet). New York: Child Welfare League of America, 1946. 6. Clifton, Eleanor, "Treatment in Support of Normal Growth Processes," in Child Therapy: A Casework Symposium (pamphlet). New York: Family Service Association of America, 1948. 7. Hamilton, Gordon, Psychotherapy in Child Guidance. New York: Columbia University Press, 1947. 8. Hutchinson, Dorothy, "The Parent-Child Relationship as a Factor in Child Placement." Family Journal of Social Casework, 27:47-51 (April 1946). 9. Lauer, Edith L., The Role of Substitute Parents in the Life of the Emotionally Deprived Child (pamphlet). New York: Child Welfare League of America, 1937. 10. Lewis, Mary E., "Long Time Temporary Placement." Child Welfare, 30:3-7 (October 1951). 11. Philbrick, Norma, "The Interrelation of Parent and Agency in Child Placement." Journal of Social Work Process, 3:17-28 (December 1939). 12. Pollock, Jeanne C., and Rose, John A., "Psychotherapy with the Foster Child." Child Welfare, 28:3-8 (June 1949). 13. Radinsky, Elizabeth K., "The Parent's Role in Long-Time Care." Child Welfare, 29:8-12 (February 1950). 14. Schoenberg, Carl, "Long Time Foster Care as an Agency Service." Child Welfare, 30:3-7 (May 1951). 258

Additional Reading 15. Simon, Abraham J., "Social and Psychological Factors in Child Placement." American Journal of Orthopsy chiatry, 20:293302 (April 1950). 16. Wires, Emily Mitchell, "Long Time Care in a Public ChildPlacing Agency." Social Casework, 32:202-207 (May 1951). Chapter 5. Casework 'with Foster Parents Little has been published that has direct reference to work with foster parents. The following articles, for the most part, have only a few pertinent sentences. But such descriptions of the feelings of parents, children, and social workers sometimes aid in deductive thinking about the relationship of these problems to foster parents. 1. Brandzel, Esther A., An Experimental Use of the Temporary Home (pamphlet). New York: Child Welfare League of America, 1946. 2. Clothier, Florence, "Problems in the Placement of Illegitimate Children." Bulletin, Child Welfare League of America, 20: i8 (March 1941). 3. Cowan, Edwina A., "Some Emotional Problems Besetting the Lives of Foster Children." Mental Hygiene, 22:454-458 (July 1938). 4. Deming, Julia, "Foster Home and Group Placement." American Journal of Orthopsychiatry, 10:587-593 (July 1940). 5. Fredricksen, Hazel, The Child and His Welfare. San Francisco: W. H. Freeman, 1948. 6. Gardner, George E., "Ambivalence as a Factor in Foster Home Failure." American Journal of Orthopsy chiatry, 3:135-139 (January 1942). 7. Gordon, Eleanor W., "There Is a Time in the Affairs of Children." Bulletin, Child Welfare League of America, 24:4-15 (February 1945). 8. Gordon, Henrietta L., "Discharge: An Integral Aspect of the Placement Process." Family, 20:35-42 (April 1941). 9. , Foster Care for Children (pamphlet). Washington, D.C.: Federal Security Agency, Social Security Administration, Children's Bureau, 1951. 10. Hutchinson, Dorothy, In Quest of Foster Parents. New York: Columbia University Press, 1943. 11. , "The Parent-Child Relationship as a Factor in Child Placement." Family Journal of Social Casework, 27:47-51 (April 1946). 259

The Art of Child Placement 12. Jolowicz, Almeda R., "A Foster Child Needs His Own Parents." Child, August 1947, pp. 18-21. 13. Kline, Draza, and Overstreet, Helen Mary, "Maintaining Foster Homes through Casework Skills." Social Service Review, September 1948, pp. 1-6. 14. Lauer, Edith L., The Role of Substitute Parents in the Life of the Emotionally Deprived Child (pamphlet). New York: Child Welfare League of America, 1937. 15. Lippman, Hyman, Foster Home Placement of Older Children (pamphlet). New York: Child Welfare League of America, 1940. 16. Philbrick, Norma, "The Interrelationship of Parents and Agency in Child Placement." Journal of Social Work Process, 3:17-28 (December 1939). 17. Price, Morris H., "The Place of Psychiatric Consultation in a Child Placement Agency." Jewish Social Service Quarterly, 28:366-374 (June 1952). 18. Radinsky, Elizabeth K., "The Parent's Role in Long-Time Care." Child Welfare, 29:8-12 (February 1950). 19. Richman, Leon H., "The Significance of Money in the Child Placing Agency's Work with the Child, Own Parents and Foster Parents." Social Service Review, 15:484-493 (September 1941). 20. Stoll, Margaret, "Foster Parents' Influence on Parent-Child Relationships" (Master's thesis, University of Minnesota, 1952). 21. Weisenbarger, Ruth, "Direct Casework with the Child in Foster Home Placement." Child Welfare, 30:3-6 (April 1951). 22. Wright, Dorothy G., and Leitch, Mary E., "The Use of Boarding Homes in Conjunction with a Private Psychiatric Residential School." American Journal of Orthopsychiatry, 16:78-82 (January 1946). Chapter 6. Casework with Adolescents 1. Austin, Lucille N., "Some Psychoanalytic Principles Underlying Casework with Children," in Child Therapy: A Casework Symposium. New York: Family Service Association of America, 1948, chap. i. 2. Burmeister, Eva, "Institutional and Foster Home Care as Used by an Agency Offering Both Services." Bulletin, Child Welfare League of America, April 1942, pp. 18-27. 3. Dula, John E., "The Child Away from Home." Journal of Social Casework, 29:130-135 (April 1948). 260

Additional Reading 4. Gordon, Eleanor W., "There Is a Time in the Affairs of Children." Bulletin, Child Welfare League of America, 24:4-15 (February 1045). 5. Horrocks, John E., The Psychology of Adolescence. Boston: Houghton Mifflin, 1951. 6. Howard, Frank M., "Institution or Foster Home?" Mental Hygiene, 30:92-104 (January 1946). 7. Josselyn, Irene M., "Social Pressures in Adolescence." Social Casework, 33:187-193 (May 1952). 8. , The Adolescent and His World. New York: Family Service Association of America, 1952. 9. Lippman, Hyman, Foster Home Placement of Older Children (pamphlet). New York: Child Welfare League of America, 1940. 10. Malm, Marguerite, and Jamison, Olis G., Adolescence. New York: McGraw-Hill, 1952. 11. Maris, Madeline, "The Agency's Part in Helping Adolescents to Assume Responsibility." Bulletin, Child Welfare League of America, 21:2 8-30 (April 1942). 12. Milner, John G., "Some Determinants in Differential Treatment of Adolescents." Child Welfare, 29:3-8 (October 1950). 13. Nicholson, Marion B., "Therapy with Placed Children." Bulletin, Child Welfare League of America, 21:31-34 (April 1942). 14. Wright, Dorothy G., and Leitch, Mary E., "The Use of Boarding Homes in Conjunction with a Private Psychiatric Residential School." American Journal of Orthopsychiatry, 16:78-82 (January 1946).

261

Index

Adolescents: anger, directed at caseworker, 232; "big sister" substitut homes, 220-30; boardinghouses for, 228-29; casework with, 231, 23536; characteristics of, 200-10; characteristics that make placement hard, 220-21; close friends of, 21415; delinquent gangs, 222-23; delinquents, 221-23; depressions, 216; distrust of adults, 212-13; faults, 217; feelings toward agency, 214; gifts, 233; group care, 82; idealism 213, 217; immaturity, 224; importance of clothes, 215-16; institution or foster home? 80-83; institutional living, 226-27; limits, 234; missin parents of, 224-25; negative feelings toward parents, 234; older foster parents for, 230; places to live, 226-30; preplacement in institutions, 81; problems in placement, 218-26; psychiatric interpretation of, 213-14; relationship to caseworker, 231-32; repressed type, 219; revolt of, 80-81; "saints and sinners," 210-11; sensitivity, 216; testing caseworker, 213; withdrawn type, 224; work homes, 227-28 Adoptions, 70-74 Advice, giving of by social workers, 155-56 Aldrich, C. Anderson, on needs of babies, 4-5 Autoerotic behavior in young children, IO-II 262

Axelrode, Jeanette, definition of supportive therapy, 118 Babies: autoerotic behavior, 10-11; communicating with, 27; disturbed by changes, 5; empathizing with, 12-13; feelings about changes, 2627; foster care for when sick, 7; hospitalization of, 6-7; insecurity shown by overeating, 19; institutional care, 8-12; marasmus, 9; need for mothering, 8; needs of, 4-5; participation in placement of, 14; preparation for placement of, 3, 26, 28; replacement of, n; illness of in foster homes, 7; skilled workers needed for, 3; visits to doctor, 22 Baker, Inez, role of the placement worker, 39 Bishop, Julia Anne, child's inappropriate anger at foster parents, 166 Boardinghouses for adolescents, 2282 9 Bowlby, J., understanding parents, 113-14 Brace, Charles Loring, 72, 74 Brandzel, Esther, role of social worker toward child, 50-51 Burmeister, Eva: adolescents in foster homes, 82; foster home care, 86; institutional care, 78 Case histories: Anderson, Signe, 23652; Carlson, Jenny, 92-105; Du

Index Mont foster family, 191-204; Eileen, 57-63; Flannigan case, 126-43; Johnny, 63-68; Jones, Jerry, 14-30; Ralph, 52-57 Caseworker, see Social worker Ceremony, 27 Change: as it appears to babies, 5, 26-27; as it appears to gradesters, 45; preparing foster parents for, 28 Child welfare worker, see Social worker Children, see Gradesters Confidences, 160-61 Correctional institution, 84-85 Custody, 123-26 Defensiveness of children, 39 Delinquents: characteristics of, 22123; in foster care, 85-86; gangs, 222-23; in placement, 83-86; sexual, 223; sources of referral, 221-22 Deming, Julia: conflicting loyalties, 90; group care for adolescents, 82 Depressions, 216 Discipline, 164-65 Dula, John E.: advantages of foster homes, 86-87; grouP care for adolescents, 82 Dumpson, James R., problems of adolescence, 211 Empathizing: with babies, 12-13; with gradesters, 43-44 Foster fathers, 174-76: aggressive, unusual type, 176-77; neglected by social workers, 176 Foster home care: for adolescents, 82; advantages of, 82, 86; for delinquents, 85-86; early history of, 74-75; foster home or institution? 80-83; selection of homes for specific child, 188-91; special values, 89; vested-interest group, 75 Foster mothers: characteristics of, 167-74; dominant type, 167-68; for group homes, 76-77; lack sense of privacy, 169-70; pride in role, 17071; special skills, 169-72 Foster parents: adoption wish, 14950; ages of, 150, 230; attitudes of, 144-45; characteristics of, 144-51;

characteristics social workers seek, 163-67; confidences about child, 161; confidences about parents, 160-61; dependence on social worker, 149-50; different from caseworkers, 151-53; disciplining of child, 164-65; faulty relationships with own parents, 163, 180-81; feelings about what child tells social worker, 161; financial motivation 147-48; gratitude expressed by agency, 165-66; identification with foster children, 148-49; matching standards of foster parents and children, 188-89; moneyhandling problems, 182-83; negative feelings need airing, 158; natural children oi, 177-80; "political philosophers, 149; preparation for separation, 28, 159-60; problems in work with, 153-54, 180-88; reluctance to release child, 185-86; reluctance to share child with agency, 164, 181-82; responsibilities, 183-84; revoking licenses, 18788; selection a calculated risk, 190; sense, of detachment, 28; social workers' methods of help, 155-60; supportive work with, 156-57; surrendering too easily, 186; unmet needs of, 145-46; vacations for, 159; wish for child to help, 148 Freud, Anna, on deprived parents, 119 Freud, Anna, and Burlingham, Dorothy T.: on matching "living standards in home selections, 189; on replacement vs. institutionalization of babies, n Garrett, Anette, social worker's role with child, 50 Gordon, Henrietta, evaluating capacity for parenthood, 120 Gradesters (children of school age), 32-35: biases toward social workers, 45; congregate vs. foster home care, 35; deprived children in placement, 37; empathizing with, 43-44; fear of change, 45; inarticulateness, 46; institutional vs. foster home care, 35-36; meaning of 263

The Art of Child Placement separation to, 36; secure in placement, 35, 37; selection of right homes for specific children, 18891; ties to missing parents, 109; ties to parents, 40-42; value of parents to, 107-11 Group care for adolescents, 82 Group homes, 76-77 History taking, 113 Hospitalization of babies, 6-7 Hostility in children, 48-49 Howard, Frank M., group care for adolescents, 82 Hutchinson, Dorothy: importance of discussing children's problems, 42; meaning of separation to children, 36 Inarticulateness of children, 46 Infants, see Babies Institutional care: for adolescents, 82-83, 226-27; f°r babies, 8-12; early history of, 71,76-77; or foster care for gradesters? 35-36; when use is indicated, 77-80 Institutionalization vs. replacement, ii Institutions: correctional, role of social worker in, 84-85; description of, 91; special values of, 89-92 Intake interview, 41 Interviews, scheduling, 51 Introduction of baby to agency, 21 Johnson, Adelaide M., and Ross, Helen: on characteristics of gradesters, 33; on psychiatric interpretation of growth, 213-14 Jolowicz, Almeda R., child's feelings about missing parents, 225-26 Latency, 32-35 Lerner, Samuel, values of institutional care, 90-91 Lippman, Hyman S., foster home care for adolescents, 82 Manning, Marilyn, adolescents' distrust of adults, 212 Marasmus, 9 Matching homes and children, 189 Mothering, babies' need for, 8 264

Mothers: ambivalent, 40; treatment of narcissistic, 119-20 Overeating, symptom of insecurity, 19 Parents: absent, but important, 109, 225-26; accepting, 114; casework with, 116-23; deprived, 113-14,119; diagnosis of their problems, 116; effect on foster parents, 180-81; giving up custody of child, 123-26; helping them to gain insight, 121; need for placement services, m16; negative feelings of adolescents about, 234; negative feelings of young children about, 225-26; participation of in placement, 41; reevaluations of, no; seriously disturbed, 118; supportive therapy with, 118; tempo for movement in casework, 122; value of to children, 107-11 Parenthood, capacity for, 115, 120 Placement: of delinquents, 83-86; of deprived children, 37; emergency type, 49-50; framework, 115-16; initial adjustment to, 51, 87; need of parents for, 111-16; preparation of babies for, 3; problems of adolescents in, 218-26; of secure children, 35, 37; of siblings, 79 Polier, Justine Wise, early history of adoptions, 72 Promises to children by social workers, 49 Protection cases, 42 Regression in children, 32 Rejection by parents, 112 Replacements, 87-88: of babies, 11 Ribble, Margaret: on change as it effects babies, 5; on marasmus and its causes, 9 Rogers, Carl R., attitudes of good foster parents, 144-45 Role of placement worker, 39, 50-51 Ross, Helen, social worker for adolescents, 232 Ross, Helen, and Johnson, Adelaide M.: on characteristics of gradesters, 33; on psychiatric interpretation of growth, 213-14

Index Selection of homes, 189-91 Self-awareness, needed by social workers, 107 Selig, Martha Keiser: description of institution, 91; on institutional care, 79 Separation: effect on babies, 6; effect on gradesters, 36; imagining, 125-26; preparing foster parents for, 28 Sexually delinquent children, 223 Siblings in placement, 79 Sick babies, foster care for, 7 Social workers: for adolescents, 23132; generic training needed by, 40; help for parents, 116-23; personal and professional selves, 1516; role in placement of gradesters, 40 Spanking, 184-85 Spitz, Rene, effect of separation on babies, 6 Spock, Benjamin, characteristics of gradesters, 33-34

Suspiciousness of children toward social workers, 37 Taft, Jessie: on parent participation in placement, 41; on separation, i25-26 Tempo of movement into placement: for children, 29-30; for parents, 122 Temporary homes, advantages for babies, 28 Therapy, supportive, 118 Time: limits, 122-23; use of with gradesters, 48 Toilet training, 29 Visiting by parents, 121-22 Vollmer, Herman, hospitalization of babies, 6~7n Wage homes: early history, 71; use for adolescents, 148, 227-28 Young, Leontine R., on parental rejection, 112

265