The philosophy and rationales of The Browndale Treatment Process
by JOHN L. BROWN, FRSH, ACSW, AGFA Founder of Browndale
The Browndale Treatment Process is based on some basic underlying principles and rationales which I will begin to outline in limited detail in this article. This will in no way be a definitive statement on our treatment process, but it is the beginning effort to share more fully the elements behind our methods and processes as well as a more precise statement of the processes themselves. Some of this material will have been published in other articles, or will be similar to material in other articles which have appeared in past issues of this magazine.
Over the last 22 years there has been very limited opportunity for dialogue with my colleagues in Ontario. I would hope that this statement would make it possible for us to begin to have dialogues. I have structured this article in point form and each of these points will constitute a separate statement that may be obtained for discussion purposes as separate rationales that can be looked at individually.
... an extremely dehumanizing experience for the child.
- We view at all times the child who is with us as a whole unique human child with all the needs of a child, and these basic human needs take precedence over any single fact about the child. His pathology, his psychodynamics, his heritage, his race, all these things must find their place within the total priorities that follow from the child's basic human needs.
What we are concerned about here is the fact that children once diagnosed tend to be seen as cases, which is an extremely dehumanizing experience for the child. "We would not say, "This is a schizophrenic". We would say, "This is a human child who has schizophrenia". In fact, we would probably go further and say, "This is a human child who has many facets, one of which is the fact that he has a very unique and special response to life which undoubtedly could be understood if we knew all that we should know about his background, his birth, and his life up to now."
This wholeness and unity of the child is best recognized within the context of an integrated extended family unit. It is within such a unit that the child has the best opportunity for fulfillment and growth. In our need to segment and tease out specifics of deviance or psychopathology, we fragment the child. So much of our literature and much of our concept in the field of childhood psychology presents fragments rather than whole human children. This is seen as well in the programs that result from these studies. It is inevitable that if we segment the child for study, that we will learn a great deal about a part of the child. If we forget that all that we have learned is only a part, we then begin to act as though our new knowledge reflects the total child. Our remedial programs for such children tend to be skewed in the direction of our specialized knowledge about the fragment of the person that we are specialists in. The detail of that knowledge is easily construed and elaborated so that it takes up most of the daily life style of the child. This has the result of ignoring other aspects of the child that may be equally important or of greater importance than the one fragment that we have become so expert in. Our expertise tends to enhance our professional potency and we become experts because of specialized knowledge of a part of some human children. This can be extremely harmful to the child and to the whole field of child study because it distorts the total reality that is essential when we begin to construct practical programs to cope with the problems we have become expert in.
There is a human tendency to give greater weight to our own knowledge and expertise than to someone else's. As a result of this it is difficult to unify knowledge from the various specialties or fragments of childhood development.
Often the unifications that are attempted are a strange mosaic of unrelated, unintegrated, separate facts that look like a swiss cheese, or remind one of the old saying, "That a camel was a horse put together by a committee of experts on various facets or fragments of horse anatomy."
The aspect most frequently left out of programs for children who have been intensively studied in terms of the fragment or fragments that are pathological, is the human and positive parts of the child and almost always the total of the potential that he has to offset his handicap. His potential to fight against the handicap is most often missed. So we tend to get programs that are sterile, narrow, and dehumanizing but that are extremely rich in the area of our specialization. For example: programs for schizophrenic children, programs for autistic children, etc.
What we need, of course, are programs that are geared to the whole human child, that provide great opportunity for all of the child's human potential to be developed and fulfilled. This means that the very minimal that the handicapped child must have cannot be less than what we would offer to a normal child as a suitable, appropriate life style. When that has been achieved, we can then talk about the specialist knowledge that should be introduced in addition because of the child's malady. This means the life style must be normalized.
. . . there has been a tendency to isolate the child from his family during treatment.
We see the child as an integral part of his biological family and their history, and we feel that we cannot diagnose him or work with him separately from his family members or from his family history. In the human species, the child is so much the product of his family and their environment that they must always remain a central theme in all that we do with children. In practice, we have observed that the more severe the diagnostic assessment of the child is, and the clearer and more typical the child's symptoms are of the disease entity that he manifests, the more the family is disregarded. But, aside from this, in all our child welfare and child protection laws, in all of our professional practice, there has been a tendency to isolate the child from his family during treatment. The juvenile courts, the law enforcement bodies, protection agencies, the schools, have historically weakened the family's role without replacing it with something else. We feel strongly that all of our work with a child must be done within the orientation that the biological parents and the child's extended family have more to offer the child than our most carefully laid plans can offer him.
. . . we tend to view a problem child within a family as a signal for help for the whole family . . .
In the past, much was made in clinical circles of the fact that the disturbed child was a scapegoat for the family unit with the implication that somehow the child had to be separated and protected from the consequences of this role and that the parents were "baddies" because they unconsciously laid onto their child problems from within themselves. While we recognize that families do scapegoat certain children and that some family health or stability depends on specific role assignments for each family member — some positive, some negative — we tend to view a problem child within a family as a signal for help for the whole family and, particularly, for one or both of the parents.
Man has not yet created a modern state that can provide supports and feelings of individual worth to the individual person that are equal to the supports and feelings of personal value that were a natural part of the extended family experience. In the western world we have somehow forgotten the importance of this. I think even in the best of the socialist countries this has not been fully appreciated either since there appears to be an assumption that the state can do it without the extended family.
I can remember as a young man in the United States the argument in welfare and in some of the ethnic communities with which I was related, around whether or not extended family members should be held responsible for the care and actions of handicapped and deviant children. I remember one of the telling arguments against supporting extended family members to give service to children to whom they were related was that there would be a tendency for relatives to rip-off the state subsidies or supports that would make kinship care possible. It was felt that somehow unrelated, specially trained, objective persons would be less likely to exploit the child. Forty years later we can see the consequences, and the useless ineffective social service systems in welfare, corrections, and health that have resulted from this decision. The family and kin were consciously bypassed by the so-called experts in child care in the last 40 years.
This has been a serious detour on the road to adequate child and family services by the western countries. We must now go back to that point of detour and re-evaluate the effectiveness of policies, programs, and laws that absolve parents and kin of children from responsibility for the child. The state and sponsoring agency have been too ready to take on parental and kin roles and they have failed to deliver even remotely close to what parents and extended family kin could achieve and support in service to the child. I don't think we need to spend a lot of time developing this point or arguing about the salient facts. We have the evidence clear before us in our decaying social order and in the failure rates of our expensive state sponsored programs for children. We have an even more telling story in the human misery and waste of human potential that these programs foster. We need to urgently resurrect extended family kinship models and find a way for the state to become a partner with the family.
- We view the child in his existence as the sum total of many separate developing physiological systems that intermesh, each in their time, as he grows and develops, each with their particular role to play in the unity of his particularities as a child. These systems emerge from conception to death in a predictable orderly fashion which we can understand and relate to what the person needs and what is happening to him at any given moment.
Marx said that "Mind is matter that thinks", and we add to this observation that “mind is matter that thinks and feels,” on the assumption that each experience recorded by the nervous system records not only the event or the experience but also the psychological emotional response or feeling to the experience. This produces in the growth and maturation of the child separate emotional psychological systems that reflect and control the human’s use of himself and responses to the world within him and around him. These intertwining, intermeshing, psychological systems help us understand the history of the need gratifications and learned psychological responses of the child. From birth onward, the child is part of a social milieu which is made up of a variety of specific systems or relationships, expectations, gratifications, fulfillments, and demands. These are inseparable form the psychological biological growth and experience systems referred to above.
Because man is a finite organism his experiences are finite and we can come to know all of these things through the study of mankind itself and through the study of the unique human being that we are dealing with as a representative of mankind. The last 300 years of man's history has revealed either the specific data, or indicated where that data could be found in future investigations and study. The last 30 years has overshadowed all of man's previous history in the area of man's study of man. We try to remember that while the study of man itself has been individual, un-unified, and fragmented, the subject of this study - man himself – has always been a unity, a balanced organism made up of many separate interrelated systems that strive for homeostasis.
Within each of these systems and between these systems there are harmonies and antagonisms which we must recognize and use in our specific work with each child. Each system asserts itself against and receives resistance from the other systems. Each system receives support and resistance within a system. This results in antagonisms and conflicts that represent each and every stage of man’s growth and development.
These are part of the forces that shaped our evolution from a more primitive order to a more sophisticated and complex order. These are the forces that are shaping our destiny now and at any given moment when we pause to study or to reflect on who we are, where we are, and why we are. The degree to which we organize our life styles, our social and economic systems, our individual and family life patterns, in harmony with or opposition to these forces, will measure the fruitfulness of our life and the success and achieve3ments of our generations.
As the systems within the individual himself become integrated, he must take a position for himself about the systems that are part of the world around him. He must choose his role. He must choose how he wishes to exert his individual forces to support or inhibit these systems. Man is not an island to himself; he must take his place and his role in the world in which he lives.
- We approach each child with the assumption that he has a strong drive to normalcy — that he wants to be part of the world he lives in, the people, the institutions, the activities around him — unless he is victimized by them, and then he will withdraw. The child's coming to us indicates that he has been excluded, victimized, or that he has made the decision to withdraw to some degree or other from the world and people around him. It is sometimes difficult for us to understand that the child's withdrawal is because he has been victimized, when his history reveals that there have been many organized group and individual efforts to help him_and his family over the course of his life.
Yet it is true that all the children that come to us have been victimized and that they are in various states of withdrawal or preparation for withdrawal when they come to us.
. . . one accepting, supportive, extending gesture can completely eradicate years of hopelessness and despair.
When things are out of balance for any living thing, the first response is to assert activity that will correct the imbalance. If these assertions or aggressions fail to correct the imbalance, the person ultimately withdraws. He loses his sense of purpose, his self-esteem, and energy for action. With children there is a great capacity for revival and one accepting, supportive, extending gesture can completely eradicate years of hopelessness and despair. Many repeated acts of positiveness will, inevitably, if persisted in, lead to the development of the capacity to trust; and the capacity to trust leaves one free to function as an independent human being. This is what we mean by the child's drive to normalcy. It is never seen until the child is within a positive environment and then it suddenly blossoms as though it has been waiting a long time for the warm rain, the gentle wind and the sparkling sunshine to start its growth again.
In our discussion of normalcy we are not talking about bell shaped curve distribution, or averages. We are talking more about that which is natural for persons at various stages of growth and maturation, at various stages of personal and social awareness and within a family-wide range of individual differences. We are talking about what is a harmonious balance between what a person is, what a person can do, and what expectations are set for that person. We are not talking about good or bad. We are talking about reality. We believe that a retarded child, or a schizophrenic child, or a character disorder child, can have a normalized life style. We further believe that they have a right to it which cannot be questioned because of expediency, or cost, or convenience.
- We always view children as having great adaptive capacities and a remarkable and sometimes unbelievable resiliency that helps them overcome hardships, abuse, and neglect with very little input from others required. Of course, this only really works if the environment is positive and if the adults love the children, believe in them, and share themselves with them. This view makes it possible for us to be hopeful about the most difficult and unresponsive children and it gives us the strength and wisdom to work with the most belligerent, negative, acting out children. We believe that the more difficult and extreme the child's behaviour is, the harder we will have to work to involve ourselves usefully with him and that this will produce the most benefits to us, ourselves. Our added efforts never affect the child alone but benefit us, as staff, to an equal degree.
It is extremely encouraging and exciting to witness the tenacity and resiliency that children demonstrate in our rehabilitative work with them. Of course, this is equally true of adults and exactly the same with parents. It is as though man has a strong urge to a positive existence and while we view man and his frailties, we must remember that in the evolution of man, he has gone from the lesser to the more in all aspects of human existence.
. . . where there are children there is a future .
In a cynical world this positivism is invigorating and reminds us: Where there is life there is hope, and where there are children there is a future, and that the mass of mankind tends to follow the laws of evolution.
We have to remember in all of our work with children and adults that the person needs love, the person needs to belong, to be cared for, to be useful, to be wanted, to be precious and adored. Life in isolation holds only horror for man. All of the potential that the human being has blossoms as a result of intimacy and involvement with others, and social usefulness.
Almost all of the children and families who are part of the social service child welfare and child protection systems feel unloved and worthless. They get this feeling from our basic attitudes about the services we provide for them. In a "free enterprise society" services to people always have the lowest priority. In such a society, these people tend to be surplus since they represent a financial burden and therefore they are seen as undesirables. All the pleasant and thoughtful platitudes of social workers and counsellors can't overcome the loud and clear message that we, as a collective society, give to these people. It is essential that a child receive care and love and have a precious position with his parents and family, but it is also equally important that he has this precious position within the extended family and within the social community.
Systems of support and help that we provide to people should never undermine their dignity and worth as human beings. In an era of preoccupation with cost accounting, it is good to remind ourselves that the rationalization or justification of having programs to help children and their families rests on the fact that they are alive at this time, in this place, and no other justification is necessary.
Man must be useful. Children recognize this very early and many of their early efforts are designed to be useful to the people around them. In the "free enterprise society" there is always a large proportion of people who are made to feel useless because they are not in a position to produce competitively within the system. Demoralization, cynicism, anti-social attitudes emerge when people are kept from useful roles.
We are all imprisoned within our physical body. We have limited modalities of communication which at conception are useless to us and which must be developed. At birth we exist in a state of isolate loneliness having been separated from the physical bond that made us one with our mother. From that day onward, we seek to find ways to duplicate with others that great unity that we had beyond ourselves within the womb. In our personal relationships, in our roles, in our work, we strive to escape that isolation. We must view the children in our programs in their isolated state and think of ways that we can directly and indirectly "bridge over" to them.
The great extensions and beauties of life are felt and experienced most keenly and most fully when we are loved by the people around us. It is a requirement that all persons need and that is perhaps the greatest force that man has yet produced. Unfortunately, it never exists without its opposite and this is a reality the child, parent and all of us must live with.
We recognize that all children need adult models for attitudes, value systems, and a frame of reference to judge their behaviour in the past, the present, and the future. If the child is offered a variety of adult models he tends to choose those adults who are most effective, most useful, most friendly and most inspiring. Historically, the extended family provided a large number of models for the children. The nuclear family and the urban isolated family offer the child few models. The institutionalization and bureaucratiza-tion of our churches, schools, retail outlets, and our recreation have left the child with few community models other than fast buck operators, hard-nosed, cynical entrepreneurs, the tough, no-nonsense bureaucrat, and the financially successful put-together clergy. Positive adult models available to our children in North America are virtually non-existent.
The task of deciding our preferences of what we want our children to be poses a great dilemma in a society that is rapidly changing and that has not made up its mind about what is good and, in fact, where the majority of people are confused about what they believe in. Nevertheless, we must find models that are meaningful and useful to the children that we raise. What do we want them to be when they grow up? What would we have liked to have been ourselves that we are not? What are the most important values that we know? Each family, each functional parent, each biological parent has to make decisions about these things. This is especially urgent for us now in the west because our society, as a whole, has little to offer in setting out guidelines for what should be valued and what should not.
- We try to remember, in how we structure our alternate living arrangements and how we support the family in the child's home, that all children need easily distinguishable role models to project themselves into. Unisex orientations may be the ultimate in togetherness for socially lonely uncertain adults, but it provides nothing for children. Men and women are different — their roles are different, not as determined by chauvinistic sexists, but as it has been worked out by all mammals through an evolutionary process. Young girls and boys growing up need to have easily identifiable men and women to model after if they are going to be themselves fulfilled within the sex that they were given at conception. This, of course, doesn't mean that boys do certain jobs and girls do certain jobs. Most tasks in life are totally indifferent to the sex of the person performing them except sexual relations and child rearing.
Mankind is made up of two unique and distinguishable sexes. Each child born falls into one or the other of these categories and must identify himself with one or the other. This modelling occurs very early in life from the time the infant begins to distinguish the object world around him and takes on the heavy task of identifying all the separate things and learning their names. He discovers that no matter what size or shape or colour or character people assume, they always break down into two classes, men or women, and that he belongs to one through no choice of his own.
He is already committed before he discovers that he is one or the other. In homes where the parents are sexually strong in their role, the task for the child of assuming his own sexual role is easier.
In our own work with children, we like our staff to be comfortable whatever their sexual role is and to be essentially satisfied in that role. The treatment centre is not the place for staff who are unsatisfied or uncomfortable in their sexual role or antagonistic to persons of the opposite sexual role, to work these things out. To be a suitable staff one must have resolved this earlier. Adults do not have the right to act out confusions in these areas with children who are not their own. I personally believe that they don't have the right to act out these confusions with children who are their own, either.
- We have a strong conviction that all children need to have intimate daily life experiences with all the generations of man from infancy to old age. The extended family in nature provided this wide range of generational experience. This was the condition under which man lived until the child labour legislation forced families to be dependent on one or two producers and the convenience of living close to the factory or centre of commerce in minimally built housing forced the biological parents to live separately with their children away from the rest of the extended family. The child needs these generational experiences for a variety of reasons which we have for the most part failed to study or understand.
No parent, even if they are available to their children full time, can raise a child by themselves. Children need a greater variety of adults. In the extended family, each person had a part to play that contributed to each other and to the group. Most of these roles were supportive roles and in our "free enterprise society" we failed to provide these supportive roles when we destroyed the extended family structure. In all "free enterprise" countries, this same thing has happened with the same consequences. It has been thought by sociologists to be a byproduct of industrialization, but 1 think it would be better identified as being the byproduct of exploitive industrialization, for surely there is no need for this to be the consequence of an industrialization program by a society.
The ultimate costs to a society of industrializing without regard to the consequences of extended family structures, as compared to doing it with a consideration of these structures. is infinitely greater in monetary terms as well as human terms. In a "free enterprise society", exploiting natural resources, or industrialization in areas close to the raw materials and energy sources, is always based on the maximum potential profit which can be accrued to the entrepreneurs. But even under socialism, in the industrialization of certain areas in Siberia and Eastern U.S.S.R., the planners and bureaucrats have opted for expediencies that disintegrate families and result in strong nuclear family organization. That the Soviet Union has enriched these areas with education, day care, state sponsored services to the parent, the child, and that they have assured a rich cultural life is not enough. Until and unless they ensure extended family kinship they will be making the same mistake, only to a lesser degree than that which is made when huge oil cartels in conjunction with the American government develop methods to exploit the energy resources of the arctic regions of Alaska.
Neither the U.S. government nor the companies themselves even make a pretence of offering personal and family services or the availability of the cultural richness of our heritage. The workers and producers on this project are disregarded totally in their person. The most they can expect from the government or the companies is that they will tolerate individuals who come to exploit the isolation and loneliness of the workers. Gambling, prostitution, booze, and drugs "are allowed" by company and government officials and represent the sum total of what our society thinks people need. The workers' unions offer even less. In the most exploitive manner imaginable they use the dues of the workers to buy the land and build the buildings that in turn will exploit the workers. They become one with the managers. These realities are part of what we, in our society, must contend with when we talk about corporate and government input to strengthen the role of the family.
National governments should set restrictions on industrial, commercial, and natural resource development that protect the extended family structures. We do not need to develop at the expense of people. We have been brainwashed to believe that only at the expense of families, children, and workers, is it possible to achieve development. This is not true.
- Growing children need an opportunity to learn by doing, with support and praise and with lots of chances to make mistakes and to correct their mistakes without criticism or abuse. Each stage of growth and maturation presents new challenges for mastery to the child and in ordinary families in the community young children are given many opportunities to do and make mistakes, getting praise for whatever they produce. However, it seems that once a child has a diagnosis, everything he does is related to that diagnosis and there isn't a careful separating out of that which is normal for his growth and maturation from that which is appropriate within his symptomatology.
If a child is emotionally immature, he should be allowed to experience learning by doing at his emotional age as well as learning by doing those things that he can at his chronological age. One should not be sacrificed for the other. Children who have been diagnosed frequently get little praise or support in their efforts. They generally never experience the adult in the specialized facility that they are in, rationalizing their behaviour or their performance the way a parent will when he wants to encourage his child's efforts. We must in the treatment home and with the parents and children in their own home, develop and maintain this positive attitude toward all of the performances of the child.
- We try to establish the importance of the child's need to have assurances of good predictable care within an atmosphere of acceptance and love. Children that come to us from within the child services systems experience great un-evenness in care. In any political jurisdiction in North America, services under the auspices of any single government department or under the auspices of the licensing section of any single department represent a wide range in quality of care from gross abuse to temporary alternative parenting. Any child that goes through the child welfare system learns to expect the worst and is always pleasantly surprised if the worst doesn't happen when he is moved from a place that he knows to a place he doesn't know. In all the things we do with children, we must help them to experience high quality care within an atmosphere of love and acceptance and in all our work with our colleague agencies, we must work for that goal too. So we share in writing, in films, and in training programs all that we know. Our programs must be open and available for people to see.
Editor's note: We would welcome comments from readers on these 11 points. We will be publishing more material on the Browndale Treatment Process in point form in subsequent issues of Family Involvement.