The Browndale Therapeutic Family
An alternative model to the institutional
setting for emotional disturbed children and adolescents.
by
   Dr. Otto Weininger 

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Dr. Weininger is a clinical consultant psy­chologist at Browndale and Associate Professor, Department of Applied Psychology, at the Ontario Institute for Studies in Education, Uni­versity of Toronto. During the Fall Term 1974, while on study leave, he was an Attached Staff with the Department for Children and Parents, Tavistock Clinic, London, England.

 

The following is the transcript of the address he gave to members of the staff, students and visiting scientists of the Tavistock Institute of Human Relations, the Tavistock Clinic and the Portman Clinic and Child Guidance Training Centre on October 25th, 1974, when he was the invited speaker at the monthly Scientific Meeting.

 

The Browndale therapeutic family1 evolved from two sources. First there was the groping to­wards more useful and workable ways of helping emotionally dis­turbed children, beginning with a group home institutional setting 20 years ago. And along with this practical learning went a deepen­ing appreciation of the role of the family in the ego growth of children. Browndale began with sophisticated techniques especial­ly adapted to the needs of the dis­turbed and institutionalized child and has gradually reached to­wards those simplest and most spontaneous of non-verbalized structures which underpin the nur­turing family.

 

1The Browndale program has 635 child­ren in therapeutic family homes in Ontario and British Columbia; in Wis­consin, Illinois, Michigan and Arizona; and Holland and France; and about 700 families monthly in non-residential pro­grams.

 

 

Today, the Browndale therapeu­tic families live in ordinary homes scattered in the community: out­wardly, they are indistinguishable from their neighbours. Where Browndale homes once used to be distinctive by their intensity . ..". one had the sense of both children and staff pitched very high and the most therapeutic moments were felt by some to be those moments of dramatic revelation and intense interaction .. . the pre­dominant tone today is that of the normal family. No more than four or five children, with a male and female surrogate parent, live in each home. (Some of the families are a little larger in some of the bigger farm homes). The children are as varied in age, sex and per­sonality as they might be in any family. The daily routines and in­teractions with the community (from playing on the street with neighbourhood children, to shopping at the supermarket, to at­tendance at local public school) approximate the daily patterns of any family.

What is the most radical about the therapeutic family is simply that it is a model of what normal extended-family life, well and thor­oughly supported by the commun­ity, might be. (Brown, J. L. 1969, 1974).

Our treatment pattern, then, goes back to our perceptions of the family functions. The family is the fundamental and enduring unit in society through which reality and meaning are communicated to family members. The literature points out that the problems child­ren have are mainly the result of inadequate or over-reactive inter­actions with their parents. Further, we now understand that children may develop emotional difficulties as a result of child-parent reaction. Moss (1967), Robson (1967), have already demonstrated that the mother's feelings are, at least initially, under control of stimuli provided by the young infant; others demonstrate that the infant's smile may trigger the mother's instinctual nurturing feel­ings, and Robson (1967) shows that eye-to-eye contact between mother and child also has a posi­tive effect. It is almost as though the mother needs to be recognized and welcomed by the infant in a way that makes sense to her. On the other hand, if the infant does not receive the care, the consist­ency of feelings, the satisfaction of needs from the mother, then he in turn will react with angry feel­ings, resistant attitudes, and per­haps physical difficulties. Spitz (1946) has shown very clearly that the infant may die if he is not provided with sufficient mother­ing, even though he has adequate food, shelter and warmth. The Robertsons' work (1958) shows that children respond with grief, depression and withdrawal if they are separated from their family for even as short a time as ten days.

 

 

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Safety net for child's ego

The family gives shelter and care, passes on traditions and at­titudes, and provides structure for the child's life. It is the foundation for the developing personality; when the child's emotional needs are under or over-gratified, the per­sonality is distorted. One of the critical functions of the balanced family is the continuity of warmth, care and acceptance. Against this background, the child will be able to deal adequately with frustra­tions and anxieties. The web of consistently caring relationships is the safety net for the child's de­veloping ego. His self-esteem, his courage for the high-wire of human endeavour, are nourished by his perception of that accept­ance, which he understands through the tokens of food, physi­cal care and reliable responsive­ness. This is the parental gift: to enable the child to see himself as

an adequately developing person, neither overwhelmed by immedi­ate frustrations nor encapsulated in his narcissistic feelings of omni­potence.

Means of allaying anxiety

As the child is enabled to mend his wounded ego (and those wounds arise necessarily from the non-gratification of immediate de­mands), he comes to view his parents as a source for supplies. This gradual transition from uni-centric omnipotence to identifica­tion with seemingly powerful adults is extremely important in the growth of the child, emotion­ally and socially. The child who does not see the adult as a source of supplies does not begin to identify with the powerful adult and sees himself as less than a person. Either he withdraws into depression, and/or he becomes hostile as an attempt to gain some foothold on feeling powerful. (Brown, J. L. 1969).

The symptoms of disturbed re­lationship may show up academi­cally (the child may fail, under­achieve, or over-perform); there may be direct acting out (delin­quency, sexual deviation); it may be expressed socially (withdrawn, depressed passivity; hostile ag­gression). Whatever the mode or modes of expression of his prob­lem (Freud, A. 1946), the child is nevertheless reacting to some pathological interaction within the family (Ackerman, 1958). He is learning ways of handling the familial conflict and subsequent anxiety through symptom produc­tion. The symptoms, however diffi­cult for the child, are nevertheless his best means at the time of al­laying the anxiety which would be overwhelming to his fragile ego. The child who cannot protect his ego by symptom production avoids family pathology by psy­chotic behaviour.

Once the family experience has proved inadequate in meeting the real psychological needs of the child, and the self-protective symptomology has been set into action, the family members be­come locked into disturbed pat­terns of relationship. These pat­terns are like an invisible wall between parents and child: the parents reinforce the wall, even when they think they are breaking it down, because the child now sees their efforts as counter-pro­ductive of warmth. Siblings, too, are caught in the web of interac­tions: it would be dangerous to their own precarious stability, to their own relationships with their parents, to do anything else. Rig­idity, stereotyped patterns, con­crete actions are the order of re­sponse. Hostility and rejection are the felt emotions. The disturbed child, seen in this context, does not need institutionalization. Above all, he does not need further isolation from wholesome com­munity and family patterns, nor does he need a fragmented and specialized "treatment" of his "problem". What the walled-off child needs is to relearn and re­live experiences in a family, where he will be able to satisfy the very early emotional needs without conditional acceptance and with­out hostility, and where he can test out his psychological drives in a setting which is structured, safe and understanding. This fam­ily should permit him and help him to regress when necessary, and will help him behave as a child of his age when and where he is able to ... but will not stress continued expectations which are beyond his emotional age level. This family will essentially help him to make use of his islands of ego strength and health, no matter how few they are, and build upon these islands, rather than concentrate on the pathology and symptoms which are so visible and so often entrenched (Brown, J. L. 1973).

Not a bundle of problems

Browndale, over the past eight years, has focussed on creating a substitute family that would ful­fill these conditions. An absolute ground-rule has been that the dis­turbed child has exactly the same basic needs as any child . . . first and foremost, he is not a bundle of problems, but a whole child with additional needs (Brown, J. L. 1969). Going back to our an­alysis of the family functions, that means at its most basic level a provision of the tokens of care that flow from parents and are provid­ed in an individuated way. Food prepared in central kitchens and distributed to "cottages"; bed­rooms furnished by a central or­dering office; or parenting provided by a merry-go-round of shift work­ers on rotating schedules, are not perceived by the child as tokens of authentic, caring parenting. Nor can a child care worker who has no continuing responsibility for the child and his well-being be per­ceived by the disturbed child as a reliable source of supplies.

 

 

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In creating the surrogate family, therefore, it was necessary for Browndale to authenticate the full parenting role of the child care worker by removing him or her from the medical hierarchy. The surrogate parents run their home in a very real way: they are ulti­mately responsible for the child, they furnish and shop for the home, manage the weekly budget, save and plan for family vacations, deal with neighbours and mer­chants, fill the role of the parent in community events (parent-teacher nights at school, for ex­ample), and provide the structure, the daily routines, and cultural tone of the home. Like any ordi­nary parents, they call on commu­nity resources for relief; because they do not live in the houses, but work there from wake-up till bed­time, they hire community people to serve as night staff, cleaning help, or occasional babysitters. Like any responsible parents, they are on call to the night staff or babysitter at any time of day or night should a crisis arise.

The surrogate parent carries the sustaining relationship with the children in care. His or her daily behaviour with the child is in re­sponse not to the treatment dic­tates of a medical authority, but to the child's own needs. In inter­preting the child's needs, and as­sessing progress, the therapeutic parent has a full range of profes­sionals on whom to call. There are other therapeutic families in the community, with whom there are lively interchanges, visiting back and forth, and so on. There are the child care resource people . . . senior and experienced child care workers who act as visiting aunt­ies and uncles to all the houses in a region, offering a wider spec­trum of relationships to the child (as in any extended family) and offering support and advice to staff when called upon. Then there is Browndale's professional "re­source bank": social workers, psy­chologists, psychiatrists, nurses, dieticians, who are on call 24 hours a day. The therapeutic par­ent, like any parent, decides when to call in professional help, and also decides whether or not to fol­low the professional advice . . . "because no-one in the treatment program has a better knowledge of the child and his needs than does the therapeutic parent who lives with the child and shares all his on-going daily routines and activities" (Brown, D. 1969).

Freed from rejection

Before the child can begin to ex­plore and satisfy his emotional needs, a relationship of trust must be established. The child, who has been led to expect punishment or withdrawal from his natural par­ents, learns that in the therapeutic family he is freed from the possi­bility of rejection and the threat of punishment. In addition to the therapeutic parent's caring role, he also takes on the task of guidance and education, providing the child with models for identification so that he will be able to feel produc­tive and effective in society. Im­portantly, the therapeutic parent involves himself with the child to an extent dictated by the child's dependency needs, not the needs or time convenience of the worker or the community (Brown, J. L., 1969).


An episodic account of an eight year old boy's day in a Browndale family may illumine the workings of the therapeutic family:

Johnny lives in a pleasant sub­urban home with four other child­ren, ages 8 to 16, plus a dog, plus two young "parents". Steve, the head of the family, is 25 years old and in his third year with Brown-dale. He came with a certificate in business administration and a background of working as a vol­unteer with a boys' club: he was looking for work that would give him deeper personal satisfaction than he could find in business. Joan is 24 and a registered nurse. She has been a private duty nurse, caring for newborns and their mothers, has been a governess and has travelled. She came to Browndale six weeks before this episode.

8:00 a.m., during the summer holidays: Doreen, the night service staff, was in the kitchen helping the three youngest children find something to eat before Joan (the therapeutic mother) arrived to prepare breakfast. Johnny had asked for a "mushy" omelet made with mustard, ketchup and snack bits; he ate it drenched with extra ketchup and began playing jacks with Doreen.

Joan arrived shortly. She began frying eggs, coaxing Johnny to have some too, but Johnny was cranky now and "accidentally" threw a ball across the kitchen. Joan quietly placed it out of reach. Johnny then began an argument with Bob, an older boy in the family, about some toy trucks. Joan suggested they settle the quarrel when Steve arrived, and the squabbling faded away.

9:00 a.m.: The reason for Johnny's irritability became ap­parent when Doreen, a Browndale nurse, phoned to remind Joan of Johnny's dentist appointment that day. Given the message, Johnny raced around the room, yelling and crying, and then darted upstairs. Before Joan could reach him, he had locked himself in the bath­room, shouting, "I'm not going! I'm not going!" Bob, the older boy in the therapeutic family, proudly exercised his mechanical skills by getting the bathroom door open. Doreen arrived at this moment, and after being told about the crisis by the other children, went upstairs. Johnny, Joan and Doreen decided together to postpone the appointment until another day. Johnny, quieter but still tear­ful, came downstairs, wondering aloud whether he was getting sick. He decided he had to "take his tentature". Joan helped him, making soothing conversation un­til he regained his composure. His temperature was 98.8. "Does that mean I'm not sick?" Johnny de­manded. Joan assured him that he was not sick but might want to rest a little anyway. Comforted, Johnny went off to sit in the living room, while Joan turned to an 8 year old girl who had been upset by Johnny's outburst. Laurie, the girl, gradually calmed down as Joan brushed her hair and put ribbons in it.

 

 

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Dynamically, then: the thera­peutic home provides a reliably safe environment physically (i.e. Johnny is not allowed to bounce his ball in the kitchen) and emo­tionally. Though Johnny is unable to face his dentist appointment, there are no recriminations and no withdrawal. In fact, he is able to find a way (the temperature taking) to reassure himself that he is still cared for, and the par­ent reacts responsively. It is the sheer daily-ness of the routines (the breakfast, the temperature taking, the safety rules, the hair brushing) through which the es­sential trusting relationship is established.

11:00 a.m.: Johnny discussed, calmly and realistically, his plans for the day when he will keep his dental appointment. Later, he join­ed an ongoing game of jacks with the other children and Joan. He insisted on using a damaged ball that bounced erratically. When Joan suggested he might have better luck with another ball, he flared up in anger . . . "Don't give me advice!" . . . but soon, quietly, switched balls. Johnny, who has difficulty in writing his own name and can't sit still long enough to concentrate on figures, was in­volved in this game for a consid­erable length of time, interacting with the other children, keeping track of the complicated score, and displaying great dexterity with small objects.

Dynamically, then: through re­laxed play in the family setting, the ego strength of the child is constantly reinforced. In the game of jacks, Johnny gained ego strength through his pleasure in play, his conceptualizing of num­ber groups, his eye-hand co-ordi­nation, his ability to play by the rules, and his self-control.

Late afternoon: After a family outing, Johnny came into the liv­ing room with a length of fishing line and a small crane. Steve quickly checked to see that there was no hook on the line, and went on to remark how hard Johnny was working on fixing the crane. Johnny responded immediately, and he and Steve went off to find tools to do "some hard work" on the crane. Equipped with screw driver and pliers, both set to work. Johnny told Steve exactly how tight to make a certain bolt. Steve responded by asking repeatedly, "Like this?" until Johnny was satisfied. When they got to a part that Johnny felt competent to handle, he took over while Steve watched with interest. When a screw dropped, Johnny casually "ordered" Steve to put one leg up while he, Johnny, searched on the rug. Steve just as casually obliged. When Steve was called away to cut the meat for supper, he asked Johnny if he thought he could continue working on his own. Johnny thought he could, and did.

Dynamically, then: by constant­ly bolstering the child's real areas of strength, normalcy and compe­tence, the therapeutic parent helps him replace his earlier hurt and suffering with real em isfactions, and then growth. In this instanc feeling of adequacy, sorely tried in the mon ive dental appointmet happily reinforced.

After dinner: Johnny and Steve walked to the drug store to get someme ointment for another child at Johnny also bought a new leash for the family dog and was anxious to test it out. Steve had to go  out again on another errand but agreed that Johnny should walk the dog, with specific  instructions on  how far he migh go. Before long, Johnny was running down the sidewalk with the dog. Joan appeared at the door commenting favourably on the new leash. Before going back she gave Johnny new instructions on how far he might go. When she came back out again a few minutes later Johnny had strayed past the boundaries. Steve, just returning and hearing from Joan what was happening, quickly Johnny inside and explained that he was to follow the rulesJoan set in his absence, even if they were different from his own.  He suggested, and Joh agreed that Johnny often heard only what he wanted to hear, It was agreed that Johnny could go outagain when  he felt he could stay within  the set limits. Johnny argued briefly, but without mucu energy Shortly afterwards, Steve noticed Johnny back at work on the crane  and came over to ask if any help was meeded. Later, Johnny put away his toys. Steve took him to the kitchen for a bedtime snack. Joan asked if Steve could tuck Johnny in as she was busy with Sue. Steve piggybacked Johnny upstairs.

Dynamically, then: Johnny takes the reprimand from  from Steve calmly. He is able to see that there relationship is not diminished, though he will not be allox3ed to break the rules and his therapeutic parents will be supportive of each other in maintaining the ssecurity of the  children. Through participating further in the work on the crane, and through feeding and loving physi­cal handling at bedtime, Steve reassures the boy that he, Johnny, will not be able to "spoil" the good things and continuing ac­ceptance offered by the family.

 

Understanding essential

Often the child's growth is ac­companied by recognition of why he has had troubles and symp­toms: along with this may come a ventilation of hostility, great de­mands for reassurance, and much physical affection. Patience, un­derstanding and endurance are essential on the part of the thera­peutic parent. Mainly, the parent has to act like a person and com­municate with the child by what­ever means are available. Perhaps all they can do at first is to sit on the floor and eat marshmallows, or lie on the grass and feel the warmth of the sun on their bodies. It is the experienced communica­tion between the two people that begins the long, hard road back to life and livingness. It is the "result of the reflections he gets back from the persons who care for him" that "he begins to get not just an image of 'I exist as a self but also 'I have value', if the per­sons who care for him reflect that value back to him." (Brown, J. L. 1969)

In the therapeutic family, the child becomes responsive, self-reliant and creative. He no longer lives within an isolated nuclear unit, but becomes aware of the interdependence of one family member with another, of one fam­ily unit with other families in the community. He has 'uncles', 'aunt­ies' and 'cousins'. He is sure that his needs will be satisfied by a variety of people, all desirous of helping him achieve an effective, satisfying life. Not to be under­estimated is the therapeutic effect of the other children in the family. By painstakingly careful grouping, by grouping according to varied strengths and not according to similar pathologies, the siblings are made part of the therapeutic unit, exerting a strong normalizing pressure on each other.

It is crucial not to be deceived by the apparently easy normali­zation of the life style. It is not just the mildly affected youngster to whom this therapeutic family is adapted: On the contrary, many of Browndale's children are among the most severely disturbed mi­nority of disturbed children, child­ren who have often been refused treatment elsewhere. Because the therapeutic family is so de-institu­tionalized, because at every point it reinforces the child's "islands of ego strength", there may be hours in every day in which no pathology is in evidence. Nevertheless, care­fully built into the family routines are subtle and complex structures, well understood and integrated by the child care staff, to make this open setting at once safe, orderly and constructive.

Staff respond sensitively

When the therapeutic parents turn to the professional resource bank to check out their progress (they ask questions like 'How can I cope with the children's rivalry?'; 'Is our family feeling safe enough so that this child will feel com­fortable investigating his earlier hurt?'; This girl is 10 years old and likes to be fed her meals; I think this is O.K. but I need your help to feel secure about it'; or 'I think this child needs extra help to be able to interact with the therapeutic family . . . he's too far out; I can't reach him') the pro­fessionals help the staff to re­spond sensitively to the child's needs, while at the same time try­ing wherever possible to normalize the child's lifestyle rather than focussing on pathology. When a therapeutic parent gets sidetrack­ed into dealing with fragments of pathological behaviour, the pro­fessional's support helps to re-focus him quickly. The "mother" and "father" of one Browndale family consulted a psychologist in the resource bank about severe bedtime difficulties with a ten year old boy. Both had become absorbed in the problem of how "handle" the child's tearful ta trums and near-violence at be time. It soon came to light th the boy dreaded sleep because it heralded fearsome "monster" nightmares.

Dynamically, then: The psychogist pointed out that the therapeutic mother, by putting the be to bed herself, was inadvertent reinforcing the retaliatory Oedip theme of the nightmares. The father was advised to take over the the bedtime routine himself, with much physical gentling. The nigh mares, rather than being airily di missed as "just bad dreams" or  laboriously analyzed for the boy benefit, were to be dealt with by affectionate reassurance that the father would let no harm come 1 the boy, and that the boy's wholness was important and valuabe to the father. Within a week, the parents were able to report that the bedtime difficulties had var ished.

This is the essence of normal zation: the professional support and strengthens the parents' wil ing capacity to tune in to th child's deepest needs. The treal ment then flows, not primaril from a detached hour in the da or week, but from the therapeuti parents' informed and tender re sponsiveness, woven into th hourly fabric of family life. Th professional resource bank peopl are always available for an emer gency, an inquiry, a call invitin' them to visit or to have lunch, o for a telephone talk about one o the children in the family. The re source bank people are prepare* to discuss or visit a particula child and to help make plans fo children in treatment. They alsi make planned regular visits fo consulting, exploring therapeutii family interrelationships and trans actions, and assessing the child': individual emotional, social am academic growth.

Children with every type anc degree of disturbance, including the physically handicapped, the

mentally subnormal, the psycho-neurotic and the severely dis­turbed and so-called mentally ill children, are taken directly into treatment. Each child is assessed by the professional staff and plac­ed as quickly as possible into a therapeutic family. The children in the family range in age from 2 years to 19 years, and thus act as older and younger siblings to the new child. His placement in the therapeutic family will generally be determined by the kind of prob­lems he has, his age, and the area (rural, or urban) from which he comes. We try to keep children in the milieu that is most familiar to them, rather than to give them any further unnecessary jolts by plac­ing them into areas which are totally unfamiliar to them. Separ­ation from their home is enough of a jolt.

 

Within the therapeutic family, the child is provided with the op­portunity to learn and experience, to relearn and re-experience the very difficulties and interpersonal problems which fostered his dis­turbance in his own family. Un­fortunately, many of our children (64 per cent) have been separated from their families at very ear|y ages, and have an unusually dis­torted and peculiar view of family and family relationships. These children try to deny the existence and substance of their own and other family relationships and ties as well as what we call the "family reverie", which acts to hold and contain the child to his relationship with the therapeutic parents. The special family interrelationships of caring, and listening provide this holding relationship for extremely disturbed children.

Since the child lives with thera­peutic parents who have been helped to respond to his needs without punitive reactions, the child is freed from overt feelings of rejection and punishment. The therapeutic parents gain under­standing of how to help the child express his feelings through action, through play and verbaliza­tion; the therapeutic parents are helped to understand the child's unconscious patterns of behaviour in order to help the child begin to explore his sources of anxiety and strengths. The child, rather quickly, begins to gain some feelings of emotional closeness and warmth as a result of the care, limits, and responsiveness to him as a child. This is, to us, the beginning of a family reverie a relationship which acts as a holding agent, for the child to view and contemplate his feelings without threat of re­jection, of smothering, or of in­difference.

The child, in turn, learns to further and deepen his tie to his therapeutic parents, and then to further experience deep pains and unconscious wounds. The strong relationship between the child and his therapeutic parents allows him to explore these wounds, and should a program of individual treatment be necessary, then a trained therapist from the profes­sional resource bank will begin to have visits with the child. His therapeutic parent is included in the therapy sessions, particularly if the child wishes him to be. We think that at first the child is afraid he may lose or weaken the tie between himself and the thera­peutic parent if he sees the pro­fessional therapist alone. Within time, and through interpretation to the child as well as to the parent, the child usually comes to see the professional alone. However, the therapeutic parent is given under­standing of the session, and if necessary some direct advice. These sessions may last for a month on a twice a week basis, or they may continue for several months. At other times, it be­comes necessary for the profes­sional to work with the child and his therapeutic parent and to help them both understand the com­plexity of the child-therapeutic-parent transference relationship they have entered into, and to which aspects they are both re­sponding with their old uncon­scious "own family" dynamic transactions.


The child and therapeutic parent also experience thereapeutic families and become  aware of the interdependent family upon another. The families do not suffer alone or in silence. they are not isolated necular families; and by not being necular they are able to gain emotional reassurencnce, satisfactions, and just plain baby-sitting or work fromother families. We are impressed by the way in which tl family can offer support to each nuclear unit and prevent disasters which would no do active intervention from professionals.

The therapeutic fan usual types of home j have said, and when the child attends the n munity public school.

It is noteworthy th per cent of the childr to Browndale have : culties. They are unal they are unwilling to at or they have been refi sion to schools beca; tinued destructive an< behaviour. Upon ad Browndale, these chil< do not attend any kin Gradually, they atten oriented developmenl and later on they atter schools. The develop gram is directed to p child with interper dependency satisfacl strong child-teacher These, we think, allow mobilize primitive cor his ego and gradually functioning so that su as comprehension, ji tention, visual-motor gradually come into pi is encouraged to use which are symbolica his level of developn his development prc the art materials are complex, with acade being interwoven wi His learning proceeds mental fashion with c medium for ego grow

Essentially, then, we assume that the therapeutic parent is the most significant person in the treatment program for the child. He cares for the child in all re­spects. He is essentially the child's parent. He has the added respon­sibility to help the child discover himself, to understand some of his difficulties and to find possible solutions.

The therapeutic parents bring a wide range of interests and ideas to their families, but mostly they come because they want to in­volve themselves in a deep and significant way with children and because they have the desire to extend their own understanding


about themselves. The therapeutic parent undergoes a growing and developing process along with the child; and opportunities for per­sonal growth are made available to this person. We usually find that as the child develops, the therapeutic parents feel the need to understand the impact of the child upon themselves and of themselves upon the child. To ask for this "feeling" to come earlier is wrong, we think, or to demand that the therapeutic parent be in­volved in such a program without his own perception of this need, is wrong for us as well.

We think that treatment for the emotionally handicapped child in a therapeutic family in an ordinary community setting, encourages and provides the avenue for emo­tional growth and development. The child begins to sense a free­dom to explore his world and be curious about himself, for his therapeutic family has provided him with safety (Routine, limits and anchor points Brown, J. L. 1974), structure (relationships) and tenderness (emotional gratifi­cation). The child can look out from himself, to his family, to his world, and begin to realize and recognize that there is now an enduring stability for him in how he perceives and is responded to.

 

 

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