Paper
Institutional routines as social training: Strategies in therapeutic residential care to normalize and re-integrate vulnerable children
- issue: Issue 1 / 2009
- authors: Tine Egelund, Turf Böcker Jakobsen
- keywords: residential care, normalisation, institutionalisation, Denmark
- views: 3619
- downloaded: 0
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abstract
Background. This paper discusses professional efforts in residential care to normalise and re-integrate highly vulnerable children. The study concerns a specific type of institution, therapeutic residential care for children with severe emotional and behavioural problems. Data derives from an ongoing qualitative study of residential care in Denmark which includes empirical studies of a number of very different institutional settings.
The therapeutic residential institution forms a specialised form of care that depends on skilled staff, usually working from an explicit theoretical (psychological) foundation. This paper investigates how this strongly professionalized intervention takes place in practice. The prospects for 'normalising' children and for re-integrating them into society - assumed to constitute more general objectives of child care policy - are discussed.
Purpose. The paper attempt to answer the following questions:
- What are the practical implications of creating everyday living environments for vulnerable children in which a therapeutic agenda is all-encompassing?
- Do strongly professionalized settings where most activities and relations are guided by therapeutic intention provide the foundation for the kind of normalisation and re-integration of children that is both desired and expected?
Method. Data derive from qualitative studies of two therapeutic residential institutions that were roughly similar in terms of size, organizational structure, and professional orientation (preferred psychological theories, leading principles of treatment, etc.). In both cases, ethnographic fieldwork was carried out over a period of two months, involving approximately twenty days of participant-observation. Efforts were made to participate in a wide number of activities, including planned exercises, school classes, meals, staff meetings, and case conferences. In addition, semi-structured interviews were conducted with all groups among staff, and a considerable range of documents were collected.
Key findings and implications. The ethnographic study reveals the primary normalisation strategy of the therapeutic institution to be an effort to establish a meticulously ordered living environment for the children. The setting is expected to provide the kind of consistency and predictability that children have ostensibly lacked during early childhood. Institutional activities are repetitive of nature and managed within brief time intervals. Further, most aspects of everyday life is organised within the confines of the institution. The careful organisation of children's time and space is endorsed professionally by psychological staff and legitimised by psychological theory, e.g. notions of "early deprivation".
Within that frame of reference, the very structure of everyday life is central to treatment. Thus, institutional routines become an important training ground for the normalisation of children. For instance, the repetition of well-structured meals that take place in a similar fashion every time is expected to offer children a (new) sensation of confidence as well as an opportunity to learn basic social and relational skills.
The paper demonstrates that such professional ambitions are confronted with a practical paradox. The paradox arises because the efforts towards normalisation take place in a markedly "artificial" environment. Social life in general is not characterised by a meticulous repetition of daily events. Also, when institutional routines are framed explicitly as a training ground, actions and relations that otherwise compose meaningful elements of social life are changed into exercises or rehearsals. The dilemma of "imitation" is well-described in relation to other institutional contexts of treatment. In therapeutic residential care, however, the dilemma is enforced by the fact that the routinised life of children only faintly resembles that of other children in contemporary society.
The paper further shows that in the face of this dilemma, therapeutic objectives tend to change. If normalisation and re-integration into mainstream society proves impossible to realise, children are instead framed within a medical horizon as chronically ill. Professional attention now turns from the process of learning general social skills towards a process of accomplishing self-knowledge. For instance, children should come to understand why they cannot engage in relationships with more profound emotional contents.
By conclusion, the paper points out the need for professionals as well as for researchers to consider the implications of creating living environment for vulnerable children in which therapy is all-embracing. Perhaps more clearly here than in other residential settings, children learn rules and regulations that seem to apply more to the institution itself than to the demands and expectations of the outside society.
Key references
Bateson, G. (1972). Steps to an ecology of mind. Chicago: Chicago University Press.
Bergmark, A. & L. Oscarsson (1988). Drug abuse and treatment. A study of social conditions and contextual strategies. Stockholm: Stockholms Universitet.
Svensson, K. (2007). Normer och normalitet i socialt arbete (Norms and normality in social work). Lund: Studentlitteratur.
Contacts: Tine Egelund, Programme Director, SFI - The Danish National Centre for Social Research, Herluf Trolles Gade 11, DK-1052 Copenhagen K, E-mail: te@sfi.dk, Phone +45 3348 0821.