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Services for difficult children and youth: innovations and evaluations


This paper analyses the way situations experienced by vulnerable children and young people can be faced, in order to provide them with support to overcome their problems. This topic will be analysed from the point of view of social psychology. I will focus on events which took place in Italy, hoping this may be relevant and helpful in solving similar problems in other countries.

1. Difficulties which might impact on children's psycho-social development are first of all related to the inadequate care and support they receive from their birth families. This counts for the period which goes from children's birth to their latency period and early adolescence. It is also evident that also family problems can cause significant problems related to the their development and to the building of their personal identity.

There is evidence, however, that problems during adolescence (from early adolescence) arise from several negative factors, including family influences.

Regarding in particular 10-11 year-old children, family difficulties must be widely considered: poverty, lack of one parent due to divorce or death (one or both), high conflict level between parents, often related to a combination of problems (multiproblematic families), the distance between school and family.

For long time (from the Italian unification until the 1970s) in Italy the most obvious response to these situations has been the residential care, ranging from institutes for illegitimate children (whose mother was not married) to orphanages designed for orphans or children whose parents were very poor and finally to the boarding schools. After the Second World War, due to the influence of differential psychology (IQ tests) and psychopedagogy on care policies, "clinical-pedagogical" clinics (IMPP) were created to help children affected by mental health problems or maladjustment problems. The IMPP spread was rapid, particularly in some Northern regions: a few of them was managed by provinces (because of their administrative responsibility on psychiatry sector) and this was very important because it abolished the placement of troublesome children in psychiatric hospitals; most of them, on the contrary, were privately managed. Indeed, the fees paid to IMPP were higher than those paid to "normal" care institutions.

From the late1950s and the early 1960s the knowledge of Spitz' psychoanalytic studies on anaclitic depression started to spread also in Italy - this related to children placed since their birth in English institutions which can be compared to Italian institutes - together with the results of J. Bowlby's research on the effects produced by long-term child institutionalization.

The debate focused on the need to make these collective settings more human, non only in terms of sanitary-health and food/dietary aspects (which are significant as an immediate emergency aid in case of wars or humanitarian disasters but no more acceptable in well-being periods or peace), but also in terms of relationships, affective and interpersonal relations, and seamless education granted by caregivers. Moreover, the logic of long-term foster care for vulnerable children placed in full-time institutions was started to be discussed through the implementation, as an alternative, of services for vulnerable families that supported them economically and educationally. In addition, there was the problem of reforming adoption and foster care laws, according to the idea that providing a child lacking his/her birth family with the care of another family may be more effective than a long-term placement in residential care.

As well known, the change in cultural atmosphere as well as the identification of "new" possible interventions, which are different from traditional ones, does not involve a sudden change in regard to practice. According to Serge Moscovici, the most characterising aspect of human behaviour is inertia. This has occurred even in the theme being discussed and occurs in many other settings. Frequently residential institutes for children and youth continued to be as they were long time before; at best only little changes were made, such as changing their name into "educational and care" (non only care), decreasing the number of admitted children - which generally remained very high - turning their name into some others evoking the term "family" but without changing the internal organization of space and vital rhythms; the "educators"' attitude focussed on discipline rather than on relationships remained.

In the mid 1960s, administrative surveys supported by psycho-social evaluations stressed the lack of any real rehabilitative function within these huge psycho-pedagogic clinics placed in different Italian regions. Regarding this, public opinion showed their increasing interest in understanding which institutional dynamics affected children's "normal" development.

Different socio-psychological studies on the psychological atmosphere characterising these institutions and the damage they provoked were carried on, together with studies focussed in finding alternative interventions to residential ones. Thanks to them evidence was made on the differences between the life a child experiences in family-living and that inside an institute. The latter appeared to be different from the former according to monotony (repetitive days), heterodirection (the daily behaviour of children is prearrang­ed by defined rules, reinforced by the constant presence of an adult), homogeneity (there is no chance fo variation in daily life), fragmentation (all activities are compulsory within the institution but, on the other hand, cannot be prolonged beyond the given time).

2. During the 1970s a drastic criticism was made in Italy, not only against institutes for children, but also against all institutions, in particular psychiatric hospitals; indeed, they were presented as having an isolating function for the "different individuals" excluded from the society. Regarding this the decision to close psychiatric hospitals had a great echo (law n. 180/78).

At the same time new rules were made to create local services aimed at supporting families and facilitating the return of institutionalized children in their families. Where for some reasons this reunification was not possible, children were usually placed in groups of 5-6 peers guided by 2-3 trained educators (pedagogues). These groups were placed in normal city flats and received a given budget from a welfare agency (public or private), which was administered by the adults in accordance with children. Afterwards, the assumption that institutes must be abandoned started to be taken for granted. It is interesting to pay attention to the mechanisms activated since the beginning of the group care within these flats - mechanisms developed in ways which were often unexpected and difficult to interpret in time. In this regard a distinction must be made between groups composed of children formerly placed in care institutions and those composed of children coming directly from different settings (street children without family support or coming from violent or multiproblematic families). Those coming from a long period of institutionalization experienced some sort of enthusiasm at the beginning of the placement because of the freedom and autonomy found when living in the flat. Some weeks later, however, they were all intensively confused, thus creating a highly-tense atmosphere within the flat. This second phase - which last for some months - tried educators' patience in a strong way, as they were quite always engaged beyond the working hours. Where they had remained present and kept discussions open with their children during difficult moments, confusion was slowly overcome to allow the restructuring of individual behaviours - this brought some sort of independent creation of new living rules. This global and complex change - repeated for many groups - was interpreted in a socio-dynamic way. In this regard, people defined it as a three-phase paradigm (the discovery of a new life-style, crisis, reorganization).

For those children coming from outside, the experience of group care started directly with the crisis-phase (derived from the child refusal of any collaboration with adults) and then, 3-4 months later, turned into a responsible reorganization of behaviour. Systematic research on long-term outcomes in regard to these innovative experiences have not been done. Unfortunately, the lack of attention to essential follow-up research - in order to evaluate outcomes and gain long-term knowledge on individual changing processes - is common within social services.

Available observations (various experts kept in touch with their group of adolescents after leaving or during their stay), however, show that group experiences led then to an adequate social placement for those who had joined it, particularly if this group stay had lasted for at least one year.

Conclusion. It is quite evident from clinical and psycho-social research that, in order to have an healthy development, the child must develop - since birth - an emotive, intense and stable relationship with one ore more adults. Studies on the attachment theory provide precise and closely related analytical indications. Such conditions must be assured to everybody, to those who had experienced the lack of socio-affective relationships inside their family as well.

Long-term residential institutions are not able - due to their structure and internal organization - to grant the essential conditions needed to support the children's healthy development. For this reason - which is not related to the professional competences of staff - institutions must be definitely overcome. Despite current laws, in Italy some of these institutions are still open, particularly in the Southern regions. This is something against the law which needs to be overcome as soon as possible.

The problems that children without families or coming from pathologic or seriously problematic ones have can be solved through the use of adoption, foster care, and educational family-group placement. Which is the more adequate response to individual needs as well as the more effective to grant the development of child's identity must be analyzed case by case. Regarding this, some criteria were distinguished according to age, gender and the psychological characteristics that children without family had.

There are other criteria to take into consideration and they refer to the notion of developmental tasks that each individual need to face in his/her life. These developmental tasks can be faced adequately and so overcome, if the child (male or female) lives in a relational setting that guarantees emotional support and, sometimes, material support. When a child lives in such a setting which does not provide this kind of support, to face the developmental tasks is nearly impossible. For this reason the individual risks to become an adult without having acquired a well-structured identity, loosing energies in inadequate behaviours. Recent studies (Berti, Palareti, in press) on criteria for evaluating group care for children at-risks will be used for highlighting the necessary conditions to guarantee an adequate development of these children.

Contacts: Augusto Palmonari, Dipartimento di Scienze dell'Educazione, Università di Bologna, via Zamboni, 34 40126 Bologna, Italy, E-mail: augusto.palmonari@unibo.it, Phone +39 051 2091620.


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