This  page, edited by Mark Smith, is introduced to reflect the growing interest in social pedagogy in the UK.  A principal focus of the page is residential child care though the ideas which underpin social pedagogy have relevance to the nurture of all children. Your comments as well as articles relevant to this new page are welcomed and should  sent be to  Mark.smith@ed.ac.uk

Dr. Mark Smith is Head of Social Work in the School of Social and Political Science at the University of Edinburgh. His particular teaching interests are Ethics and the political and  organisational context of social work. His papers, essays and articles are widely published and he is the author of Rethinking Residential Child Care. He is member of the goodenoughcaring Journal’s editorial group and edits the Therapeutic Care & Social Pedagogy page of this website.

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Articles to be found scrolling down this page include:

Upbringing and the pedagogical relationship

by Mark Smith

 

Good enough social pedagogy

by Mark Smith

 

The Relevance of Social Pedagogy in Working with Young People in Residential Child Care

by Gabriel Eichsteller and Viki Bird

 

So what makes it therapeutic ?

by John Diamond

 

A Commentary for the Holistic Politico – Psychological Model(2011) – for the Solution Focussed Discussion of a Child’s Mental Health Needs and their Wellbeing within the Context of a Multi-professional Planning or Child in Need Meeting

by Dave Traxson

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Good enough social pedagogy

by Mark Smith

This page is devoted to exploring social pedagogy or rather, perhaps, social pedagogies. Over the past few years, social pedagogy has attracted considerable political and professional attention. As someone with a fairly long-standing interest in the subject I’m pleased about this. I do, however, fall prey to a level of cynicism about what might be behind the upsurge in political interest. My concern is that, notwithstanding some examples of excellent practice, residential child care, systemically, is not working in the UK. Its difficulties are not just around simplistic and ideological arguments identifying poor outcomes but about the lack of any commonly understood or claimed conceptual base for what it is that residential care ought to be about. Yet, despite its failures residential child care remains stubbornly expensive and politically sensitive. Politicians recognise this, especially the expensive bit. They are likely to be receptive to arguments that Europe does things better and that most of Europe adopts some model of social pedagogy as its organising framework for caring for children. The easy answer is to make a link between social pedagogy and improved outcomes for children and to seek to import a system into a very different social and cultural context.

Academics, too, can be seduced by social pedagogy and I include myself in this. I thought I had a reasonable handle on it and have gone so far as to commit some of my ideas to print (along with a colleague, Bill Whyte). Then, attending meetings of the Centre for Understanding Social Pedagogy at the Thomas Coram Research Unit, I realise that Europeans, who I assumed had this sussed, have different and contingent understandings of what social pedagogy is or might be in their different national contexts. The one thing I did feel on fairly solid ground on was a belief that social pedagogy took practice away from an overly individualised, therapeutic orientation towards a broadly socio-educational one. Then, I reviewed Hans Kornerup’s ‘Milieu-Therapy with Children: Planned Environmental Therapy in Scandinavia’ and could have been reading an account of life in an English therapeutic community. The influences drawn upon in Kornerup’s book read like a roll call of the great and good of therapy: Freud; Winnicott; Bowlby; Aichorn; Bettleheim and Redl and Wineman to name but a few. So, I’m unsure once again just what this thing called social pedagogy might be.

The lack of a clear definition of social pedagogy is disconcerting to those who might hope for an ‘off the shelf’ alternative to residential child care as it has developed in the UK. It is also pretty exciting, though, and offers an opportunity to begin to build up a view of what social pedagogy might be in a UK context (and perhaps what social pedagogy might be in different national contexts within the UK).

If I have difficulty with saying what social pedagogy is I must also admit to a long-standing difficulty in knowing what ‘therapeutic’ means. As someone who doesn’t come from a therapeutic community background I can find the term a bit off-putting. I am reassured by some of Fritz Redl’s thoughts around its meaning. According to Redl it can mean that ‘you still have to feed them’ and in doing so ‘don’t put poison in their soup’.  I could just about manage therapy at that level. So, in thinking about what therapeutic social pedagogy might begin to look like I would urge that ‘therapeutic’ is considered in its various and broad guises.

This page is provided as a discussion space between what has broadly developed as therapeutic care in the UK and the social pedagogic models which have developed in Europe. Although these have a focus on residential child care it is our view that the principles which underpins these positions have relevance to the nurture of all children. As ever your comments as well as articles relevant to this  page are welcomed. The page is edited by Mark Smith.

 

Comments

Jonathan Stanley of NCBRCC comments,

There is along standing British tradition of therapeutic child care practice based on psychodynamic foundations. There is a growing interest, discussion and development taking place about Social Pedagogy. In European countries the two approaches are both united and separate, an understanding has been developed through dialogue. There is recogntion of the need for both approaches to meet needs, and that inform the practice of each tother.  This page offers a space for a dialogue – papers,presentations,articles comments and discussion.

Sylvia Holthoff and Gabriel Eichstellar of Thempra write :

We think it’s  important for this page to be nuanced in how social pedagogy is portrayed. One of the important things to keep clear is that it’s not an approach in a more Anglo-Saxon understanding, but an academic discipline in some European countries, similar to psychology (in several other European countries SP is a profession but not a discipline). In fact it’s therefore impossible to speak of one social pedagogy, and we can identify many different social pedagogies. This is where Jonathan’s point is helpful about social pedagogy and therapeutic care being both united and separate, depending on the pedagogic and therapeutic concept that an organisation may have worked out for themselves.

So this is going to be a complex challenge, especially as social pedagogy isn’t really well-know or -understood in the UK and people begin by understanding it from their own perspective. The challenge lies in inviting them to explore beyond their own perspective, to be open to genuine dialogue which recognises others as equal partners in exploring a theme together. That’s the kind of ethos we would like to see in the discussion.

It might be helpful for the discourse to approach professionals in Denmark or Germany or other countries to contribute too, so that we can get many perspectives on social pedagogy which reflect the diversity and complexity but also give a sense of what underpins it.

We’re interested to see how this space will be taken up.

Norma Hart of Aberdeen University writes

Mark it is good to see this development –  I’d like to be connected please.

One of my areas of work at present is considering ‘social pedagogy as a training for working with vulnerable individuals in any setting with any age group.  Much of what is written discussed is only with regard to children and  mainly focused in residential settings
Charles Sharpe responds

In his chapter entitiled “The Profession at Work in Contemporary Society” in The Socialpedagogue in Europe – Living with others as a profession  ( Davies Jones, ed. English edition, 1986  Zurich  FICE/UNESCO), Haydn Davies Jones  writing in the 1980s suggests that while social pedagogy as a profession was principally born out of a need to care for children and families whose lives had been disrupted by WWII, it was developing an interest in working with adults in residential and community settings. This interest  included, in France, the care of the elderly and the care of the elderly with special needs, in Scandinavia and Holland the care of adults with physical and mental health difficulties, and in Germany the care those in prison and those in hostels following a prison sentence. Like Norma I would be interested to know how far these initiatives developed.

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The Relevance of Social Pedagogy in Working with Young People in Residential Child Care

By Gabriel Eichsteller and Viki Bird

 

Viki Bird worked as an Learning Support Assistant for 2 years in mainstream education and then moved into mainstream residential child care work where she has worked for 4 years. For the last 3 years Viki has been heavily involved in the implementation of Social Pedagogy which has been a great source of inspiration for her.

Gabriel Eichsteller is a director of Thempra, an organisation that provides personal and professional development courses in social pedagogy and works together with organisations on systemic implementation projects and promotes social pedagogy across the UK.

 

“All children are artists. The problem is how to remain an artist once growing up.” Pablo Picasso

 

The art of being a social pedagogue

In many European countries social pedagogy has historically evolved as a profession and discipline concerned with holistic education and well-being. As such it has roots in youth work, social welfare, early years, formal education, and care settings. Therefore, social pedagogues usually work in a wide range of settings across the lifespan – working in children’s centres, schools, youth clubs, children’s homes, with disadvantaged groups of adults (asylum seekers, adults with disabilities, drug users, homeless people, delinquents, or whole communities), or in older people’s homes and hospices. Whilst the meaning of social pedagogy in practice will differ depending on the setting and context, there are common principles underpinning social pedagogy.

Social pedagogy, it could be argued, is all about being – about being with others and forming relationships, being in the present and focussing on initiating learning processes, being authentic and genuine using one’s own personality, and about being there in a supportive, empowering manner. As such, social pedagogy is an art form: it’s not just a skill to learn but needs to be brought to life through the social pedagogue’s Haltung(her attitude or mindset)[1]. In other words, social pedagogy is not so much about what you do, but more about the ‘how’. This perspective of social pedagogy means that it is dynamic, creative, and process-orientated rather than mechanical, procedural, and automated. It demands from social pedagogues to be a whole person, not just a pair of hands. The art of being a social pedagogue can be illustrated by many practice examples we have come across as part of our work with children’s homes in England, Scotland and Northern Ireland. The narrative of one of Essex County Council’s residential workers, Viki Bird, aims to provide you with inspiring insights into what it means to be social pedagogical, so that you can explore and reflect on how your practice connects to social pedagogy. In doing so, we hope that you can see the potential which lies in social pedagogy, the learning opportunities it offers us all to become even better and realise our own potential.

Social pedagogy is not about good practice – it is about better practice. Rather than having a good-enough approach, social pedagogy encourages us to be aspirational, to constantly look for ways to improve our work. After all, it lies within our human nature that we can always learn more, further enhance our well-being and develop even stronger relationships. If we as professionals show such aspirations in our practice we’re not only becoming better through our own efforts; we also set a positive example to the children and young people we work with, an example that can encourage them to be more aspirational too.

What becomes apparent in Viki’s account is the journey which Viki and her team have been on, their eagerness to question, reflect upon and develop their practice and make things even better for the young people in their care. Social pedagogy has given them a framework, which guides them on their journey and helps them identify areas of development. In this process they have mainly built on the resources and potential within their team, and their ability to relate their practice to social pedagogy as well as their persistence to work on some of the more difficult and challenging issues have led to an impressive journey for the team and the young people in their care. Here is Viki’s account, which is based on a presentation she gave at a care leavers’ conference at London City Hall [2] :

 

Social pedagogy in practice – Viki’s journey

I’ve been asked to share with you a brief insight into social pedagogy and the impact it has on our relationships with the young people in residential care. I’ll begin with providing you with a short background of our social pedagogy journey, followed by an overview of how social pedagogy has helped us support young people in developing their identity, build positive relationships with them and challenge social stereotypes about young people in care. These three aspects are at the heart of what’s important to young people in our homes and explain why the implementation of social pedagogy has become so relevant to our work.

In September 2008 Essex County Council began to implement social pedagogy across its children’s homes. This began with the organisation, ThemPra Social Pedagogy, introducing itself at conferences and visits to our homes, followed by 6-day training courses on social pedagogy, 2-day residential courses to develop social pedagogy change agents, team days to develop a social pedagogic culture and follow-up degree level course work. But it doesn’t stop there…

I speak as one of many Social Pedagogy Agents and residential workers who have fully engaged with this holistic and solution-based approach to working with young people, and as one who seeks to enthuse and motivate my colleagues and others across Essex and beyond to recognise the benefits of working with social pedagogy. In my experience social pedagogy enables confidence, backed up by theory and experience to best support young people in our care in their learning and development.

For us in residential child care the framework social pedagogy provides is most importantly seen to complement our already established best practice and not replace it. This is vital to its success, so individual homes and individual practitioners can adapt and evolve its methods using key elements suited to the current culture and the dynamics of a particular environment.

My personal workplace is in a long-term, teenaged, mixed gender, 8-bed residential home, and this is where I am drawing my experience from. And it is my understanding that the crucial factor in social pedagogy is exactly the ‘social’ aspect.

 

Developing positive relationships

By concentrating our efforts towards forging authentic relationships with our young people, we can substantially improve their outcomes. We have therefore wholly taken on board the ‘Common Third’ element,[3] which promotes the use of actively creating opportunities for shared learning experiences within and outside of the home. The Common Third is best explained by visualising an equal triangle with the young person at one point, the pedagogue at the next, and the task being the third point. We are encouraged, then, to translate every available opportunity when working with our young people as a means of building common ground through shared experiences. This crucial foundation in relationship building has had a massively positive impact in our home, and this has been achieved by providing learning environments where participation becomes almost a natural desire for all involved.

The resulting outcomes of focusing our attention on our relationships sees more and more of our young people having the confidence to develop their personal relationships with family, carers, friends, teachers, health professionals, and others. Equally this gives them a future outreach base, with which they know they can comfortably revisit us and continue to gain support and guidance beyond their time in care.

 

Changing approaches to risk-taking

To give you an understanding of how far we’ve come in a short time I ask you to consider how prior to the implementation of social pedagogy we were almost considered to be ‘risk-obsessed’ and of having a ‘cotton wool’ approach to care.

For example, our young people were only allowed to go to the beach if an extensive risk assessment was written, then the area was combed for dangerous objects, and subsequently, if all was ticked and approved … they were only allowed to paddle in the sea up to knee height anyway! A somewhat limited experience as I’m sure you’ll agree. Yet where we were previously restrained by particularly strict risk-assessment factors such as this, we have now successfully moved towards a growing confidence in our own judgement, by questioning and challenging practice and procedures in order to better socialise and equip our young people in today’s society.

Now I personally bounded into my role as a residential worker 3 years ago full of enthusiasm and ideas to generate activities and experiences, which were often considered ‘too risky’ to undertake. However, by expanding our knowledge and drawing on social pedagogy concepts such as risk competence [4]we have found we can shift the expectations, norms and procedures to help us provide worthwhile opportunities which enhance our relationships and the care experience.

 

Supporting young people’s inclusion and identity formation

This progressive shift has seen improved inclusion through reviewing and updating the consideration towards risk whilst allowing for the beneficial factors to be given equal priority. I’m not talking about throwing caution to the wind, but simply enabling a confidence to make a professional judgement towards developing our young people’s competencies in identifying and managing risks themselves instead of having to rely on adults to do it for them.

From this we have been introducing various new ideas such as having therapeutic campfires in our grounds, embarking on graffiti projects; young people are taking ownership of their home by being involved in the decoration and maintenance; they are planning their own activities for the holidays; we have themed events, activity-based group gatherings and many, many more simple and effective tasks that occur on a group or one-to-one basis. Even a basic washing-up chore becomes a valuable learning opportunity where communication is vital to gaining a deeper understanding of the young people we work with, their inner worlds, what they’re thinking and who they are.

We recognise then, the value of quality time spent introducing new ways to engage and communicate with our young people by simply making the most of the time spent in their company. These shared experiences are then crucial to building the firm foundations upon which the relationship can then explore the many issues facing our young people.

In terms of identity we are empowering them with the confidence to develop this aspect by individualising their care plans to convey an in-depth understanding of the whole person, their strengths, their achievements and their aspirations and not just how to manage their behaviour.

A good case in point would be one of our long-term school refusers who had low self-esteem, was insecure with her family’s unconventional lifestyle and was continually reminding us ‘You don’t know what it’s like to be a kid in care!’ (minus the expletives).

Her transition back into full-time education and the plan to return her back to the family home in the very near future has been the result of extensive work around our relationships with her and her family, and from this, building her self esteem and helping her to feel secure enough with her identity to engage with outside assistance and not remain in the sheltered confines and comfort zone of the care home.

The contributing factor here saw us move away from the expectation we should not engage with young people who refuse school in order that it may seem more exciting to remain at home, but instead using those opportunities as a platform to encourage independence, motivation and self-worth to achieve a positive outcome.

Here it is important to add that carers, social workers, family and the wider community are all stakeholders in a young person’s life and we are increasingly inviting opportunities for communication and inclusion in order to enhance their care experience.

We have seen the benefits of inviting all those involved in regular BBQ events, where our young people are fully involved with the preparation and everyone has enjoyed a day of participation in activities and guests have been presented with a showcasing of talent.

This extension of the Common Third doesn’t only have a tremendous impact on the self-esteem of our young people but brings about yet another valuable opportunity to forge strong relationships with those involved in looking after them.

 

Building bridges into the community

Whilst it’s fantastic to bring the community in, it’s equally important to encourage our young people to go out and contribute to the wider community, and this has been evidenced via articles of achievement being reported in the local newspaper, contributions being made to the Care Matters magazine and project work such as with the local Carnival Organisation, all of which help to promote positive publicity and a sense of acceptance.

A recent example highlights this: one of our young people actually wrote a letter of complaint to a sports organisation after having had his place withdrawn due to the behaviour of another resident at our home who attended the same club. He challenged their discrimination, successfully and quite rightly, and was sent a substantial letter of apology and invited back with immediate effect. His talents have since awarded him a special mention in the paper for fastest lap time despite being the youngest member of the club! A great outcome, I’m sure you will agree.

But this is just one of many recent examples whereby our young people are confidently contributing to their development and to society by making their voice heard and by making their voice count. However, whilst we strongly encourage participation by our young people, we cannot do this effectively without increasing our own participation by way of looking at ourselves and consistently reflecting on our practice.

 

Being professional and personal

The core of our work focuses on the ‘3Ps’ element[5] of social pedagogy: the Personal Pedagogue – what we give of ourselves, the Professional Pedagogue – our knowledge and conduct, and the Private Pedagogue – our lives outside of work. It is through this means that we are able to consider how we as workers can approach our young people and become authentic practitioners by working with their best interests in mind. Through constant reflection on our own experiences in life and not just in the working environment we learn an awareness of how our Personal, Professional, and Private involvement affects our practice and our approach towards our young people.

To convey this better I’d like you to picture, if you will, the London Underground network with the care system being the circle line and the many routes to and from this central hub being different stages in the young people’s journey through care. Both the young people and their carers all need maintenance, direction and a network from which to make their journey through care as comfortable as possible.This network has to cater for the individual traveller as well as transporting whole groups towards positive outcomes and desired destinations. I, for one, strongly believe that social pedagogy provides us with the network to do this.

 

Concluding thoughts

Given the scope of social pedagogy, I have only been able to touch upon a mere fraction of the wealth of knowledge and evidence that backs up this insightful approach, which can forward our thinking and support us to responsibly consider the future of care. But essentially, social pedagogy encourages us to be an artist and think creatively and imaginatively, to challenge ourselves and overcome barriers to communication within our homes and out into the wider community. It also teaches us to be adaptable and resourceful, which is a necessity in today’s current climate. That said, we do, however, have an appreciation for social pedagogy not having a ‘magic wand’ effect, but indeed a profound effect on positive outcomes nonetheless. And when I said at the beginning ‘It doesn’t stop there!’, it is vital to recognise that our momentum continues to gather pace as we pro-actively contribute to the practitioners forums within Essex Residential Services, host our own pedagogy team days and reflect on and share our practice as an extension of the training that was initially given. The aim is to become a suitably self-sufficient, holistic, flexible and well-educated workforce within the Children’s Service.

So having been provided with a cleverly adaptable framework and a complementary approach to our practice I hope you can appreciate why we are hugely enthusiastic about exploring, evolving and improving our future role in caring for and meeting the needs of our young people.

And finally, we also hope that by sharing this brief insight you have gained an understanding of the relevance of social pedagogy in residential work. If you wish to find out more please get in touch with us (“victoria.bird@essex.gov.uk”; “gabriel@thempra.org.uk) or visit www.thempra.org.uk”.

 

Notes

[1] For a detailed explanation on the notion of Haltung please see “http://www.childrenwebmag.com/articles/social-pedagogy/the-notion-of-%E2%80%98haltung-in-social-pedagogy “
[2] Evaluating the Care System for Young Londoners, organised by the ‘Children Living Away From Home’ Division of LB Redbridge and the Children and Young People’s Unit of the Greater London Authority, 13th October 2010.
[3] For further information about the Common Third please visit “www.thempra.org.uk/concepts_c3.htm”
[4] See Eichsteller & Holthoff (2009), which is available on “http://www.thempra.org.uk/downloads/Eichsteller%20&%20Holthoff%20-%20Risk%20Competence.pdf”
[5] For a comprehensive explanation of the 3Ps, please visit “www.thempra.org.uk/concepts_3p.htm”

 

Comments

Charles Sharpe writes,

In Viki’s and Gabriel’s stimulating and informative article, Gabriel seems to suggest that Winnicott’s notion of “good-enough” is a descriptor of a kind of care which does not ask that the carer to be aspirational for the child she cares for. This is a misapprehension of the concept of “good-enough.” It is the carer’s quality of being good-enough which is the essential element for a child if he or she is to become imaginative, creative and aspirational. Winnicott originally coined the phrase “good-enough” to take pressure off the young mothers to whom, as a paediatrician, he was giving support. He thought that our society and our culture placed unduly idealistic expectations upon a mother and so he was in a sense reassuring mothers that they would be “good-enough”. He suggested that the mother need not be “perfect” and that it is important for the baby’s development that she is not for she must over time sensitively and gradually relinquish her total absorption and adaptation to the baby’s needs. This is an important step for it is during this process that the baby individuates towards developing “the capacity to be alone”, safe in the knowledge that the mother is in close proximity. In doing this the mother, and those others around her who give her support, provides a “facilitating environment” and it is in adapting to this changing environment that the baby first exercises imagination (that is, aspiration) and creativity. According to Winnicott a baby’s first creation is often what he described as the “transitional object”, usually a soft toy or a piece of material which the baby has “created” to fill the mental space vacated by the gradual withdrawal of the totally absorbed mother. At the time Winnicott was developing his theories of human development he was focused upon the mother as the baby’s carer but later he suggested that while the mother did not have to be the baby’s principal carer, it was nevertheless developmentally necessary that someone ensured that “good-enough” caring took place. When Winnicott turned his thoughts to children in residential care he argued that the good-enough caring process needed to be in part practically, and in part symbolically, reproduced to provide for children whose experience of good-enough caring in early childhood has been disrupted. When children and young people come to live in a residential setting the carers may have to adapt to a child’s primitive, infantile needs in order to establish within the child a sense of security and a trust in his environment. Once this has been achieved the child is more ready for the carers to be less absorbed in meeting his primitive needs and more ready to play, to be imaginative, to be curious, to be creative and to be aspirational. Without the provision of good-enough caring aspiration cannot exist.

 

Gabriel Eichsteller responded,

Thanks for clarifying this, Charles, and ensuring that readers won’t misunderstand Winnicott’s concept. I did not mean to refer to his notion of good-enough care, but rather wanted to highlight the importance of us not being complacent about our practice, of wanting to develop our understanding and skills on an ongoing level. This doesn’t mean social pedagogues must be perfect or superhuman – quite the opposite: our human side is most important in social pedagogical relationships. And so is our human ability for lifelong learning and development. The great thing is that we can do this in the interactions with children, using the Common Third as an opportunity for shared learning and for role-modelling our own attitude to learning.

 

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John Diamond’s paper

When the initial idea to set up this page was mooted it was suggested that John Diamond’s presentation to the 2009 Tavistock conference would provide a good platform from which to take forward questions of therapeutic and social pedagogy. John has kindly provided his paper for inclusion on the site. John is Chief Executive at The Mulberry Bush. Here is his paper which is the text of his presentation at a Tavistock Conference ‘So What Makes It Therapeutic ?’ on 16th October 2009. Comments welcomed … indeed positively encouraged!

‘So what makes it therapeutic ?’

I’m approaching this talk with an interest in the heritage of psychodynamic training in residential work- how the DNA is passed on. I hope to share something of what we’re learning in the evolution of training at the Mulberry Bush.

Hand written minutes from the Mulberry Bush School Board of Management meeting, 29th March 1965 state:

‘The Chairman intimated that Mrs Faith King had been accepted for a course in child welfare at Bristol University, starting in Sept. 1965. Mr Chris Beedell briefly explained about Grant entitlements and suggested the school make up any difference equivalent to her present salary.’

We have come a long way since 1965. Thanks to Dave Roberts our Head of Training and Consultancy, we now have our ‘Foundation degree in therapeutic work with children and young people,’ validated by another Bristol based institution the University West of England.

Since 2008 we have enrolled 30 Mulberry Bush workers as students on the course. The foundation degree exceeds the national requirements, and we are confident that by 2011 we will have a graduate workforce. I’ll explore why the course content makes it a valuable model for reflective work based learning in residential care.

Why is specialist therapeutic residential child care necessary ? and ‘what conditions for learning are required for workers to meet the needs of children with severe attachment disorders’. Research carried out by Roger Clough, Roger Bullock, and Adrian Ward ( 2006) proposes a distinction between the placement needs of different groups of young people separated from their birth families. They define the third category of children as:

• Children with extensive, complex and enduring needs compounded by very difficult behaviour who require more specialist and intensive resources.

The Mulberry Bush School was founded by Barbara Dockar Drysdale in 1948. We have been working with chaotic and unintegrated children for 61 years. Due to early trauma, these children have not developed a secure attachment, and consequently have not developed a coherent sense of self. For such children close relationships and the intimacy of family life are often felt as unbearable and intolerable, and they will test out any such relationship or environment to destruction. These are the children who without an early specialist therapeutic fostering or residential intervention, will experience the terrible destiny of multiple placement breakdown.

So what does living alongside severely emotionally troubled children feel like?  How do workers make sense of their experience, and make a difference to a child’s life ?

 

An anonymised case history: Lucy’s story.

At the age of three Lucy was taken into care. She had been living with her mother in a house which was being used as a base for trading in drugs and prostitution. As a result of living in this environment Lucy had experienced severe neglect as well as extreme physical and sexual abuse. Lucy’s behaviour had become so disturbed, that she was found to be eating off the floor with several dogs also inhabiting the house.

By age 6 Lucy had experienced three placement breakdowns. One week into her new placement, her carers reported that her daily behaviour included wetting and smearing, self-harming, unprovoked aggression, insomnia, inappropriate affection to strangers, extreme controlling behaviour and cruelty to animals. Her insomnia resulted in one of her carers having to stay awake all night with her. Attempts at schooling failed, as she attacked teachers and children, and disrupted any group situation. Lucy started therapy sessions via the local CAMHS team. Her therapist commented ‘she brings chaos and destruction into everything she does’.

Despite the therapy, after 4 months Lucy found herself excluded from school, and the home placement was at breaking point. Now aged 7 she was referred to the Mulberry Bush School. A dedicated staff team worked alongside Lucy and the other children in their household creating a reliable daily routine. This routine included ‘close in’ supervision and support for the children through all aspects of the day: mealtimes, playtimes, bedtimes, and transitions to school.
In the education area Lucy joined the foundation stage where she was helped to start to enjoy learning again. She was encouraged to play, listen to stories, sing, and dress up. Carefully managed one to one and group sessions allowed her the experience of starting to learn co-operatively.

Staff found managing Lucy’s hateful and aggressive behaviour very challenging, and struggled with the intensity of the feelings that she projected onto and into them. They used the range of support structures; individual and group supervision and consultation, to discuss and make sense of the powerful feelings of despair and hopelessness they felt. Over time, by engaging with the feelings induced in them, they were able to formulate new strategies and create opportunities which helped Lucy start to think and talk about her confused, betrayed, and angry feelings.

Initially holiday times with her carers were still difficult. Lucy continued to exhibit her previous challenging behaviours. However over time they noticed that she was more able to vocalise her needs, and she began to display more loving and affectionate feelings. After three years Lucy was able to return home. Although demanding she is no longer unmanageable, and enjoys attending a local school for children with moderate learning difficulties.

So what principles and theory for a ‘model of work based learning’ emerge from this story? I’ll talk about :

The matching principle, the reflection process, and using countertransference.

Adrian Ward (1998) whom we regard as another key figure in this training tradition defines the matching principle:

‘that in all professional training the mode of training should reflect the mode of practice’.

Adrian relates this concept to the work of a former colleague Sara Stevens who applied a similar principle to the supervision of residential workers. She argued that the model of supervision should include group discussion, and ‘working alongside’ in order to match the variety of modes used in residential provision. This concept was also reflected in Peter Hawkins and Robin Shohet’s (1989) book ‘supervision in the helping professions’ in which they suggest ‘where possible the supervision context should reflect the therapeutic context which is being supervised’.

The benefit of a match between training and practice is in placing an understanding of ‘process’ at the heart of the task.

We should remind ourselves that outcomes only emerge out of process. As I explored in Lucy’s story, engaging with the process of the lived experience of daily routines in residential life allows staff and children to develop close relationships. The weave of conscious and unconscious interactions can be felt, observed, thought about and talked about. It is within this ‘close in’ intersubjective experience, that children start to internalise nurturing and empathic interactions; the building blocks of good experience; leading to them developing a better understanding of their feelings and sense of self; the process now referred to as ‘mentalisation’.

In his book ‘the reflective practitioner’ (1983) Donald Schon makes a distinction between ‘reflection in action’ and ‘reflection on action’. He describes ‘reflection in action’ as the ability to improvise during an intervention. As we heard in Lucy’s story, the use of creative and opportunity led interventions remains vital in our work with emotionally troubled children. Such experiences convert to ‘reflection on action’ when they transform theory in the light of learning from past experience.

In their work with Lucy, care workers were supported to talk about their emotional experience, the diagnostic aspects of their countertransference in order to understand the despairing and desperate feelings that Lucy was  ‘transmitting’ or projecting into them. This understanding allowed them to feel emotionally freer, and more able to respond in insightful and empathic ways towards Lucy. In the absence of such reflective spaces, the risk is that the team might simply mirror and react to such projective processes by becoming punitive, or rejecting of the child’s behaviour, rather than understanding it as a form of communication.

The aim of our foundation degree is to explore this match between training and practice. Workers are encouraged to bring their own experiences into the themed seminars, and by doing so import elements of the process of their practice into the process of training. When there is a sufficient match within the training session, opportunities are created for deeper reflection, allowing care workers a better understand of how they interact as transmitters and receivers of these conscious and unconscious elements.

 

Social Pedagogy and Therapeutic Child Care

Recently ‘social pedagogy’ has been identified as a relevant practice model that might be applied to raise standards in residential care.

Social Pedagogy is a European model which embeds social work training within a valued and high quality residential care system. Each country Germany, Belgium and Denmark has a slightly different approach influenced by their history, culture and society. And each pedagogic model varies dependent on the task of the institution in which it is practised. The model works from the understanding that everyday activities such as cooking, mealtimes, sport and playtimes can provide a situation in which children and adults can find a common purpose and interaction in order to develop relationships.

As I explored in the story of Lucy, this use of the ‘lived experience’ as a medium for facilitating emotional growth also finds expression in terms such therapeutic child care, ‘planned environment therapy’ as defined by Psychiatrist Marjorie Franklin in the UK in 1945, or the American version ‘milieu therapy’ developed by practitioners Fritz Redl and David Wineman in the 1940s and 50’s.

How do therapeutic child care and social pedagogy overlap and align? I am aware of how when thinking about the individual needs of children within a  group situation, the risk is  that we polarise or split off different parts of the whole dynamic. As I have explored in our foundation degree training, for adults engaged in working with emotionally troubled children, reflection on and acknowledgement of the relationship between the individual and the group is essential in formulating an intervention to help the child, and to make sense of the strong feelings and trauma that are otherwise ‘passed on’ to others through chaotic and distorted behaviours.

Each intervention with a child requires different tools or fields of vision. Maybe it is helpful to distinguish between therapeutic child care, as providing the ‘microscopic’ view of the individual child’s needs within the therapeutic relationship, and the social which might be viewed through the ‘binocular’ field of vision as defined by the current interest in social pedagogy.

A singular focus on either the individual or group is insufficient as a practice model in residential care, but together they form a complementary three dimensional ‘field and ground’ framework for meeting the needs of the most emotionally troubled children.

This synthesis of these two fields of vision, which we attempt to capture in our training, might be called ‘therapeutic pedagogy’. There is an African saying that captures this ethos: ‘It takes a whole village to raise a child’.

In Conclusion

The richest vein of the heritage of reflective work based learning is our shared ‘lived experience’. If children such as Lucy have access to responsive and empathic adults within a living/learning environment, they really can learn and grow emotionally, leading to good outcomes and improved life chances. The alternative is a life of chaos and institutionalisation.

At the school we reduce incidents of aggression by 95%, we re-integrate 84% of our children back into family life, and whereas only 8% of our children could make use of a classroom environment on arrival, 100% can do so on leaving.

And finally, how we deliver this process of transformation through relationships from the one to one, to the group, to the organisation, and out to society, remains a largely undiscovered but vital task into the future, for all of us here today.
John Diamond.

 

References

 

Clough,R.Bullock,R. and Ward, A.(2006) What works in residential care: a review of research evidence and the practical implications. London : NCB

 

Franklin, M.(1945) The use and misuse of planned Environmental therapy. London : Social and psychological series.

Redl, F. and Wineman,D. The Aggressive Child. New York : The Free Press.

Schon, D. A.(1983 The Reflective Practitioner. New York : Basic Books.

Ward,A. & McMahon,L.(eds)(1998) Intuition is not Enough : Matching Learning with Practice in Therapeutic Child Care. London : Routledge

 

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A Commentary for the Holistic Politico – Psychological Model(2011) – for the Solution Focussed Discussion of a Child’s Mental Health Needs and their Wellbeing within the Context of a Multi-professional Planning or Child in Need Meeting.

Dave Traxson has sent us this text of a seminar which was presented on January 12th, 2012 to the British Psychological Society (Division of Educational and Child Psychology) conference Change in Mind : Changing Times at Stratford upon Avon.

Dave believes the paper represents a radical attempt to promote solution focussed discussion at case conferences about a child’s mental health needs. It is rooted in humanistic psychological principles and it is compatible with the ethos of Social Pedagogy.

Dave and his colleagues would like this model to be it widely circulated for caring professionals to use. They make notes to help formulate their hypothesis on the blank proforma and use the full version as an aide memoire for prompting areas of discussion. Initial reactions have been very positive and they are looking for further support with this shared endeavour in order to challenge the influence of the imminently arriving DSM5 from the United States of America in 2013 which will widen prescribing and would in his view result in many false positives in the mental illness for children and young people.

 

Dave Traxson is a senior educational psychologist for Worcestershire County Council.

 

A Commentary for the Holistic Politico – Psychological Model(2011) – for the Solution Focussed Discussion of a Child’s Mental Health Needs and their Wellbeing within the Context of a Multi-professional Planning or Child in Need Meeting.

(HPP Model : Traxson, Parker, Rowland and Matthews 2011)

 

“What we require as professionals is a naturalistic narrative about needs and opportunities for change rather than a dysfunctional discussion of dubiously diagnosed disorders”(Dave Traxson 2011).

 

Features of the model:

– A multi-dimensional discursive approach that challenges the dominant ‘within child’ biomedical model of mental illness that currently drives the majority of practice with CAMHS and Psychiatry professionals.

– An optimistic and Solution Focussed approach to the understanding and resolving mental health needs that uses a Humanistic Psychological perspective to generate thinking and solutions for a client.

– It provides an Aide Memoire to professionals in a multiagency meeting to stimulate discussion about areas that might be impacting on a young person’s world and also stimulates creative solutions involving them to help resolve their current difficulties.

– A blank proforma allows summary notes to be taken of the discussion that can then be formulated into a Hypothesis and Action Plan to help avoid the need for psychotropic medication to be used with the child. The hope is that it will encourage creative thinking in the ‘team around the child’ to develop proactive strategies that resolve issues without recourse to ‘quick fixes.’

– Colleagues using it have reported that it promotes a Holistic reflection on the young persons’ needs and helps to ‘unstick’ bio-medical ‘log jams’ that can often result from only looking at the presenting situational pattern from a rational scientific angle.

– A Key Issue is the use of terminology. For instance the difference between ‘client’ and ‘patient’is a fundamental one.’Patient’ often represents a totally different ‘mind set’ for those involved and has so often the meaning of ‘doing to someone’ rather than the ‘co-constructed’ view of ‘discussing with’ and the notion of ‘shared responsibility’ for the agreed way ahead.

 

Some quotes related to the model:

“The promotion of holistic assessments and self-directed behaviour in young people is more effective than treating of them as mentally ill or as patients that the health system acts upon in either a hopefully beneficial or sadly all too often a harmful way” (Dave Traxson).

“ The paramount responsibility of all child care workers is safeguarding the welfare and the emotional wellbeing of the children with whom they work,” as stated by many Directors of Childrens’ Services in the United Kingdom.

“Formerly, when religion was strong and science weak, men mistook magic for medicine; now, when science is strong and religion weak, men mistake medicine for magic” (Thomas Szasz).

“Diseases are malfunctions of the human body. Diseases and illnesses have specifically biologically based tests. Observed behaviours alone cannot usually be interpreted or treated either as a disease or an illness” (Thomas Szasz).

“ Labelling behaviour as a mental illness(or disease) is stigmatisation and not diagnosis. Giving a child a psychiatric drug (especially under six) is poisoning not therapy” (Thomas Szasz).

“The two most precious things in life are children and freedom and medicalisation harms both of these”(Thomas Szasz).

“No further evidence is needed to show that ‘mental illness’ is not the name of a biological condition whose nature awaits to be elucidated, but is the name of a concept whose purpose is to obscure the obvious”(Thomas Szasz).

“Psychiatry is still so subjective that it would be more honest to use social science methodologies for assessment and review rather than medical model systems.This would better safeguard our children” (Dave Traxson).

`“An individual child’s mental health can not be separated from the health of all the many interacting strata that constitute a rich and diverse society in our modern world. It starts with the family and wider community in which they are nurtured or not as the case may be”(Dave Traxson).

 

Holistic aspects of the model

There are a multitude of interactive factors or variables that impinge on individual children and can either support their healthy growth or interfere with the positive development of their ‘identity’ and their ‘integration of self.’

 

Just a few are:

environmental – for example, disadvantage, poverty, exercise, locality, air quality including crop spraying and sound or infra- red pollution.

education – for example, positive expectations of children, quality of personalised programme, relevance, and the influence of inspirational teachers.

toxicity – for example. relationships, abusive households, medications, subcultures, environmental pollution and dietary additives.

biological – for example, physical and mental health, genes and family traits, diet, toxins, metabolic rate and recovery rate.

interpersonal – for example, e.g. interpersonal transactions,(T.A.), family dances,(Family Therapy), friends, social groupings , social dynamics and personal power(Family Links), bullying or being bullied.

spiritual – for example,beliefs, dogma, inner peace of mind, spiritual ideation, meditation, special place or sanctuary and personal relevance.

political – for example, oppression, ideology, mind set, class, elites, status, power relationships, personal relevance and prejudice.

behavioural – for example, learnt responses, traits, behavioural patterns and reinforcers (external and intrinsic).

historical – for example, family norms, parenting, support for education and the individual along with their successes.

patterning – for example,routines, established patterns of behaviour, family dances, sleep and eating patterns and biorhythms.

emotional – for example, loves, hates, hopes,fears, emotional articulacy or E.Q, ablity to maintain relationships and cope emotionally with them.

intellectual – for example, interests, hobbies, reading preferences, self-expression, response to challenge and stimulation.

aesthetic – for example, music, colours, arts and crafts, architecture, drama, environmental stimuli e.g. light , smells and response to paintings etc.

 

All of these dimensions have positive and negative elements that interact to produce the ‘big picture.’ The aim of mental health work is simply to ameliorate wherever possible some of the negative aspects and to promote the psychological benefits of increasing the person’s development of their own chosen positive ones in many and varied ways. Mental wellbeing will then automatically improve within the individual child and also within their own circle of influence with their family, friends, social groupings and colleagues.

 

Political aspects of the model

That all individuals live in, and their ‘mind sets’ are fundamentally affected by, a ‘social world’ within which they either succeed and thrive or struggle and decline. It is an essentially political ecosystem where it is often normal for power to be unequally distributed with the powerful always striving to maintain their dominance. They consequently further diminish the influence of the ‘disempowered’ and ‘underclasses’ in order to ‘profit’ from them or ‘abuse’ their power over those individuals.

Subcultures within the greater society that the individual chooses to join or is coerced to belong to can also impact greatly at this level, for instance in gangs, secret societies, cults or evangelising groups of any faith, political persuasion, or belief subgroup.

 

Psychological aspects of the model

An individual’s mind and will are the strongest determinant of their ’empowerment’ or success in life and should not be impeded by the “toxic labelling” of unnecessary categorisations and scientifically dubious judgements made by professionals.This would the help to reduce unnecessary “toxic prescribing” of drugs that may not be in the person’s short or longer term best interests.

Labelling with the new proposed categories of mental illness using the DSM5 in 2013 is increasingly unacceptable to more and more members of society. For instance, “ub-clinical normal variation social anxiety” that until now we have called ‘shyness’ and “subclinical normal variation depression” which is usually called ‘sadness.’ “The Good it does is temporary. The harm it does can be permanent.”(Ghandi)

The Holistic Politico-Psychological model of appraising and meeting needs identifies the necessity of maximising appropriate support and of reducing areas of interference to help people achieve theirpotential and use their unique personality to succeed with their total performance both mentally, socially and physically.

So simply put as a society we must find nurturing, relevant,empathic, creative and motivational ways of supporting people who are struggling to succeed or experiencing temporary states of alienation, fear and disempowerment in their current state of being.

Performance is the total response of a human being both mentally and physically to the demands placed on them and to the positive and negative factors of the world around them. Mental health teams should be working towards achieving and maximising these shared outcomes with individualised approaches that suit a person’s current wants, their mutually determined needs and their situation, starting with where they are at and not where society or professionals think they “should be.”

We need to reduce the stress in their ‘stress bucket.’

 

“Basically if we reduce the ‘teaspoons’, ‘cupfuls’ and ‘kettlefuls’ that helps people develop more self-control, enhancing their personal self-efficacy and their feelings of self-worth and wellbeing. 

Traxson, 1993.

 

The support offered could include :

“Human Bridge” activities :

Social Pedagogy – an intensive North European approach using regular psychologically based life-coaching, by highly qualified professionals, for vulnerable and ‘Looked After’ young people. A postive outcomes of this approach is that 6 out of 10 who have expereinced it get into University compared to 6 out of 1,000 in the U.K.(See cope-yp@blogspot.com and use search engine on blog).

Trusting relationships with key adults – who for instance act as a ‘social interpretor’ and ‘learning coach’ to support young people through the school day.

Positive Targetting by key adults who arrange regular appointments with young people to motivate them,to discuss concerns and to help them solve problems. They have ‘meaningful conversations’ with the young people about the ‘relative progress’ they are achieving.

 

Mentoring and life – coaching.

Modelling, in which a young person observes closely a trusted adult completing relevant and key tasks, discusses them, does does them in parallel and then attempts to do them on their own(The Model – Lead – Test Approach).

Talking Therapies

Cognitive Behavioural Therapy (CBT)

Solution Focussed Brief Therapy (SFBT)

Reality Therapy (RT)

Rational Emotive Therapy (RET)

Psychotherapy

Person centred counselling

Non directive counselling

Coaching

Play Therapy

Art Therapy

Drama Therapy

Music Therapy

 

Other therapies

Hydrotherapy, Aromatherapy, Hypnosis and ‘Ego Strengthening’, Positive Visualisations, Affirmations, The Emotional Freedom Technique (EFT), Neuro – linguistic Programming (NLP),’Retracking’,”Repunctuating the day” with postive activities etc.

 

Physical outlets for channelling feelings

Outdoor pursuits programmes

Land based sports e.g. the Zen of Golf, orienteering, cycling etc.

Martial arts training and the associated self- discipline

Walking and trekking

Water based sports e.g.canoing,sailing,water skiing.etc

Sky diving and bungee jumping

Xtreme sports

Gym fitness routines

Circus skills e.g.juggling

Zumba and exercise classes

Dancing / line dancing

Music :playing individually or in a band

Yoga

 

Healthy diet interventions

‘5 a day,’ or mindful eating

 

Promoting good sleep patterns

avoiding stimulants

 

Animal based interventions

Equine Therapy

Horse riding

Rearing animals

Stroking pets

Animal welfare

 

Working for charities

 

Work experience with caring employers

 

 

Structured play

 

Increasing self-expression

 

Poetry

Painting / sketching

Sculpture

Pottery

Playing an instrument

Joining a band

Music

Dance

Creative writing

Photography

Digital photo labs

 

Building self-esteem programmes

 

Stress management programmes

 

Building self-control programmes

 

Building emotional intelligence programmes

 

Parent training programmes

 

Alternative curriculum programmes

 

<1>Relaxation training

 

Progressive relaxation training

Deep breathing techniques

Yoga

Massage

Meditation

Mindfulness training (focussing on the present sensory experiences, for example breathing.)

 

Mapping analogy for planning

“Any journey is therefore personally mapped discussing these options with a trusted other and uniquely routed, based on all the idiosyncratic ‘topograhical features'(‘hills’, ‘valleys’,’sanctuaries’,etc.) that might or might not assist them or hinder them on their journey to their preferred future destination.”

(Traxson, 2011)

We should aim to build resiliency in vulnerable others in all of these following areas.

To overcome adversity and build resilience, children ideally require:

unconditional love and acceptance

some autonomy/ choice over decisions

trusting relationships with significant adults

feelings of independence / self-direction

making relative progress with tasks

secure relationships in the community

strong role models foster friendships and commitment

a safe, stimulating and stable environment

create a sense of ‘belonging

self-confidence and faith in themselves and their world

an intrinsic sense of optimism and self-worth

 

All these things help to build resilience.

 

Ideas on Building Resilience by the ‘father of positive psychology’ – Martin E.P. Seligman

“Strangely, however, about a third of the animals and people who experience inescapable shocks or noise never become helpless. What is it about them that makes this so? Over 15 years of study, my colleagues and I discovered that the answer is optimism. We developed questionnaires and analyzed the content of verbatim speech and writing to assess “explanatory style” as optimistic or pessimistic. We discovered that people who don’t give up have a habit of interpreting setbacks as temporary, local, and changeable.That suggested how we might immunize people against learned helplessness, against depression and anxiety, and against giving up after failure: by teaching them to think like optimists.”

We believe the Holistic Politico – Psychological Model builds incrementally on the previous British Psychological Society’s “biopsychosocial model” proposed by Meyer et al from the 1970’s onwards. The latter model has sadly not significantly altered the power base or potential for negative influence of the psycho-physical / bio-medical model which still predominantly pervades the collective thinking in child mental health work and modern psychiatric practice.

Dave Traxson can be contacted by telephone at 01562 757775 or by email at traxsondave@gmail.com

The proforma for the Holistic Politico-Psychological Model can be found at Dave Traxson’s blog at http://cope-yp.blogspot.com

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Therapeutic care and social pedagogy

Please e mail your comments, articles or recommended reading to Mark at  Mark.smith@ed.ac.uk