Date Posted: Thursday, 20 August 2009

This short piece was written to stimulate thought about boundaries amongst a group of residential child care workers who had completed their induction period at a child care organisation in the private sector. It is a very short overture to what in my view should be the subject of a great symphony in residential child care work.

 

The therapeutic nature of boundaries in residential child care

Some time ago I was telephoned by an incredulous staff member of a children’s home who had not been able to attend a staff meeting at the children’s home at which I had been discussing the care and control of the children with the residential child care staff. He said that he had been informed by his colleagues that I was an advocate of therapeutic care and he was very concerned that with my therapeutic background I would soon be suggesting that there should be no sanctions or consequences if personal and social boundaries were broken by the children at the home.

In expressing his anxiety, this worker was voicing a widely held fallacy which goes around that working ‘therapeutically’ (particularly in a psychodynamic sense in which human behaviour is felt to be a consequence of unconscious as well as conscious forces) with troubled young people means excusing any anti-social behaviour because it is understood that such behaviour is determined by unfortunate experiences the youngsters have had earlier in their childhood. To an extent this is true but it is only one part of the story. To work therapeutically with youngsters is not to suggest that anti-social behaviours should be tolerated as the price the residential child care staff – supposedly in some notional way taking on a role for the wider community – have to pay for the past experiences of these youngsters. It is because residential child care workers have to contain the emotions of children who are deeply  troubled that dealing with personal and social boundaries is at the heart of their therapeutic work. What engaging therapeutically with children and young people does not promise  is a ready and time-limited precisely scripted intervention that will fix the difficulties these children and young people face.  What the therapeutic approach in a children’s home establishes right from the start is that to some extent all the relationships formed in a children’s home, will take place and explore emotional and behavioural  boundaries for a considerable part of child’s stay in a children’s home until dealing with extreme feelings of  loss, abandonment and grief can be processed,contained and dealt with by the child himself.  In working in the life space of deeply troubled children and young people who have lost, or been rejected by a significant adult attachment figure – usually a parent – residential child care workers must accept that their work will be at this threshold and not in a comfort zone well within a regimentally controlled  boundary.

When 13 years old Jerry who has recently been placed in a children’s home throws his dinner plate across the dining room and screams murderously at his keyworker, he is not deliberately breaking any boundaries his keyworker and her colleagues may have set for him about correct behaviour while in the dining room ; nor is he conscious that he is raging against something he has lost. He will not be conscious that his outrage against his keyworker is what he is feeling at a very primitive level about his mother. This is the mother who has allowed him to be placed in the children’s home while her new partner’s son is now occupying Jerry’s bedroom in his family home. To direct this anger at his mother may be too terrifying for him because he fears if he did she would abandon him forever.

For residential staff to respond to Jerry’s behaviour at this stage as the deliberate breaking of boundaries is to misread the emotional dynamic. Of course when the aggressive nature of Jerry’s behaviour has calmed, it can be addressed but first and foremost he must be emotionally contained. It is important for the residential child care worker to acknowledge Jerry’s anger and terror while he is raging and for her to be with him rather than against him. Just as a mother absorbs the terror behind her infant’s screams of rage, processes these within herself and returns the feelings in a way which assures baby, so the keyworker and her colleagues must deal with Jerry’s rage. This is difficult for the keyworker. Jerry’s fear and rage will communicate itself to her. It may arouse some of her own primitive anxieties about losing control and it may become tempting to find forceful and threatening responses in order to control Jerry. Yet to do this would be to breach an important boundary. The keyworker by taking in Jerry’s fears and acting them out herself would be behaving in the same way as Jerry. She would have lost her adult boundary and become a terrified child too. In therapeutic work with children and young people this is the important boundary and children and young people know it.

The keyworker who stays with Jerry by acknowledging and containing his anxiety, who deals with the anti-social aspects as soon as he is ready to accept them places herself in a position to develop a mutual and real relationship with him. In doing this the worker is also exercising the important principle that working therapeutically is an internal and inter-personal process of relationships ; the relationship which we as individuals have with ourselves, relationships between young people and the staff, relationships between young people and other young people, and the relationships between the staff members themselves.

Another aspect of working therapeutically is that the consequences do not close something off. Events in the life space are seen as parts of a continuing and developing dynamic rather than a procedure which is considered complete as a consequence of a prescribed sanction. In working therapeutically discussions between the care worker and the child following events like the one involving Jerry in the dining room do confront the real issues, but within a cocoon of tolerance and acceptance. Healthy relationships between any human beings cannot be built on the exercise of power which is expressed solely by externally imposed sanctions when one party in a relationship can arbitrarily decide that the relationship is over.

What residential child care workers immersed in the life space of young people may find difficult to accept is that they may have as much responsibility as the young people for the disorder in the children’s home particularly where the social climate is such that boundaries are so inconsistently maintained – so often lost – that the staff are always in peril of losing their legitimate and healthy position of authority.
Working therapeutically in a young person’s life space and a healthy relationship between an adult parenting figure and a young person means making sure that any events and issues arising which threaten the boundaries are never left undiscussed or are not worked through. It may be that the nature of events will dictate that such working through may have to delayed until later but the process is never left hanging in the air. It is the adult’s part in the relationship to make sure that this communication takes place.

Some issues to think about for yourself and in discussion with colleagues

How far do you feel the concept of having a relationship with yourself has a meaning for you ?
What do you feel the nature of your relationship with a young person should be ?
Can we be too accepting and tolerant of children and young people ? If so or if not so, think of the reasons for your answers.
Do you expect to work at the boundary between acceptable or unacceptable behaviour with the youngsters in your home ? Discuss what this might mean.
Who or what do you think gets in the way of helping youngsters maintain consistent boundaries ?
Can you think of times when you have felt anxious and fearful while working with young people ?
Do you think it is reasonable to suggest that you as a residential child care worker may be responsible for inconsistent boundaries ?

CS January, 2005.

© goodenoughcaring.com and Charles Sharpe