Who would have imagined that a hole in the middle of a bed could have torn a hole so large that it nearly destroyed the last vestige of an American family.  But when a young father concerned about his toddler's welfare turned to the Illinois child welfare system for help that's exactly what happened.

The mother's drug use continued even after her participation in seven treatment programs and the father had been unsuccessful at convincing her to not take their two year old son along when she purchased drugs.  Leaving for work each morning, the father was apprehensive about the boy's well-being while in the sole care of the mother and after the mother burnt a hole in their bed while smoking, in 1991, the father called the Illinois Child Abuse Hotline requesting assistance for the mother.

When an investigator was dispatched to look into the matter, the father asked for assistance with child care, in an effort to alleviate the possibility of any harm to their son while he was at work.  Upon completion of the investigation a private agency caseworker was assigned the case. The father's continued requests that treatment be provided for the mother fell on deaf ears, according to the father.  Instead, the caseworker proceeded to remove the child from the parents' custody, citing their escalating arguments with each other.  When two months later the mother gave birth to a second boy, he too was immediately placed into a foster home.

I became involved with this family in 1993, when I worked in the new IDCFS targeted case management (TCM) unit.  The purpose of TCM was to monitor, advise and work with the private agencies in their handling of long-standing, obstinate foster placement cases with the goal of achieving a stable resolution.

During our first meeting, the parents said that the caseworkers had never tried to assist them, but instead were insistent in keeping their two children with their respective foster parents.  The father was incredulous that it was he who had called the department requesting help and had not been the subject of any abuse or neglect report; but as a result of his outreach had ended up losing his boys.  Moreover, though they had several relatives with whom the children could have been placed, each boy was placed separately in a nonrelative home, they said.  The department's official goal for the boys' future, spelled out in the family's service plan, was long-term placement, the precursor to adoption.  

The father was not alone in his incredulity.  As I examined the particulars of the case things just did not add up.  The children were on their way toward adoption.  But why?  The neglect allegations, brought to the department's attention by the father, involved only the mother.  The father, who had moved into another apartment without the mother, was adamant about wanting the boys returned to him and I saw no reason why that should not have happened.  The father, who was employed as a machinist, had a good and stable work history.  But even if there had been some issues precluding the immediate return of the children to the father's custody, there certainly was nothing in his background to warrant adoption.

The forum at which foster children's placement goal received the department's stamp of approval, which then determined the official route in which the case was to proceed during the next six months, was the administrative case review.  I believed that reversing the goal of long-term placement and changing it to return home was warranted and I therefore spoke with the state-wide case review administrator, after which a new case review was scheduled.

I also found a private attorney for the father, who would have more time to devote to his situation than would the routinely appointed public defender.

The state-wide administrator herself presided over the new case review, which was attended by family members, the caseworker who had led the case down the adoption road and the case reviewer who had authorized the original plan.  During the unusually long review, in which an in-depth examination of the facts took place, the father pounded the table saying that he wanted his kids back.  This was evidence that the father was prone to violence and could not be trusted with his children, said the caseworker and the original reviewer, in their attempt to justify their puzzling decision to steer the case toward adoption.  The year was 1993, and little did the father know that even after the placement goal was reversed at this review to return home, an increasing number of child welfare players were to hound him for the next seven years, in the absence of any evidence, of having violent tendencies.

By now the mother, the subject of the maltreatment report, had died.  The private agency and some others continued in their attempts to portray the father as a violent drunk, contrary to any evidence.  When a domestic violence assessment revealed no evidence of violence, the father was forced to undergo another such evaluation, which yielded the same results, and then yet again, another evaluation.  Still nothing.  The father was forced to submit to so many alcohol assessments, all indicating that he had no drinking problem, that he alone could have kept an evaluator in business. 

Throughout this ordeal the father was steadfast in his determination that his sons be returned to his custody.  And, it paid off--in part.  The older boy's foster parents did not fight to keep him and he was returned to the father.  But the father was up against a wholly different situation with the younger boy's foster parents.  They were a wealthy childless couple living in a large suburban home.  The child, who was born two months after the older brother's removal from the parents' custody, was placed with them immediately after his birth.  These foster parents fought with all their might and money to keep him.  To do so, they had to continue the pretense that the father was a violent alcoholic who was unfit to parent.  And that they did.

It became more difficult to continue to portray the father this way since he now was raising his older son and doing so quite well.  Three independent psychiatrists who reviewed the case said that the younger son was "bonded" to both the foster mother and to the (biological) father.  The former state-wide case review administrator, now the deputy director in charge of the department's clinical services division, testified during a Juvenile Court hearing that this was not a child welfare case because the father had never abused or neglected his children.  Further, she testified, "The father's behavior with the younger boy was exemplary."  This was a custody case, and, one of the worst at that, she said, and it was therefore her recommendation that joint custody be awarded to the father and foster parents.

Neither joint nor sole custody was awarded to the father.  In spring 2000, the court awarded guardianship of the younger son to the foster parents.  The father told me in 2004 that since that ruling there had been a two year period during which he saw the younger son only twice.  According to the father, after the younger son, then 13, demanded to see him and said that he wanted to live with the father and brother, they saw each other about once a month.  The father said that the 13 year old had serious behavioral problems at the foster home and at school which led to several psychiatric hospitalizations.  The older son, 15 at the time, who had been living with the father, was well adjusted and did well in school, the father told me. 

The particulars of what happened to this family offer some insight into what can and often does occur when competence and ethical standards are missing in child welfare work.  We will discuss this in more detail in the next blog article.





 



 

The great majority of parents who become involved with the child welfare system are from impoverished backgrounds.  They usually have not had opportunities to pursue interests which would have allowed them to build satisfying and rewarding lives. Their school experiences were the source of much puzzlement and  left them with lifelong bad memories.   Both vocationally and avocationally their lives seem bleak, certainly to themselves but also to outsiders.  Their experiences have not included the pursuit of distant goals which necessitate long-term planning and the postponement of more immediate activities and desires.  Some of these very characteristics and experiences are also important for good parenting.

Many of the habits they have become used to and the sources of satisfaction with which they have become familiar have  developed  within a limited range of access.  They are well aware of the inequality and the inequities between them and those whose success they see as being of an unattainable realm.  

Were someone to engage them in a discussion about their hopes and aspirations, for themselves and for their children, they would probably initially hesitate to wish for much, but would then shyly enumerate more or less the same things middle-class parents expect for their families.  But unlike middle-class parents, they would be describing what they consider to be an unattainable dream.

Then one day a child welfare caseworker comes knocking at their door.  Go to parent training classes; go to counseling sessions; go to drug evaluations; go to drug abuse treatment; and by the way, what have you stored away in the fridge, let's take a look.  On one hand, ya, this is bad, but so is so much else in life, so just go along with it all.  But on the other hand, what's the point of all this stuff, of learning about parenting; what good will it do anyway, we're not going any where; if I start doing some of this new parenting will my kids have a chance for a better life?  They're not getting out of this mess no matter what I do.  So just leave me alone; my kids aren't doing so bad anyhow.  And counseling... if I want to chit chat I got my friends to talk to, and they understand me better than that shaking head who barely remembers my name.  

But what if that knock at the door would offer some real help--some real hope--with making some of those shyly enumerated wishes a reality?  What if instead of counseling, genuine discussion would ensue about the parents' aspirations and then help would be provided in locating the resources to start making them a reality?  What would the parents' thoughts about better parenting skills be like were they themselves to begin experiencing more satisfying and productive lives?  What would their thoughts and hopes for their children's lives be like?  Would they then not look upon parenting classes and even appropriate and competent counseling as two additional things that can help turn their lives around?   

While exceptions no doubt exist, the usual approach to mandatory parent training and various kinds of treatment is misguided.  Rather than foisting these "services" on families without regard to their circumstances, in what amounts to a highly incongruous manner; rather than treating these families as if they were psychiatric patients in need of treatment, consider first the context within which the alleged maltreatment exists and work to change that.  Parents will then see a reason for better parenting, which will become one of the things they also aspire to achieve.

 

 
   

A child who has been removed from her parents' custody because of alleged maltreatment may bring with her something more than a change of clothing and perhaps a favorite toy.  But what that something is can differ widely.  We would be mistaken to assume that the recollection--conscious or unconscious--of every child living in foster care includes thoughts or images of severe distress resulting from past maltreatment.  And this is so not because of experience too painful to bear but rather because the formation of such thoughts may not have entered the child's conceptual apparatus to begin with.  Or, perhaps did at one point but then later changed.  There are several possible explanations for this:

1) The child may not have ever assigned distressful meaning to the maltreatment; 2) Some level of distressful meaning may have been assigned but not an extreme version; 3) Initial thoughts of distress may have been set aside as a result of a change in the child's understanding and view of what occurred; 4) The child may have believed that the parents' motivation was positive, contrary to the actual behavior, and that dominated her understanding of what occurred; 5) The child may have assumed a philosophical understanding of the parents' behavior and then placed it in a benign context.

The child may have developed seriously distressful thoughts about past maltreatment but here too it will be important to understand what exactly those thoughts are.  Our initial hunch may be surprisingly inaccurate, or perhaps partly so. 

Variables such as age, temperament, verbal ability, experience using complex ideas, the extent to which the maltreatment differed from the child's usual experience and other aspects of the parent-child relationship will factor into the formation and nature of distressful thought patterns. 

So, no specific thought pattern can be assumed to exist.  The fact that one is a foster child does not include the automatic premise that severe distress exists.  And it therefore can not imply that even more than distress, that trauma exists.  Yet, distress may be present  but still not trauma.  Since "trauma might be defined by the objective attributes of the stressor, by the subjective response of the victim, or by both," as psychologist Richard J. McNally has written, an established system-wide approach that uniformly matches the foster child with so-called trauma therapy is more than mistaken and likely hurtful to the child.  It also serves as a prime example of what drives and motivates child welfare policy and procedure.  The concept  trauma, which has become quite a buzzword in child welfare circles, has been providing regurgitated promises of healing offered up in big-dollar contracts, just as its many ancestors have done for decades now.    

Just as it has become common to hear cheerful talk of foster children's possible coming adoption, without any sensitive regard to the real troubling meaning of this for the child and her parents, so too has child welfare discussion about trauma come to embody similar cognitively dissonant chatter.  As if describing appetizing items on a dinner menu, a child welfare agency administrator might  rattle off the various services provided ending with and then we do the trauma.         

This dilettante approach presents the possibility of several additional problems for the child.  Such indiscriminate treatment can in fact lead to distress for the child who has been designated "traumatized," while in reality her set of circumstances are not so.  Misplaced focus on past events can also lead to overlooking the very real distress of being separated from one's parents and of living with strangers.  

And, as this or any other kind of typical treatment proceeds, most often the child's normal development--the kinds of things that are essential for building a satisfying life, now and in the future--are just not on the agenda. 

Additional clarification is needed to explain how the elevation of child welfare work into a prestigious profession will occur and why it is integral to real and substantial change.  The following components will result in the view of a prominent and respected child welfare profession:   A rigorous graduate program housed in university psychology departments offering comprehensive training for potential child welfare workers;   A well publicized standard including clear requirements that new child welfare workers must meet;   The gradual emulation by peers, near and far, of those students who have come before them;   Word will increasingly get out that this new child welfare worker is engaged in important work that can truly facilitate real hope, help and change and this will encourage other potential students to enter the field;  Family members who become child welfare clients will be cognizant of the special qualifications workers possess and be more likely to expect real positive outcome from their intervention (this will be reinforced by the respectful and informed actual interaction between the parties);  Government funding will be used more precisely and economically leading to more funding for high quality education and occupational training for parents and their children.

The fact that such a transformation is difficult to fathom does not mean that it is but a mere dream or unreal.  It means that the road ahead is difficult but doable.  And if it turns out that it is not doable, that is no reflection on the idea itself but rather on the doers--or the lack of.  There may be other ways that can also lead to the kind of change the present child welfare system screams out for, but they too will entail much difficulty.  And, after so many decades of dancing in place, its high time to start moving and to do so in totally new directions. 

The action required to transform child welfare work into a prestigious profession that smart and dedicated people will aspire to be part of gets to the heart of what does not work in the current system and also to exactly what is necessary for real and substantial change.  

Cigarette smoke whirling in your face, the young mother's ceaseless tobacco habit vies with her angry and sometimes vulgar verbal assaults at testing your patience.  You're there to help, you say, but even after several home visits she doesn't buy it.  It's hard to tell whether she's looking at you or at the blaring television whose off button seems to have waffed away in all that smoke.   But her seven year old reportedly comes to school filthy and smelly and has had welts and scratches and the three year old and her infant girl have recently missed their doctor's appointments.  The school principal says that the mother was seen with drug dealers and claims that that explains why the children aren't getting enough to eat.  

Indifference sometimes takes the place of her anger as you return to try to establish some rudimentary connection but as days turn into weeks nothing seems to click.  

What are you, the caseworker, feeling?  What are your thoughts about the mother?  About her parenting skills; about her possible drug use?  About her interaction with you?  About your own competence as a caseworker?

This is clearly very difficult work.  And it is work that can not be approached with a tool box full of techniques and ready-made utterances.  While the broad outline of the above scenario may  appear commonplace, its many intricacies certainly are not.  Work with a family such as this may take a very long time or substantial improvement may occur within a relatively short time span.  Even the exact same statement made by two individual mothers, depending on such variables as context, can have very different meanings. Or, even by the same mother at various times.  This is one reason why a store of vast knowledge is vital and why the ability to know how to use that knowledge is even more critical.

But in addition to knowledge a caseworker must posses certain characteristics without which, in many situations, such as the one described above, there will likely be little or no progress.  Deep caring and empathy, compassion, patience, respect for the parents and the belief that they can improve their situation are a must.  A steadfast commitment to not give up and to hope that this persistence will eventually inspire the parents to work toward improving their own situation is imperative.  And, of course, an honest and ethical mind-set that would never consider anything but the interest of the family in any decision must be foundational.

Given the difficult and complex nature  of child welfare work and what should be the requirements for the job, a key to real change is the elevation of this field to a profession equal to other prestigious occupations.  A profession that will attract people who have chosen to pursue this work after much deliberation.  This can start with rigorous academic training.  This has not been the case until now.  Not in the required training and certainly not in the culture of how it has been viewed by outsiders and by those who themselves are employed in the child welfare system.  

What we are talking about demands a total change in what we have been accustomed to.  It will not be easy nor will it be fast, but it can happen.