Family therapy as an alternative to foster placement

The River Reporter
Thursday, January 10, 1991
FEATURE ARTICLE

By THOMAS RUE

Our culture has an unfortunate tradition of exiling stressful members. Too often, "difficult" youngsters are relegated to foster care or residential placements when behavior problems develop.

In 1989, U.S. Department of Health and Human Services figures indicate there were 52,189 children in New York State's foster care system. This was up from 27,504 in 1986. By contrast, neighboring Pennsylvania had 15,416 children in care during 1989, up from 14,685 in 1986. Each of these placements cost the state in the neighborhood of $45,000 per year.

Rather than removing children from the home, in-home family therapy is often a better and less expensive solution, preventing out-of-home placement. Meeting the family on its own turf, a trained counselor can observe and respond to things that would never be so obvious in a sterile office setting. Important systemic factors can be missed when professionals only see one family member, or even an entire family in an artificial context.

Family therapy begins with the counselor looking at how the family lives, without focusing too closely on any one member. How is power distributed in the family? Are personal boundaries respected? Who gets blamed when something goes wrong? How are problems solved? Are rules and limits observed? Is substance abuse a significant issue?

The therapist is attentive to the fabric of the family's daily life -- the mundane moments spent together which offer continuity and safety through trials. The therapist also encourages a process of nurturance between parent and child or other family members.

Family structures maintain themselves, like systems generally, through homeostatic cycles. Homeostasis is defined in the dictionary as "the tendency to maintain a uniform and beneficial stability within and between its parts; organic equilibrium."

How families manage to do this varies, but singling one member out for blame is particularly common.

"Scapegoating" is a word used in family therapy to describe the development of behavioral symptoms in one family member. This person is often presented as the identified client in counseling In Hebrew, the word azazel (scapegoat) literally translates "a goat for going away." It seems particularly appropriate in the context of sending a child off into placement.

The word comes from the biblical book of Leviticus, chapter 16: "And Aaron shall cast lots upon the two goats; one for the Lord, and the other for the scapegoat. And Aaron shall bring the goat upon which the Lord's lot fell, and offer him for a sing offering. But the goat on which the lot fell to be the scapegoat, shall be presented alive before the Lord, to make an atonement with him, and to let him go for a scapegoat into the wilderness."

Nathan Ackerman, M.D. may have been the first therapist to apply this concept to families. He noted the process begins when one individual -- often different in some way from the others -- becomes the family scapegoat or "whipping post." As that individual is singled out and punished for causing family disunity, various realignments of roles (which are not necessarily constant) follow within the family, such as "healer," "rescuer" or "persecutor."

In some families, the scapegoated individual is actually physically sent away, taking upon himself or herself the pathology for the entire family. In other situations, the scapegoat may assume different roles, such as playing the clown or family mascot, the erratic genius, saint, fool, malingerer, boaster or villain. At various times, family members may exchange roles as needs change. As crises arise and resolve themselves, different family members may offer themselves as scapegoats. In a very real sense, we are all fools or actors in a drama.

Through the lens of counseling, family members may grow to see this process as a mutually causal cycle -- sometimes described as a drama or dance -- in which all act to maintain a functional balance, rather than the acts of a malicious or bad child.

By being chronically truant, acting out sexually, stealing, or abusing alcohol or other drugs, young Johnny or Janie may be giving vent to problems elsewhere in the family system. Perhaps Johnny's divorced parents have been fighting over missed child support payments, placing Johnny in the middle. Or perhaps a young mother has begun dating for the first time since her divorce, and Janie feels she is losing contact with her father and now may be losing her mother too. The acting out may serve the function of drawing the parents together to resolve an immediate problem or crisis such as in responding to the threat of a juvenile court petition filed by the school or police.

This type of interpersonal abuse is rarely deliberate or even conscious until it can be pointed out by an outsider. It is a healthy and normal process expressing itself in an unhealthy way. IN the course of induction to the family's unique relating to itself and the world, experiencing the family's reality, a therapist can join with the family in searching for alternatives to help resolve its own problems.

In the above situations, joint counseling might help the divorced parents realize the effects their behavior and words are having on Johnny. Or there may be ways to empower Janie to better get the attention she needs from father, and at the same time permit mother to pursue an active social life.

Even in a family where the parental marriage is intact, when clear boundaries and a clear generational hierarchy are not present in and between parent and child subsystems, behavioral dysfunction can also arise. Fro example, children can be given inappropriate information, like being informed a parent has had an affair. Or an older child might be called upon to perform excessive childcare tasks with younger siblings, blurring parent/child relationships and roles. Child sexual abuse is perhaps the clearest example of blurred generational boundaries.

The important thing, even when everyone does not participate in therapy, or in every session, is for the counselor to understand and convey that one member's problem is the family's problem. The family can mobilize its resources to create a solution. Substantial restructuring is often necessary. Sometimes not. Sometimes only one or two sessions are required to make desired changes.

But every child needs and deserved to be loved and care for by a real family and mother. Any alternative is second best.

In-home therapy or other preventive services, are less expensive than foster care, in both human and financial terms. Family counseling can help make what may have been a bad situation for the family and the community more livable, and take fewer tax dollars than placing children to live with strangers.

[A contributing editor to The River Reporter, the writer is a National Certified Counselor who lives and practices in Monticello, New York.]

editorial:
What is a parent?