The Experience of External Consultancy in a Therapeutic Community for Children

Published in the journal Therapeutic Communities (1998), Vol. 19 No.3 © The Author.

This paper is about the work of Isabel Menzies Lyth as an external consultant to the Cotswold Community in its transition from being an approved school to a therapeutic community. The role of an organisational consultant is to work at the dynamics of the whole organisation and how the various parts relate to each other and to the whole. I attempt to illustrate the way this works by choosing five themes, among many, which emerged during the period of Isabel’s consultancy. Although these themes relate to work done in the 1970s, they are still relevant for the Cotswold Community and I believe they will be relevant to other therapeutic communities and the residential sector in general.

An earlier version of this paper was presented at Individuals and Institutions: Exploring the Interface, a conference held to celebrate the 80th birthday of Dr. Isabel Menzies Lyth, on Saturday 13 September 1997 at Green College, Oxford.

The Cotswold Community is a therapeutic community based on a small group way of working (Whitwell, 1989). The setting suits this approach, located on a farm, with numerous buildings, creating a “village” type of community. This is in contrast to those residential centres that revolve around one large or main building. The client group, emotionally “unintegrated” boys who have been abused (emotionally, physically and often sexually), find being in groups immensely difficult and need to be in small groups with a lot of individual attention. In addition most of the staff live on site which contributes to the sense of a therapeutic village, with sufficient emotional health to contain the collective emotional disturbance. The boys attend a physically separate school which is within the Community.

Boys are referred by Social Services, Education Departments and Health Trusts from all parts of Britain. We prefer to make a start in the therapeutic work before the onset of adolescence, so the age of intake is 9-13. Our therapeutic approach requires a long-term placement, which is on average four years, but could vary from two to six years. Our work is informed by psychodynamic principles and we especially draw on the work of Winnicott (1976 and 1984) and Dockar-Drysdale (1990 and 1993).

The boys live in four separate households, set in their own grounds, with up to ten boys in each group. You could say that the Cotswold Community consists of four mini therapeutic communities and a therapeutic school. Each household has a staff team of six residential social workers, two domestic workers and a volunteer. In addition two teachers work with each group in the school and they also contribute some time into the household outside of the school day. Therefore, the “treatment team” working with each group of boys consists of residential social workers, domestic workers, teachers and a volunteer. The Cotswold Community as a whole requires a management team, office staff, maintenance and farm staff to make it work.

Three of the four households are “primary” working with boys at the first stage of their treatment, helping them to achieve emotional integration and to begin to develop a sense of self. The fourth “secondary” household admits boys from the three “primary” households when they have outgrown the need for the more regressed culture and need to be in a more age-appropriate environment which encourages them to take on more personal responsibility and responsibility for the group and the way the household functions.

Historical introduction

A community was first created, out of the original farm, in the mid-1930’s when it became a Bruderhof (a place where brothers live) community, consisting of people who fled from Nazi Germany. They converted the original farm buildings into dwellings and places to meet and built the buildings we now use for our school and two of the four households. In 1942 the Cotswold Bruderhof came to an end when the German members had to leave the U.K. to avoid internment and the farm and buildings became the Cotswold Approved School. There were scores of approved schools throughout the country housing young offenders on approved school orders made by Magistrate Courts. They were in effect junior borstals with the emphasis on training (or punishment depending on your perspective). Approved schools were supposed to be rehabilitative. Increasingly research demonstrated their ineffectiveness in this respect (Millham et al, 1975). In the early sixties there were numerous scandals in several approved schools which hit he headlines. The time was ripe for a change. The government of the day was drawing up the 1969 Children and Young Persons Act which abolished the approved school system. However, as far as I am aware, out of the many approved schools, only two successfully transformed themselves into therapeutic communities, Peper Harow (Rose, 1990) and the Cotswold Community (Wills, 1971). Richard Balbernie was appointed in 1967, by the Rainer Foundation (the managing body), to lead this transformation.

In my view, the appointing of two consultants in 1968 were vitally important decisions which confirmed the success of the wish to transform. The first was the appointment of Barbara Dockar-Drysdale as Consultant Psychotherapist to work with the staff teams, providing clinical supervision and helping to develop a fully therapeutic culture. She continued in this role for 18 years.

The second important consultancy was from the Tavistock Institute and in particular Ken Rice for the first two years of the transformation until his sudden death in 1969. Since then the Community has had continuous and ongoing consultancy from the Tavistock Institute. After Ken Rice’s death this was taken on by Isabel Menzies Lyth for the next ten years. Following her retirement in 1980 Dr. Eric Miller took the role of consultant and has continued to the present time.

Organizational themes

A theme which runs through the consultancy provided by the Tavistock Institute is the Community’s relationship with its parent organisation because Cotswold is unique among therapeutic communities for children (not so for adults), in that it has always been part of a large organisation: the Rainer Foundation until the end of 1972; Wiltshire County Council from then until 1st April 1997; and since then NCH Action for Children.

In Ken Rice’s words “… what can be said with some certainty is that if the Cotswold Community is to be experimental (and innovative) then it requires special protection – in particular protection from interference. The more it is buried in the administrative structure the more likely it is to have its freedom restricted by the need to satisfy too many authorities.”

Each time the Cotswold Community has transferred from one parent organisation to another, it has been a very painful process with deep-rooted fears and anxieties coming to the surface in the form of mutual recriminations and mistrust. For example, when we transferred from the Rainer Foundation to Wiltshire County Council in 1973, the predominant fear was that we would be swallowed by a large bureaucracy which would insist on enforcing the rule book and diminish the flexibility which a therapeutic community needs to thrive. In 1997 when we transferred to NCH Action for Children we had fears about our corporate identity being engulfed and lost by their corporate identity. This took the form of arguing about logos and whose logo went where on the official writing paper or advertisement. Therapeutic communities in particular strive for a strong “we” feeling to bind the community together. This can lead to the negative feelings being projected outwards onto the harsh, uncaring, unresponsive parent organisation, who are equally wondering what on earth possessed them to take on the responsibility of this problem child and accordingly oscillate between feeling punitive or permissive towards the community. Consultancy is vitally important to help make sense of this dynamic and to avoid its worst excesses.

I think this theme has probably been one of the dominant issues during Eric Miller’s period of consultancy, when for at least 15 years we have been trying to move back into the voluntary sector, in order to achieve a more secure basis for the future. Having now achieved this, with Eric’s help, and solved one major life-threatening problem we are faced with many smaller problems which the transfer has thrown up.

The working notes

Between them Ken Rice and Isabel Menzies Lyth produced approximately 20 working notes (papers), based on this consultancy work at the Community. This is unpublished material. Going through the papers which Isabel wrote, I have selected five themes which seem to me to have an on-going relevance. Perhaps more importantly they give a feel of how Isabel worked with the presenting problems from the Community at the time and helped us to think about them in a different way.

The frequency of Isabel’s consultancy was usually every two or three months. However, during more difficult periods it may have been monthly.

She would either spend a complete day or sometimes two or three days together, for each consultancy. There would have been some discussion, during the preceding days, within the staff groups, concerning the most urgent issues with which we would like her help. A programme would be worked out in advance to make sure the relevant people were available. For example, if there was to be a discussion on the role of household manager it would have been important for all four household managers to be involved in the work.

The programme was not supposed to act as a straight-jacket and, especially on the 2-3 day consultancies, Isabel would follow her nose if she felt the presenting problem was hiding a more important unconscious problem. The verbal feedback session at the end of the consultancy would be important when some emerging ideas would be debated. This was followed several days later with a written working note which would be available to the whole staff team to read and debate and take action where appropriate. These working notes would sometimes hold no surprises, being more of a synthesis of our collective insight. At other times they would be a bit of a bombshell to the consciousness of the Community.

The working notes were circulated very widely throughout the staff group. There would be a period of discussing, arguing over her observations. Some areas of work featured in working notes over several months as observations and responses were batted backwards and forwards, e.g. the work around the decentralisation of central services into the four households. Over these bigger issues the integrative process was more protracted.

Theme 1: Male/female staff

Isabel started her consultancy to the Cotswold Community in 1970 and one of the themes which she picked up on, in her first working note (Menzies Lyth, 1970 and 1988), was the importance of the quality of the relationships between male and female staff.

Also important for the establishment of masculine models by male staff is their relationship with female staff, since an important aspect of mature masculinity is to be able to develop a secure, concerned, respectful and confident relationship with women. In the running of a house, as of a family, male staff and also boys might do what are conventionally feminine tasks and female staff what are conventionally masculine. In a family these matters tend to be worked out implicitly and operated according to the idiosyncrasies of the personalities concerned. In a working unit they need to be clarified and operated more explicitly although still within the limits of the personalities deployed.

The approved school was a completely male environment, with virtually no female staff, so it was no wonder that in Ken Rice’s working note the emphasis was on male identification, male role models, the constructive use of male aggression. Clearly as the therapeutic approach of the Community was evolving, the importance of women in the staff team was developing and has continued to do so. However, we still have further to go because, although the Community is 50% staffed by women, it is seemingly difficult for women to succeed in more senior management positions, especially the role of household manager.

Theme 2: Managing scarcity

Those of you who have been to the Cotswold Community will probably have noticed that it is a bit “scruffy” although well looked after. We have clearly never had masses of money to throw at problems, although on many occasions have been seduced into thinking this is the answer. Some therapeutic communities for children and adolescents have made a virtue out of a very lavish lifestyle. Isabel did not collude with the pressure to recommend more and more money as the answer to problems. Quite the contrary. For example, staff and boys continuously lobbied for more and more money for food. Isabel’s approach was to encourage the household to accept budgetary responsibility for the food money. Almost overnight the money went further. Staff and boys were in a position to decide where to get the best buys. There was far less wastage when everyone was involved in preparing meals and deciding on the menu. Facing up to scarcity, having the conflicts, but also having the responsibility and the authority to overcome the problem, was a very creative exercise.

It was clear throughout all the discussions, as always, that the resources available to meet demands and needs are quite inadequate. Nor can one hope that they ever will be fully adequate.

What in some way is more important, then, than that they should be adequate, is how the inadequacy is managed. There is a very crucial but very painful management task for the whole Community and for its sub-systems. Only too often the whole Community can become persecuted or distracted by the idea that ‘they’ should give us more and become involved in attempts to get more from any available source. From the point of view of ego-functioning in the real world, however, it is important for both staff and boys to recognise that life is like that – resources are always limited. The central therapeutic task is how to learn to live with this problem. Staff could help by a realistic approach, i.e. we cannot have everything, how do we make do as best we can with what we do have. This includes not only the development of physical resources, but also of less tangible things like staff time.

Facing up to the scarcity of resources, but not being defeated by it, led to a sort of self-help culture where we felt able, for example, to convert buildings ourselves, with the boys’ involvement, into dwelling places. This was a fundamentally different approach to bringing in expensive outside contractors. Although we have had to adjust this to take account of the younger boys now, the spirit of self-help is still to be found in our culture. It also still feels a relevant model to present to boys, which will be of use in their future lives, a model of shaping one’s environment and owning it rather than being swamped and defeated by it.

Theme 3: Decentralisation

The approved schools, like many large institutions, had centrally provided services e.g. kitchen, dining room, laundry and sewing facilities. This was seen as the most efficient and cost-effective way of providing them, which in fact it wasn’t because of the huge amounts of wastage. During Isabel’s period of consultancy the Community decentralised the kitchen, dining room, laundry and sewing into the four group living households. Although many of the arguments would today be more readily accepted, at the time in the mid-70s it seemed revolutionary. The staff working in these central areas had profound fears about closer contact with the boys, having been hidden away in their own little bolt-holes. The bureaucracy, of which we were a part, had major worries that standards would fall and spending would go through the roof. What Isobel was able to demonstrate was that giving people clear budgetary responsibility is more likely to lead to a greater sense of economy, a more careful use of resources and greater value for money. This was very clearly seen in the decentralisation of the provision of meals. Isabel identified three major benefits of decentralisaton:

1. It would directly enhance the therapeutic work with the boys by bringing them into closer contact with the nurturing side of basic care, but also the anger that goes with facing up to scarcity. The more conflicts to do with scarcity can be brought into the group living households, where they can be worked out in small group situations, the better, since this lessens the likelihood of paranoid projection systems developing between different parts of the Community, which would be anti-therapeutic as a model for boys.
2. There is the growth in stature of the staff who take on the delegated tasks. This cannot but make them more effective in work with boys, especially as regards providing positive ego-models for identification.
3. Maximising the opportunity for boys, with staff, to have an experience of living as similar as possible to that of normal boys living with their families, e.g. to go shopping, to experience the conflicts involved in choice, to learn to deploy the limited amounts of money available.

Theme 4: Rivalry between staff groups

Residential schools or children’s homes with education on the premises are usually bedevilled by intense rivalry between teachers and care staff. This may relate to different conditions of service. Historically teachers have tended to look down on care workers. Teachers have had a stronger professional identity, linked to a clear training programme. Most care workers are professionally untrained. The Cotswold Community was keen to establish a sense of belonging to a treatment team, whatever the professional identity. Richard Balbernie was so determined to elevate the role of group living workers in relation to teachers, he was in danger of relegating teachers to the “second eleven”. During her consultancy Isabel continuously worked at the dynamic between group living and education.

The question posed was whether the Polytechnic (the Community’s school) is a service to group living, or not, and the focus of concern appeared to be whether the Polytechnic was “justified” in returning a boy to group living if he appeared too disturbed or disturbing to be effectively managed in the Polytechnic for his own and other people’s good.

Discussion of such issues aroused a number of questions in my mind. I felt that the problem might have been wrongly formulated, i.e. not is the Polytechnic a service to group living, but rather, how the Polytechnic and group living can best work together in the service of boys. This was when I became concerned about possibly anti-therapeutic group and individual projective systems operating between and within the Polytechnic and group living. For example, a Polytechnic group could be viewed as an “inter-group exercise group” exported into the Polytechnic from group living and vice versa. It would seem important, therefore, to keep in touch with these processes and control rather than be controlled by them. An example quoted led me to suspect that a particular boy in a Polytechnic group who was very difficult for the teachers to manage and disruptive to the work of the group could, in fact, be a receptacle and actor-out of group forces coming from the other boys in the group, the whole thing very much reflecting something that was going on between group living units as reflected through the boys in the Polytechnic group. The other boys took no responsibility for this disturbed boy’s behaviour and one could only have the suspicion in this case that he and the group were acting out the idea that the Cottage boys are the most, or even impossibly, disturbed. This seemed to be linked to a tendency to see boys perhaps too much as individuals and not enough as themselves being precipitates of group forces and acting under the influence of very powerful projections into them.

This rivalry and boundary skirmishing can still flare up over who is left holding the messy baby, but we did establish a clear sense that both group living and education are part of the same treatment task. I think the problem we face now is the growing pressure for our education area to be more school-like, to follow the national curriculum, and for education to become separated from the therapeutic task. This could split the staff groups.

Theme 5: Dealing with dirt and mess

By now it should be clear that within the Cotswold Community system any part or sub-system was open to scrutiny, including its relationship to the whole system. In June 1973 a presenting problem was the discontent and stress within the group of women employed as “cleaners” within the group living units.

….. The cleaners themselves state that they do not get “job satisfaction” in working in the houses and do not get the results they would like.

They deal on a physical level with the dirt and mess caused by boys. How far are they somehow reflecting similar feelings in professional group living staff about doing an inadequate job or less adequate job than they would wish with the “dirtiness” and “messiness”, i.e. the illness and lack of integration in the boys themselves? It may be significant here that my visit happened very soon after two major outbreaks of violence, a fire in one of the households and Danny’s attack on Margaret. How far are the cleaners being used to discharge in a relatively harmless and displaced way the counter aggressive feelings raised in staff by boys’ aggression and the fear of violence? The cleaners are reported as using rather violent language or it was used about them, e.g. “shock troops descending in pairs on units brandishing their mops”. An aggressive attack on dirt and mess is acceptable, whereas it is not acceptable to attack the boys who cause the dirt and mess.

How much does the cleaners’ problem reflect a continuation of the situation I hypothesised in my last report, that a dependency subculture might be developed as a means of keeping at bay the feared violence and the counter aggression of the staff? As a member of another similar institution said to me the other day, “the children here expect the place to run like a hotel”. Trevor Blewett has made similar remarks about the boys in his unit. I also had the impression that the standard set by the cleaning women and not reached, might very well be unrealistically high, with the professional group living staff and the cleaning staff in some collusion about this so as to give gratification to boys and exert a civilising influence. I am reminded here of some of the comments made about boys recently treating professional staff like servants and slaves and the difficulty in breaking that sub-culture.

I think it might be worth having a look at these suggestions at least and if there is any validity in them to attempt to revise the situation in terms of these mutual projective systems as well as taking what steps are possible to relieve realistic work pressures on cleaners.

Conclusion

These themes that I have selected have their place in the Community’s history, but they are all relevant today, and I imagine resonate with problems in other organisations. They are about the forces and pressures that never go away, i.e.

• splitting
• projection
• avoidance of pain/responsibility
• passing the buck
• anti-task forces
• inter-group rivalry
• boundary skirmishing
• scapegoating

As I see it, the role of a consultant is to help us to see some of these dynamics, in which we are so caught up, whether at the level of individual work with a child, group of children, staff team, inter-group dynamics and organisational dynamic. Residential institutions are especially prone to redefining bad practice as good practice, hence many of the abuse scandals that have come to light in the last few years. Consultants can play an important part in helping to prevent this because they are less likely to get drawn into a collusive system. Their job, in my view, is to be a continuous irritant in the sense that the equilibrium is disturbed by fresh insight and feedback, which the staff group, by themselves, may not see because they are too defended or “can’t see the wood for the trees”.

References

DOCKAR-DRYSDALE, B. (1993) Therapy and Consultation in Child Care, Free Association Books

DOCKAR-DRYSDALE, B. (1990) The Provision of Primary Experience, Free Association Books

MENZIES LYTH, I. (1970-79) Working Notes, unpublished.

MENZIES LYTH, I. (1988) Containing Anxiety in Institutions, Free Association Books

MILLHAM, S., BULLOCK, R., AND CHERRETT P. (1975) After Grace – Teeth, a comparative study of the residential experience of boys in approved schools, Human Context Books

RICE, K (1968) Working Notes, unpublished

ROSE, M (1990) Healing Hurt Minds, Routledge

WHITWELL, J (1989) The Cotswold Community: A Healing Culture, International Journal of Therapeutic Communities. Vol. 10 (1).

WHITWELL J. (1992) Gravel Barons versus a Therapeutic Community, Therapeutic Communities, Vol.13(2)

WILLS, D. (1971) Spare the Child, Penguin

WINNICOTT, D.W. (1976) The Maturational Processes and the Facilitating Environment, The Hogarth Press 1976

WINNICOTT, D.W. (1984) Deprivation and Delinquency, Tavistock Publications