ISP Newsletter Editorials – 2006
January
One of my Christmas presents was the latest book by Alan Bennett, “Untold Stories”. I heard him read an extract from it a few weeks before on Radio 4. Here is a small part of that extract. I hope it encourages you to read more.
‘We had left Mum at the hospital that morning looking, even after weeks of illness, not much different from her usual self: weeping and distraught, it’s true, but still plump and pretty, clutching her everlasting handbag and still somehow managing to face the world. As I followed my father down the ward I wondered why we were bothering; there was no such person here.
He stopped at the bed of a sad, shrunken woman with wild hair, who cringed back against the pillows.
“Here’s your Mum”, he said.
And of course it was only that, by one of the casual cruelties that routine inflicts, she had on admission been bathed, her hair washed and left uncombed and uncurled, so that it now stood out round her head in a mad halo, this straight away drafting her into the ranks of the demented. Yet the change was so dramatic, the obliteration of her usual self so utter and complete, that to restore her even to an appearance of normality now seemed beyond hope. She was mad because she looked mad.
Dad sat down by the bed and took her hand.
“What have you done to me, Walt?” she said.
“Nay, Lil”, he said, and kissed her hand. “Nay, love”.
And in the kissing and the naming my parents were revealed stripped of all defence. Because they seldom kissed, and though they were the tenderest and most self-sufficient couple, I had never seen my father do anything so intimate as to kiss my mother’s hand and seldom since childhood heard them call each other by name. ‘Mum’ and ‘Dad’ was what my brother and I called them and what they called each other, their names kept for best. Or worst.’
I found this very moving, bringing back childhood memories of that part of my extended family that lived in Mansfield. It is also a vivid reminder of the lack of sensitivity within institutional routines.
Another Christmas present was a didgeridoo. I annoyed everyone at Tunstall Court, and at home, as I practised to make the deep sound that I know they are capable of. It was very therapeutic for me, if not for others. In the paper that I wrote for the ISP Play Conference 2004, “The Serious Business of Play”, I mentioned the significance of making a noise.
“As an example of the confusion about play in adulthood, think about making a noise. Many adults have considerable anxiety about how much noise is acceptable (apart from the neighbours from hell). Noise can be a wonderful form of play and is closely connected to the fundamental issue of how entitled we feel to express ourselves in a range of different ways, play being one of them. Singing, moaning, humming, whistling, shouting: all declare our presence and express how we feel at that moment. To release the voice is to release the self. Noise-making is a way of taking your own desire for space seriously; it is a way of expressing your need to be there and to be noticed.”
(If you would like to read the whole of the paper you can access it here on ISP’s website.)
I recently read a piece by a music therapist who said she thought she should be called a sound therapist because music suggests musical, which can intimidate. Everyone, she thought, had a sound within them. I certainly found a didgeridoo sound in me which I liked to make.
At the Cotswold Community, a residential therapeutic community that worked with severely emotionally disturbed children, where I previously worked, we used to plan the physical environment as carefully as the emotional climate. I was reminded of this when I saw an article by Billy Pughe in Children Now magazine.
“ A [home] offers the child reliable, stable and predictable provision, not only of physical nurture but a sense of there being plenty – of toys, games, art, ornaments, plants, furnishings, comics and books. It is child centred and reflects the personalities and needs of the children living there. The home will offer warmth in every way, so floors, for example, will not be left bare but covered with rugs and bathmats to create a sense of comfort.
Windows can be a significant feature of a house and, like doors, they can represent different things to different children. For some they offer security, a barrier to keep out external impingements; for others they allow the external world to see in. Bare windows are often the focus for acting out behaviour and it is helpful, therefore, for all windows to have good curtains….
Thought is given to the colours in which rooms are decorated and the mood they create. Carers are aware of the possible links a child may have with some colours and be thoughtful about why a child chooses a particular colour, especially for their bedroom. [We found that red, orange, purple and black could be disturbing colours in bedrooms.]
Most children [who are looked after] have never experienced a sense of safety or consistent boundaries, and the home’s external environment can symbolically provide this for the child by attention to its boundary. All our homes have a physical boundary which separates them from neighbouring properties. This will usually be a fence or a hedge. The boundary is well maintained and respected; a hole in the fence or a dead hedge will not be containing for our children, who may feel they could fall out or that danger could get in. Symbolically this may give the message that the carers will not contain them or keep them safe.
Gardens are well maintained and cared for, with grass regularly cut, hedges trimmed and a colourful selection of plants and shrubs reflecting the seasons and symbolising our ability to grow and keep things alive. The care of the garden and plants symbolically represents the process of nurture and growth, which can be of great benefit to children in their recovery.
We ensure that there are enough chairs at the dining table so that everyone can sit together, providing a message that all belong and all deserve a place within the home.
The decoration and furnishing at the home will indicate who lives there, including pictures of the children and pictures made by the children. It is important that children feel they can leave some of their belongings around the home, such as a toy or a game, to communicate that they have a space within the whole home and not just their bedroom.
Of particular importance are the children’s bedrooms, the space which perhaps reflects a child’s internal world more than any other. It is sometimes argued that a child’s bedroom should not be interfered with by the carers even if this means the space is unkempt and chaotic, and the reasons for this are often linked to children’s rights. However, just as we would strive to help a child with their inner chaos and confusion, we believe it is important to intervene and help a child maintain some order in their bedroom. If we don’t we are inviting a child to wallow in their chaos.
Similarly when things are broken in the home we aim to repair them as quickly as possible. We want to pass a message that damage can be repaired, that broken things can be fixed.”
February
Last month I referred to the first signs of spring, which was clearly tempting fate, as winter has reminded us that it still has some teeth. Despite the cold weather I find it cheering to see some daylight remaining at the end of the afternoon. When I listen to the Archers and hear about the lambing season it reminds me of my days living at the Cotswold Community, where lambing was an important feature on the farm there and an optimistic time of the year. The children were fascinated by the “birthing” process and not entirely in a sentimental way. The occasional death couldn’t be avoided. Similarly it was important to show the efforts made to effect a bonding/attachment when an ewe initially rejected her lamb. If this failed the farmer tried to effect an adoption by another ewe and if this failed the last resort was bottle feeding. All very relevant material for looked after children. It seems appropriate that a sheep is our cover photo.
Last week I was invited to work with the students at Reading University who are doing the MA in Therapeutic Childcare. They are the last group of students to do this two year course as it is stopping in July. I was saddened to hear this for many reasons, including the fact that I was a member of the steering group that helped to get it started under Adrian Ward. I also saw several people use the course to advance their careers, eg, John Diamond who is now the Director of the Mulberry Bush School, did the course while he was a Household Manager at the Cotswold Community. Patrick Tomlinson who is now Director of Therapeutic Practice at SACCS, also did the course while at the Cotswold Community. Our very own Simon Peacock, Children’s Social Worker at ISP Chesham, also did the course while working for Northants.
I was particularly interested in the fact that out of the 16 students, 3 of them were working for fostering organisations. Not surprisingly they were interested in why I had moved from a therapeutic community to a fostering organisation. They were keen to know how I had found the move and what prompted me to move in the first place.
I explained that one of the reasons for my move was the increasing concern I felt about the children we were putting together in groups and the negative effect they could have on each other. Therapeutic communities thrive on creating positive group cultures. This takes a lot of hard work and can so much more easily be destroyed than created. ISP interested me because it had the ability and the resources to put together bespoke packages for children in order to meet their needs. The negative contagion within groups could be minimised by the ability to think and act flexibly.
The other encouraging thing that came out of meeting these students was the realisation that therapeutic childcare can be practised anywhere. It is not confined to a therapeutic community, which is a very specialist setting.
March
I was recently given an excellent paper to read and would like to share a couple of extracts with you. The paper is “Towards an Integrated Network” by Jenny Sprince in the Journal of Child Psychotherapy Vol. 26, No. 3, 2000.
“At one early meeting with the twelves-and-under team, link workers described how their foster-carers avoided physical contact with children for fear they might be accused of sexual abuse. One member reported that foster-carers were advising one another that this was ‘good practice’. The team were shocked to realize what was happening. Young, frightened children, separated from their parents, could go to bed night after night without a goodnight cuddle, while they watched their foster-carers showing ordinary affection to their own children. We discussed how much this must exacerbate a foster-child’s jealousy, and how violent and angry it might make him. Workers gave examples of behaviour that, they realized, might well be the result of such feelings. They started thinking about how much a child who had been sexually abused might wish to return to the abuse if the alternative was a life without any physical affection at all, and how such treatment was bound to increase their belief that the abuse was their own fault, or made them bad and dirty and unlovable. We discussed how the team could help their carers to distinguish parental cuddling from sexual cuddling, and pass this learning on to the children. ‘Yes’, they said, ‘but how do we pass that learning on to the field-workers?’
Indeed, my early meetings with the resource teams were dominated by complaints about the unthinking behaviour of the field-workers, and it was hard to find a helpful response. I could talk, and did, till I was blue in the face, about the persecutory pressures that the field-workers were under. By far the most useful solution, I discovered, was to ensure that in all such cases the foster-team link worker could arrange a consultation meeting for themselves and their fieldwork counterparts so that we could discuss the case together.”
Jenny Sprince’s concluding remarks in the paper are:-
“In their search for containment, looked-after children project elements of their disturbance into the network around them as powerfully as they do into us and our consulting rooms in the course of individual treatment. As child psychotherapists we have an expertise that should help us to make sense of this process. Similarly, our understanding of the unconscious interactions between children and parents give us valuable insights into organizational dynamics. Social services departments are desperately in need of the help we are equipped to provide.
However, this is work that needs to be undertaken with caution. It can be hard to step back from the lure of one-to-one work with children, and our identification with them, and still harder to keep thinking psychoanalytically with a group of professional colleagues amid the turbulence of a social services environment. Over the years, I have found it essential to undertake extra training and supervision, in order to understand the dynamics of these and other organizations.
It is increasingly important that child psychotherapists, working with looked-after children broaden their scope in order to understand and interpret the wider perspective, and provide better support to social workers and foster-carers who struggle with increasingly complex cases.
Few of us would consider taking an individual child into therapy without working with the family. For looked-after children, parental responsibility is often in the hands of a complex organization of carers, including field-workers and their managers as well as foster-families and birth parents. We have an obligation to learn to work more effectively with that larger family.”
It seems to me that ISP is increasingly using this model to good effect.
April
The Children’s Laureate, Jacqueline Wilson, is leading a campaign to restore the custom of grownups reading aloud to children. In an article in The Independent on Sunday, 30 April, 2006, she wrote:
“….I happened to be talking to a group of children and mentioned bedtime stories. These were middle-class cherished children living in a leafy suburb, but, not a single child could remember ever having been read a story by their mother or father. Quite a few had story tapes, which are splendid but they’re no substitute for a real warm loving human being, cuddled up beside you, reading you the story there and then.
So this is my new obsession. I want everyone to read aloud to children, from the age of nought to eleven ……
Lots of parents and carers already read to babies and toddlers, partly because of the excellent Book Start scheme where new mothers get sent wonderful brightly coloured picture books. It doesn’t really matter at this stage whether you’re reading nursery classics or not. It just has to be stories that your children actually like.
Children do not need grand performances with loads of expression and a different funny voice for each character. Maybe we’ve all got a little overawed by the professional performances of actors on story tapes. Children just want to hear someone they care about telling them a story…. An ordinary pleasant talking voice is all that is required.
Some people think it is weird to suggest that it’s very rewarding to carry on reading aloud long after your children are fluent readers. I think it is such a lovely cosy family thing that it’s worth perpetuating as long as possible. It doesn’t have to be at bedtime ….
If you read aloud to a six, seven or eight year old, you can tackle really meaty, juicy, nourishing books that might be too daunting for them to plod through themselves…”
She then suggests some books that are excellent to read aloud:-
- Where the Wild Things Are by Maurice Sendale
- We’re Going on a Bear Hunt by Michael Rosen
- The Amazing Story of Adolphus Tips by Michael Morpurgo
- Clockwork by Phillip Pullman
- The Velveteen Rabbit by Margery Williams
I can vouch for the effectiveness of reading aloud to children, whatever their age. Children living in residential group homes at the Cotswold Community, as a matter of routine, listened to a story as a group, before going to bed. They loved it and it didn’t require any Oscar winning performance on the part of the grownups for this to be a success.
Our walking companions on the Cotswold Way, Peter and Jacqueline, have recently acquired a boat. It used to be a fishing boat but has been converted to a residential boat. On Good Friday, Ann and I went down to Southampton, where it is moored, to visit them while they were there for the weekend. We passed several flashy, up market marinas before we eventually found their boatyard, which at first glance could have been a scrap yard. This was reinforced by seeing several ex-navy landing craft, brought back from the Falklands. Their boat is called “Weird Fish”, which seems appropriate as this story unfolds. After being there for an hour or so, Peter suddenly said, “Would you like to go on its maiden voyage?” Ann, who is not a water person, turned white but when the rest of us responded enthusiastically she went with the flow, so to speak. Peter started up the diesel engine and it made a deep, growly noise. It is quite a big boat so it took a lot of manoeuvring to turn it round without crashing into the other boats moored there. We eventually got out into the River Itchen, which is pretty wide just before it flows into the Solent. Peter seemed to be spinning the steering wheel furiously but to little effect. He had to continuously put it into reverse to keep control of where it was going. Jacqueline and I were on the deck looking out for other craft. After about 20 minutes Peter announces that there must be something wrong with the steering because it was not responding. I could tell Ann was thinking she should never have embarked on this escapade. Peter must have had similar thoughts to me when I had a gear lever problem with my new Audi car. You can’t quite believe, or don’t want to believe there is a problem with the machine you have just acquired. You tend to think you haven’t got the knack to work it properly.
It became obvious that we wouldn’t be able to return the boat to it’s mooring without help. Eventually we saw some people on the river bank with one of those rigid bottom inflatables. I tried to gesture that the steering was caput and they eventually got the message. They gave us a tow and then helped to nudge the boat into position. This rescue took over an hour. We’d provided great entertainment for the other boat owners who came out to greet us and exchange near disaster stories. According to them they’d all been through a similar experience. This didn’t help me convince Ann that messing about on boats could be an interesting hobby in our old age!
I have just finished reading “A short History of Tractors in Ukrainian” by Marina Lewyeka and can recommend it as a good read. Anyone born in the late 40’s and brought up in the 50’s will be able to relate to the following extract:
“My mother had known ideology, and she had known hunger. When she was twenty-one, Stalin had discovered he could use famine as a political weapon against the Ukrainian kulaks. She knew – and this knowledge never left her throughout her fifty years of life in England, and then seeped from her into the hearts of her children – she knew for certain that behind the piled-high shelves and abundantly stocked counters of Tesco and the Co-op, hunger still prowls with his skeletal frame and gaping eyes, waiting to grab you the moment you are off your guard. Waiting to grab you and shove you on a train, or on to a cart, or into the crowd of running fleeing people, and send you off on another journey where the destination is always death.
The only way to outwit hunger is to save and accumulate, so that there is always something tucked away, a little something to buy him off with. My mother acquired an extraordinary passion and skill of thrift. She would walk half a mile down the High Street to save a penny off a bag of sugar. She never bought what she could make herself. My sister and I suffered humiliation in home-made dresses stitched up from market remnants. We were forced to endure traditional recipes and home baking when we craved junk food and white sliced bread. What she couldn’t make had to be bought second-hand. Shoes, coats, household things – someone else had always had them first, had chosen them, used them, then discarded them. If you had to get it new, it had to be the cheapest money could buy preferably reduced or a bargain. Fruit that was on the turn, tins that were dented, patterns that were out of date, last year’s style. It didn’t matter – we weren’t proud, we weren’t some foolish types who waste money for the sake of appearances, Mother said, when every cultured person knows that what really matters is what’s inside.”
If you ever see me picking up the red elastic bands discarded by postmen then you know it’s that bit of me that was brought up to store them “just in case”. The “just in case” was never defined.
May
ISP was a co-sponsor of the Nancy Hazel Memorial Lecture, which took place on the evening of 9th May at the Foundling Museum in London. The main speaker was David Blunkett. There were also short speeches from Don Brand and Mike Lauerman both of whom worked for Kent Social Services in the 1970’s and 80’s. “Who was Nancy Hazel?” some of you may be wondering. This is what the programme notes said about her:
“Nancy Hazel was a remarkable woman. She set up the Kent Family Placement Project in 1975. The prevailing view at that time was that teenagers were ‘unfosterable’.
Nancy believed in the capabilities of ordinary families to provide good, creative foster care. She had the determination needed to overcome resistance and scepticism from various quarters, and a strong belief that labelling young people ‘unfosterable’ was unjust and unsound.
Nancy Hazel and the Kent Family Placement Project believed that if foster carers were properly trained, supported and paid it would be possible to foster looked after children close to their family and friends
The success of this pioneering project led to its ethos and practices being adopted by fostering services across the UK, fostering brighter futures for thousands of young people in the 30 years since its inception.”
July
It has been several months since I indulged myself with golf stories because I know there will be many readers who will groan and move swiftly on. However, I ask you to look at the human drama involved rather than the technicalities of golf. After all why is it so many of us turn to the back pages of newspapers? Surely it is the human drama of sport, the continuous soap opera of following a football team etc.
All of this is a preamble to my one tiny pinprick of a moment of glory when I won the ISP golf competition. For those of us who remain in the lower echelons of golf’s “hackers” the very infrequent moment of glory has to be savoured, despite the accusations of “banditry” from fellow competitors (see Les’ article).
I have previously quoted from a column in the Independent on Sunday, written by Peter Corrigan, called “The Hacker”. A few weeks ago he wrote the following piece “Good doctor’s revolutionary remedy”:
“Hackers don’t have many genuine friends in golf – apart, that is, from the fellow sufferers they play with. Other golfers mock them when they do badly, call them bandits when they occasionally do well and try to diddle them out of shots at every opportunity.
But this is an appropriate week for all golfers of the faltering fraternity to remember a man who deserves to be regarded as their very best friend. This week, the Open takes place amid the stamping grounds of Dr Frank Stableford, creator of the scoring system that is used and revered throughout the golfing world.
The good doctor was a member of Royal Liverpool, over whose Hoylake links The Open will be played. More importantly, he was also a member of nearby Wallasey GC, where his famous system was finally formulated in 1932.
Frank’s motivation was to invent a scoring method that enabled a player to recover from a disastrous hole or two and still be a challenger. There is a plaque on Wallasey’s second hole, where he says the idea came to him, and the club are bracing themselves for an influx of pilgrims during The Open……..
Frank Stableford was a colourful man. He drove a yellow Rolls-Royce and was rarely without a bright bow tie. Towards the end of his life he played more snooker than golf, and when he was told at the age of 88, that he was going blind he couldn’t bear the thought and put a gun to his heard.
Frank Stableford certainly wasn’t a hacker – not at golf anyway. I don’t know about his surgery – but this incredible man did more for us than anyone; with the possible exception of the man who invented beer.”
I have been pleasantly surprised by the interest shown in my regular reports on our walking adventures. There are more fellow walkers in ISP than I realised. Obviously we all walk (as I write this I realise I shouldn’t take this for granted) in the putting one foot-in-front-of-another sense, but going on a long walk of several miles is something else. You have to be prepared for different eventualities and a pessimist like me is prepared for more of these than most. I even carry a whistle, my Dad’s old rugby refereeing whistle. Consequently my rucksack weighs twice as much as anyone else’s. I tell myself it’s good exercise, like carrying a golf bag for 10 miles! Water is heavy and one of the good things about coming to the end of a long walk is the fact that your rucksack is lighter, having drunk the water.
On Saturday Ann and I did another leg of our journey along the Cotswold Way, from Chipping Campden to Bath (102 miles). This leg was from Painswick to Stonehouse in Gloucestershire. The scenery was outstanding as we followed the Cotswold escarpment. We missed a turning while we were engrossed in conversation. Unfortunately this entailed a tough walk uphill of at least half a mile to get back on track. That certainly taught us to be more alert. We saw two deer chasing each other through the woodland, seemingly oblivious to our presence.
Peter and Jacqueline have a boat and you may remember we had a hairy experience when we participated in its maiden voyage under their ownership, only to find that the steering didn’t work which resulted in having to be unceremoniously towed in. On this walk Peter told us he’d fixed the steering and was planning to cross the Channel and would I be up for accompanying him? Could you imagine what preparations a pessimist like me would have to make? After seeing the TV programme about David Walliams swim across the Channel, “the busiest shipping lane in the world”, I’m not sure that Peter should try. Admittedly the thought of arriving in a French port in time for coffee and croissants is appealing, but this is quickly followed by the thought of drifting helplessly in the Bay of Biscay. We probably should settle for a quick foray into the Solent!
September
The main thing that has happened to me since the last newsletter was a visit to the USA in early August to spend time with the treatment foster care organisation PATH Inc. I first heard about them last year at the IFCO Conference in Madison, Wisconsin. It was a pretty indifferent conference but the presentations by PATH stood out. They started up in the 1970s by foster carers and they are also not-for-profit. They now operate in four states: Minnesota, North Dakota, Colorado and Wisconsin. When I returned from IFCO last year I started corresponding with Amelia Franck Meyer (Director of PATH Wisconsin) and she was very positive about the possibility of a visit. After I’d already decided to visit PATH I heard their name mentioned at the Nancy Hazel memorial lecture. One of the speakers mentioned that before she started the Kent scheme, that ultimately lead to the foundation of ISP, Nancy Hazel went to the USA and spent time with PATH, so it seemed appropriate that we had come a full circle and I was returning for inspiration.
My journey out to Minneapolis was eventful. I’m a neurotic traveller who has to allow time for a variety of “what if” scenarios so I allow double the time sensible people factor in for a journey. However, this was an occasion when my neurosis paid off. The trouble is it will be justification for all the “what ifs” in the future. I had to get from Gloucestershire to Gatwick early on Saturday morning, normally a good time to travel. When I got to the M23 I’d heard that there was a bit of a hold up but this turned out to be a complete standstill caused by a bad accident. I looked around at the other cars and could see on people’s faces that there were many needing to catch a flight. After half an hour some people started to drive up the hard shoulder. The “what if” time I’d allowed passed and I was eating into check-in time. I phoned Northwest Airlines to see how flexible they would be about check in. After another half hour the accident was cleared and we started to move. I heard some people saying they’d missed their flight but I was ok. When we boarded the plane we didn’t move. After half an hour the captain told us they’d been allocated another runway, but it wasn’t long enough (!) and they would have to reduce the weight of the plane by taking off some baggage. A ripple of anxiety and indignation spread through the cabin as people could be heard saying, “It had better not be mine”. After a further half hour delay the captain told us that the original runway had been allocated and we could proceed. When you travel on your own there is no one to whom you can let of emotional steam, which I found rather difficult.
When I arrived at Minneapolis airport I found the Immigration Officer quite hostile, eg, “What are you doing here?” “I’m here to visit a childcare organisation.” “You’re not planning to look after children are you?” “Not if I can help it!”
I planned to hire a car to get from the airport to the town of Eau Claire which is about a two hour drive. I was dreading trying to find the right road. Despite being given foolproof instructions I took a wrong turn and started to panic as I imagined being on a highway going in the totally wrong direction for a few hundred miles. By some miracle I ended up on the right road but I couldn’t tell you how I did it. US roads have a different culture. Their road signs are different. It is vitally important to know whether you are heading North, South, East or West. Most cars have a compass. It is confusing when you join Highway 35 (East) and you have to choose between North and South. Once you understand the logic it is straight forward.
I’d booked myself into a B and B for the first few nights, at a place called the Atrium (a central courtyard), recommended by PATH. I thought it would be better than an anonymous corporate hotel and it turned out to be a great choice. My room was called the Willow Room, because the bed was made from willow and the canopy was made from branches meeting in the middle, decked with fairy lights. It was just as well I wasn’t on anything chemical!
When I arrived at the Atrium I was offered wine, cheese and biscuits and sat in the garden to enjoy the evening. The Atrium was set in a small wood and had a lovely flower garden. I thought I saw a dragon fly hover near the flowers. It was the wrong shape for a dragonfly and then I realised it was a humming bird – an existential moment. I’d never seen a humming bird before – a magical moment. The Atrium did the most wonderful breakfasts – a fantastic combination of sweet and savoury. Celia and Dick Stoltz have produced a recipe book of their breakfasts. Here is one you might like to try.
Praline Pancakes with Caramel Whipped Cream
Makes 8 (3”) pancakes or 6 (4”) pancakes. Serves 3 – 4
- 1+1/2 cup flour
- 2+1/2 teaspoons baking powder
- 3/4 teaspoon salt
- 3 tablespoons sugar
- 1 egg, well beaten
- 1 cup milk (use water for lighter pancakes)
- 3 tablespoons oil
- 1/3 cup chopped pecans
Mix (don’t overdo) all ingredients and let batter rest for 15 minutes. I use 1/4 cup measure for each pancake cooked on preheated griddle over medium heat until edges dry and bubbles appear on pancake surface. Turn and cook until done. If doubling or tripling the recipe, keep warm in 200〫oven until all are made. Top each serving with a dollop of caramel whipped cream just before serving. Put the remainder of the cream in a small crystal pitcher to pass.
What did I learn on the visit? I was interested to see how carers were involved in the governance of PATH and I certainly came back with thoughts about how this could be developed in ISP. PATH have four fee levels which are related to the level of intensity of the work with the child. In ISP we only have one fee for fostering with a higher level if we provide education. There seemed to be a much greater level of co-operation between PATH, the state and counties within which they work. This makes it possible, I think, to have a more open relationship with the local authority, a greater sense of trust than I think is the case in England. The different fee levels work for PATH because it is the assessed needs of the child that determines the fee. They don’t seem to have the continual pressure to reduce fees which we see in England.
I was impressed with the way that all their staff were expected to be a bit entrepreneurial. They all knew that they had to go out and get work for PATH. I was challenged by the non-restraint policy in PATH Wisconsin. PATH in the other 3 states didn’t adopt this policy. Amelia’s view was that if you train people to restrain they will do so. The Director of PATH North Dakota disagreed. He didn’t want to exclude children who were known to need some physical management. I have heard a similar debate within ISP. I was also impressed by their use of teleconferencing and thought we should have this facility at Tunstall Court. It could help our weekly Multidisciplinary Assessment Panel (MAP). There are some weeks that Centre Managers are unable to travel to attend. Teleconferencing could facilitate their inclusion.
Through being at PATH I learnt about “Therapeutic Crisis Intervention for Family Care Providers”, a training programme put together by the Family Life Development Centre at Cornell University. Here is an extract from their training manual.
FOUR QUESTIONS
Adults interacting with children should be positive, have good relationship-building skills, be respectful, have good communication skills, and be able to avoid becoming engaged in negative interactions. All family care providers should have an understanding of the organisation’s policies and protocols and should be fully trained and practiced in crisis intervention techniques mandated by the organisation. There should be plenty of supports and supervision available to carers to promote positive practice formation and reflection. Open and honest discussion should be encouraged in addition to free exchange of information. All carers should be encouraged to engage in activities and discussions that promote self-awareness and skill enhancement. Training in the dynamics of crisis and power struggles is essential.
Before jumping into a situation and reacting, adults should stop and think about what the most appropriate response would be, given the factors involved. Four questions to ask at the outset of a potential crisis to identify the most appropriate intervention strategies are:
1. What am I feeling now?
2. What does this child feel, need or want?
3. How is the environment affecting the child?
4. How do I best respond?
What Am I Feeling Now?
Adults communicate their emotions to children even if they are silent or speak in a very controlled and calm manner. The cliché that one “cannot not communicate” is certainly true in dealing with crisis situations. Children are astute observers of nonverbal behaviour and often have learned to anticipate angry outbursts. They may be more attuned to the adult’s feelings than the adult is! For carers, being aware of their own feelings is the first step in controlling their own behaviour and formulating what they want to communicate to the child.
What Does This Child Feel, Need or Want?
When dealing with an emotionally charged situation, the question, “What does this child feel, need, or want?” leads to a discovery of what the child’s feelings are or what the child is seeking to achieve by the agitated or aggressive behaviour. It can also lead to greater empathy and understanding of the child because it reveals how the child’s behaviour represents an attempt – however dysfunctional – to meet a need. This may, for example, be: (a) a need to feel safe, (b) the desire to be treated fairly, (c) a need for attention, or (c) the desire to feel important or to be accepted.
Adults who ask themselves (or the child directly) what the child feels, needs or wants help avoid misinterpreting the child’s intentions or concluding that “she’s just bad,” or “he’s just out to give me a hard time”.
The more information collected about the child in care, the more prepared carers will be to respond in a therapeutic and supportive manner. Information gathered from a variety of sources about the child’s skills, abilities, interests, preferences, general health, and patterns of behaviour will help the care team develop an individualised crisis management plan that can accommodate the individual child’s needs and help de-escalate potential crises. Not only is it important to know how the child behaves in certain situations, knowing how the child perceives and interprets events is especially helpful in preventing and responding effectively in potential crisis situations. Children who have been abused and neglected often attribute negative or hostile motives to others, especially in stressful situations.
How Is The Environment Affecting The Child?
It is important to manage the environment. Many times potential crises can be prevented or diverted my modifying those conditions in the environment that might be contributing to the stressful situation. If other children are present, they may be watching and become agitated by the interaction, or they may be providing the stimulus that is raising the vulnerable child’s anxiety. Are there elements in the environment setting the conditions for challenging behaviour?
The time of day, day of the week, of combination of other family members and activities will also have an impact on the level of stress in the home and therefore on the children. Is everyone feeling vulnerable and upset, or is it a quiet Saturday afternoon when family members are engaged in leisure activities and there is an opportunity to discuss difficult or painful feelings?
Preplanning for crisis situations is essential. It is important to work within the regulations of the agency, as well as meeting the needs of the child.
How Do I Best Respond?
It is the adults’ response that will de-escalate and defuse a volatile child in most cases. Once the adult intervenes, it is important to recognise that the intervening adult influences the outcome. The need to respond to the child in crisis in a timely, helpful, and therapeutic manner is critical. In order to be in control of a crisis situation, adults must first be in control of themselves. In dealing with potentially volatile and destructive children the tasks are to: (a) manage the environment to neutralise potential triggers, (b) engage the child and defuse the challenging behaviour, and (c) exercise self-control over feelings the situation evokes.
Volatile situations are dynamic and constantly changing. Carers continually make judgements in their attempts to de-escalate situations. They must assess the situation, decide on a response, respond, and then monitor and evaluate the impact of their behaviour on the child and the situation. By using the framework of the four questions outlined previously, carers have a process to use when choosing intervention strategies.
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I can’t resist tagging on this newspaper article by Garrison Keillor, which I read in Minneapolis. I can relate very easily to his mournful humour – perhaps it’s my age. Hope you like it too.
64 Candles and Slice of Humble Pie
Maybe not all the dreams will come true, but there are books to be read and songs to be sung.Garrison Keillor
The Old ScoutTwenty four people packed into the dining room for my 64th birthday dinner and made a steady dull roar from the salad course right on through the cake and coffee, and I hardly got a word in edgewise. People kept inquiring if I was having fun, which is irritating. The answer is no. I don’t want to be 64. I want to be 43. But that’s life. Life is one disappointment after another. Jesus said the meek would inherit the earth, but so far all we’ve gotten is Minnesota and North Dakota.
The crucial questions when you turn 64 are: Will I be needed and will I be fed? Feed should be tied to usefulness, I suppose. A man should earn his daily bran flakes. And what you need a 64-year-old for is ornamentation. We are here to show that power is an illusion. You don’t know that at 43, and at 64 you do. Man is a passenger on the bus and has little influence on the outcome. A newspaper columnist has no more clout than a horsefly. We inveigh, we fulminate, we sing our little aria, and something else happens.
As Solomon said, the race is not to the swift nor the battle to the strong nor success to a guy with connections in Washington. The poor Coushatta Indians of Louisiana got suckered into funnelling money to various congressmen to make friends and protect their casinos. They came out looking like dopes. Kenneth Lay raised buckets of money for the Current Occupant and what did it avail him in the end? Not much. Anybody who tries to buy political influence is kidding himself. You could just as well throw the money from a moving vehicle. The bums who pick it up will do about as much for you as the bums in Washington.
It dawns on me that my Minnesota Twins do better if I’m not there cheering for them. I leave town and they have a big winning streak. I go to a game, and our pitcher gets in trouble right away, our clutch hitters hit into double plays with the bases loaded. The team rallies when I go out for a bratwurst, but once I’m back in my seat, our relief ace gives up a cheap home run. This is humbling.
But any parent knows about humbling. Children grow up, and your influence over them declines precipitously. You begat them because you picture yourself as a wise and beloved patriarch, but instead you become the warden of San Question. Your offspring yell at you and bang their tin cups as you walk through the cellblock. You try to enforce a few rules, and they ignore you. They become painted women in tiny shorts and tank tops and lascivious boys dancing in dim basements to bands with names like Stark Raving Idiots and Degenerate Thrombosis.
Either they will slide into a life of crime and addiction, or awaken in time to get into medical school and become paediatricians. One or the other. Either they’ll wind up in the Big House, sullen, chain-smoking, heavily tattooed, or they’ll be making the rounds in a starched white smock, placing stethoscope against the chests of tiny infants. And you, Mom and Pop, will have had mighty little influence on the outcome.
What a 64-year-old guy believes in, finally, is preservation. If you have no new ideas, maintain the old ones, such as kindness, generosity, humour. I live in a graceful neighbourhood of old homes, a comfort to pedestrians, the work of hundreds of dedicated restorers and renovators. There are classic texts to be read again, Horace and Marcus Aurelius and A J Liebling. Old guys sit and sing old songs and lend some breadth and majesty to the world. Last month I wrote a sonnet. It wasn’t bad. My cousin Susan has, in the midst of encroaching tract houses and minimalls, kept a magnificent country yard and garden that carries on the elegant spirit of Aunt Josephine. In a low dishonest age, to raise tomatoes and marigolds is to testify to the loveliness of the world. Some people dare to dream big dreams and others find the world almost unbearable.
At 64, a man is too old to dream or to despair, but he can recite a sonnet, sing “Frankie and Johnny” or “Old Paint” or “The Frozen Logger” reminisce about a trip to New York City in 1953, and be a staunch liberal. One could do worse.
October
My two week holiday in Dubai was my first assignment for the newsletter as the Middle-Eastern correspondent. What a contrast to Singapore, which is equatorial, hot, steamy and green. Dubai is in a desert, so the colour of sand dominates. There is greenery in Dubai but it is completely dependent on irrigation. The miles of black irrigation pipes winding between trees and plants is one of my abiding memories.
My daughter has just bought a garden. A company arrives and prepares the garden, which previously was just a patch of sand, by laying the irrigation pipes before laying a lawn and planting palm trees etc. which will grow quickly in the constant warmth. Water is a scarce resource which makes having a garden expensive. Apparently the local Arab population don’t have to pay for water, so their gardens are usually greener than everyone else’s.
When we arrived at Dubai it was the last few days of Ramadan, excitement was growing over when the holiday, Eid-al-Fitr, which marks the end of Ramadan, would start. It is linked to the first sighting of the new moon. Starbucks and Costa Coffee were shut during the day during Ramadan which made shopping experiences less enjoyable.
Dubai is expanding at a phenomenal rate. Apparently one third or one quarter of the world’s large cranes are based there. I’m not surprised as it seemed like a vast building site. There must be tens of thousands of immigrant workers involved in the building industry. How they work in the phenomenal heat astounds me. It is cooling down now but it still reaches 35 degrees centigrade in the middle of the day.