TYPICAL ISSUES FOR CHILDREN IN PLACEMENT

The families of children who require placement have histories of living in homes characterized by substance abuse, homelessness, domestic violence, AIDS, emotional disturbance, poverty, and incarceration (Children’s Defense Fund, 2000). Children born and growing up in families struggling with these problems suffer consequences in the form of attachment, trust, identity, and loss difficulties. Often their development has been compromised because of environmental factors that have left their parent(s) overwhelmed, helpless, and hopeless. Growing awareness of the importance of helping the family has resulted in programs that are family centered and focused on family preservation. Many practitioners now believe that it is artificial and faulty to separate children’s issues from family issues (Walton et al., 2001). I have repeatedly maintained in this book my own belief that helping the family is essential to helping the child. However, I want to emphasize that a family focus may not be sufficient to help a child whose development has been seriously compromised. Many of these children need individual professional help to overcome the aftermath of their traumatic histories of neglect and abuse. Social workers and other practitioners must be sensitive to the impact of a child’s history on his or her development and be knowledgeable about some specific child-focused methods for helping. In my opinion, working only with the family without devoting additional special attention to the child’s individual needs cannot repair the damage and attachment issues caused by years of neglect and/or abuse. Many children in foster care and in other forms of out-of-home placement require interventions specifically aimed at assisting them with their grief work, with traumatic memories, and with issues related to their identities. In turn, foster parents who assume the care of children with multiple losses need assistance in understanding the children’s extensive needs to respond to them sympathetically and realistically. The past cannot be erased, and developing trust in adults may take some time. The range of intervention methods to meet these diverse needs includes family, group, and individual helping approaches.

INTERVENTIONS WITH THE CHILDREN
 Most (if not all) children in foster care and in residential treatment have experienced losses, ranging from multiple moves to parental separation, death, or abandonment. Many of these experiences qualify as traumatic, and the children’s behavior may be partly explained as derived from PTSD. The fact that these experiences are frequent does not make them easier for the child. A child who must enter new schools several times during his or her elementary school years is required to make repeated efforts to make friends and establish “credibility” among children who have already formed peer relationships and who may not enthusiastically welcome newcomers, especially when they are different because they are not residing with their own parents. Some schools routinely have time-limited groups in the fall of each year to help integrate new students into the school and also to provide them with a ready-made group of peers with whom to establish friendships. These groups would be helpful to foster children who have been placed in a new school district. Unfortunately, however, the transfers do not always occur at the beginning of the year, and therefore the groups may not be available when most needed. In any case, the school social worker should be notified when a foster child enters a new school so that this professional can try to provide appropriate services to the child. The Case of Dave Pelzer: A Foster Child with a History of Abuse In three autobiographical accounts (1995, 1997, 2000), Dave Pelzer describes the repeated physical and psychological abuse he suffered at the hands of his mother. Eventually he was removed from his home after school personnel on several occasions noticed his serious bruises. He had difficulty adjusting to a series of different foster homes in which he was placed between the ages of 9 and 12. Pelzer describes how he had feared his mother’s wrath if he revealed “the secret” about his abuse to anyone. After his placement, he kept asking himself whether his mother had ever loved him and why she had treated him the way she did. He was admittedly confused and felt that somehow he must have deserved the abuse. Pelzer refers to experiences that are common among foster children, namely, his difficulty making friends in school and his discomfort about having to admit to his peers that he didn’t live with his parents. He also reports his willingness to steal to gain acceptance from other children. Fortunately, one of his foster mothers had a great deal of experience and the ability to deal effectively with children who had very troubled backgrounds. Her approach emphasized the children’s strengths. She acknowledged Pelzer’s potential and warned him that he could end up in residential treatment if he continued to get into trouble. Pelzer’s three memoirs present an insider’s view about foster care that includes his gratitude toward the foster care system, which he credits with saving him. The Case of Maria: An HIV-Positive Foster Child In the previous editions of this book, I wrote about the case of Maria, age 10, who was in foster care because her mother had died of AIDS and because she had no known relatives who could care for her. She and her 13- year-old brother, Mario, were placed in a foster home. The foster parents, who had three of their own children, wanted to adopt Maria, but she felt conflicted because the foster parents did not intend to adopt Mario, who had acted out against them and was subsequently placed in a residential treatment center. Part of my work with Maria consisted of helping her understand and connect with her past, so that she could grieve her serious losses. This was accomplished by having her create a lifebook and write a letter to her deceased mother and by taking Maria and Mario to visit their mother’s grave. These interventions, which can be adapted for use with other children in placement, are discussed next. Specific Methods for Helping Children with Grief Work The following interventions can be used with children in foster placements to help them mourn their losses. They may be used in individual sessions, in tandem meetings with siblings, or with a group of bereaved children. See Webb (1993, 2001, 2010) for detailed case illustrations demonstrating the use of these methods. Lifebooks A “lifebook” is a document in which an individual records his or her unique life story (Aust, 1981; Backhaus, 1984). When created for the benefit of children in placement, it contains stories and/or factual accounts dictated or written by the child about his or her memories; it also contains the child’s own drawings and may include photographs, if available. The use of a “time line” in the lifebook helps the child depict the significant events of each year of his or her life, clarifying various moves and the significant people at each location (Doyle & Stoop, 1991). The purpose of making the lifebook is to help the child understand his or her own history and simultaneously to provide the opportunity for validation and release of feelings connected to the powerful memories. Since the first publications in the 1980s describing the use of lifebooks with children, there has been a flood of materials on the market to guide practitioners in helping foster and adoptive parents to assist their children with the process of recording and reclaiming their own past histories. See various publications listed on the Internet under “lifebooks” to uncover booklets and manuals such as My Foster Care Journey (O’Malley, 2006) and The Child’s Own Story: Life Story Work with Traumatized Children (Rose & Philpot, 2005). Letters to Absent or Deceased Family Members and Others An essential part of grief work involves the expression of feelings related to the unexpected death or departure of a family member. Often when a death or other loss, such as abandonment, occurs, the family members are left wanting to see the person again so that they can ask or tell them something important. This “unfinished business” sometimes consists of expressing anger or sadness at being left. Writing letters to the missing or dead person and reading these aloud in an appropriate setting can relieve the person of some of the burden of sadness, guilt, or anger. This may be relevant for foster children who feel unfairly treated or who have been abused, as well as for children (and adults) who have suffered a loss through death. (See Figure 10.4 for a form letter to a person who died.) The healing dynamic in writing such a letter relates to the individual’s taking action in a situation in which he or she previously felt powerless. It is not necessary for the letter to be delivered for it to have a positive effect. However, I do recommend the creation of a ritual or ceremony in which the person can read the letter in front of a picture of the absent person and/or at a meaningful place or time.