April 23, 2015

Rediscovering a conceptual gem for therapeutic out of home care.

This article was authored by Janise Mitchell,
Deputy CEO of the Australian Childhood Foundation.

Sometimes you come across a journal article that is way before its time. It makes you reflect on how knowledge itself develops over time and how the essence of our work comes from reflective observation and analysis. It also highlights that ideas for supporting children who have experienced abuse and neglect did not start with the discovery of the neurobiology of trauma, but had its roots in the early practices of child protection and child welfare.

Henry Maier’s 1979 paper – The Core of Care: Essential Ingredients for the Development of Children at Home and Away from Home – was published in 1979 at a time when the internet was not invented. It is as current today as it was innovative then.

Maier identified seven vital components in the core of care for children who were removed from their family in order to protect them from abuse and neglect.

Bodily Comfort

As a child’s bodily comforts are met, they feel treated with care. Throughout life a sense of well-being and care is experienced when one’s body is free of stress. The experience of discomfort makes people feel unwelcome, worthless and isolated. Young people need to have private spaces that are unconditional.

Differentiations

Individual children all have different temperaments. This requires that caregivers differentiate in the way they respond to them. Temperamental differences impinge on development. Some young people require bodily contact as part of close personal interactions while others need some distance and rely on eye and marginal body contacts.

Rhythmic Interactions

Rhythmic experiences promote feelings of belonging and continuity. These can be simple things like walking, laughing or clapping together. Playing ball games can also create these rhythms. Rituals are the social counterpart to psychological rhythmicity. Formal rituals might be the kind of things that happen on birthdays.

The Element of Predictability

To know what is likely to happen in the future lends a sense of order and power to people’s lives. Predictability can be encouraged by engaging with young people in activities. The young person accomplishing a new task requires recognition for their mastery of this rather than an evaluation in terms of good and bad. Maier (1979) however cautions that a healthy sense of order does not come from a book of house rules but needs to grow out of the lived experience of those who live and work in a centre.

Dependability

When repetition, rhythmicity and predictability are combined, the child will feel good and cared for because these experiences establish a sense of certainty. The feeling of dependence creates attachments and intimacy which are pleasurable and safe.

Personalised Behavioural Training

It is only when a trusting relationship has been established with caregivers that effective behaviour training starts. This is because behaviour is moulded largely by the caring person who the young person perceives as being on his or her side.

Care for the Caregivers

It is essential that the caregivers are nurtured and given caring support to enable them to transmit this quality of care to others. Caregivers are enriched or limited as agents of care according to the care they receive.

With the insights offered to us by neuroscience, these principles have been confirmed.

In therapeutic care, these elements resonate and continue to reflect the relational needs of children and young people.

I am interested to hear how relevant you think these elements are today in the practice of child protection and out of home care.

Maier, H. (1979). The core of care: Essential ingredients for the development of children at home and away from home. Child Care Quarterly, 8, 161-73.