On Child Abuse, Therapy, and “Blood to a Vampire.”
The Business of Child Abuse
By Joshua Allen
To misquote WC Fields; “Therapy to a Social Worker is like Blood to a Vampire.”
Therapy is the number one tool that Social Workers use to assist Abused and Neglected children through the continuing crisis of past and future thoughts, behaviors and feelings that make up the lousy world of a foster child.
It is not always the birth parents that can cause emotional trauma. Even the best intentions of all involved workers and foster parents can and do lead to further anguish as the stricken child is led through the maze of Social Workers, Therapists, Lawyers, Judges, Foster Parents, Birth Parents, Medi-Cal restrictions, indifferent public school teachers and assorted fools and well-meaning dunces to whom they come into contact.
It is the very desperation to help these children that lead to the referral of therapists as one of the first things a Social Worker will do when a new child is put on his or her caseload.
Often, one of the first difficulties to arise concerns the scarcity of Bilingual therapists who can speak the language of the foster child and for that matter the foster parent. The majority of foster children in Los Angeles are of Hispanic parents.
Therapists are frequently interns (Post educational counselors working on their hours to satisfy licensing requirements). These “interns,” are supervised by licensed therapists who hopefully ensure time is well spent as the Intern learns their new trade while treating foster children.
The quality of these interns varies, and it is in the clinics or individual therapists’ economic interest to keep these children in therapy as long as possible. That does not mean therapists are acting unethically, it only means there is a financial incentive involved, and there are times Medi-Cal is billed for unneeded therapy. A foster child will need to have a minimal diagnosis (such as oppositional defiant disorder) before the government may be billed and such treatment is justified. Some therapists become quite expert in doing just that.
However (and the author can only speak anecdotally), few interns or for that matter therapists have had any significant amount of therapy themselves, and so they are minimally aware of what it is like to sit on the other side of the couch, beyond some of their graduating requirements.
Many would claim that this is not a limitation on the intern’s ability to do good work. Therapy after all is time consuming and expensive and significant results (without the use of psychotropic medications) can take a great deal of time.
The efficacy of therapy for foster children then is something not often discussed, since there are few if any real alternatives or substitutes that can partially make up for why a child is placed in foster care in the first place.
Some children go through so many therapists over the years that they seem to be immune to any of the tools a therapist brings to the table. Abused and Neglected Children may continue with failing grades, dangerous sex, drug use and petty crime until they emancipate or return home to their birth family where things are worse.
This game of “musical therapists,” is something seen with foster children who are in the system for a few years, often being placed into half dozen or more homes during that time.
Psychotropic medication often works to help a child but is controversial and many therapists and social workers don’t like them as they believe:
1. The use of psychotropic medications only masks symptoms and fails to deal with the underlying problem; or is too toxic for young livers.
2. Psychotropic medications are used too much as a sort of economical behavior modifying agent.
3. Social workers and therapists may have a societal or cultural influenced prejudice against the use medications in general whenever a child is involved.
Ignorance in this area is not unprecedented within the community of therapists, case workers, politicians and media organizations. The half hour, impossible to get, infrequent appointments with a government psychiatrist doesn’t inspire a lot of confidence.
The charge of “Over Medicating,” is so over used and self-satisfying that it often precludes any real discussion regarding pros and cons and becomes a lazy rejoinder to such a complex issue.
Of course, a foster child will always do better in a foster home that is loving, kind, and nurturing.
And that’s not complex at all.