THE BLOG

Time to Pension Off Old Thinking About Residential Child Care

31/01/2013 12:40 GMT | Updated 02/04/2013 10:12 BST

Early intervention for children in need could stop them becoming children in care. For many this will be successful, depending on their needs.

Some will be adopted. For many this will be successful, depending on their needs.

Others will be fostered. For many this will be successful, depending on their needs.

Yet when it comes to residential child care, children's homes, the predominant policy makers' view is that it should be avoided. There is a needless block on thinking that it can be the right placement for the right child, like the other options.

This is not the thinking in other countries. Recently published research shows the efficacy of residential child care elsewhere.

So why have we long persisted with this mindset, and what are the effects on policy and practice?

First, we should delve into history to find that this thinking has now reached pensionable age.

Since discussion around the Curtis Committee in 1948 we have been discussing the competing merits of family based and residential care options.

Back then the two leading child care thinkers, Bowlby and Winnicott, explained their views. Bowlby emphasised the preventative over the remedial and 'better a bad home than a substitute'. His aim was reducing if not removing the need for young people being 'taken into care', curing deprivation by what today would be called early intervention. He favoured family-based care even extending to 'cottage homes' but was 'reluctant to fully endorse the sort of therapeutic benefits to be derived from systematic, specialised hostel-type provision.'

Yet there was another view. Winnicott's experiences led him to think that deprivation was never going to disappear and he endorsed all provision. He was not so confident in the resilience in all circumstances of the ordinary family to provide the required structures for deprived young people. A small well-supported residential home, 'primary home provision', could provide a suitable 'facilitating environment' for such young people.

If we are to succeed in our current rethinking of how we meet the needs of young people in need we should adjust our thinking about children's homes, fostering and adoption.

It is time to heal the gap and to question our assumption of a hierarchy of placements.

Sometimes, explaining objective fact doesn't suffice as it is held in place by the subjective experience of many decades of 'this is how we do things. What are the fears that keep us following the old script?'

With 6,000 young people in our children's homes, the persistent need is obvious but why not accept that children's homes are needed?

The reasons may be psychologically deep. Informal and repetitive patterns of thinking and behaviour provide comfort and predictability. Each new generation follows the scripts that direct the binding values, behaviours, and emotional connections.

So what might be the 'truths' that will help us with our thinking?

Most children in care have straightforward needs or a long history of disability, difficulty or disruption, including abuse or neglect and can benefit from family-based care.

Yet as Winnicott observed, some children have extensive, complex and enduring needs compounded by very difficult behaviour. They need specialised and intensive resources, which are mainly available residentially. The children's serious psychological needs and behavioural problems can overshadow other goals.

The levels of these needs are beyond the comprehension of most people, even professionals and politicians. Yet for us to survive emotionally we may have to make their needs seem less important, perhaps as a choice they take, and that other family-based placement options can replace residential solutions. In doing so we deny them what they need. Our wants outweigh their needs.

Part of this is rational enough: the residential child care sector and residential child care as a profession have much to do to get as good as possible. Yet another part is beyond such reason but means wishing the needs of the young people and the sector away.

No amount of early intervention takes away the necessity of residential solutions for such children. In previous decades, we had prodigious early intervention with a series of nets that caught and supported various needs. It did not mean that we needed less residential care.

Previous decades show that early interventions of any sort, even boarding schools, do not necessarily decrease the need for residential child care and children's homes. It is an option for some young people provided nowhere else. No extension or specialism in other placement options have what residential options can provide. We need residential options first for some young people and no barriers to the right placement at the right time.