Milieu‐therapy With Children: Planned Environmental Therapy in Scandinavia

Abstract

Milieu-therapy With Children: Planned Environmental Therapy in Scandinavia By Kornerup Hans ( ed .) Lejre, Denmark : Perikon , 2009 ISBN 8788503569 , 369 pp, £27.00 (hb) (distributed by NCB ) In my ignorance, I have always made the assumption that residential childcare in Scandinavia would not be afflicted by the absurd and destructive government u-turns and reorganisations, and professional fads and fashions that British children’s homes have suffered over the last 40 years. I was wrong. Our good, liberal, clear-thinking Nordic colleagues have, like us, had to struggle to maintain a few beacons of light still burning and still showing the way. According to this interesting and instructive collection, one of the foremost surviving examples is the Nebs Mollegard ‘treatment home’, where most of the book’s authors have worked at some time. Editor Hans Kornerup begins with a short history of ‘milieu-therapy’ from the Scandinavian viewpoint. Of course, we share the same roots of therapeutic care, the same theoretical base with names such as Melanie Klein and Donald Winnicott, Aichhorn, Bettelheim and Redl. But, since the 1970s, the Scandinavians have developed their own distinguished strand of theory and practice, some of which is presented in this volume. Helle and Jesper Pederson’s early chapter on ‘The daily life of a milieu-therapist at a residential treatment home. Living and working in the midst of children’ is an excellent introduction to therapeutic childcare. I have already begun to use it at one of the children’s homes where I work as a consultant. ‘Children are all different and treating them individually is also a way of treating them equally’ (p. 51): discuss! The book is full of such usefully provocative statements. In ‘Supervision of Milieu-therapists’ (Heidi Rose), the author digresses (her own word) on method: ‘There is a tendency in our day to seek rapid, easy techniques for solving complex issues. Everyone is asking for tools! Ideas of quick and easy techniques are non-compatible with milieu-therapy’ (p. 128). Yes, this is what (nearly) everyone is asking for and, to their shame, this is what the mainstream of our government policy, training institutions, children’s social work departments, and regulation and inspection ask for. Do not question or think; avoid the risks of relationship work; fill in the forms; and do not blot your copybooks — quick and easy does it! While being detailed and specific about therapeutic practice and theory, several chapters pose important political and ethical questions. Is the main task ‘Service, treatment or collaboration?’ asks Erik Larson in the third section called ‘Procedure’. ‘Concepts such as service, the customer and product have entered the vocabulary, without the question having been raised as to whether these concepts adequately represent the institution’s primary task’ (p. 289). If children’s homes are providing a service for their local authority customers, they cannot at the same time provide ‘milieu-therapy’ or treatment for the children that the local authority places. Of course, they must work together – collaborate – with the local authority for the best care and treatment, but the downfall of so many children’s homes in Britain has been the willingness to agree that the customer (he who pays the piper) calls the treatment tune. And when so much of children’s residential provision is privately run for profit, it is hardly surprising that the customer is king, while the child is seen as an expensive encumbrance and a drain on council tax. The book lacks an index and has been rather superficially edited. There are frequent errors and omissions in the writing; in addition, the translation to English is sometimes challenging. Nevertheless, I have gained much from reading this committed, practical and stimulating book. I strongly recommend it to everyone involved in direct therapeutic work with children, and with managing and teaching such work.