Child Guidance Clinic Research Articles

The extended family revisited: grandparents rearing grandchildren.

Census data are presented to document the increase of children under age 18 who are not living with either natural parent and the large numbers being reared by grandparents. The literature is reviewed and discussed in terms of the recent changes in the family, the traditional role of grandparents, and questions concerning elderly people rearing young children. A project is described that identified grandparent guardians of grandchildren receiving outpatient psychotherapy in a university-based child guidance clinic.

Working together: Child guidance clinics and social service area teams

Abstract There seems always to have been some barriers to the smooth working together of child guidance clinics and social service area teams. The ‘discussion’ over the role of social workers in child guidance clinics and their relationship with colleagues in area child care teams is ongoing and seems in danger in some places of being ‘solved’ by the withdrawal of social workers from child guidance clinics. Some things have changed very little since the publication in 1975 of the Child Guidance Special Interest Group's discussion document comparing the social work roles in the two settings. As a social worker who has spent equal amounts of time working in each agency—and experiencing first hand the ‘splitting’ of loyalties this can arouse—the author explores the relationships between the two agencies at practitioner level and in particular looks at the joint work that is possible using a structural family therapy model.

Family therapy in childhood disorders: A greek experience

Abstract This paper refers to the child rearing practices and to the situation of family therapy in Greece. Quite a few children in Greece live in an overprotective, overcontrolling, and overdemanding environment, i.e., in a stressful and noxious one, which could be held responsible for the children's emotional problems. The efficacy of family therapy is compared to that of individual therapy in a child guidance clinic. The data point toward a possible superiority of the family therapy approach over individual therapy.

Behavior problems and social competence of clinic-referred abused children

Research concerning the behavior and social problems of abused children has yielded mixed results. Understanding the psychological impact that abuse has on these children, however, is crucial to appropriate treatment. In this study, 18 abused, 20 nonabused but troubled, and 21 nonabused control children, ages 6 to 12 years, who are clients of a child guidance clinic were compared on the Achenbach Child Behavior Checklist. Descriptive information including the severity, duration, and recency of the abuse was also compiled for the abused subjects to aid in the data analysis. The results varied from original expectations. The data clearly showed that both the abused and troubled children had more behavior problems and were less socially competent than their control group peers, but aggressiveness was the only behavior problem of thirteen clusters analyzed that distinguished the three groups. The results are discussed in terms of their application to the understanding of the abuse-trauma syndrome and the treatment of these children.

A videotape parent education program for abusive parents

The San Fernando Valley Child Guidance Clinic (SFVC) offers a parent education program for abusive and high-risk-for-abuse parents. Structure and content of the program were derived from theoretical and empirical descriptions of abusive parents. The program is based on a videotape, “Hugs 'n' Kids,” which consists of 13 episodes showing common problem situations between parents and their preschool children along with three or four alternative ways the situation could be resolved. Parents meet in a group and discuss one episode per week. Over 200 parents have participated to some extent, and 40 participated in pre- and posttests to assess program effectiveness. The program appears to have met its goals. Parents who completed the program demonstrated increased knowledge of alternatives to physical punishment and understanding of normal child development as well as changed attitudes toward children's misbehavior.

Overrepresentation of Adopted Children Attending a Children's Mental Health Centre

A retrospective analysis was made of case records of children attending a Children's Mental Health Centre during the years 1959 to 1973. Annual comparisons were made between the numbers of adopted children seen in the province of Ontario and within the clinic setting. The results indicated that over a fifteen year period the adopted children in the clinic were seen with twice the expected annual incidence predicted from the community rates.

An Insider's Comparison of a Major Family Therapy Doctoral Program and a Leading Nondegree Family Therapy Training Center

This paper presents the author's experience of family therapy training in the doctoral program in Marriage and Family Therapy at Purdue University and in the Post-Doctoral Clinical Psychology Internship and Weekly Extern programs at the Philadelphia Child Guidance Clinic. The author describes each of the programs, compares their major features, and suggests general considerations for choosing either a doctoral program or a nondegree training center in order to learn family therapy.

To reclaim a legacy: Social rehabilitation

The article describes the first year of the Social Rehabilitation Program for children and their families at the Philadelphia Child Guidance Clinic. A parallel is drawn with the beginning of family therapy and the ecological approach under Salvador Minuchin in 1965. It traces the difficulty in maintaining outreach community work because of funding problems and productivity requirements of the funding agency, and ends with the return to the community approach under the new program. The program is described primarily through case examples.

Preventative adolescent psychiatry? Practical problems in running social skills groups for the younger adolescent

In order to develop autonomy an adolescent needs a satisfactory peer group experience. Poor peer relationships in children and adolescents are an important factor in the development of psychological disorder in adults. Family therapy and individual psychotherapy by themselves may not attend specifically to the issue of helping a child improve his peer relationships.The first part of this article deals with theoretical considerations including the concept and development of social skills. The second part describes how we set up and run our social skills groups in both a Child Guidance Clinic and a school for the maladjusted. Issues such as selection of children, creating group cohesion, and techniques for intervention (including social learning games, modelling, role plays and cognitive strategies) are discussed. The third part portrays an attempt to evaluate outcome. Throughout we share practical difficulties we have encountered.

A social worker's pregnancy and its effect on casework

Abstract This paper is an account of my personal experience of casework in a Child Guidance Clinic during my recent pregnancy. It looks at the effect of the worker's pregnancy on her attitude to casework and her relationship with the client and explores, through case material, how this can affect the outcome of the work.

Directed Art Counselling in Child Guidance Clinics and Elementary Schools

Directed Art Counselling in Child Guidance Clinics and Elementary Schools

Psychologists, Psychiatrists and Special Educational Needs in Britain since 1944

Abstract This paper provides an historical survey of special educational provision in Britain by tracing the part played since 1944 by psychologists, psychiatrists and guidance clinic personnel in meeting the requirements of children with special educational needs. While the pre‐1944 story is covered in such standard works as Pritchard (1963), discussion of the period since the Education Act of 1944 is scattered in research journals and isolated book chapters. The present account attempts an initial synthesis, outlining the history of educational psychology since the appointment of Cyril Burt in 1913; the change from a medical to an educational model of special need; the growth of child guidance clinics; the role of the psychiatrist; development of new guidance concepts in the 1970s; and an outline of treatment approaches in child guidance. The paper concludes by referring briefly to the allied fields of counselling and research in education for children with special needs.

The consequences of child abuse for the formation of relationships with peers

The peer interaction of 26 physically abused children was observed and compared to the peer interaction of normal children (n = 26), neglected children (n = 4) and children referred to a child guidance clinic (n = 21). The children were either enrolled in a day-care intervention program and observed in well-established peer groups or not enrolled in peer-based intervention and observed in newly formed peer groups. The hypothesis that abused children who were enrolled in day-care intervention programs would be more competent in peer interaction than abused children who were observed in newly formed groups and not enrolled in peer-based intervention programs was supported. The peer interaction of abused children in well-established groups was similar to that of normal children and more skillful than that of abused and clinic children in newly formed groups. Normal children engaged in similar peer interaction in newly formed and well-established groups. The results are discussed in terms of the social support network provided by the day-care intervention and missing in the family environment of abused children.

William Healy (1869-1963): pioneer child psychiatrist and criminologist.

William Healy, M.D., a pioneer psychiatrist and criminologist, established the first child guidance clinic in the United States in 1909, and was an early advocate of both the "team approach" and the "child's own story" in treatment and research. One of the founders and the first president of the American Orthopsychiatric Association, Healy helped introduce Freudian thought into the United States. Among his contributions to the field of criminology are his book The Individual Delinquent (1915) and his "multifactor theory" of delinquency, which broadened the field and moved it away from European criminology's stress on genetic factors. Healy developed an elaborate methodology for the complete study of the offender by a variety of specialists. He was also a reformer in the field of corrections, based on his investigations of several institutions for delinquents.

School psychology in Great Britain

The development of child guidance in Britain is at least in part indebted to developments in school psychology in the United States. Historically, the British Children’s Act of 1908 first required that juvenile courts and magistrates seek psychological assessment for children appearing before them. Burt (1937, 1950) inspired much of the early development by working as the first British psychologist in the educational setting in 1913. Clinics were later set up, and the Commonwealth Fund was used to finance the Child Guidance Council, founded in 1928. Under the National Health Act of 1946, a new approach to child guidance was established. The Education Act of 1944 and the National Health Act of 1946 provided for the merging of Health and Education. The Underwood Report (Her Majesty’s Stationery Office (HMSO), ‘95.5) supported the fusion of education and health services for maladjusted children, and led, in 1959, to Circular 347 that recommended that each authority should set up a Child Guidance Service consisting of a School Psychological Service and the Child Guidance Clinic. After 1955 and until the 197Os, the Child Guidance Service was composed of a Child Guidance Clinic and the School Psychological Service. Clinics had an essentially medical orientation; services took an educational and psychological approach. The two worked together as a team. Considerable research has since supported the approach that psychological and educational problems are connected and require joint efforts for resolution (Lowenstein, 1983a).

Patterns of childhood psychiatric disorders in India.

Epidemiological studies on the prevalence and patterns of childhood psychiatric disorders in India are practically non-existent. The present study was carried out to systematically analyse the demographic and diagnostic variables relating to the children attending the child guidance clinic over three consecutive years. There was predominance of males, within an age range of 6–14 years. The commonest problem seen was mental retardation (30%) followed by epilepsy (16%). Of the emotional disorders, most frequently encountered was neuroses. Relatively fewer cases were seen of conduct disorder, emotional disorders specific to childhood, hyperkinetic syndrome or specific developmental delays.

Are child guidance clinics an anachronism?

Are child guidance clinics an anachronism?

The family and childhood psychosomatic disorders

A major recent advance in the understanding of the maintenance of psychosomatic disorders has been the development of a theoretical model utilizing the concepts of General Systems Theory. The model directly addresses the impact of contextual factors upon an individual's physiologic and emotional functioning. Familial and extrafamilial influences appear to be related to psychosomatic symptoms in a circular feedback fashion. Research carried out at the Philadelphia Child Guidance Clinic has identified characteristic dysfunctional patterns of family interaction in families with a psychosomatic member. These include enmeshment, overprotectiveness, rigidity, lack of effective conflict resolution, and involvement of the affected child in marital conflict. Structural Family Therapy, systemically based family treatment incorporating goal directed interventions in family interaction, has been applied to the treatment of psychosomatic disorders in children, adolescents, and young adults with highly successful results. Therapeutic techniques are specifically designed and implemented to transform dysfunctional patterns of family interaction and provide family members with methods of effectively responding to psychosomatic symptoms while encouraging developmentally appropriate function for family members and improved overall family function. Of major importance in this work is the establishment of a collaborative medical-psychiatric team providing integrated and consistent treatment.

Data on the Conners Teacher Rating Scale from a British clinic population

Conners Teacher Rating Scales were completed on 124 boys aged between 5 and 11 years who attended the child guidance clinics of a large southeast London psychiatric hospital. Comparisons were made with the data provided by Conners (Am. J. Psychiat., 1969,126, 884–888) in which the factor structure of the scale was first identified. This was in response to a reported failure to replicate the scales factor structure in a clinic population despite a number of confirmatory studies on large numbers of children in general populations. Of the scale's five original factors, three were clearly identified. The other two, labeled Hyperactivity and Inattentive-Passive, comprised a single factor. A fifth weaker factor not identified by Conners (1969) was found, consisting principally of antisocial conduct items. The results are seen as providing further evidence of the scales robustness in this, the only other reported clinic study and one in which British children were used for the first time.

Work with parents of abused and neglected children

THIS COMMUNICATION is based on the experience with 19 families whose abused or neglected children were hospitalized at the Children’s Department, Ullevaal Hospital, over a period of one year. The work with the families was limited to the duration of the child’s stay in the hospital, and did not differ in any qu~i~tive way from other parental or family coun~ling in the area of child care, preventive health services, child guidance or adult psychiatric social work. The aims were: 1) to establish a relationship with the parents; 2) to conduct a psychosocial inquiry; 3) to attain a psychosocial diagnosis of the family; 4) to decide on a plan of treatment; and 5) to motivate parents for cooperating in treatment. Before any constructive work with the family could take place, we found they had to experience a relationship characterized by sufficient trust to enable them to participate adequately in a psychosocial inquiry into the current family situation. Thereafter, through cooperation of the inte~~fession~ team, evaluation led to formulation of a family diagnosis and adoption of a treatment plan. Such a plan included a wide spectrum of measures from long-term support to such extreme and authoritative interventions as taking the child into care. An important aim also was to motivate parents to further cooperation with community resources such as kindergarten, municipal health and social centres, child guidance clinics, foster homes or children’s homes. This discussion is limited to the development of the relationship with the parents, the psychosocial inquiry, and motivation of the parents. In conclusion, the important question of the relationship and personal reactions of the team to the parents they encountered is examined.