Time to Mourn Again – Why some placed children have a rocky adolescence

Time to Mourn Again

TIME TO MOURN AGAIN an article for all who care for adopted or placed children

 Time to Mourn Again

As published in  Maluccio, A., Krieger, B,. & Pine, B.A. (1990).  Preparing Adolescents for Life After Foster Care. New York: The Child Welfare League of America

All foster and adopted children struggle with the need to make sense of placement in the least hurtful way possible. The loss of home and family is a deeply wounding experience, and it must be explained and fully mourned before the foster child can begin to plan for the future. If the past makes no sense of the hurts of the past remain open wounds infecting the present, the path to the future is full of dangers.

A primary question posed by placement is: “How come you can’t stay with your own family?” How this question and others raised by placement are answered will have an effect on the placed child’s future well-being (Brown et al. 1986). Moreover, the questions must be answered twice, for the cognitive limitations of childhood dictate one set of answers, and the expanded cognitive abilities of adolescence raise doubts about the explanations that earlier mollified and comforted the placed child.

The youth who learns to think abstractly understands perhaps for the first time that his or her parents could have behaved differently.  The pain created by this cognitively forced examination of old explanations brings about a need to mourn once again the losses associated with being a foster child. Some adolescents manage this re-mourning adaptively. Others find the pain nearly overwhelming and, in an effort  to deal with that pain, act out against themselves or against others—or perhaps both. That reaction can threaten their ability to prepare for adulthood as well as jeopardize the stability of the foster placement. This chapter places acting-out behavior within the context of a necessary grieving process brought on by changed cognitive abilities and suggests ways in which the social worker can educate, support, and sustain foster parents and adolescents through this crucial time. One such case illustrates the process.

Consider John. He was originally placed in foster care when nine years old. His three- and five-year-old sisters were placed in another foster home at the same time.  John’s parents were alcoholics, and all three chil­dren had been neglected and abused. At the time of placement. John was a quiet child, slightly withdrawn, compliant and ready to please. He was also eager to be reunited with his sisters and parents. He denied that his parents had a drinking problem, John used the fact that his father had an ulcer and his mother suffered from chronic lower back pain, caused by a drinking- related an accident, to explain why he and his sisters could not live with their own parents. “They were sick and we didn’t help them enough,” he explained to his social worker.

Efforts to reunite the family failed. The parents separated, the father left town, and the mother’s alcoholism worsened.  Eventually, all parental rights were terminated, and the girls were adopted by their foster parents. John, then twelve, did not want his foster parents, the Browns, to adopt him and instead maintained that his mother would be hurt by the adoption. John periodically contacted his mother and accepted her vague plans to have him  live with her again.

Six months after his sisters were adopted, John began to complain about his foster parents. His complaints were generally vague; he felt they were too restrictive and not understanding enough. Moreover, he was argumentative and angry most of the time. Soon after he began complaining about the Browns, his behavior deteriorated even more: his school performance declined; he began to cut classes; he often stayed out past curfew. Fortunately, the Browns had had considerable experience with adolescents and were tolerant of his behavior.

Three days after John’s thirteenth birthday, however, he showed up at his social worker’s office and demanded he be placed in another foster home. His request was at first denied, but when he ran away and threatened to keep running away if not re-placed, he was finally moved to a second foster home.  He did well in this home for three months, but then began to abuse drugs and engage in other self-destructive behavior. When he refused to go for treatment for his drug problem, his  foster parents requested his removal. John was then placed in a residential treatment center from which he often ran away. He was frequently found at his mother’s home. During this time he visited the Browns twice.

During one of his runaways, he was arrested for robbery and was placed in a locked detention facility. His mother promised she would get him released to her custody, but when the time came for the court hearing, she failed to appear. Much to John’s surprise, however, the Browns did come. Moreover, they agreed to have John live with them after he had received treatment for his drug problems.  John entered a drug treatment program; during individual sessions with the social worker, it became clear that his denial of his parents’ drinking and other problems had broken down. He used the sessions to review the hurts his parents had inflicted on him. and was finally able to see that drinking was the primary reason his parents had not been able to care for him. After six months in the treatment program, with help to mourn what might have been, John returned to live with the Browns.

John was luckier than most adolescent foster children: he worked through his losses, he had foster parents willing to maintain a long-term bond with him, and he had a social worker who helped reunite him with his foster parents. A great many foster children are not as fortunate as John. They either remain stuck in the mourning process or during the course of re-mourning and working out their rage, destroy all possibility of remaining with their foster families. Whether the placement survives the re-mourning process is often determined by the foster parents’ willingness to understand and endure the acting-out behavior.

More than endurance, however, foster parents offer a pivotal and sustaining force in helping assure that the adolescent moves through :the re-mourning process adaptively. Their help can promote growth and healthy interdependence. Lack of help and understanding on the part of foster parents, as well as lack of agency support to foster parents, can lead to placement disruption and solidification of maladaptive behavioral patterns. To be helpful foster parents must recognize that adolescence is a time of renewed mourning brought about by the changes in the way the adolescent thinks.

Foster parents attempting to care for a re-mourning adolescent need to understand a number of dynamics including the losses connected with being a foster child; how the preadolescent child mourns losses; how the emerging cognitive processes of adolescence lead to re-mourning; the course of the re-mourning process; and finally, the effect of re-mourning on the adolescent, the foster parents, and the biological parents.

The Foster Child’s Experience of Loss

Foster children experience a number of losses. Viewed from a cognitive standpoint, their suffering involves the four major sources of uncertainty: the new, the unpredictable, the contradictory, and the conflicting (Kagan 1978).  Foster children confront these sources of uncertainty in relation to inner self and connections with significant others, both of which intensify the psychological burden. They must deal with the new, such as family, home, values, and status.  They must live with the unpredictability and impermanence associated with placement. Perhaps foremost, they must deal daily with the contradictions and conflicting beliefs about self, worth to others, control over decisions, and the meaning of separation from parents.

From an analytic perspective, these uncertainties and losses con­stitute the four calamities of childhood: loss of object, loss of love, loss of power, and punishment or loss of self-esteem.  Uncertainty results from fear of the possibility that these calamities might occur; depression exists when the feared loss has occurred (Brenner 1982).

Foster children experience both uncertainty and loss in relation to each of these calamities. They experience object loss, for they are no longer in their parents’ physical presence, and they have lost the familiarity of their homes, their neighborhoods, their schools, and their friends. Even if they hold steadfastly to the idea that their parents do love them, they no longer have a daily experience of that love and therefore view foster care as a diminishment or loss of parental love. Moreover, placement forces children to confront their own and their parents’ weaknesses. They believe that loving parents do not willingly place a child in foster care.  No child really wants to be moved from his or her home; placement clearly constitutes a loss of power. Finally, placement is experienced as punishment, and the child suffers a diminished sense of self-worth.

The question “How come you can’t stay with your own family?” epitomizes all of the potential hurts facing placed children as they try to explain to themselves why they are not able to live in their own homes and with their own parents. Most clearly, however, the question raises the very real possibility in the child’s mind that placement means a lack of parental love.  Loss of love is a key component in the adolescent re-mourning process.

Adolescents not living with their parents have been found to be significantly more depressed than their counterparts (Teri 1982). The loss is particularly threatening when it entails the less of mother’s love. As Kagan (1988 265-266) notes:

 A mother’s love for the child is treated as a mysterious force which. if sprinkled plentifully over young children, guarantees salvation. But for the child who is not fortunate  enough to have had a loving mother, the future is poisoned. This faith in the power of love does not operate across all cultures, nor has it been consistently held to throughout the history of our society.  Nevertheless, it is a potent assumption today, and one that greatly increases the pain….

 In their examination of the effect on foster children of parental failure to visit or maintain  contact, Fanshel and Shinn underscored this basic need of children to believe they are loved. As the authors note:

Our data suggest that total abandonment by parents is associated with evidence of emotional turmoil in the children. We can think of no more profound insult to a child’s personality than evidence that the parent thinks so little of the relationship with him that there is no motivation to visit and see how he is faring. Good care in the hands of loving foster parents or institutional child care staff can mitigate the insult but cannot fully compensate for it (Fanshel and Shinn 1978: 487—538).

All adolescents suffer when faced with a loss of parental love. Adolescent foster children confront the potential loss of parental love daily; it is a testament to human adaptability that so many accomplish as much as they do. Suffering is better endured if it makes sense, and suffering children seek to understand their pain. Their efforts to understand depend upon the level of their cognitive abilities.

Changing Thought Processes Pre-Adolescent Thinking: What Is Ought To Be

When children are placed in foster homes, examinations and reasons are sought by all involved parties. Consequently, children are often presented with a number of conflicting views about why they are in placement. Often these explanations will involve blaming someone or something, since one of the principal ways people resolve uncertainty is by finding someone or something to blame (Kagan 1978). Many parents will blame outside forces; practitioners will often blame psycho-dynamics or societal forces; foster parents might blame the child’s own  parents; and most pre-adolescent children will look inward for an explanation and will blame themselves.

Consider how abused and neglected children often explain their parents’ hurtful treatment of them: “All parents beat children.” “Of course, my mother beats me; she has to teach me right from wrong.” No matter how parents treat them, most pre-adolescents believe that this is how loving parents treat children. Pre-adolescent children have difficulty imagining other children are treated differently from the way they are treated. They cannot deal with the abstract; they can think only about what they know and live with. They believe that “what is ought to be.” When the “what is” turns out to be something painful, they will think the pain is deserved punishment. They will seek the cause of the pain and punishment in their own being and  behavior.

To a certain extent, such self-blaming thought processes serve a useful purpose, for they permit foster children to maintain some control and some belief that they will be able to return home someday. The alternative is too bleak to be considered: if the cause is not in the children, but in parental limitations, the children are forced to consider the possibility that their parents either do not love them or are weak and powerless. Both of these beliefs are untenable and are defended against by the placed child, whose emotional and physical survival depend on alliance with a greater and more powerful force. No matter how weak or abusive are the parents, the child needs to believe that they are the best of all possible parents. Childhood is, therefore. a time when parental limitations are for the most part denied by blaming the self.

Adolescent Thinking: An Interest in the Possible

Unlike the pre-adolescent child, however, adolescents can think abstractly; they can deal with ideas and possibilities. This ability, allows adolescents to imagine a better world, a better self, and better parents. Moreover, unlike pre-adolescents, they can compare their parents to other parents, and in doing so become aware of their parents’ limitations. Their faith in parental infallibility erodes. Eventually, the belief system regarding parents shifts, and the perfect parents of childhood are lost. Viewed from the perspective of mourning theory, childhood represents the first stage of mourning—denial of loss. The changing thought processes of adolescence break down this denial, and the adolescent enters the next stage of mourning—anger.

The realization that parents are not perfect creates anger in children. The sense of having been betrayed by the people they loved and trusted most is strong. The greater the discrepancy between the child’s view of the parents and the adolescent’s more objective views, the greater the sense of betrayal and the greater the anger.  Much of the moodiness, the anger, and the despair of adolescence begins in the uncertainties created by the loss of childhood’s beliefs, particularly beliefs relating to self and parents.

Fortunately, for most adolescents the readjustment of thoughts and feelings about parental limitation occurs slowly.  Strong feelings do not run dangerously high. This permits a manageable resolution to occur.  Gradually, the bad-good parent seesaw stabilizes, and parents are viewed more realistically.  Anger, grief, and blame subside. Resolution of the conflicting believes is achieved.  The loss of the parents of childhood is accepted, and the third stage of mourning, the period of resolution, occurs.

Placed adolescents are not so fortunate, however, for placement greatly complicates the adolescents ability to objectify parents.  Placed adolescents do not compare abstract parents.  They live trapped between two sets of parenting figures; their own parents, either as experienced or as imagined, and foster parents.  Moreover, the discrepancy between the idealized parent of childhood and the objectified parent is usually greater for foster children than for children who are raised by their own parents.  When combined with changes in the belief system inherent in an adolescent’s cognitive development being in placement frequently forces a premature and too rapid awareness of parental limitations upon the adolescent.

The effect is similar to the process called “treatment shock” which refers to the shock of a therapeutic and nurturing environment on a deprived child.  The child’s denial of parental limitations is suddenly overturned, and the child’s former view of the world no longer exists.  Treatment shock is characterized by mass evacuation of anger, a fear of closeness or love, and unrealistic longings for more than can be (Redl and Wineman 1957).

In the case cited earlier, John’s behavior involved venting of hostility, fear of closeness to his foster parents, and unrealistic longings for love from his mother as well as his foster parents; he expected love and approval from all his parenting figures no matter what his behavior.  Both treatment shock and re-mourning involve the same dynamics.  Treatment shock, however is caused by a shift in environments; re-mourning is caused by a shift in cognitive abilities.  Both, however, involve uncertainties about the quality of parental love.

The concept of love is abstract and cannot be thought about by the pre-adolescent child.  For example, a pre-adolescent child does not really understand the golden rule.  When a pre-adolescent child who has been hit by another child is asked what action the golden rule suggests, the response will likely be to hit the person back.  Thinking of an alternative is too abstract a task for the pre-adolescent.

An adolescent can, however, think about the true meaning of loving behavior and can interpret the golden rule accurately.  The adolescent can think about love as not wanting to hurt the beloved even in the face of hurt from the beloved (Kohlberg and Gilligan 1972). This change in the ability to think about love imposes new hurts on adolescents as they struggle to explain why they do not live with their own parents.  Adolescents can see that their parents have hurt them, and this recognition leads them to question whether or not they were loved.  Re-mourning has begun.

The Re-mourning Process

Re-mourning follows the same process as mourning proper: a period of denial, a period of strong feelings, and a period of acceptance.  The major loss of love being experienced during the re-mourning process, however, is a loss occurring in the child’s mind as a result of increased cognitive abilities.  It may or may not reflect an actual change in life events.

 Denial

The pain created by realizing for the first time that placement means being unloved is immense and cannot be immediately tolerated.  Regression frequently accompanies pain.  The regression that results from a foster child’s recognition of parental limitations most frequently leads to a rebound denial; biological parents, particularly if they are absent, are idealized.

Despite the re-mourning adolescent’s efforts to deny parental limitations, the pain remains; the foster child cannot completely discount the parents’ absence and a growing awareness of their limitations. The denial is incomplete. The adolescent is forced to explain feelings of hurt and uncertainty in a way that does not add to growing doubts about parental love. As adolescents look about for a cause or an explanation of their current uncertainty and pain, often their eyes first light on the foster parents, who are, after all, there. Moreover, there is a strong human tendency to view two simultaneously occurring events as sharing a cause- and-effect relationship.

The adolescent is aware that being in foster care hurts. The pains of being a foster child justify, in the adolescent’s mind, making the foster parents targets for retaliation. The combined idealization of parents and concurrent denigration of foster parents is a clear indication that re-mourning has begun; it is important to remember that the adolescent’s changing thoughts are not sufficiently developed to permit an understanding that the felt rage is displaced anger created by past parental wounds, the uncertainty of shifting beliefs, and the breakdown of denial surrounding the biological parents’ limitations.

Similar dynamics operate in some of the adoption breakdowns that occur during adolescence. As one adolescent, placed in foster care because her adoptive parents were unable to tolerate her acting out, explained to her social worker: “When I was a kid, I thought my adoptive parents were the most wonderful people in the world. Now I wonder how I could have been so blind. All the things I’ve done. I’ve done because I can’t stand my adoptive parents any more, just looking at them makes me angry.”  A number of months later, when this girl was able to consider her anger toward her biological mother, her anger toward her adoptive parents began to ease, and eventually she was able to return to her adoptive home.

The adolescent’s initial tendency to blame foster parents is exacerbated by the fact that, as suggested earlier, the nurturing from the foster parent often becomes salt in old unhealed wounds.  One youth placed in a short-term foster home asked his foster parents repeatedly to treat him more harshly. “You’re nicer to me than my parents, ” he said. “That hurts. Get meaner. You’ll see that I’ll calm down.” It is a little understood and perverse fact of any foster parent’s life that normal nurturing can become a constant reminder for some placed children and adolescents of their birth parents’ failures. The very acts the foster parents believe will comfort and aid a foster child may only increase pain.

Moreover, living with nurturing parents forces adolescents, particularly if they have previously experienced abuse and neglect to endure a component of treatment shock called “Starvation Hunger in The Promised Land” (Redl and Wineman 1957). Even as adolescents are undergoing a major belief system change—coping with feeling betrayed by their parents and learning to deal with parental limitations—they also yearn to take advantage of the gifts of love and affection being offered by foster parents. As adolescents realize their needs have not been met, they feel like the starving man, who suddenly finds himself in a four-star restaurant with unlimited funds but a seriously shrunken stomach: he tries to satisfy his hunger; he asks for more and more, but the more he eats the more he sickens. Adolescents who try to glut themselves on foster parents’’ offerings eventually fall victim to the realization that strangers are offering more love and nurturing than biological parents. This realization traps the adolescents between betraying either their own parents or their own wants and needs.

The loss of the placed adolescent’s idealized view of biological parents as well as the loss of their physical presence is deeply traumatizing. Moreover, the adolescent’s identity rests on identification with biological parents, and the loss of them as caring persons strikes a painful blow to the adolescent’s feelings of self-worth. The hurt and rage the adolescent feels can reach monumental proportions; strong feelings can run dangerously high.

Strong Feelings

Re-mourning’s second stage, the stage of strong feelings, is marked by acting out. The adolescent, with increased cognitive abilities, is better able to assess whether the punishment experienced fits the crime. Since placement is felt to be extreme punishment, the youth believes he or she must have been very bad to deserve such a fate. Such thoughts can lead to extensive acting out as the adolescent tries to document the badness in order to justify parental rejection. Frequently, the acting out not only documents the youth’s badness but, particularly when taking risks or substance abuse are involved, simultaneously helps numb the pain.

Moreover, the angry behavior can be used to force foster parents to became cold and rejecting. If all parents are bad, then the adolescent’s parents are not unusual. “All parents are alike, they all care more about themselves than their kids,” observed twelve-year-old Mary to her social worker, as she was being moved from yet another foster home. Mary’s mother placed  her when conflict developed between Mary and her stepfather. Within six. months of placement, Marv had lived in three different foster homes. With uncanny psychological discernment, she discovered the one piece of behavior that each family found impossible to tolerate. In her first home, Mary had repeatedly stolen from the foster mother and a number of the foster mother’s friends. This behavior was upsetting to the foster mother, but she was able to tolerate Mary’s stealing until it spread to some local stores. When Mary was arrested for shoplifting, her foster mother asked that Mary be re-placed.  Mary was then moved to a Jewish foster home, where she proceeded to spray-paint swastikas on both the inside and outside walls of her foster family’s home.  She was placed with yet another, this one noted for being able  to work with difficult teenagers. Mary managed her move from this home bv sexually assaulting the foster parents’ three-year-old niece. By forcing her various foster parents to reject her, Mary proved to herself that rejection was the norm. Her familiar view of the world was maintained, and any uncertainties created by the differences between her various foster parents’ and her own parents’ treatment of her were thereby resolved.

These interlocking issues of intensified self-blame, displacement of feelings, and rationalization underlie the acting out of many placed adolescents experiencing the re-mourning process. The acting out creates even further difficulties, since it usually generates guilt and the concomitant need for punishment. Unless a punishment acceptable to the adolescent is forthcoming, both the existential and guilt-related anxieties and uncertainties increase.

The re-mourning induced acting out can become circular and self-feeding.  Adolescents act out to prove their badness, to numb their pain, and to force their foster parents to reject them. As guilt over the acting out and displaced anger increases, the acting out also comes to serve punishment needs. Severe enough punishment will ease the adolescent’s conflicts temporarily. However, if punishment is not forthcoming, the youth’s uncertainty and guilt intensify, leading to increased acting out and increased guilt, anguish, and uncertainty.  Adolescents can become frantic in this circular repetition of efforts to explain the losses and hurts of their lives.

 Acceptance

Adolescents can make peace with their status only when they ultimately say: “Yes, my parents, no matter how much they may love me, hurt me.”  Resolution means accepting things as they are (Jewett 1982). It has occurred when the past can be recalled without undue anger or grief. Achieving this is not easy. Just as mourning is not accomplished in finite stages, re-mourning involves moving back and forth among the three stages.  Denial slowly turns into recognition of the loss and hurt. Strong feelings emerge, but the pain cannot be endured, and denial is thus resurrected. Eventually, as the pain can be tolerated, the strong feelings predominate, and moments of acceptance begin to occur. Gradually, acceptance begins to predominate, and eventually it is reached.

“My anger and hurt just wore out” was the way one articulate foster child described her movement into acceptance.  “I figured my social worker was right when she pointed out my parents had done the best they could and I should try to think about that and go on from there. With her help, I stopped raging. 1 tried to think about the few good times we had and that helped me get on with my life.”

Another described it this way: “The hurt and anger slowly dried up, and one day I realized they were gone.  I kept going to see my social worker, but I didn’t want to talk about the past anymore.  I had more important things to do with my life than to keep looking back.  I have scars, but the big hurts have healed.  I survived my parents’ limitations, and maybe I’m even stronger because of their problems.”

Not all youngsters articulate such feelings. For less verbal youngsters, acceptance has occurred when behavior becomes less controlled by strong emotions. The angry acting out subsides, the grief lessens, and the calm periods become longer, until it is eventually clear that the youngster is moving forward with his or her life: the past has been accepted both intellectually and emotionally.

Helping the Adolescent Re-mourn Childhood Losses

There are a number of ways the adolescent can be helped to re-mourn childhood losses. Traditional supportive approaches are useful. Some adolescents are helped by verbally reviewing their past or by the use of devices such as life lines (Court 1980) or life books (Backhaus 1984), both of which highlight important personal events.  Others need to ventilate and talk about their painful feelings. The picture becomes more complicated when re-mourning takes the form of intense acting out.

As long as discharge of feelings can be accomplished by way of acting out, the youth will not face underlying conflicts.  Mourning requires that the pain be experienced if acceptance is to be achieved.  Because the acting out serves to prevent pain, containing it is not always immediately possible.  Unfortunately, the acting out of an angry adolescent is difficult to tolerate; once re-mourning begins, the current foster care placement may be threatened.

Preserving the Placement 

The first task facing the practitioner is preserving adequate placements. Foster parents frequently become targets of the re-mourning adolescent’s anger and hurt, and it is imperative that they be helped not only to understand the re-mourning process, but that they be supported and sustained while the acting out is running its course.  This approach will not be easy; the re-mourning adolescents acting out creates issues of uncertainty and powerlessness in the foster parents.

 Limiting Blame

If the youth needs to force rejection, the foster parents are essentially out of control as parents, leading to feelings of failure, uncertainty, and a need to find someone to blame.  Foster parents can often blame the adolescent, any and all former caregivers, including biological parents, the social workers, and each other.  But blaming only provides a temporary release from the uncertainty created by living with an angry, blaming adolescent. Moreover, if too much blame is assigned to the adolescent, not only is the placement endangered,  but so is  the child’s ongoing relationship with the foster parents.

Once a re-mourning adolescent begins to act out, maintaining the existing placement demands the existence of a strong alliance between foster parents and social workers.  Social workers need to understand their role regarding foster parents and acting-out adolescents; the latter will want the social worker to join in blaming the foster parents. Simultaneously the foster parents may want the social worker to join them in blaming the adolescent.  Blaming either merely perpetuates problems.

Instead, families can often be helped by the social workers use of an educational approach, which includes encouraging foster parents to see the youth’s behavior as part of the grieving  process with an emphasis on the word process.  This knowledge allows the foster parents to see the acting out as a positive and necessary step to resolution of grief. And while it is in the best interest of youths to help them to contain their hostility, foster parents will also be helped to understand the value of the anger.

Social workers can also help angry adolescents and foster parents to cease blaming each other by clarifying the difference between “good enough” and failed parenting.  Most parents are “good enough” parents (Bettleheim 1987). A failed parent often feels love but does not translate that love into minimally appropriate behavior.  Failed parents are parents who assault, severely abuse, abandon, or severely neglect their child. The fact that most abused and neglected children do not know what normal family life is can lead them to expect too much of foster parents and to assign blame whenever foster parents fall short of the child’s expectations.

Practitioners can also overstate the foster parents’ role in creating the re-mourning adolescent’s acting-out difficulties, thereby implying their failure.  To determine that the foster parents are “good enough” parents, it is useful to recall the foster family’s level of functioning before the acting out began. When the foster child and the foster family have shared a positive relationship before the onset of adolescence, the most helpful stance for the practitioner is to view the problem as related to the re-mourning process. The cause of the acting out lies in the adolescents handling of painful feelings; when the youth has worked through the feelings, discord within the foster home usually fades.

Relieving Guilt

When it has been determined that the foster parents are “good enough”’ parents, direct efforts to relieve their guilt are often useful.  Sometimes just knowing that acting out has a name and a purpose relieves the foster parents and stabilizes a deteriorating placement. Such relief permits the foster parents to stop personalizing the hostility.  If the foster parents are going to be able to avoid becoming enmeshed in the adolescent’s acting out they must learn to see the youth’s anger as separate from them, as illustrated by the following example.

Mr. and Mrs. Green had reached the point of despair regarding their ability to maintain thirteen year old Delphine in their home.  She had been in their care for three years and was being freed for adoption: the Greens had hoped they could become her adoptive parents.  But after two years of positive adjustment in the Greens’ home,  Delphine had begun to pick fights with them.  The fights always ended with Delphine’s running to a friend or a neighbor’s house or, on occasion, to the local police.  During these episodes Delphine had the friend’s parents or the neighbor or the police intervene on her behalf with the Greens. The Greens were threatened and embarrassed by constantly being forced to explain their behavior.

Moreover, in response to Delphine’s provocations, the Greens had violated their personal standards of good parenting.  One or the other had yelled and both Mr. and Mrs. Green believed raised voices were a sign of failed parenting.   Despite the efforts of their social worker to be supportive, the Greens were enmeshed in Delphine’s acting out.  They felt guilty: Delphine sensed their guilt and this exacerbated her uncertainty.

Fortunately, at about this time,  the Greens and their social worker both attended a foster parent training session in which re-mourning was discussed. During the discussion period that followed the presentation, Mrs Green broke into tears of relief.  She said later told her social worker, “Just knowing we weren’t to blame gave me the strength to go on.”  Following the training session, the Greens connected with a Tough Love group.  The support of that group helped them cope with Delphine’s acting out.  Eventually Delphine was adopted by the Greens.

Overcoming Anger

In a recent study of cognitive-behavioral interventions for reducing parental anger in the face of perceived provocation by children helping the parents maintain empathy with the child’s feelings was deemed important. Another finding of this study suggests that problem solving directed toward the control of parental anger is also useful; the use of cognitive restructuring and problem-solving skills appeared to be of definite value in alleviating parental anger (Whiteman et al. 1987).

The case of Delphine and the Greens offers a good example of the importance of a cognitive restructuring approach:

As long as the Greens believed Delphine’s behavior was proof that she did not care for them, their frustration grew. As they understood that her behavior was a displacement of anger created by earlier hurts and had more to do with her growing awareness of her own parents’ limitations than with feelings about them, the Greens were able to defuse their hurt and understand Delphine’s pain. A cognitive reframing of their beliefs led to their willingness to learn how to deal more appropriately with Delphine’s provocations.

Anger can also be managed through the use of time-outs, thought-stopping, and barb training.  The time-out is a frequently used behavioral device that can prevent reinforcement of angry or aggressive behavior; it usually involves removing the aggressor from the scene of the aggressive behavior. A simplified version of a  time-out involves an agreement between two angry persons to take a break from discussing a problem because when anger is mounting a cooling-of period is indicated. More complicated time-outs involve contracting with a youth that certain aggressive behaviors will signal a time-out, during which he or she will be expected to go to a quiet and unrewarding place for a specified period of time.  If the youngster’s behavior continues to be unacceptable, the time-out period can be extended (Barth 1986).  Both Delphine and the Greens were taught to call a time-out when either felt they were reaching a boiling point in their efforts to deal with her difficulties.

Thought-stopping involves identifying dysfunctional thoughts encouraging the individuals to think those thoughts and then signaling the individual to stop usually by yelling the word  “Stop:” Eventually, the client is able to stop the dysfunctional thoughts without outside help (Martin and Pea, 1988).  Mr. and Mrs. Green were taught to say a loud “Stop!” to Delphine whenever she began castigating them or saying they did not love her. They were also told to follow their command to stop with a strong statement about their love for her. Eventually, Delphine connected her anger to feelings of being unloved and was told to remind herself when upset: “The Greens care about me.”

Barb-training involves desensitizing individuals to anger-creating situations and, most particularly, to dysfunctional reactions to criticism.  Youths are advised to maintain eye contact with the barb deliverer,  to keep a neutral or pleasant facial expression, to respond in a calm tone of voice, and to develop and carry out a plan or action that will eliminate the problem. Role-playing is used to rehearse the individual in handling barbs.  The next step is helping the individual to handle barbs from an increasing number of individuals (Barth 1986). These techniques can best be taught through a small-group, problem-solving approach that allows time for skill building and then supports the maintenance of new skills once they have developed.

Placement Disruption

Sometimes disruption cannot be avoided. In John’s case, his displaced anger at his parents resulted in his demanding that he be replaced. Fortunately, he had a social worker who was prepared to use the disruption as a way for John to mourn his losses, while deepening his relationship with his foster parents. The foster parents were helped to sustain their interest and concern in John because Mr. Smith, the social worker, understood the Browns’ need for guilt relief.  Mr. Smith made it clear to the Browns that John’s request for re-placement indicated his difficulties in handling his mother’s limitations and was not an indictment of the Browns’ ability to provide good care;.

Moreover, Mr. Smith ultimately made the decision that John needed to be placed in another foster home, since he believed it was not possible to maintain an adolescent in a foster home when the adolescent has decided that he wants to live somewhere else and is willing to act out in order to achieve re-placement. In those situations planned intermittence is generally preferable to an acted-out disruption.

The decision to replace a foster child is never easy. Too often the entire burden rests on the foster parents. As long as the foster parents are willing to tolerate the acting out, the general pattern seems to be to not disrupt the placement. Failure to purposely disrupt placement, however, may allow the acting out to reach the point where the relationship between the adolescent and the foster  parents is breached.

Disruption Criteria

As reluctant as most professionals are to re-place an acting out adolescent, re-placement or temporary intermittence of a placement should be considered when the following events occur simultaneously: (1) the youth is requesting a re-placement; (2) the youth’s acting out is continuing to escalate in the face of reasonable counter-measures and (3) the youth is using drugs or alcohol abusively, is endangering his or her physical life by taking risks, or has committed violence against property and now threatens violence against individuals.

Although re-placement should not occur precipitously, some youths caught in the agonies of re-mourning might well be helped through a cooling-off period in a treatment facility or in a temporary foster home.  And surely planned intermittence is more appropriate than waiting until the foster parents and adolescent reach the point of irreconcilable differences.

Re-Placement in Foster Homes

It is also important to note that a youth who has been removed from a foster home for acting out can be re-placed in another foster home, rather than in an institution. Distance from the foster parents can clarify for youths the source of their anger, thus helping to facilitate the grief process; indeed, some children need to be in a number of homes before resolving the uncertainty about the limitations of their parents and coping with the re-mourning process. Recent research indicates that even after a number of disrupted foster care placements, some children seemed to adjust well to a subsequent placement (Fanshel et al. 1987; Fein et al. 1983). In fact, in contrast to prevailing practice wisdom, there seems to be no correlation between the number of placements and ultimate success in the final placement (Fanshel et al. 1987). A child who has objectified biological parents and reached an acceptance of their limitations is often finally able to live with another family.

Maintaining Ties

If the way has been kept open, some adolescents can be re-united with former foster parents, as in John’s situation. Only after he had begun to accept his mother’s limitations was he able to live with his former foster family.  Mr. Smith’s efforts to help the Browns to remain emotionally connected to John maintained the possibility of return when the time was right. Throughout his work with them, Mr. Smith recognized that the Browns were clearly “good enough” foster parents. He believed their rules were reasonable and reasonably enforced. He believed their responses to John’s acting out were also reasonable.  He did not view the Browns as creating or contributing to John’s difficulties. He was therefore able to alleviate their guilt and help them to stop personalizing John’s attacks, while supporting their continuing interest in being of help. Of equal importance was Mr. Smith’s having taken responsibility for deciding to re-place John, alleviating the need for the Browns to assume the burden of deciding when enough was enough.  Consequently, it was not difficult for the Browns’ doors to remain open since it was not they who had closed them.

Once re-placement occurred. Mr. Smith maintained contact with the Browns and kept them abreast of John’s status.  He encouraged them to write John and let them know that, even though John did not respond, the letters were important to him.  Once it was clear that John was beginning to accept his mother’s limitations and to control his acting out, Mr. Smith actively worked with the Browns to accept John once again into their home.

Conclusion

Mourning and re-mourning are processes that require time.  Maintaining a longitudinal approach is essential.  Inability to offer immediate comfort is painful for both foster parents and social workers.  Whether the adolescent is mired in depression or desperately resisting it by angry behavior, caring people want to help. When the adolescent’s hurt cannot be quickly eradicated, feelings of failure on the part of the caregivers ensue.

These feeling may lead to a “dance of blame” in which all parties lose. It is the job of the  social worker to keep the blaming process from becoming circular. By maintaining a longitudinal approach, providing needed support and information, and focusing on the process, social workers can help to soften feelings of failure and the circle of blame can be avoided.  Given enough tune, old wounds may heal, and the adolescent in foster care can then move forward toward adulthood and interdependent living.

REFERENCES

Backhaus, K.A. “Life Books: Tools for working with Children in placements.” Social Work 29. (November-December 1984) : 551-554.
 
Barth, R. P.  Social and Cognitive Treatment of Children and Adolescents.  San Francisco. Jossey Bass Publishers. 1986.
 
Bettleheim. B. A Good Enough Parent. New York: Alfred A. Knoph. 1987.
 
Brenner, C. The Mind in Conflict.  New York.  New York: International Universities Press, Inc. 1982.
 
 
 
Brown,  G.W.,  Harris, T.C., and Bifuico, A. “Long-term effects of early loss of parent.”  In Rutter, M., Izard, C.E. and Read, .P.B. (editors), Depression in Young People, New York: Guilford Press. 1986. 251-296.
 
Court, N. J. “The Time Line: A treatment tool for children.”  Social Work 25 (May-June) 1980):  235-236.
 
Fanshel, D., Finch, S.’ and Grnduy, J. “Collection of data relating to adoption and foster care.” Unpublished paper.  Washington, DC; U.S. Department of Health and Human Services, Office of Human Development Services, Administration for Children, Youth, and Families, September 1987.
 
Fanshel, D, and Shinn, E. Children in Foster Care: A Longitudinal Investigation.  New York: Columbia University Press, 1978.
 
Fein, E., Maluccio, A.N, Hamilton, V.J., and Ward, D. “After foster care: Outcomes of permanency planning for children.”  Child Welfare 62 (November-December 1983): 485-560.
 
Jewell, C. Children Cope with Separation and Loss.  Harvard, MA: Harvard Common Press, 1982.
 
Kagan, J.  The Growth  of the Child.  New York.: W.W. Norton.  Inc. 1978.
_________The Nature of the Child.  New York: Basic Books, 1984.
 
Kohlberg, L., and Gillian, C. The adolescent as a philosopher.”  In Kagan, J., and Coles, R. (editors),  Twelve to  Sixteen: Early Adolescent. New York: W.W. Norton and Company.  1972, 144-179.
 
Martin, G., and Pear, J.  Behavior Modification: What It Is and How to Do it.   Englewood Cliff, NJ: Pretence Hall, 1988.
 
Redl, F., and Wineman, D. The Aggressive Child.  Glencoe, IL.: The Free Press of Glencoe, 1957.
 
Teri, L. “The use of the Beck Inventory with adolescents.”  Journal of Abnormal Child Psychology 10 (1982): 227-284.
 
Whitman, M., Fanshel, D., and Grundy, J. “Cognitive behavior interventions aimed at anger of parents at risk of child abuse.” Social Work. 32. (November-December): 469-476.
 
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