Therapy Strategies for Working with Underprivileged Youth

An Inner City School Social Worker Shares Two of His Cases

Howard Honigsfeld

Public School 48, where I’m on staff as a social worker, sits on a block between a juvenile detention center and a strip club. The school serves around 900 mostly Hispanic and African American children in prekindergarten through fifth grade, with a large percentage of those kids living in shelter apartments. Of course, PS 48 has an educational mission, not a clinical one, but I’m part of a service staff that includes speech, occupational, and physical therapists. I became a social worker because I wanted to directly address the problems---truancy, childhood depression, and the overwhelming responsibilities of being an older child raising siblings---that were keeping them from functioning well in school. My current job is to counsel children with Special Education Services, as well as to handle the daily emotional crises that arise in a place like PS 48. A week of work can be exciting, frustrating, and often hair-raising---anything but boring.

I start at 8:00 a.m., going down to the gym for morning lineup to see if anyone’s arrived sad or disheveled, so I can intervene before his or her day worsens. Afterward, I have a schedule of children to see, individually and in groups, but throughout the day, I’m regularly called when unexpected problems arise. Today, a teacher calls me soon after I return to my office, explaining that 8-year-old Shakira’s holding her stomach because her mother punched her there. When Shakira comes to my room, I start by reassuring her, as I usually do, that she’s not in trouble, and her teacher sent her to me because she’s concerned. Shakira describes how her mother got angry and struck her at breakfast when she wiped her little brother’s mouth with a paper towel instead of a rag.

It’s hard to hear about kids being abused, but I’m careful not to get so focused on her being hit that I don’t make contact with her as a person. As I ask her how she likes her class, what she likes to do after school, and what kind of music she listens to, she begins to relax.

My role in working with neglected and abused children depends on each case. In mild neglect scenarios---such as parents allowing their children to watch adult movies or play video games for most of the day---I prefer to talk to parents in a matter-of-fact way about the effects of violent and sexual images on a child’s development. If my tone is right, parents are generally thankful, although they often say little.

In more severe cases of suspected abuse, like Shakira’s, I call children’s services. Often, the results of an investigation will lead to families getting customized services, including in-home parent coaching, household assistance, and a case worker to help improve their lives. Rarely is the neglect and abuse judged to be so severe that a child is removed from the home, but sometimes that happens. I make a note to check up on Shakira later in the week, after an investigator from children’s services has visited her home.

Later that week, Jamaya walks in, sits quickly, and folds his arms. Tears start to run down his cheeks. He’s a sensitive boy, who gets upset when teased. He can dish it out, though, and often gets in trouble. Today, I give him my “Ned and Ted” talk, something out of my grab bag of tried-and-true methods that I use to get through to kids without sounding too therapeutic. I tack two cartoon faces, Ned and Ted, on my bulletin board. They’re both the same smiling picture, except Ted has no ears. I ask Jamaya if he notices the difference. When he notes that Ted has no ears, I say he just sometimes turns them off. Kids seem to accept the idea that they can choose to turn their ears off when someone’s teasing them more readily than they can accept the advice to simply ignore them. To illustrate this point, I tell Jamaya that he probably has his ears turned off to some things right now, like the truck driving by the school and people talking in the hall. “You’re listening to me,” I say, “so you’ve turned your ears off to the other stuff.” He gets the idea and is willing to try it. We high-five each other, and he skips out of my office with a smile.

Whenever I work with children, I make sure they know I like spending time with them as people and my interest in them isn’t solely focused on the problem they’re having. In our work together, I try to channel their interests and expand on their successes. I explain the main reason I’m working with them is to help them meet a specific goal, and we often talk about who in their lives would be especially proud to see them moving toward their goal. Also, I make it a priority to find something I like about a child, and then I make sure to let him or her know about these positive qualities I see. This kind of sustained interest in a child week after week is often more important than any specific technique I might use.

When I return to my office, there’s a message from children’s services about Shakira’s case from Monday. The abuse allegation was determined to be unfounded: evidently she’d made similar, unsubstantiated claims in the past. With a start, I realize that I’d forgotten to check in with her again. I leave a note with her teacher for Monday, asking that Shakira see me after morning lineup. It’ll be the start of a new week, filled with the inevitable crises and challenges, but also with the smiles and small accomplishments that come each day at PS 48.

This blog is excerpted from “A Suicide Note in Crayon." Want to read more articles like this? Subscribe to Psychotherapy Networker Today!

Topic: Children/Adolescents

Tags: neglect | psychotherapy | social work | social worker | therapist | therapy | rapport | networker | humor | domestic | inner city | schools | teacher | mentor | mentoring | neglected | children's services | child services

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