House-guests

This summer and fall have been filled with a constant flow of overnight house-guests.  Second week of July, my good friend from Texas, we'll call her "Texas Ninja".  She brought a friend with her the first few days and then her other friend drove in from Iowa for the weekend.  For that visit, Texas Ninja slept on the sofa, and I borrowed a friend's air mattress for the spare bedroom for the Texas Ninja's friends.

Then came "California Drummer" for a weekend in August.  Meanwhile, I was also in the midst of the homestudy process for becoming licensed as a foster parent/home.  So when my father came for a two-week long visit at the beginning of September, I rushed out to get a twin bed the night before he arrived (I hadn't had any bed for my spare room and they stated it would be required prior to my last visit and licensure).

"Roomie" stayed with me for the second week in October, followed by "Redmond Homemaker" with her dog from the 20th to the 25th, and "Omaha Marrieds" for the weekend following.  Needless to say, I am happy to finally have the place to myself with no prospective visitors on the horizon as I settle into hibernation mode for the imminent long Chicago winter.

A year ago I never thought I could live by myself.  Ever since moving away from home after high school to go to college I have always had roommates.  The thought of living by myself scared me.  I thought I would isolate myself, become depressed.  The thing that motivated me the most to get a place of my own was the hope of filling that empty space with that of a foster child.  But it's been nine months now of having my own place and I am still on my own.  And I absolutely love it!

While my father was here for two weeks and I found myself emotionally drained and barely able to function, I wondered, "How will I ever do this when a child is staying with me?"  In these short  nine months I've grown so used to being on my own and having my own space that I'm not sure how I will ever adjust to the change.

It seems that the spring was used as my nesting period, my getting used to living on my own and creating a comforting home environment.  Summer and fall and the revolving door of house-guests were prep for sharing my space with a child.  It really hasn't been all that bad.  In fact, part of the greatness of having my own place has been the flexibility to have people stay over.

In my previous four years of living in Chicago, I have never had such a constant flow of visitors.  Never before has my father been able to have such a long visit due to overstaying his welcome in a roommate's home as well.  It feels good to have the home and stability to provide housing for my guests.  And now I have it to provide a foster child too!

A Place Somewhere In Between

When I first got my job at the hospital I was commuting about an hour each way on a good day.  After a commute home of 3 hours in a snowstorm on a bad day, I was fed up, I needed to live closer to work.  As a therapist dedicated to my job, I needed something both convenient and affordable due to entry level wages and horrendous student loans.

Since we are a low-income hospital that borders one of the poorest sections of the city, there is a substantial amount of affordable housing around the hospital.  That being said, it can also be a bit sketchy, and can get a little tricky finding the balance between affordability and safety.  A little too far in one direction and the rent triples, and continues to rise as you go toward increasingly more desirable neighboorhoods.  However, if you start going in the other direction, the prices fall drastically while the number of shooting fatalities listed on the police reports skyrockets.

Somehow, I was able to find my balance with an apartment I could afford, on a street that I feel safe, with a short 5-10 minute commute to work.  The point of all this being; I'm not actually "within the thick of it."  If I were within the thick of it, I would be on the other side of the hospital, afraid to leave my house at night in what some of my patients experience on a daily basis.  If I were within the thick of it, I would be doing everything in my power to kick my cocaine addiction and still not be able to turn my back on it.  But in reality, I only get to hear their filtered stories, and in that respect I am only an "outsider looking in."  I hear their stories and then return to my sheltered life and my cozy little apartment where I'm nowhere close to the thick of it.

Instead, I am in a place somewhere in between.  Geographically, I live with a primarily hispanic community directly south of me, with a less affluent black neighborhood just west of me, a gentrifying white population to the north, and another burgeoning white community to the east.  Just in my 5-unit building alone, we meet all the demographics of the community surrounding us.  Directly adjacent to me, the early 20s artistic, white, hipster roommate pair; below them the newly-wed, also employed in social services couple; in the basement, a latino couple with a baby; and below me, our token black man.

I spend my evenings in an apartment somewhere between the wide diversity.  I spend my work days amongst people below the poverty line.  And I spend my weekends socializing with other privileged white folk.  Though, because of the field I chose, I may not make enough to live in a fancy neighborhood, I am able to live comfortably enough not to have to worry about where I will get my next meal.  In that respect I am somewhere in between the rich and the poor, the minority and the majority, those turning a blind-eye and those within the thick of the poverty.  Somehow, I am able to find my balance in a place between the two.

How about you?  Are you on the front lines and within the thick of it, someplace in between and an outsider looking in, or are you turning a blind eye?

Placement Call

I got another foster care placement call this week.  Somehow saying no was easier this time than last.  Again, she didn't fit within the confines of my "ideal" child mold.  An 11 year-old girl needing a transitory home between her current foster/adoptive family and going home to her biological mother.  Even before speaking to the social worker in further detail, I had a feeling about the motives for the move.  The girl wanted a home where she did not have an attachment to the caregiver so she could reestablish loyalties to her own mother.  So rather than the role of teacher/therapist as I'd hoped, or parent or attachment figure as it would be with the two young children, I would be expected to be in yet another role, more of a friend, at a minimum of an arms length away, nonetheless.

My thoughts were taken back to my own 11 year-old self and remembering how hard my life was even as a child that had not experienced much trauma at that time in my life.  Remembering how volatile my relationship with my mom was even without having a bunch of other foster mothers in the picture too.  Take my feelings of not having my mother as there for me as I would have liked and magnify it by 100 for me to even imagine what this child might be going through.

I had to admit to the social worker that I was a bit triggered.  What happened to the girl that when my parents got divorced at that age wanted to reach out and help others going through similar experiences? When did I become so afraid of pubescent girls?  Probably, just in having been one and knowing how awful I was and not wanting to have to deal with one of me.

Part of me wonders if it might have been good for me.  If I might have been able to work through some of my fears and my own mommy issues.  Another part of me wonders if I'm really not as ready as I thought I was for this and I'll just keep turning down the kids one after another.  But I have to hold on to the hope that the right kid will come along, that there will be a child that I am my most stable self with and that I will still have my own personal growth in that strength, stability, and vulnerability.

What do you think?  Did I make the right decision?  What are your experiences parenting or being 11 year-old girls?  How have your mommy issues effected your decision to be a foster parent?  How does the relationship you have/had with your mother effect your parenting skills?

Deinstitutionalization

We are all well aware that the two systems within which I work are broken.  Mental health/Medicaid system as well as the child welfare system have definite deficits.  Through my process of working in them, I've wondered how they've gotten this way.  What happened to the lunatic asylums and the orphanages that used to house our mentally ill adults and despondent children?

From my internet research I don't find any clear law or act that got rid of those kinds of institutions all at once.  It was all pretty gradual, perhaps first initiated with the Social Security Act in 1935.  And in the 1950s psychotropics came out and greatly reduced the symptoms of mental illness.  In 1963 Kennedy was able to pass the Community Mental Health Centers Act.  He had a special concern with those with mental illness because his own sister had been lobotomized in her early twenties.  Also in the 1960s, the Federal Aid for Families with Dependent Children legislation provided funding and services for preserving biological families and preventing children from being placed in orphanages.  The premise of these two legislative measures was on track, provide services for individuals needing care within the community rather than locking them away in institutions.

Those of you educators out there know the common phrase, "least restrictive environment."  That was our hope with deinstitutionalization, provide environments that were less restrictive and envelop those with disabilities into the community at large.  But somehow, we've let individuals fall between the cracks and are not providing those environments for them.  There are people with mental illness not receiving the proper after-care services, floundering in the broken system.  There are children in the welfare system jumping from one home to another in our efforts to provide them a less restrictive home environment setting.  Though we may have gotten rid of a lot of the evil institutions, it doesn't mean that the people that were in them no longer exist.  They still need our help.

If interested, find out more about:
A legislator whose "reforms" he worked on worsened his son's life (excerpt of this article also published in Washington Post) by Paul Gionfriddo, author of blog entitled, Health Policy

the high concentration of people with mental illness in the Uptown area of Chicago, and

the rise and demise of the American orphanage

My 9-5 Job

In everyday life, I don't often talk to people about my work.  It just feels complicated, like it's too hard to explain and people would never really understand.  Going into graduate school I never pictured myself in the setting in which I currently work, in fact, I don't even think I knew it existed.  I'd mentioned my motivation for going to grad school in an earlier post: I wanted to help children who were having emotional/behavioral problems due to abuse and neglect.  Once getting to grad school I realized that the majority of the entry level positions for expressive therapists in the Chicagoland area were in inpatient psych (psychiatric) settings.  So after graduating and struggling to find work in the field for a year, that's where I found myself, inpatient psych.  It's been almost a year since I started working as a therapist at a small neighborhood hospital which provides health services to low-income families.  I work on the hospital's small (24 bed and 12 bed) inpatient psych units, adult and geriatric, no pediatric psych unit at my hospital.

If you all are anything like I was prior to entering the field, most of your understanding of "mental institutions" has been through Hollywood and movies.  You know One Flew Over the Cuckoo's Nest and Girl, Interrupted, etc.  There are definitely aspects of those movies that are somewhat reminiscent of what my job is like.  There is always at least one extremely interesting character on the unit that keeps things highly entertaining.  There are occasionally restraints, but there are no straight jackets and we try to keep them restrained as short a time as possible.  People don't exactly line up at a window to get their medications, however the reality is that medications are pushed and most people spend the first couple of days of their hospital stay in a daze as they adjust to their meds.  And yes, there are psychotherapy groups where the patients sit around talking and confronting one another on their stuff but those are usually pretty rare and hard to facilitate.

Gone are the days of people being carted off to the insane asylum when they have some kind of mental break.  Psych hospitalizations are typically only five to seven days at my hospital.  People have barely enough time to be minimally stabilized on medications before being discharged back into the community.  And as I said before, the first 3 days of that week long stay is spent sleeping and the next 3 days is spent counting the hours till they can get out of there.

People come into our hospital for all different reasons and there are people of all different functioning levels, backgrounds, and race.  In order to be admitted, they must have a psychiatric diagnosis though often just  for labelling and insurance compensation purposes.  We have people ranging from our "frequent fliers," those that come in often with whom we are well acquainted, to first timers who have never experienced a setting anything like this.  We have people that are homeless knowing all the right things to say to get them a bed and 3 meals for the week.  We have individuals that are drug addicts who used all their public assistance money on substances and need medications to curb the withdrawal symptoms until they get their next check (also knowing the right things to say to get hospitalized).  We have patients that are severely depressed and have attempted suicide.  We have all ranges of schizophrenia, from people with acute psychosis who are in catatonic states to high functioning individuals who have auditory hallucinations that they can tell you about rationally.  We have people with bi-polar disorder, severe anxiety, delusions, and paranoia.  We have sex offenders, ex-cons, prostitutes, people that have been shot in the head, and people like you and me.  All individuals with individual life stories and individual problems.  My job is to hear, understand, and have compassion for those stories.

As you can imagine, there's not a whole lot of therapy that can happen in a week long hospital stay.  We as therapists, meet with each of the patients to do their assessment within the first 72 hours of their hospital stay.  Meanwhile, the patients also meet briefly with their psychiatrist, their nurses monitor their medications, the social worker meets with them to discuss their discharge plan, and we have Mental Health Counselors on the floor who provide for their daily needs.  Often times, they refuse to meet with us therapists and have no interest in any kind of therapy.  So that may be the only interaction I have with a patient. 

My primary role is leading groups.  I have to take all those people who have completely different problems and come from completely different walks of life and somehow make them a cohesive group.  We try and do at least one talk/process/psychotherapy group a day where we discuss what brought them into the hospital, how they can stay out of the hospital, and encourage them to seek therapy after they get out.  But getting a bunch of people so different to connect means we must be creative with our therapeutic methods.  We utilize music, art, and if I'm lucky, dance and movement to help patients understand and connect with one another.  Then I go sit behind a computer and chart about it.

So that's my job in a nutshell.  I lead groups, I occasionally meet with individual patients, I chart on my interactions, I go to meetings, try to get along with all my crazy coworkers, and hope that at the end of the day that I have made at least one small snippet of difference in at least one patient's life.


Check out some movies about mental illness.

Saying No

My first foster placement call came a few weeks ago, prior to being licensed.  During preparation for the licensing they continually ask you what your ideal candidate would be for placement.  I had that rehearsed and figured out, "A boy under the age of 8, probably African-American, with a permanency plan goal of return home."  Why a boy, they would ask, most single woman your age prefer girls?  "Girls are too much drama, I want a child that is more straight forward and will go ride bikes with me and go play outside."

I imagined an aggressive child with a lot of behavior problems in which my patience and experience as teacher and therapist would come in handy.  They had us do exercises in which we would picture our lives  with our "ideal" child.  I picked that age because he would be young enough for me to be bigger than and manage but that he would also go to school while I worked during the day.

But in reality, your "ideal" child does not just appear out of nowhere.  It's not like going shopping or even like going to an animal shelter where you can scan the crates for just the right dog or cat that will fit right in with your family.  They call you regardless if it is "ideal" when they have a family in crisis and a child is in need of a stable home.  I certainly was not prepared for that and most definitely not prior to being licensed.

Nonetheless, I was contacted,  "We have a sibling pair, a four-month old baby boy and his 3 year-old sister who have been at the shelter for the past month waiting for placement.  They are Caucasian which may have been what made them difficult to place.  We can put a rush on your license and see about placing two children with you rather than the one if you are interested in taking them."  So the initial reaction of myself and many I talked to: "A FOUR-MONTH OLD!!!"

After my initial shock, I started imagining what my life would be like.  I would be dealing with night-time feedings and trying to get two small children up and to day-care prior to getting to work and then picking them up, feeding them dinner, and bedtime drama on top of my already draining work environment.  But I was also imagining myself in a role unlike the one I was picturing in with my "ideal" foster child.  Rather than teacher/therapist, I would become an instant "parent" and attachment figure to two very small impressionable children.  I would see a baby develop from infancy on into toddlerhood.  Not only that but I would be assisting in making sure that these little ones continued to  maintain a relationship with their mother who would be doing everything she could to get them back.  It was then that my maternal desires started kicking into overdrive and even before meeting these two little children I was falling in love with them and their mother who had just lost them!

I was ready and willing to take them in but others that I talked to about the prospect were still in a state of shock.  They tried to talk me out of it with realistic expectations of what I was about to walk into.  There was little opportunity for them to gradually come to the state of acceptance and understanding of the situation.  The placement would need to happen immediately, like within the next 48 hours.  It took all by power to call the social worker back, "I regret to inform you that I will not be able to take these two children in."

I was absolutely heartbroken!  Before I even met these children and I was having the hardest time letting go.  It is so hard for me to accept the fact that I will not be able to save every child, that there are a lot of children out there needing stable home environments, but that it is not my responsibility to take them all in.  I have my strengths and weaknesses and placing a four-month old and a three-year old with a single woman who works full-time was probably not in the best interests of the children or for my own sanity.  Sure, I could have done it, I could have somehow managed and been a good temporary mother.  But the timing just wasn't quite right and there's the possibility that I will be the "ideal" placement for some other child down the road.

Of course, one of my questions for the social worker at our last home visit, "Did you place them?  Are they in a good home?"  I was reassured by the fact that she had placed them.  It was not my responsibility, there were other people out there that could hopefully provided a better home than I.  I also asked about the process, "Is it just like this for every placement call?"  Surprisingly, I was a little disappointed by the answer.  The agency I went with does not typically get these kind of immediate return home placement type of contracts.  She told me, "Only about once a year do we have a situation like this one."

So what if I missed my opportunity?  What if my "ideal" child never comes along?

For those of you readers who are also foster parents, what was your placement call?  When was the first time you said no to a placement?

My Newest Endeavor

Ten years ago, the summer of 2002, I took a class entitled Child Psychopathology.  The professor, was a stereotypical looking psychoanalyst, you know, the bearded Freudian type that you see in movies.  Only this wasn’t a movie, he told real life gut wrenching stories about real life children. 

The first day of class he started out by stating that he grew up in a “foster home.”  He then proceeded to let it come out gradually that he was not a foster child himself, but that his biological parents took in numerous children in their home throughout his childhood and adolescence.   These experiences shaped him and motivated him to become a psychologist and his stories in turn impacted and inspired me in such significant ways that I write about it today, some 10 years later.

I had some additional exposure to foster care through student teaching, also in college.  A little girl who was a foster child in a large family was in the kindergarten class in which I worked.  She had one final visit with her mother before her mother had to relinquish all parental rights during the time I worked in that classroom.  In the Head Start classroom I taught in next, I wanted so bad to just take home one of the little girls who always showed up so dirty and hungry. 

Another one of the little girls had horrendous behaviors after having been separated from her mother early on in her childhood.  Though she lived with her mother then at age 4, the earlier separation had been damaging to their attachment and her ability to relate to anybody.  Yet she was one of my favorites.  There was something about providing structure, love, support, discipline, and care to children that so desperately needed it that made me feel so fulfilled.

After college, I had my own classroom, and became acquainted with more four year olds having experienced more trauma in their short lives than I have at age 30.   Another foster child, a little girl and her little baby brother who had an amazing foster mother.  Another one, transitioning into our classroom after having been at a therapeutic preschool due to her sexual abuse and resulting behaviors.  Two different boys living with their grandmothers after witnessing deaths of their respective parents. 

I wanted to do more for these children than I could as their classroom teacher.  I decided to move to Chicago and get my masters degree.  I again choose internships that would provide me the opportunity to work with similar types of children and families.  One of my first clients was a family with 4 foster children under the age of 5.  The foster mother wanted us to work with the kids because of their behaviors.  But the main problem was in the parenting, or lack thereof, of the mother.

I will be the first to admit that there are many problems with our foster care system.  There are people that are in it for the money, though there really isn’t much money involved.  There are people that are ill prepared even if they do have the best intentions.  Often that is what leads to multiple placements and compounded traumas of many children in the system.  Working with those children was my second internship at a residential treatment center for children and adolescents.  Most of the children there had had upwards of 8 different foster home placements prior to being referred to the treatment facility.  If you ask me, that’s a whole lot of rejection and reason to have major emotional and behavioral problems.

So why is it that the people on the front lines have the least amount of training and education?  I realize that book smarts is not everything and that they do have a lot of required training in order to get licensed as a foster parent.  But I can’t help wondering if I might be able to do a little better.  I can’t help wondering if the little guy I wrote my thesis on and worked with at the treatment facility might have turned up with less problems if he had been placed with someone like me to begin with.  I can’t help but wonder if all my experiences, my education, my care and concern might be really great for some family out there needing to get back on their feet.

So all my wondering is finally coming to actually seeing.  Last February I moved to my own apartment with an extra bedroom with the intention of being a foster parent.  Since June I have been going through the licensing process and today was my final visit with the social worker in charge of licensing.  She told me that my license to be a foster parent/home should be coming in the mail in the next few weeks!

Though there are families that go the foster-to-adopt route, it is not my intention.  I do not mean to take some child away from their biological family.  My intention is only to provide a stable home environment for a child whose parents just need to get things together before getting their children back.  I’ve been told that this takes one to two years.  How will you be able to do this, become attached to a child and then let them go back to a less than ideal living situation, I’ve been asked.  You know, I’m not quite sure.  I do know that my belief is that, if at all possible, a child belongs with his or her biological family.  It that child can grace me with his presence for a year or two, my hope is that we will both come out stronger because of it.

What do you think?  Have I lost my mind?  For those of you that are foster parents, how long had you thought about it and wanted it before going for it?  Does anybody else only want to foster and not adopt?  What is your motivation/story behind wanting to do either?