Case Studies - Page 4

Eliciting Hope

Empirical research hasn't been done on the effectiveness of Kids' Skills, but a wealth of anec­dotal evidence now exists in the form of stories like this one, reported by professionals from several countries around the word. The cases all follow the same steps—finding a skill, discussing its benefits, naming the skill, and so on—yet they're all different; the ages of children vary from as young as 3 to as old as 18, and the problems that have been dissolved include everything from the trivial to the severe, from bad table manners to refusal to eat, and from swearing to uncontrollable violence. The method seems applicable not only to problems with psychological origin, but also to behavioral symptoms associated with neurological conditions, such as AD/HD, AS, and autism.

While Kids' Skills appears to be effective, it comes with a caveat: it works only when practiced in a way that adheres to its underlying tenets of respect for the child's self-determination and building true cooperation with the child's social network. Much can be accomplished by putting children in charge and making sure the rest of us act as their supporters.

Despite the step-by-step structure, the detailed instructions, and even a workbook to adhere to, Kids' Skills isn't intended as a protocol to be followed rigorously. It's rather a proposal for one possible set of guidelines that can help us work with children and their families in a way that elicits hope, involves the community, and recognizes the value of our children's inherent creativity.

Case Commetary

By Michael Ungar

Ben Furman and Christine Beuer are to be commended for offering us a positive, respectful approach to children's mental, emotional, and behavioral problems. Kids' Skills, the program he created, makes innovative use of both strengths-based and narrative practice, and has the potential to build a child's resilience. By asking the child what she or he can do, rather than focusing on deficits, Furman and Beuer have found a simple way to engage children in an intervention meant to empower them. There's a great deal of charm to their discussion of Carla and the therapists' careful attention to developing strengths, rather than searching for pathologies.

Despite having much to recommend it, however, I do have a few reservations about Kids' Skills. Its approach seems solid with the authors at the helm, but I wonder if it can stand up to broader application, in different social contexts and cultures. It's apparently been adapted in countries and cultures around the world, but class often trumps culture when it comes to determining which treatment model is likely to work with which client.

Children from middle- or upper-class families in different Western countries are going to have more in common with each other than will children from the same countries living in poverty, or socially excluded because of race or ethnicity. Though I applaud Carla's effort to heal herself, many of the children I work with don't have parents with the skills to negotiate contracts with their children, much less the time or the money to organize "garden parties." I'd be curious to hear from a Kids' Skills advocate working with a child in a less supportive social ecology. What if the child has no friends at school willing to provide reminders about how to act in a prosocial way? Even worse, what if those in the child's social network value problem behaviors more highly than positive ones?

My second reservation comes from a worry about Kids' Skills effectiveness. Furman and Beuer, to their credit, acknowledge the lack of research measuring Kids' Skills outcomes. Measuring outcomes can be difficult with child-
centred interventions that encourage flexibility. While I have no doubt the approach works when competently applied by an engaged therapist dedicated to helping a child find his or her own solutions to problems, it's less clear whether Kids' Skills is a distinctive model that adds to good solution-focused or narrative approaches to psychotherapy.

Finally, as much as Carla appears to be setting her own goals, and was remarkably competent articulating the benefits of those outcomes ("My friends would respect me more, and they'd like to play with me more"), I wonder about the authors' conviction that children truly choose their goals in this approach. How much do Carla's caregivers influence her choice of therapeutic goals? Certainly many of the children with whom I work might want respect and friends to play with, but they also want people to "shut up," or to make sure that their siblings don't get more attention than they do. In other words, some children might choose antisocial goals, or insist that others change, rather than they themselves. Resistance to following the rules or meeting caregivers' expectations can be the way a child maintains a sense of personal cohesion when treated unfairly. It's unclear whether Kids' Skills can help children mistreated by their families, schools, or communities, and those who challenge rules when those rules (and the adults enforcing them) are wrong.

None of these comments should take away from the positive, empowering tone set by a Kids' Skills advocate. Carla is happier as a consequence of the help she received. Indeed, it seems to have been the first intervention to make a difference in her life. For that, Furman and Beuer should be complimented. The challenge now is to see if Kids' Skills can create just as much magic, consistently, in other contexts and cultures.

 

<< Start < Prev 1 2 3 4 5 Next > End >>
(Page 4 of 5)