On the day that eight-year-old Joey* learned that he would never be returning to live with his biological mother, he explained to his therapist that she hadn’t been coming to visit as often because he hadn’t been obeying his foster mom. It took Joey over two years to feel safe enough to share ideas like this with his therapist. She tried to help him understand that he was not responsible for his mother’s less frequent visits, but she also knew that this idea gave him some sense of control over the events in his life, over which he actually had absolutely no say.
Only a few weeks earlier, Joey’s foster mother had insisted that his older brother be moved to a different home because the two boys fought too much. His new caseworker, the third in two years, was worried that the foster mother would have Joey removed, too, if his behavior didn’t improve. While Joey had begun to be more verbally expressive, he did still wet himself when he was anxious and acted out when stressed. The combined loss of his brother and the hope of returning to his mother in the space of a few weeks had certainly contributed to some regression.
Joey’s therapist was stunned when she received an excited call from his caseworker, announcing that a therapist at a clinic near the foster mother’s home, whose work she knew well, had an unexpected opening and was willing to see Joey. She had already scheduled an appointment for him for the following week. The therapist who had been seeing Joey through A Home Within expressed her concern that his stopping therapy with her would mean yet another loss at a critical time. She worried that he would regress even more and lose his newly developing verbal capacities. If his acting out escalated in response to an additional loss, which seemed more likely than not, his foster mother might actually ask to have him removed.
However, the caseworker was adamant, explaining that it would be so much more convenient for the foster mother to get Joey to his appointments at the clinic and that she and her supervisor had already informed the foster mother of the change. Joey’s attorney, who had referred him to A Home Within because he thought that Joey really needed a long-term relationship with a therapist, also tried unsuccessfully to intervene and have him continue with the person he had finally come to trust. The combined voices of the therapist and attorney about the importance of lasting relationships could not compete with the expectation that the new therapist could somehow turn things around quickly, especially since Joey could get many other services at the clinic.
Sadly, his therapist explained to me, “I did everything I could to protect my relationship with Joey. I really care about him but I couldn’t prevent his having yet another loss—this one completely unnecessary. I’m worried that the caseworker is expecting the new therapist to work miracles. They just keep adding services—as if more people and new people are more important than familiar people and relationships that last. What if this doesn’t work and Joey does get moved and the clinic isn’t convenient for the new foster mother and he has to start over again? Why not try to support the relationships that are already in place instead of creating yet another transition without the support that it needs to succeed?”
When faced with a relationship under stress—as was the case with Joey and his foster mother—it is often tempting to make a change in the hope that a fresh start will erase the problems at hand. And changing a therapist seems less disruptive than changing a foster home.
Under externally- and internally-imposed expectations that placement stability must be maintained above all, caseworkers and supervisors often feel as if they have little choice but to respond to the demands or desires of the foster parent, even when doing so places additional demands on the child. And, unfortunately, even when they want to offer services to support and sustain the placement, there may be few resources available.
Joey’s A Home Within therapist was unable to stop the transfer to the new therapist. However, she was able to slow the transition and support Joey through it. She made clear to all of the adults involved in Joey’s care that she would like to stay in touch with Joey, through occasional notes, phone calls, or visits. The new therapist promised to stay in touch and let her know whether and when maintaining contact with Joey would be helpful to him.
Even though Joey did get a new therapist, it is not clear that it was necessary for him to lose someone he had only slowly come to trust and count on. The fact that he will continue to have therapy does not mitigate the loss of a relationship with someone who had become important to him. We cannot prevent every unnecessary loss, but we will continue to carry the message that lasting relationships are essential for healthy development and every loss has lasting negative consequences.
* The child’s name has been changed and identifying information has been eliminated.
By Toni Heineman