A School Psychological Service in Action
- Author:
Agataha H. Bowley, Ph.D. yf
Psychologist, Leicester School Psychological Service I think it is true that a conference may be said to have succeeded in some measure if it stirs the participants to some small fury of thought. It is of value to the individual and to the institution or organization which the individual may represent if it stimulates a scrutiny of method and motives, an analysis of achievements and shortcomings, and if the individual returns to his centre of action, whether in the backwoods or at the hub of the universe, in a mood of complacency tempered by self-criticism.
The Annual Conference on Mental Health held in January this year proved stimulating to me personally, and brought home to me the fact that we live indeed in an interesting age, that the world is passing through a critical period, that the National Association for Mental Health has an important contribution to make to local, national and international affairs, and that one may well feel proud to belong to this Association and proud too of one’s profession these days. Stirred by these thoughts, I am tempted to describe the various ways some of us in Leicester are seeking to build up the mental health of the future generation in a small way, partly because this may be helpful to others working in similar circumstances, partly because it will be helpful to my staff and myself to scrutinize the work we are doing, and to estimate the degree to which we succeed and the degree to which we fail in what might be termed broadly preventive work and re-education of parents and children in difficulties.
A School Psychological Service is primarily a community service. Its function is to co-operate with all individuals and agencies who are endeavouring to fulfil the psychological needs of children, and to bring psychiatric, psychological and social aid to those parents and children who for one reason or another are experiencing difficulties in living, and who need specialist assistance in matters of personality adjustment.
The Functions of the Psychiatrist and Psychologist Before describing the organization of this service, which is under the aegis of the local education authority and for which an educational psychologist is responsible, I want to comment briefly on this rather vexed question of the functions of psychiatrist and psychologist in the field of Child Guidance. In my experience, I have never found it possible to give adequate assistance to parents and children in this type of work without the services of a psychiatrist being available for treatment, for consultation, and for advice and guidance. At the first stages of my career I worked in Child Guidance Clinics directed by medical psychologists, and I have since found this experience invaluable. I think psychologists who find themselves responsible for Child Guidance Services without this type of preliminary experience, and with insufficient psychiatric assistance in their area, are bound to find themselves in very great difficulties indeed, unless they confine themselves strictly to ” educational ” matters only, which is almost impossible to do. I have now spent some 16 years in Child Guidance work, and I find that, with increasing age and experience, one learns more fully one’s own potentialities and one’s own limitations. One learns how much and how little one can do ! It is, I think, psychologically wrong to undervalue the contribution a psychologist can make, but it is surely equally wrong to underestimate the contribution that a psychiatrist and a psychiatric social worker can also make in this vital matter of building up good mental health ih parents and children. A psychologist, by means of his training and experience, should be able to recognize when the mental condition of the parent or child requires the treatment that only a qualified psychiatrist can give, and be eager and willing also to accept guidance and help from a medical psychologist in regard to problems of minor maladjustment in children. If the training of a psychologist fails to help him to recognize his own limitations in this matter, it has failed indeed. On the other hand, it is important to remember that a psychologist has usually a wide knowledge and experience of normal children and normal children’s normal difficulties, and a special understanding of the educational needs of children in the widest possible sense. A knowledge of the emotional development of children, supplemented also by a personal psycho-analysis, is, in my opinion, of very great value to the educational psychologist.
These preliminary’ remarks will serve to show that in Leicester we recognize that a School Psychological Service needs a fully qualified staff, and I should not consider it possible to carry out my duties effectively if I did not have the assistance of psychiatrists and psychiatric social workers. The psychiatrist acts primarily in a consultative and advisory capacity in our department, but carries out a great deal of therapeutic work with children, concerning whom we have consulted him, at the Francis Dixon Lodge Child Guidance Clinic attached to the City Mental Hospital, and psychiatric out-patient treatment is available for parents as required. The services of psychiatric social workers are available on a full-time basis in the School Psychological Service.
Early Ascertainment and Treatment
Recognizing the importance of the early years of childhood and the value of preventive work, we try to start at the beginning. We have not yet taken an effective part in the field of Maternity and Child Welfare, but we encourage medical officers, and nursery and infant teachers to send us children as yourg and as soon as possible. Individual and group play therapy is undertaken with these children by the psychologists, and the psychiatric social workers do as much intensive work as is practicable with the parents. These children are not seen as a matter of course by the psychiatrist, but his advice and help may be called in at any stage of this work. Many of the problems the children present are quite minor ones, often merely an exaggeration of normal development caused by a mildly disturbed home background, and usually the parents need far more help than the children. With the growing demand for the employment of married women, it is often difficult to arrange regular appointments during the day, and the social workers have consequently to undertake a great number of evening visits.
Infant Adjustment Classes
Another method of tapping potential early maladjustment is that of organizing Adjustment Classes in Infant Departments which will cater not only for the needs of the dull and backward child, but more especially for the needs of the emotionally and socially ill-adjusted child of normal or superior intelligence. In Highfield’s book,* The Young School Failure, now in the press, the function of these classes and the educational method is described in some detail. The main purpose of these classes, which are of course much smaller than the ordinary class (never more than 20, and preferably only 15), is to give the child security, an opportunity to build up affectionate relationships more readily, and to work through earlier stages of social emotional development through play and creative activities. Home adjustment is aided as well as school adjustment by the work that the Psychiatric Social Worker is able to do with the parents. Very great care, of course, is necessary in the selection of teachers able to carry out this work, and at the moment, owing to the shortage of infant teachers in general, we are unable to develop this part of our work as much as we should like. When it may be possible to set up these types of classes in all large infant departments, I feel we shall be able to do a great deal of preventive work. School for Maladjusted Children
A day school for maladjusted children, now called the Manor House School, was set up by the Education Committee in 1932, and can now be considered to have passed the experimental stage. The School Psychological Service is responsible for the selection of the children, and fulfil an advisory role in connection with the school. Intelligent children (I.Q. from 95 upwards), who are backward in school work, who are nervous, who are failing to adjust to the ordinary school, or who are presenting problems of behaviour of greater or lesser degree, are recommended for admission by the psychologists, and, subject to the agreement of the Director of Education, are transferred for a period of a year or two. The cooperation of the parent is obtained by the psychiatric social worker, who keeps in touch with the home while the child is at the school, and follows up after the child has been transferred back to the ordinary school. Educational methods used in this school are described fully in The Education of Retarded and Difficult Children in the Leicester Schools (published by the Leicester Education Committee). The great value to the child is the small size of the classes, the remedial methods suited to his attainment level and his special educational difficulty, the friendly, informal atmosphere of the school, and the understanding and skill of the teachers in handling the difficulties in adjustment as they arise.
Rather full record cards are kept, the school staff are supplied with full information about the child’s home background and the history of his difficulty, and regular fortnightly conferences are held at the school when the staff of the School Psychological Service and the school staff can meet and discuss new pupils, or problems concerning children already attending. After-care work shows again and again how valuable this type of environmental therapy can be to the child, for the percentage of success is high. Psychiatric treatment can be arranged if necessary for any child, and one of the psychologists undertakes some play therapy at the school. Recently we have started a ParentTeacher Association, run on group therapy lines to some extent, at this school and the response of the parents has been most encouraging. We found there was no difficulty at all in persuading them to express their opinions, which is an indication of the confidence they feel in the goodwill of the school staff, and the psychological staff.
There are, of course, many other aspects to the work of the School Psychological Service; the organization of Special Classes for the dull, and the backward child, remedial teaching with the assistance of Training College students, diagnostic and advisory work on a fairly comprehensive scale in connection with school problems, and home problems, and by request of probation officers and the magistrates of the Juvenile Court. The number of children referred each year is between 600 and 700 (the total school population of Leicester is about 40,000). In addition, there is a good deal M. E. Highfield. ” The Young School FailureOliver & Boyd. To be published shortly. of lecture work to groups of teachers, parents, nurses, doctors for instance, and training work with social science students and educational psychologists.
Hostel for Maladjusted Children
The most recent development, which is proving of very great value already, is the provision of hostel accommodation for maladjusted children. A hostel used during the war for evacuees has now been acquired by the Education Committee. Selection for admission rests with the staff of the School Psychological Service, subject to the Director of Education’s approval. Very unstable children, and children with I.Q.s below 80, are not admitted. A total of 20 children, roughly two-thirds boys and one-third girls, is accommodated, who are presenting difficulties of behaviour or personality adjustment related to disturbed home conditions. The warden is a trained teacher and his wife a trained nurse, both of whom have had considerable experience in this type of work during the past war, and they are assisted by three other adults. Their own child lives in the hostel, and thus the children have the very great advantage of a background of a good family unit. A full case history is furnished to the warden, frequent discussions are held with the psychological staff, home visits are made constantly by the psychiatric social workers, and psychiatric treatment is arranged as required. The children attend the ordinary schools in the city, although the hostel is in the country outside Leicester, or the Manor Hou e School, if school maladjustment is part’ of their problem. Contacts with the parents are preserved so far as possible, and visits to the hostel are encouraged. After a period in the hostel, and if the tension or friction in the home has been greatly reduced, a return home is recommended. If the home situation is intolerable, and incapable of improvement, a foster home which will satisfy, the special needs of the particular child is found, and we are just now embarking on the interesting project of building up a register of foster homes in the locality which, on the basis of psychological criteria, are considered suitable for the care of the maladjusted child.
It would, of course, be quite impossible to carry on work on such an extensive scale if the service did not have behind it the support and very real interest of a progressive Education Committee and of an enlightened Director of Education, if the cooperation of the schools in the city was not genuine and constant, if the School Medical Department did not appreciate the importance of our work, and if the staff of the School Psychological Service were not able to work as a team in co-operation with the hostel staff and the school staffs in this form of community service.
It is important, as I said before, to estimate our shortcomings as well as our achievements. Development will lie in the sphere of parent guidance and teacher guidance, I think. There is much yet to be done in the general emotional education of the teacher and the parent, in working towards greater emotional maturity in themselves and in producing psychologically good conditions in the schools. The 1944 Education Act has given to local authorities powers and opportunities hitherto unknown. The Children’s Charter, when it becomes law, will extend these still further. Let us hope that those of us who have training in psychological work will not fail to use the very great opportunities open to us, and that our own level of emotional maturity will not fall below that which we expect in others.
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