Involvement March/April 1975

The Therapeutic Family Model

By John L. Brown FRSH, ACSW, AGPA
founder of Browndale

The Nuclear Family Today

In the need for a change of morality, with youth disavowing their parents and what they stand for, the family is being torn asund­er. Those values that a family unit contributes to its members are not now available to them as a result of this. At this moment in history the family, as the smallest social unit in industrialized nations, is offering little to its members. We are in the midst of a cultural and moral revolution because it is ob­vious to the young that our society and its mainstay, the family, have failed to keep pace with the needs and the knowledge of our time.

Yet the family persists and we are forced to the conclusion that the fastest form of revolutionary change is that which occurs when the young of the family can see that the old is inadequate and must be replaced by something better. All revolutionary change occurs ultimately at this level or there is no real change.

The family units in Russia, China, Cuba, underwent radical alteration between the generations and even in the reactionary coun­tries of the West, the revolutionary change between the generations is making its impact in recent years. Such a revolutionary move­ment, however, needs guidance and structure and because this is lacking in the Western world, the potential for revolutionary change as witnessed by the rebellion of youth against the values of their parents will probably lead no­where. We are only reassured that it is indeed the necessity that each revolution find the means, once power has been transferred, to bring about the aims and changes of the revolu­tionary movement to the families and the family members.

In all modern societies, but especially in China and Russia, there has been an effort to utilize mass educational methods to sup­plement the impact and influence of the family units. Communes, nursery schools for babies and in­fants all permit the state, as par­ent, to introduce new values, con­cepts and life styles to children. It has been well demonstrated that the state can imbue children with ideas and values which it desires to promote.

Yet, each state has recognized, however reluctantly, that the fam­ily unit persists and indeed is the most significant influence for well adjusted development that we have so far been able to discover. There is then, wittingly, or un­wittingly, a turn by the state to strengthen the family units and to supplement family functions rather than replace them.

A country secured in revolution can only remain in a state of re­volutionary change, of growth and dynamic response to need and circumstances, if the family itself is revolutionized: That is, if the family itself can develop commu­nication between the generations geared to respond to the needs of the total society, as well as the local community, in the light of the conditions as they exist and the needs and knowledge of our time.

The slowdown in consolidation in revolutionary movements that has occurred in Russia and some of her smaller neighbours, has occurred precisely because they were unable to replace the family by other institutional forms and they failed to see the significance of revolutionizing the family, en­riching the knowledge and aware­ness of its members and develop­ing ways of increasing their com­munication and intimacy with one another. However, recently, two Russian psychologists have sug­gested mental health services, decentralized throughout the country, available to normal fami­lies needing information that: 1. Would prevent emotional prob­lems and, of course, 2. Enrich the normal life style.

Man needs the small, intimate, social unit that the family provides to realize his full potential. We must incorporate this into a broad socialistic planning of our state, of our production, of our educa­tion, of our life style. Efforts to replace the family with other social forms—however interesting they may be socially and academically, and however enthusiastically one can argue their merits—must and will fail because they do not serve man as he needs to be served, nor as well as the family, raw, un­assisted, trapped in its archaic traditions, can do.

Modernize that family, make available to it the knowledge of our time, help it to learn ways to communicate and be construc­tively intimate and you will see the whole of society enhanced and any revolutionary movement that consolidates the revolution in this way cannot and will not be over­come by outside forces or internal weakness. When new ideas and new ways are absorbed into the family unit, revolution is secured and its gains can be consolidated. In fact, the state of the family in any society will greatly affect the condition of the larger society or the state. The disintegration of the American community—especially in the larger urban areas—is a direct result of the inability of the unserved, isolated nuclear family to produce socially integrated in­dividuals who are capable of cre­ating and sustaining a highly civil­ized, socially integrated society.

Revolutionaries should not be fooled by all the strange, meaning­less, negative, non-progressive activities they see being performed by professionals and non-profes­sionals in the field of family work. These are indicative of the need that the family has to update itself, to be revolutionized, and modern­ized. I can only mention here briefly that while most of these programmes and efforts are false, they are working with the basic ingredients that must be worked with and they are playing around with elements of the basic forms that will eventually emerge.

There is need for the family to be served in a different model by society. The knowledge of human growth and development is real, but it is not available to 99 per cent of the families and it is only avail­able to the other 1 per cent of the families in its orientation to pathology. The professional and technical resource bank connected to the therapeutic families that we have created at Browndale is a model that could apply to the whole of society.

Of course, this would require that governments and industry and politicians recognize that the major thrust of their energy, their resources and their attention must be on the social sciences and the training of social science workers, not on the physical sciences, as it has been too long. They do not even need equal weighting. They must both be attended to with the greater em­phasis on the social sciences. The expenditure of the equivalent of the cost of one battleship, or one supersonic bomber, or one nuclear bomb spent to develop and provide resources to a random selection of families in a number of communities—urban and rural —would demonstrate in miracu­lous fashion, the need and benefit of making available up-to-date knowledge about human behav­iour, normal growth and develop­ment and the emotional nature of man and his needs, to all family members: a sort of resource to which parent and child alike could refer their problems and needs for immediate advice and help.

We have learned since the time of Marx that mind is matter that not only thinks but mind is also matter that feels. But revolutions to date have not incorporated that essential truth into their pro­grammes for people—although, in their hearts, they have known it and have generally been true to it.

In the field of mental health in the western world, society has created a large group of deviant children who have been trouble­some to manage and a threat to the established order of services. Because these children were a great burden on society and be­cause they were unresponsive to traditional services, there was room and "permission for radical alternatives". One such radical alternative was the therapeutic family home developed at Warren-dale and Browndale in the town of Newmarket, Ontario, by myself and my associates.

Therapeutic family homes are small community-based residential homes of approximately five child­ren each, with non-resident staff functioning as therapeutic parents. The therapeutic family home is de­signed to provide care to the dis­turbed child as a human child. This takes priority over reacting to the child as a problem child. This programme is designed to normal­ize the life style of the disturbed child within the community. The special needs of the disturbed child are met by professional spe­cialists on call to each house. Attached to the therapeutic family home is a professional resource bank, on call 24-hours-a-day to the therapeutic parents. The re­source bank consists of psychia­trists, psychologists, pediatricians, nurses, social workers, senior child care staff and other special­ists as may be needed from time to time. Authority rests with the therapeutic parents. The therapeu­tic family, as well as members of the resource bank, work with the child's own family. In this respect, the therapeutic family is reminis­cent of the extended family, rather than the nuclear family, with the therapeutic family home acting as an umbrella to include the needs of the child's own family. The staff of the therapeutic family home, their supervisors and the person to whom they are accountable ul­timately, are deliberately selected by us as non-professional people of sensitivity, humanness and the capacity to encompass deviant behaviour without losing the per­spective of what a child needs to develop and adjust to the irrational world and its changing forms.

The pattern of revolution his­torically has been the need after long bitter years of abuse and op­pression to mobilize revolutionary forces along military lines and to grasp political power by the force of arms. Indeed all significant major change, all substantial pro­gress in the history of the world, has been along the lines of this model. I can see the possibility of an alternative to breakdown and change if we can find a way of modifying the family unit to main­tain the intimate relationship des­cribed by Otto Weininger in his article, Another way of looking at the intimate experience: two case histories¹.

If the family can have as its ideal, not only the responsi­bility to civilize and socialize the children in the family, but, of equal importance, the responsibility to evaluate and discard the old and replace it with alternative ideas, values and means—rather than it being as it is now, the last holdout against revolutionary change—it could become the forefront of re­volutionary change and indeed the arena of such change. To achieve this, it is necessary to find a means of stimulating communication be­tween the generations within the family unit and within the intimate relationship that exists between the generations of the family, so that the young can doubt, ques­tion and innovate without having to leave the family home or dis­avow the parents and what they stand for.

We are, in our family meetings in Browndale, demonstrating this very point. Family meetings are held with all staff and all children of a therapeutic family home once weekly or more often to facilitate communication, open responses, increase participation and enhance the flow of sharing and expressing between those already related and to increase the potential for re­lationship where intimacy has not yet occurred.

Many young people today have abandoned the nuclear family which they themselves experi­enced in all its meagreness. They have sought to solve the problem of family by abandoning it and seeking other models—the corpor­ate family, the communal family, the "free love" family, etc. All these efforts are, in truth, attempts to give to themselves and their children that which can only be given by small heterogeneous groups such as the extended fam­ily of our ancestors or models simi­lar to the therapeutic family of Browndale. In fact, they have done everything but rediscover the ex­tended family. They are right to reject the nuclear family. They are right to seek that which an ex­tended family gives.

In most of the industrialized nations the last 100 years has seen abandonment of the extended family model for the nuclear family model of the industrialized sub­division — small family homes where the working mother and father live to serve the commerce and industry of the state or private enterprise, without regard to their relationship or nearness to rela­tives and extended family mem­bers. Without the comfort and ser­vice of relatives, nuclear family members are isolated and alone. Young people who are trying to find new ways of living are victims of the nuclear family that they de­nounce. As we explore the weak­nesses of the nuclear family in nature, it may be possible for us to rehabilitate and revolutionize the extended family of our ances­tors to provide a better atmos­phere for raising our children, or we might imitate the therapeutic family model and provide the necessary extended services in modernized form to the members of the nuclear family.

The "I" and the "we"

The family is the social unit that civilizes and socializes the indivi­dual into a harmony with the society around him, or — if that society is unjust or repressive — is the basis for generating the people who will produce radical change in the structure of society.

All good families produce child­ren prepared for revolutionary changes: People who will not tol­erate injustice but, more impor­tant, people who will not tolerate an indifference to, or denial of, the needs and knowledge of our time.

The Freudians think that the rebel must always be the pro­duct of an unresolved Oedipal. The rebel who produces major lasting change is the product of the family that expresses the con­tradiction central to the society and the system it is a part of. These contradictions become a part of a painful conflict between the child and the family, between the child and one or both of the parents. This produces intro­spection in which the individual searches to find why life is the way it is for him and in the process becomes aware of that which is in him, and that which is without. As a result, he becomes freer to per­ceive and evaluate the corrupt, reactionary aspects of the family and the society in which he lives and in the power structure that maintains the system.

The only way to truly achieve a family that will produce such children is to develop, within the life style of the family, patterns that generate intimacy and affili­ation between the family members with an acceptance and awareness of their differences and capacities. These things are taught to children by the way in which the adults respond to the family members, and to one another. The children in the therapeutic family must each be seen as unique and differ­ent and that uniqueness and differ­ence appreciated, applauded and given a place in the total configur­ation of the family. This is not a telling process. You don't say the words once or twice and expect results. You may say the words but, more importantly, you must live them day in and day out through all the crises as well as the normal times. Here the subtle power of non-verbal communica­tion plays a most significant role. As a therapeutic parent, you must and you will respond to each child. The verbal and conscious re-.sponse will make up a small per­centage of all you communicate to the child and about the child. The rest will be the residuals of your interaction with the child: The role you give him in your family, the manner in which you engage or disengage him, the man­ner in which you care for him, the manner in which you extend your­self or withhold yourself, the order of priority in greeting, feeding, de­parting, that you give him, the things you tolerate or do not tol­erate in others' responses to him. In these and thousands of other ways you will give him his role and his meaning in the family unit. The best way to gain control of this is to bring in an outside person for family talks at least once a week, perhaps more often, and to utilize the patterns established there and to extend the frequency and scope of your communication as a family unit.

The difficulty, of course, in all of this is in recognizing the unique­ness of the two dimensions pre­sent—the special individual pre-ciousness of the person—separate from all others and the absolutely essential group to which he be­longs—and that which must take priority over his individual unique­ness.

The "self" or the "I" is the centre of the universe. All things exist around and in terms of the self. This is the nature of human consciousness. At birth we exist in a state of isolate loneliness, without knowledge and uncivil­ized, with our perceptions and our potentials imprisoned within our body. From the moment of birth our consciousness begins to ex­plore and discover the world with­in us and the world outside us through an orderly process gov­erned by, limited by and dependent on the functioning of our sensory modalities of communication.

As the self is fed and nourished and as the self's needs are met and satisfied — stage by stage — the 'I" grows into a person and the intellect of the "I" begins to as­sess, evaluate, and extend the heritage of our culture and civili­zation. The knowledge that existed before is extended through our experience and our thought and we become one with millions in a flowing, evolving river of life.

Meaningfulness in life centres around the group to which we be­long. For most of us, it is our primary family. For those children who come to us, it is the thera­peutic family. The therapeutic fa­mily group, therefore, must tran­scend the individual. It must find for the individual within the family unit, the social place and the essential functioning role that assures the individual of a vital place in the life and meaning of the family unit in its moment-by-moment activities and functions. For there to be a vital, meaningful role for the individual in the family group means that the family group, particularly the parents, recognize the needs of the individual and their changing nature as that indi­vidual grows and matures. The family unit works to build the indi­vidual into a strong, independent self who lives fully within the needs and knowledge of our time while his optimum functioning within the family indicates a per­manent, lasting place in the fam­ily. There is, at the same time, an awareness in all family members, that change will take the child away from the family into a life separate and unique from the family and will repeat, in develop­ing a new family, the heritage of the culture modified out of his awareness and experience in the family and the community around him.

One of the most difficult aspects is allowing the child in the thera­peutic family to become free and independent. Again, it appears to be a contradiction: We want in­timacy, total child care and in­volvement; at the same time, we want the child to be free to eman­cipate himself from the family circle to independent living in a smooth transition without conflict or harsh separations that block the flow of our social and cultural heri­tage. The key is to let the child do what he is able to do as he wishes to try and prohibit him from doing what he is unable to do even though he wishes very much to try.

There is an absolute need for the child to experience, as a result of his participation in the group, that he can transcend the parents and particularly that he can im­prove on the family they created. That this gets expressed in the form of criticism, should be under­stood by the therapeutic parents. (It would save a lot of wear and tear if it were understood by par­ents in the natural family!)

These things are easily spoken about but difficult to achieve in the therapeutic family, where the children coming new to the family may be well along into their teens, with well-established life styles and strong resistance to change, and often with good intellectual and verbal skills and conceptuali­zations that are contrary to the therapeutic family purpose. In such circumstances, don't despair. Call your therapeutic family coun­sellor, bring it up in the family dis­cussions head on and prepare yourself for the ongoing "hit and run battle" that will almost surely ensue. A professional resource bank is a must at such times, both for your own mental health and as an aid to helping the child through the crisis.

As the state assumes certain family functions, we lose some of the flexibility and adaptability that the family used to have in dealing with the many variations that are presented by different children growing up. This inflexibility of the state frequently leads to alienation of the adolescent and once again emphasizes the urgency of re­establishing the role of the family in the civilizing, socializing, teach­ing and training of the young.

Teaching a Relevant Morality

A communication which passes from generation to generation, that carries the essentials important to man in their evolutionary flow through the ages, is most vitally realized within the social unit of the family.

The time flow in the natural family is slow enough to obscure this process for the most part from the family members. In the therapeutic family, time sequence is accelerated. Children and thera­peutic parent come new to the family and will experience the full meaning of the special family com­munications within a very short span of time. In the therapeutic family programme, therefore, we have an opportunity to see the in­terplay of forces that exist be­tween people of different generations as they feel the urge to pre­serve what is familiar and known and yet rhust acknowledge and incorporate into their living the changing conditions relevant to their time.

Most of the children who come to Browndale have lost touch with the major structures that com­municate the traditions. Life is a timeless sameness to them. Yet life is a limited time schedule. It runs for each of us from birth to death and much of the meaning of our life comes from our being aware of time sequences and divi­sions that help us reckon its pass­ing and live our life more or less in harmony with the natural func­tions that are relevant to the dif­ferent ages. We are not talking here about making children slaves to time schedules, though we must recognize that children who have not been well cared for, or who have been inconsistently cared for, or not closely or intimately related to parenting adults or a given life style, need initially very rigid time structures to help them predict events and learn trust and life pattern for future actions of parenting adults. Such children benefit from the security that comes from a con­sistent orderly existence that originates in experiencing essential life events such as waking, eating, sleeping, etc. So the therapeutic parents organize an orderly life style that the children can learn to trust and depend on which shows a respect for their basic childhood needs for food, sleep and physical care. Then the important repetitive events become emphasized — celebrating a child's birthday, for example, something that may be totally new to him; celebrating a child's anniversary of admission, celebrating all the holidays and festive occasions that are part of the local, national and ethnic back­ground of the child.

In this way, time becomes divided and the divisions take on special meanings and they can be experienced in comparison to one another and other children and to other adults and families in the community. Here there appears to be a contradiction in what we are doing: The establishment and re­spect for the traditions of the child, developing a familiarity and an experience around the festive days and ritualistic patterns and, at the same time, working to en­courage the child to accept new change, new ideas, new values, new images of himself and others. But this is only an apparent con­tradiction. For each of us can only accept that which is new and that which is different, that which changes the older ideas and ways for radical new forms, if we are familiar with our traditions, our background, our belonging, what we are a part of and have ex­perienced the significance and pleasures that that offers. Our history cannot be a fiction — we must know the truth of our his­torical legacy.

Revolutionaries respect history and traditions and know the im­portant part that these things play for the individual man and for man collectively.

Let's look now then to those aspects of the family that are part of its traditional historical role and which deserve enriching and pre­serving and those functions which, while they played important roles in the past, are no longer relevant and should be preserved only in the family museum.

(1) The economic role of the family

This is one of the archaic, outmoded elements. The family has, until recent times, been seen as the economic unit providing for the needs of its members. The style of life, the availability to the amenities of life, position within the community, secur­ity over time, were all left to the family to provide. We have long known that this is an untenable position. The family can be as important to its members and provide them with all they need from family living separate from its earning power or ability to in­dependently raise money. It is obvious, too, that we can collectively provide everyone with economic security. In the older societies of our ancestors life was organized around the village. The village assumed collective concern for each family and each in­dividual in a manner totally unfamiliar in our western society.

(2) The educational function

Here we must be careful. It is true that we can col­lectively provide superior per­sonnel, structures, and ap­paratus for the education of our young, but mostly this relates to technical knowl­edge, knowledge about things. Our best efforts to teach values, humanness, civilizing thoughts and deeds, social responsibility and care for one another, have failed. Our major cities and, in fact, whole nations are caught up in irresponsible crime and delinquency with gross acts of violence against others by ever increasing numbers of people. It is my belief that the family is still best able to teach the young social and human values and that a greater part of our educa­tional expenditures should go toward finding ways of in­cluding the family in the educational process — not in some meaningless, irrelevant, parent-teacher association or home and school group, but in the centre of the educa­tional process in direct con­tact with students. Along with this, there is a great need to eliminate profes­sionalism in the teacher and this can be part of the same process.

Central to all teaching would be a prime focus on the emotional and social development of the student. I am not talking here about some irresponsible, frivolous "democratic" educational process. Education is always coersive, but the coersion of intimate relationship and love produces emotionally and socially well-balanced individ­uals and that is mostly lack­ing in our educational system in the west.

Some revolutionary gov­ernments have felt that the only hope was for the state, through the school, to edu­cate the child to new values and new ways. This is an ex­tremely dangerous practice, since it tends to emotionally isolate the child and leave him without primary intimate relationships that deal with the large area of feelings that each child has as he gains awareness and insight to him­self and the world around him and as he undergoes the ex­hilarating, yet sometimes de­pressing, experience of gain­ing knowledge.

Central to involving the family in the educational pro­cess for the children, is the need to help all families learn to communicate honestly; not just their intellectual thoughts and ideas, but their emotional responses and their attitudes about one another, about the social order around them, about the history and tradi­tions that are a part of their background. It may be that such changes are impossible without the use of force to acquire power, to implement them. But there is still time for us to try.

(3) Teaching and training in a relevant morality

Here the state and the family must become partners and this is most difficult for them to do without revolu­tionary change by force of arms because the morality of most existing states is un­desirable. Yet the state has the power to impose im­morality in the guise of morality. Because this is true now requires that we assess the potential for the family to resist the imposition of immorality in the guise of morality and its ability to counter with a collective morality that which unites the individual in the family and the family as a unit against the corrupt state. Opposition to corruption always begins with the individual. It may spring up in many places by many individuals if the cor­ruption is great enough, or the opposition may develop by the courageous efforts of one or more who speak out about it. The history of the great revolutionary leaders of the last 100 years shows this to be true.

In all instances revolution­ary movements were forced to resort to arms to win their cause, with two exceptions; Karelia State in India and Chile. In the case of Karelia State, they were unsuccess­ful because the central gov­ernment overrode the demo­cratic decision of the majority using its central power over a member state. In Chile, it is still too soon to know, but having gotten power by the vote, we may well expect that it may have to defend that power by the gun.

Morality is learned and there seems to be within man a potential for fulfillment in achieving it, individual by in­dividual, and group by group. It can only really be measured in terms of a person's thought and conduct, relevant to others around him at a given time, in the light of what his life means to him at that moment. This means that the morality of the masses can change quickly and drastically and it means also, I think, that the family can be an instru­ment of change in morality. This is a good place for us in North America to start.