Tuesday, August 30, 2011

Trust and Ugly Truths

When I was growing up, my mom had this maxim that she repeated many a time. She said it just the other day when we were on our way to get her new (rescued) kitty, Ashley. She was talking about congress and the debt and such but she said it, with her usual emphasis.

"I'd rather have an ugly truth than a beautiful lie."

Having lived virtually my entire life in the lap of the luxury of a warm and loving family, never really wanting for much in particular other than things like world peace, an end to hunger and for my kids to stop bickering with their dad at the dinner table, I guess I never really gave it much thought about just how hard it might be to offer up the "ugly truth" to someone I didn't think had a vested interest in caring about me no matter what. Or maybe none of my truths were ugly enough to ever have me worried. Maybe I've led that fortunate a life.


In one of my current GAL cases, in the past year the assigned case manager for the youth has changed five times because of instability with his foster care management agency's staff. His present case manager, a not too competent but seemingly well-meaning young woman, has been on his case since shortly (read just days) before his judicial review in late February, 2011. At that hearing, which was before a citizen's review panel called Foster Care Review, she was like a deer in the headlights. But I was hopeful for this one. She used to play ball. Professionally, I mean. She looks really fit and has some fairly interesting tattoos. She has an edge about her, and I was hopeful that maybe that would be enough to bridge the gap a bit with my young man. But here we are at the end of August and, as she admitted to me at the end of July, at her second semi-annual judicial review for his case, he tells her nothing. She didn't know his sister got her kids back in upstate NY. She didn't know he still calls his deported dad in Suriname on my dime or that I pay half his school lunch money and her agency was picking up the other half because the young man got himself into a swanky magnet program at a school that doesn't provide free school lunches. She didn't know his cousins had been down here for a bit but went back to PA and that one of them had an arrest history for possession that I found in our Criminal Justice Information System. She didn't even know there were cousins because his case dates back to 1994 and even just since 2005 he's been in four different homes, had so many case managers it's dizzying and there are reams of reports in his five part file. He's been in the last home, a fabulous home (like the best foster home other than my home) for the past four years. The foster mom and I are the ones that tell his case manager the stuff that's really going on with him. When I asked this young man, who I've known since February of 2005, why he doesn't talk to her, his answer was brutally honest.

"Why should I? She doesn't know anything about me and she's not going to be around long enough to make it worth my while."

And there, in a nice, articulate nutshell, is the leading problem for children and youth in dependency.

On one of my now closed cases, a gifted 16 year old girl told me she wasn't going to be talking to therapists anymore. Over nine months of the case being in the system she had had three therapists. Her sister, age 13, was in the same boat. But the older young woman, seeing the opportunity to get it out there about what it was like being the oldest of five when your mom was so sick and addicted but really loved her kids and was having trouble taking care of them, really wanted to work with the first therapist. And she did. She talked, she made some progress processing her feelings of both anger and relief at not having to keep it all together anymore after the five kids were removed and their mom was in rehab. But the private agency providing therapy reassigned the therapist after three months, breaking the therapeutic bond abruptly when the therapist showed up and told her she was going to have to do a termination session. (That's where the therapist explains that they can't work with you anymore, why, and wishes you well and hopes you keep seeking treatment with your new therapist.) So the 16 year old started over with a new therapist. She was more guarded, but she tried. A couple of months later, you guessed it. That second therapist quit. She left the agency and then the agency assigned a new therapist. Now the 16 year old had nothing to say. She'd sit in her school's conference room or walk around the block with the therapist barely even speaking or just observing meaningless pleasantries. She had learned not to talk to a therapist. The system of care taught her how. 

This is not, by any stretch, the first time this has happened with one of my GAL kids, either. It happened in the DCF days and it still happens far too frequently in privatized care.

The young man I described above is lucky on the therapy issue, though. He has had, through his foster care management agency, consistency in therapeutic services when he's needed therapy. His therapist is marvelous and would keep in touch with him by cellphone if he needed to touch base. It got him through a rough time when his mom died of HIV. But that is such a rarity in the foster care system. In fact, I'd probably pretty much say it was that therapist being there for him. She went out of her way for him.

Instability and loss of continuity in case management and therapy give rise to serious problems in my experience as a GAL. Not at all surprisingly, youths, especially, become unwilling to trust, to invest feelings and effort, into what is a fundamental therapeutic bond- that with their social worker and/or therapist- if it is continually being broken. Most of the kids in the system, if they've been in the system for any length of time, have been bandied from pillar to post, have seen a revolving door of case managers, therapists, attorneys and in some instances, even judges. I've wondered, more than once, about what this teaches children and youth in longterm care about interpersonal relationships. That they're fleeting and not worth investing a lot of yourself?

I asked my youngest, the one who's adopted, and who's now been in my home for seven years, during which time he's had the same therapist week in, week out, (even as I type this he's still in therapy because of what all happened way back when, for seven whole years, yes, really, and I think it's done him a world of good) what he would do if he had to change therapists and start from scratch all over again.

"I wouldn't. Do that, I mean. I wouldn't do that. Talk to someone else about all that stuff? No. No way."

I think it has to be pretty much typical, really. It worries me for him though, since his therapist is near 70 and not in great health. So much trust and shared information is vested in that therapeutic bond. It's simply irreplaceable.

Further evidence for the idea that it's damaging to have a loss of therapeutic or social worker continuity is that after countless therapists, case managers, targeted case managers, independent living case managers and support coordinators and such, my friend Keyoncé had not told his present case manager (who knew hardly anything about his past, not even that his sister was also their client) that he was making ends meet by engaging in prostitution. She was simply dumbfounded and it took most of my morning and finally several three way calls with a very angry and feeling violated Keyoncé to convince her that this was true. Leaving aside the conflict I feel about having shared his private info with her in order to try to keep him safe and out of the clutches of what I can only view as someone preying on him, I'm left with the lingering, almost plaintive remarks she made to me when he was off the line. She didn't know why he hadn't told her, why he was covering things up, why he didn't tell her about all his traffic charges, the sugar daddy who paid them off, the fact that he wasn't really living with the person he said he was anymore, why he didn't mention the lack of electricity and water there as part of why he left, why, why, why? Keyoncé told he me didn't want anybody else "in his business" and now he's mad that I got him to admit it to her, even though I do think he knows how worried about him I am. But why did he tell me? "You know me. You know all about me. I can tell you that stuff."

Would you tell a veritable stranger your life story for the umpteenth time? What if it was a really sordid and ugly story filled with drugs, prostitution, and things people who are supposed to be helping you might want to judge you for? I mean, really, if you were prostituting yourself, would you talk about it easily to the nice lady you just met who doesn't know a damn thing about you, not even that you have a sister you barely know who is the same agency's client? Would you talk about the things that you had done that got you in trouble? About all your ugly truths? 

Well, whether you or I would is not the point.

Without continuity and stability, they don't.

© Bright Nepenthe, 2011

1 comment:

  1. "Would you tell a veritable stranger your life story for the umpteenth time?"

    I wouldn't. You'd be lucky to convince me to do it for the first time. These are not kids failing to work with the system; this is a perfectly natural and completely human response to a system that is clearly not designed to work with actual human beings.