Immigrant Adolescents in Resident ia l Group Care and Treatment Settings: Research and Experience in the Nether lands

E r i k J . K n o r t h Lotty Eldering

Leiden University, the Netherlands

ABSTRACT:. Increasing numbers of children and adolescents of foreign descent are current ly being admit ted to residential homes in the Nether lands. Based on research carried out in the Nether lands, this article deals with the immigran t youngster 's prob- lems, the placement process, diagnostics, t rea tment , the involvement of parents, and the impact of cul tural differences. The authors conclude that , compared to indigenous Dutch adolescents, immigran t youths in residential care more often show externalized behavioral problems. A second conclusion is t h a t i t appears to take more effort and t ime to find a sui table residential se t t ing for these youngsters, mainly because they seem to be more often unmotivated for t r e a tmen t and more frequent ly engaged in anti- social or del inquent activities t h a n indigenous Dutch adolescents. A th i rd conclusion is t ha t there are several impediments to the full involvement of immigran t parents in the i r children's t rea tment . The t r e a t m e n t i tself almost completely remains a "black box." The impact of cul ture-related differences between immigran t families and care ins t i tu t ions on communicat ion and t r ea tmen t needs more a t ten t ion in practice and research.

A previous contribution in this journal (Eldering & Knorth, 1998) dealt with the marginalization of immigrant youth in Europe and the risk factors they face in their day-to-day lives. In this article we shall deal with the placement and treatment 1 of these children in a residen- tial group care setting and discuss the (scarce) scientific research that has been conducted on this topic during the last decades in the Netherlands. The emphasis is on children aged ten and older.

As point of departure we assume that residential child and youth

Correspondence should be addressed to Erik J. Knorth, Section on Special Education and Child and Youth Care, Faculty of Social and Behavioral Sciences, Leiden Univer- sity, P.O. Box 9555, 2300 RB Leiden, The Netherlands; e-mail: <knorth@rulfsw. LeidenUniv.nl>. The authors wish to t h a n k Marijke Hamel for her help in researching the l i terature.

1The te rm " t rea tment ~ is used in th is article in the sense of a broad ar ray of interven- t ions covering basic care as well as specific therapeut ic interventions.

Child & Youth Care Forum, 27(4), August 1998 © 1998 Human Sciences Press, Inc. 237

238 Child & Youth Care Forum

care is a goal-oriented intervention, implying that on the basis of a careful analysis of the problems of the child and his or her parents or caretakers, objectives are determined that, in their turn, establish the framework for a goal-oriented approach (Knorth & Smit, 1995). The questions we formulate are:

a. What are the problems of immigrant children who are referred to residential settings?

b. Along what lines does the process of placement evolve? c. What approach is used in the t reatment , tha t is, wha t are the

most important goals and methods and to what extent are these in line with the circumstances of immigrant residents?

First we make a few remarks about the numbers of children in- volved and their over- or under-representat ion in these homes.

C h i l d r e n w i t h F o r e i g n C u l t u r a l R o o t s i n D u t c h R e s i d e n t i a l H o m e s

Numbers and Sub-groups

It is not easy to give an unambiguous answer to the apparently simple question of how many children with foreign cultural roots are admitted to residential homes in the Netherlands, since reliable and recent figures on this mat te r are not available (Task Force Jeug° dhulpverlening, 1994). According to the survey data of the national Youth Care Inspection Office about 21% of the population of residen- tial homes were children of foreign descent at the end of 1992 (Inspec- tie Jeugdhulpverlening, 1993a). The Inspection Office makes a dis- tinction between the "largest target groups of Dutch minorities policy'--i .e. , children from Surinam, the Dutch Antilles, Morocco, and Turkey, 13% all toge the r - -and "other children with foreign cul- tural roots," accounting for 8%. The former category is referred to as "immigrant children." The lat ter category is of a ra ther diverse com- position containing children from ethnic and cultural minority groups tha t have resided in the Nether lands for several decades (such as people from the Moluccan Islands and China), children adopted from abroad, refugee children, and immigrants coming from countries other than the four jus t mentioned.

We have to be careful with this 21 percent figure mentioned by the Inspection Office. One reason for this is that the percentage found depends on how the concept of "children with foreign cultural roots" is defined and the leeway this definition leaves for interpretation. The Inspection Office has chosen the child's foreign descent as the crite- rion, tha t is, whether the child or at least one of its parents was born

Erik J. Knorth and Lotty Eldering 239

outside the Netherlands. Other s tandards have been used as well, such as the section of the population with which the family identifies most or the child's nationality (cf. Bakker & Clarijs, 1994; SRJV, 1995).

Intermezzo 1. We have discovered that the standard chosen may make a lot of difference. In preparing an investigation into a category of resi- dential homes, the so-called institutions for Bijzonder Jeugdwerk (liter- ally: Special Youth Care), which house quite a few of these children with foreign roots (Konijn & Schut, 1989), we asked about the number of children with such a background. It turned out that using the criterion of country of origin of the child or (one of) its parents, these institutions had admitted 537 children of foreign descent in 1995. This is about 20% of all the children placed in these homes in 1995. However, when using nationality as criterion, this percentage shrunk considerably, to 14%.

A second reason for uncer ta inty about the numbers is tha t there is no adequate nation-wide registration of the ethnic identity of all the youth admitted to residential homes in the Netherlands, although a few initiatives have been realized. The failure to register ethnicity or nationali ty more systematically reflects a taboo against categorizing individuals on the basis of their ethnic or racial backgrounds (cf. Ver- kuyten, De Jong, & Masson, 1992).

As a mat ter of fact, the lack of data on ethnicity does not seem to be a uniquely Dutch phenomenon (see, for example, Smith & Berridge [1993] regarding the English situation). There are also countries, like Germany for instance, in which registration at the central level seems to be well arranged (see Kallert & Bacherl, 1992). This does not, how- ever, prevent another German author, Jockenhovel-Schiecke (1994), from speaking of the " . . . scarce information available" (p. 179). This author observes tha t in Germany an estimated " . . . 8% of the 70,000 children in residential care are migrants and refugees" (p. 179). And Woodley Brown and Bailey-Etta (1997) recently write concerning the USA tha t " . . . states have some difficulty in reporting data for chil- dren in out-of-home care because of missing data, differences in kind of information collected, and inability to determine race and ethnic- i t y . . . " (p. 74). So again, we need to be careful with these data.

Over- or Under-Representation?

An interesting question in this context tha t often " . . . arouses strong feelings" (cf. Ahmad, 1989, p. 158) is whether we can speak of an over-representation of children with foreign cultural roots in resi- dential care. Here - -as well as in the rest of this ar t icle--we will mainly limit ourselves to the group of immigrant youth. (For an over-

240 Chi ld & Youth Care Forum

view of immigrants in the Netherlands, their socio-economic position and Dutch minorities policy see Eldering, 1997.)

The question of over-representation is raised frequently and is usu- ally answered in the affirmative (cf. Malewska-Peyre, 1982; Stehno, 1982; Lillesaar, 1987; Barn, 1993; Duder & Dayagi, 1994; Woodley Brown & Bailey-Etta, 1997). In the USA, for example, African Ameri- can and Latino children 2 constituted about 25% of the total child pop- ulation in 1994 (Groze et al., 1994, as cited in Woodley Brown & Bai- ley-Etta, 1997), yet their share in out-of-home care settings was more than 50%. On the other hand, Ahmad (1989) questions this alleged over-representation for England, referring to an investigation of Rowe, Hundleby, and Garnet t (1989). Duder and Dayagi (1994) in Canada found tha t over-representation may to a large extent be ex- plained by the unfavorable socio-economic position of many immi- grant families as well as by specific reasons for referral tha t are rela- tively often observed in these families in Canada: alleged neglect and abandonment. Woodley Brown and Bailey-Etta (1997) discuss the his- tory of economic marginal i ty tha t rendered African American families in the USA more vulnerable to distress and destabilization, including parent-child separation:

In considering the social and family factors contributing to African American children and families' involvement in the out-of-home care system, attention must be given particularly to the economic impact of the deindustrialization of the American economy and the subsequent loss of jobs experienced in African American communities across the country (Woodley Brown & Bailey-Etta, 1997, p. 72).

What about the Dutch situation? Immigrant children constitute 9% of the total population of children up to the age of 19 in the Nether- lands (Martens, Roijen, & Veenman, 1994), whereas - -as indicated above-- they account for an estimated 13% of the population in resi- dential homes. So, the extent of over-representation seems to be con- siderably lower than is usually assumed. Moreover, there are consid- erable differences between the four ethnic groups. In the case of Surinamese and Antillian children over-representation seems to be strongest. There is a similar tendency among Moroccan children, al- though it may be of lower magnitude, and in the case of Turkish chil- dren we can speak of under-representation. 3 A report published under

~Although many of these are not immigrant children in the strict sense of the term, they represent ethnic minority groups and arguably present many analogous issues.

3Here we must be aware that the reference dates of the two sources are not identical. According to the data of the Centraal Bureau voor de Statistiek, CBS (National Insti-

Erik J. Knorth and Lotty Eldering 241

the auspices of th ree i m p o r t a n t Dutch organ iza t ions in the field of child welfare emphas izes the need for a closer inves t iga t ion of this issue (Bakker & Clarijs, 1994).

The ques t ion of over - representa t ion m a y be re la ted to the specific r isk factors in i m m i g r a n t families explained by E lde r ing and Knor th (1998). O the r r i sk factors often men t ioned in the l i t e ra tu re are unfa- vorable socio-economic and hous ing conditions, which cause a g rea t deal of tens ion (Duder & Dayagi , 1994). (In the N e t h e r l a n d s a lmost h a l f of all the i m m i g r a n t families live in the four major c i t i e s - - see Tesser, 1993; Elder ing, 1997.)

Ano the r point t h a t bears a t t en t ion here is the way child and you th care agencies themse lves deal wi th i m m i g r a n t chi ldren: in case of se- r ious problemat ic behavior, t hey appea r to refer t h e m less often to, for instance, communi ty -based care p rog rams as an a l t e rna t ive to an out- of-home p lacemen t (Stehno, 1982; H o g a n & Siu, 1988; Barn , 1993; Fletcher, 1997). 4 Simi lar indicat ions are found in Du tch research as well (cf. Van der Laan , 1985a).

The Turk ish chi ldren are an exception. I t was found (Elder ing & Knor th , 1998) t h a t on average, Turk ish boys have fewer contacts wi th the police t h a n Moroccan boys and they are w a n d e r i n g (i.e., a t least t empora r i ly homeless and/or l iving on the s treets) less t h a n Moroccan and S u r i n a m e s e boys. Fu r the rmore , Turkish girls a p p e a r to r un away from home less t h a n Su r inamese and Moroccan girls. This migh t be explained by the g rea te r social cohesion in the Turk ish community .

tute for Statistics) at the beginning of 1992 there were 336,652 children aged 0 through 19 of Surinamese, Antillian (including Aruban), Moroccan, or T~rkish descent in the Netherlands. This is 9% of the age-bracket concerned. The division across the various groups is as follows: Surinamese 2.7%, Antillian 0.9%, Moroccan 2.6%, Turkish 2.8% (Martens, Roijen, & Veenman, 1994). According to the data of the Youth Care Inspec- tion Office (Inspectie Jeugdhulpverlening, 1993a), at the end of 1992 the division of the same groups in residential homes was as follows: Surinamese 6%, Antillian 2%, Moroc- can 3%, Turkish 2%. In addition it may be observed that immigrant youths--and espe- cially Moroccan boys--are strongly over-represented in judicial juvenile institutions. However, this group of facilities covers no more than 10% of the residential capacity (Boendermaker, 1995). The immigrant juveniles are also strongly represented in the population of residential centers for short stay crisis care in the major cities of the Netherlands (Wouda, 1992).

4Service planning may reveal an (unspoken) reluctance among professionals against "strong" psychotherapeutic interventions, connected with a legacy of self-help within certain minority groups. Fletcher (1997) did research in the USA on practitioners' ser- vice recommendations for troubled youths. A sample of African American social work- ers (N= 141) rated case analogues in which client characteristics varied by experimen- tal design on racial, gender, and age dimensions. Among other things, Fletcher reports that recommendations for intervention were stronger for Caucasian adolescents than for African American adolescents. Citing English (1991), the author points at an ethnic minority bias against formal agency-based helpgiving: ". . . when given an opportunity, (they) will avoid bureaucratic services in favor of resolving their problems themselves" (Fletcher, 1997, p. 232).

242 Child & Youth Care Forum

P r o b l e m s R e s u l t i n g i n P l a c e m e n t

W h a t do we now know abou t the problems resu l t ing in the place- m e n t of these ch i ld ren in a res ident ia l home? Is t h e r e any difference be twe e n these p rob lems and those of ind igenous Dutch chi ldren? Of the var ious inves t iga t ions conducted on Dutch res ident ia l care in the las t t en yea r s or so, only one focused specifically on the s i tua t ion of i m m i g r a n t youth . The d a t a concerned a r ep r e sen t a t i v e sample of in- s t i tu t iona l ized Su r inamese , Turk i sh and Moroccan chi ldren aged 12 and older2 Al though th is r e sea rch was conducted in the 1980s, the outcomes still have va lue (Van de r Laan , 1985b, 1986).

By interviewing the var ious persons involved ( the child, the person who re fe r r ed the child, t he group leaders in the res ident ia l homes and, insofar as th is was possible, t he parents ) , 6 the problems t h a t p layed an i m p o r t a n t role as p l acemen t reasons were assessed. In ha l f to t h r e e qua r t e r s of the cases, issues concern ing fami ly funct ioning were ment ioned , such as "educat iona l incompetence" of the m o t h e r and (if still a round) the f a t h e r as well as conflicts be tween the par- en t s and the child. I t is not difficult to see a para l le l he re wi th the factors tha t , according to McCord (1990), p romote the process of mar - ginal izat ion: 1. i ncompe tence of the mother ; 2. nega t ive in te rac t ion be tween the f a t h e r and the mother ; and 3. lack of control , especial ly by the mother , in t he fami ly (cf. E lde r ing & Knor th , 1998). According to Van der L a a n (1985b), however, the pa ren t s t hemse lves men t ioned fami ly problems less of ten t h a n group leaders did. Moreover, in ha l f to t h r e e qua r t e r s of the cases the chi ldren h ad school-re la ted prob- lems, inc luding t ruancy , and problems like r u n n i n g away, l iving on the s t ree ts , and engaging in cr iminal behavior. This l a t t e r act ivi ty involved both p rope r ty ( thef l iburg la ry) and people (fighting).

By inves t iga t ing case files an a t t e m p t was m ad e to find out w h e t h e r t he r e was a d i f ference be tween i m m i g r a n t youngs t e r s an d a m a t c h e d compar i son group of na t ive youngs t e r s wi th respec t to the problems resu l t ing in p lacement . With r ega rd to two problems, signif- i can t differences (p<.05) were found: i m m i g r a n t youngs t e r s had ru n

~'rhe data concerned regard 91 children with foreign backgrounds and 85 native chil- dren who--matched with regard to sex, age, and home--serve as a comparison group. The children live in five types of residential homes: homes for working/studying young- sters, Bijzondere Jeugdzorg (BJ) institutions (specialized residential group care set- tings with extra educational program resources), institutions for vocational training, private treatment homes, and treatment centers under the criminal law.

6The various respondents were confronted with such questions as those concerning the problems that were the cause and background of the placement. Sometimes the parents were reluctant to allow an interview; interviews were conducted with 43 par- ents (particularly mothers and Surinamese parents). While analyzing the data per child the results of the various sources of data were compared.

Erik J. Knorth and Lotty Eldering 243

away from home more often, and they were more often wandering than native youngsters. These two patterns of behavior in particular increase the chance of or may be an expression of social detachment and marginalization, especially with regard to boys (cf. WerdmSlder, 1990; Angenent, 1993).

Other research not specifically aimed at immigrant children has revealed some problems that occur more often in immigrant children than in indigenous Dutch children, namely truancy and wandering (Van der Ploeg & Scholte, 1989); excessive substance use (Van Dijk, Hoolboom, & Besamusca, 1989); aggression and criminal behavior (Van der Ploeg & Scholte, 1989; Boendermaker, 1995); and a thor- oughly disturbed parent-child relationship (Van der Ploeg & Scholte, 1988, 1989). Also mentioned, although much less frequently, are: (psycho)somatic problems (Van der Ploeg & Scholte, 1988); domestic violence or being threatened with physical abuse (Wouda & Mateman, 1992); and culture-related problems (Wouda & Mateman, 1992).

It is noteworthy that the externalized or behavioral problems of the youngsters are emphasized and that internal, psychological problems are rarely reported. This may indicate that these problems occur in- frequently in immigrant children. It may also mean--and this seems to be more l ikely--that these problems less frequently reach the at- tention of social care or, if they do, that they are not properly diag- nosed (cf. Wouda & Mateman, 1992; Bakker & Clarijs, 1994).

It may also be noted that culture-related problems appeared to play a rather limited role in the process of placement. In the interviews of Van der Laan's (1983) investigation, for example, a factor such as "(dealing with) cultural differences" was reported in only 13% of the cases. And according to the case files examined in this investigation "cultural conflict" did not play a role as a reason for placement at all. This contradicts the opinion and experience of others specifying that cultural differences always play an important role, including the proc- ess of placement (for example, Ferrier & Helmantel, 1986; Weaver, 1990). The question this raises is whether the research methods used were sufficiently "culture sensitive."

The team of researchers was, however, aware of the fact that the problems of these youngsters are related to their status as immigrants from a country with a different culture. In their first report of the in- vestigation these backgrounds were dealt with extensively, including

- - the duration of the time the family was separated or together; - - the more or less "traditional" culture of the family; - - the different norms for boys and girls; - - the levels of aspiration of the members of the family with regard to

themselves and others;

244 Child & Youth Care Forum

- - t h e influence/coherence of the ethnic community; - -confrontat ion with discrimination; - - t h e (unfavorable) social opportunities for youngsters (schooling/la-

bor market); - - t h e (unfavorable) socio-economic position of the family (Van der

Laan, 1983, p. 38 ff.).

Several of these factors do not apply exclusively to immigrant clients. It can be concluded that most children are faced with problems at

more than one level at the same time and that these problems tend to intensify each other. Over time a process has taken place in which family problems, behavior problems, problems at school, and prob- lems during leisure time have accumulated and formed a circle of mutual ly intensifying areas of problems that have, so to speak, im- prisoned the child and its parents (see also WerdmSlder, 1990; Junger & Polder, 1991). In order to break out of tha t circle, social care has to be simultaneously activated on several fronts. The question is whether this happens or not.

T h e P l a c e m e n t P r o c e s s

Before we deal with social care in children's homes, we make a few remarks about the process of placement. In the l i terature we some- t imes find allegations that it is hard for immigrant children to be admit ted to insti tutions for child care or tha t these children end up in insti tutions of poor quality because of their foreign backgrounds (see Stehno, 1982; Hogan & Sie, 1988; Gibbs, 1990). For instance, Gibbs (1990) reported that a number of African American adolescents were purposively directed through the juvenile just ice system ra ther than being served in mental health systems. According to Gibbs, young people in the justice system are less likely to receive comprehensive care, which increases the chance that immigrants will already be "in a backward situation" at the gate of residential care when compared with native children.

Recently two investigations have been carried out in the Nether- lands concerning the placement of children in residential institutions. The first involved 360 juveniles (12 through 17 year olds) placed un- der a supervision order, for whom it appeared to be difficult to find a residential placement (Van der Laan, 1992). For immigrant young- s te r s - -40% of the research sample--being unmotivated for social care tu rned out to be the main child-related reason tha t an application for placement was unsuccessful, and more often than was the case with native youngsters. This concerned Surinamese youngsters most fre-

Erik J. Knorth and Lotty Eldering 245

quently, but it was also noted with Moroccan juveniles. Furthermore, it appeared tha t particularly parents of Moroccan youngsters some- times did not agree to placements proposed by the social worker, al- though this did not occur very often in absolute terms.

In the second research project, 120 children (aged 10 through 19) for whom an application for admission to a t rea tment setting had been submitted were followed for a period of six months (Knorth, 1998; Knorth & Dubbeldam, 1998). This investigation also showed tha t on average several at tempts were needed before an admission could be realized. I t took longer to find a suitable place for immigrant children and they less often ended up in the institution tha t was the first choice of the referring social worker.

However, the factor of foreign descent in itself was not a reason for stagnation in the placement process. The lat ter investigation showed tha t two other variables, namely police contacts and anti-social be- h a v i o r - m o r e frequently but not exclusively found with young immi- g r a n t s - w e r e strongly correlated with the length of the process of seeking a placement. We conclude tha t the admissibility to residential insti tutions for youngsters displaying anti-social behavior, having contacts with the police, and having little motivation for social care, is a question tha t deserves further attention.

T h e P r o c e s s o f S o c i a l C a r e

Our next question is to what extent the problems with which immi- grant children are admitted to a home are, indeed, the start ing point for the process of social care: To what extent does the approach cho- sen deal with these problems and where do we find possible bottle- necks?

Here we are confronted with what Van der Ploeg (1986) called the "black box" of residential child care. He said:

One of the most difficult issues in the residential treatment process is the relatively limited knowledge of what happens within the home. I am referring here to the restricted insight we have into the means and methods employed to solve problems as well as into the effects of these methods. As a matter of fact, this 'black box' phenomenon not only ap- plies to residential care, but to forms of ambulant care as well (p. 271).

We still know very little about the actual throughput of residential care. The investigations conducted in this domain in the Netherlands tha t could teach us something about the strategy employed in the case of immigrant residents are still very limited in number.

246 C h i l d & Youth Care F o r u m

Purposes and Methods

As a follow-up to his previously discussed investigation, Van der Laan investigated the question of the t r ea tmen t goals tha t were being considered with regard to the juveniles concerned, as well as (to a l imited degree) which means were employed and to what extent the goals were, in fact, realized (Van der Laan, 1985b). 7

In interviews, group leaders were asked to select from a list of 50 objectives those tha t were applicable for each child under considera- tion. We present here (Table 1) the goals mentioned in a minimum of 15% of the cases with respect to the ent ire group under investigation. (Because of thei r small numbers in the sample group, Turkish chil- dren have been omitted.)

The most frequently mentioned goals were those concerned with the intra-psychological functioning of the youngster, social skills (both with respect to peers and adults), and academic skills. Other, much less f requent ly mentioned items included goals related to contacts with the parents , practical skills of the pupil, and his or her deviant behavior.

There were some differences between indigenous Dutch and immi- grant pupils. Group leaders mentioned the first purpose ("intra-psy- chological," i.e., improving their self-insight) significantly more often for native youngsters, whereas the goal for immigrant children (espe- cially for Sur inamese children) was more often to teach them to ex- press their personal problems verbally. Fur thermore , providing shel- ter (which in fact is more a means than a goal--cf . Knor th & Smit, 1995), learning how to distinguish between good and evil, and resist- ing criminal contacts were more often mentioned as goals for immi- grant youngsters. Goals involved here are re la ted to behavior rela- tively often displayed by immigrant children (see above)- -wander ing and del inquent behavior.

Only a few goals exclusively related to immigrant clients were indi- cated: the promotion of knowledge of the specific cultural/ethnic back- ground and paying at tent ion to the youngster 's religion, but they did not meet the 15% standard.

In te rmezzo 2. Here we will make a short "detour." At the end of the 1980s, a research team at the University of Amsterdam (Van der Lin-

~The research group consisted of 99 boys aged 12 and older, 63 of whom had immi- grant backgrounds (42 Surinamese, 14 Moroccan and 7 Turkish children). The young- sters live in the same type of residential institutions as in the research previously discussed; some of the same children were involved. In the first survey, some of the children had already been asked to participate in the follow-up survey. The data have been added to those of youngsters who terminated their stay in the group of homes concerned during the period of July 1983-January 1984.

Table 1 Goals M e n t i o n e d by the Group Leaders for at Least 15%

of the Cases (percentages r o u n d e d off)

Goals

Whole Sample Immigrant Native Born of Children Children Children

(N = 88) (N = 52) (N = 36) (percentages of totals per column)

Intra-psychological --obtaining more self 61 50 78

insight** -- learning to talk about 52 62 39

own problems Social skills -- learning how to deal 57 50 67

with peers --understanding and 57 63 47

trusting adults -- learning how to deal 25 29 19

with authority figures --improving relations 15 17 11

with older people Schooling and education - -having children follow 52 54 50

formal training -- learning how to accom- 28 37 17

plish a task --st imulating children to 27 23 33

have hobbies - -making children be- 25 25 25

come a member of a (sporting) club

--promoting knowledge 19 25 11 of the Dutch society

-- teaching how to write, 17 21 11 read, speak the Dutch language

Different environment --offering a structured 45 48 42

setting - - tak ing over education 30 25 36

and upbringing --providing shelter* 20 29 8 Norm and rules -- learning to handle• 41 44 36

respect rules -- learning to distinguish 20 31 6

good from evil**

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T a b l e 1 (Continued)

Goals

Whole Sample I m m i g r a n t Nat ive Born of Chi ldren Chi ldren Chi ldren

(N = 88) (N = 52) (N = 36) (percentages of totals per column)

Contacts with parents - - s t i m u l a t i n g chi ldren to 32

make contacts wi th pa ren t s / f ami ly

- - s t i m u l a t i n g chi ldren to 25 improve contacts wi th pa r en t s

- - g i v i n g the pa r en t s 23 ins igh t into the chi ldren 's s i tua t ion

- - counse l l i ng pa ren t s in 18 educat ion/br inging up

Practical skills - - l e a r n i n g how to deal 31

wi th money - - l e a r n i n g how to nor- 27

mal ise the r h y t h m of life

- - l e a r n i n g how to do 20 shopping

- - l e a r n i n g how to cook 19 Resisting deviant

behavior - - r e m o v i n g chi ldren 22

from a c r imina l environment**

- - p r e v e n t i n g chi ldren 19 from l iving on the s t r ee t s / runn ing a w a y

35 28

21 31

15 33

15 22

33 28

35 17

23 17

17 22

31 8

25 11

This table was composed on the basis of a secondary analysis of the data gath- ered by Van der Laan (1985b). The immigrant group is composed of Surinamese and Moroccan children. *difference significant at p<-.05; **difference significant at p<-.01.

Erik J. Knorth and Lotty Eldering 249

den, Konijn, & Schut, 1988; see also Konijn & Schut, 1989) submitted a request to a panel of 39 experts primarily from the Dutch ambulant and residential child and youth care within the framework of a Delphi inves- tigation (Linstone & Turoff, 1975). One of the things these experts were asked was to give their opinion about the question of whether in so- called "integrated" residential care there are goals with special rele- vance for immigrant children and, if so, to list these goals. A charac- teristic feature of this kind of integrated residential care is that the treatment simultaneously affects the three living domains of the child: the social situation within the group, the school situation, and leisure time conditions. The panel did not appear to be unanimous in its opin- ion. Half of the panel were of the opinion that there are no goals espe- cially relevant for immigrant children. The other half, however, felt that there were indeed special goals relevant for immigrant children. Two domains were viewed as requiring special attention here: (1) goals aimed at the improvement of learning at school (correcting learning de- fects; promoting social attitudes; getting a diploma), and (2) goals aimed at the reduction of unfavorable external influences (withdrawing the youngster from an undesirable sub-culture [drugs, prostitution, delin- quency] and from negative social reactions).

A special area of at tention in Van der Laan's s tudy is contacts with parents. There was a ra ther large discrepancy between the previously mentioned problems of the youngsters admitted and the goals re- ported by the group leaders. Although almost all children admitted had problems with their parents, remarkably goals in this domain were less frequently mentioned. This held t rue for native youngsters, too, but it applied even more to immigrants. Only in a minority of the cases (15%) were these parents counselled by the residential home in order to gain some insight into the situation of their child (for Moroc- can parents this occurred only once). These findings seem to reflect a point of major concern in residential care: cooperation with parents in general and with the parents of immigrant children in particular (Scherpenzeel, 1985; Ten Bosch, 1986).

Unfortunately, these figures are not outdated. Recent research shows tha t the involvement of the parents is generally limited and, in addition, tha t the process of involving immigrant parents does not proceed smoothly (Oud & Jansen, 1993; Smit & Knorth, 1997). When compared to indigenous Dutch families, there is less contact between the child and his parents in immigrant families, the group in which the child lives is experienced by the parents as less accessible, and the parents are less frequently counselled. In a recently completed investigation by Van der Ploeg and Scholte (1996) among a sizeable group of juvenile homes in the Netherlands, it was concluded tha t contacts with the parents demand the highest priority (see also Jen- son & Whittaker, 1989).

250 Chi ld & Youth Care Forum

Involving Parents. Residential care of immigrant children and their families is faced with a number of problems related to cooperation with parents (Bakker & Clarijs, 1994). Most immigrant parents, par- t icularly from Mediterranean countries, have a limited knowledge of the Dutch language, which hinders them in expressing themselves, and this hampers their communication with social workers. Fre- quently, one of the children has to act as an interpreter, which, of course, may bias the information. Further, non-verbal signals may also cause misinterpretation. Weaver (1990) explains that cross-cul- tural misunderstanding is almost inevitable when two different cul- tures are interacting during a high-anxiety situation and most of the interaction is nonverbal.

Part icularly where there is a court order (such as a family supervi- sion order), social workers are often viewed as government officials with whom no relation of t rus t is possible or even desirable. It takes quite a long time to develop a good relationship between the social worker and the parents in these cases.

Another problem concerns the discrepancy of views on the appro- priateness of the measures proposed to address the behavioral prob- lems of the children. Whereas many parents of immigrant children would prefer a more disciplinary approach, social workers tend to pro- m o t e - - a t least on a theoretical level - -an approach that offers the children more autonomy and new skills, and they may tend to dis- courage punishment. In general, there is a strong reluctance among professionals in the Nether lands to use "authority" even if the profes- sional is the person in charge, as in the case of a family supervisor who has been appointed by the juvenile court (cf. Hoogsteder, Van Nijnatten, & Suurmond, 1998). The "interference" by social workers may be experienced by families from Mediterranean countries, partic- ularly Morocco and Turkey, as threatening the family's "honor" (cf. Weaver, 1990; Pinto, 1994; Eldering, 1998).

The initial stages of the process of child and youth care often follow formal and bureaucratic procedures. Whereas most Dutch clients are used to these procedures, immigrants are not acquainted with them because of the lack of child care insti tutions in their country of origin. Another factor involved is the lack of knowledge on the par t of the social worker with regard to role and authori ty pat terns within the immigrant families. The social worker, therefore, may not know how-- l i tera l ly or f igurat ively-- to "enter" the family system and es- tablish relationships. Las t but not least, methods that appear to be promising and effective with Dutch parents (for example, video home training, cf. Janssens & Kemper, 1996) may not be suitable for use in immigrant families.

Erik J. Knorth and Lotty Eldering 251

Clearly, these are many reasons for dealing with immigrant par- ents cautiously. This requires, as a rule, more time, attention, and effort compared with work involving Dutch parents. Often, however, this t ime is simply not available, which may be one of the major bot- tlenecks.

Cultural Differences in Diagnostics and Treatment. Another issue con- cerns the impact of the immigrants ' culture on diagnostics and treat- ment (Bakker & Clarijs, 1994). We have already outlined tha t social workers in Van der Laan's (1985b) s tudy did not often mention cul- ture-related problems as manifest motives for placement. This raises the question of whether the ins t ruments used by researchers are suf- ficiently sensitive for mapping the culture-related perceptions of im- migrant clients. The question is also relevant for the (standardized) assessment methods used by clinicians in child and youth care prac- tice, inside as well as outside of residential homes.

A concept tha t may help to identify differences in cultural percep- tions is clinical reality, a concept developed by the American anthro- pologist and psychiatr ist Kleinman (1980, 1988). He defines this (in the medico-psychiatric context) as " . . . beliefs, expectations, norms, behaviors, and communicative transact ions associated with sickness, (health) care seeking, pract i t ioner-pat ient relationships, therapeut ic activities, and evaluation of outcomes" (Kleinman, 1980, p. 42). Cli- ents and social workers each have their own subjective explanations with regard to the development of psycho-social problems and opin- ions on the most appropriate t rea tment , the so-called Explanatory Models (EMs). It is hypothesized tha t the (partial) failure of social care to be effective or the premature terminat ion of the t r ea tmen t 8 has to do with the inability to bridge the gap between the clinical realities of the immigrant clients and the native social workers. Re- search in the Nether lands shows tha t the differences in clinical real- i ty may be large, both in ambulan t and in residential child and youth care (Van der Laan, 1985b; Terpstra, 1986; Adriani, 1990, 1993; Pij- nenburg, 1998).

Adriani (1990), who applied this concept in his research in an insti-

SResearch in residential youth care has revealed that quite often the stay is termi- nated prematurely or not according to plan. The fact that in the case of a number of youngsters the stay in a home is prematurely terminated for negative reasons has, for example, been observed in the investigation of Wouda, Van der Ploeg, and Smit (1987). It is their conclusion that the chance for premature termination ('dropout') is greater for immigrant residents than it is for native children, but without implying that the former element is the cause of the latter. These results are in line with the results of an investigation of the placement career of youngsters in residential youth care by Vissers (1988).

252 Child & Youth Care Forum

t u t e for m en t a l welfare , gives several examples of differences in Ex- p l a n a to ry Models be tween i m m i g r a n t cl ients and Dutch social work- ers.

Case 1. The parents of a ten-year-old Turkish boy with school problems and aggressive behavior believe that their son is "possessed by a ghost." However, the social worker feels that there are problems in the family relationships; he thinks that the problems are aggravated because of the different approaches of the father and the mother in the child's edu- cation.

Case 2. The mother of a five-year-old child, originating from (the for- mer) Yugoslavia believes that her son's bed-wetting is a physical defect that should be cured by an operation. The social worker, however, is inclined to think that the child uses bed-wetting as an instrument of power because of rivalry problems with his siblings.

A th i rd example comes f rom the Uni ted Sta tes . Weaver (1990) tells of an Amer i can Ind ian boy, Tim, who had been admi t t ed to a psychi- a t r ic hospi ta l un i t where a fo rm of mi l ieu t h e r a p y was used w h e re b y the pee r group he lped to d e t e r m i n e the wel lness and progress of a pa t ien t .

Case 3. If a boy is perceived as withdrawn, uncooperative, given to ex- plosions of rage, and so forth, he might be ranked a Level Five. At Level Four, he relates to others, but he is extremely closed emotionally, shows little concern for others, and is still prone to bouts of anger. Self-disclo- sive interactive behavior takes place at Level Three. On this level, the youth also displays authentic emotions such as breaking down in tears while relating a traumatic event in his life. At Level Two, self-disclosure continues . . . . At Level One the boy is certified sane or normal and is allowed to exit the institution and return to society again.

This all sounds reasonable and fair. Yet the very behavior that the facility considered normal was quite abnormal for an American Indian [like Tim]. Being self-disclosive, breaking down emotionally in front of others, and relating traumatic experiences are all equated with losing face, shame, and humiliation. Tim would never display this behavior before other boys in his tribe, and he certainly could never behave this way in front of Anglos (Weaver, 1990, p. 69).

Van der L a a n (1985b) has also found in t e res t ing discrepancies in clinical real i ty , pa r t i cu la r ly r ega rd ing the percept ion and apprecia- t ion of the resu l t s a r r ived at. Group leaders were of the opinion t h a t goals in the fields of verba l ly express ing oneself, schooling, and prac- t ical skills could more eas i ly be achieved, whe reas goals in the do- ma in of paren t -ch i ld re la t ionships , the way le isure t ime is spent , deal ing wi th norms , and r u n n i n g away /vagrancy were cons iderably

Erik J. Knorth and Lotty Eldering 253

more difficult. According to the group leaders instrumental goals were easier to realize than expressive goals (Millham, Bullock, & Hosie, 1977).

Among the parents participating in the research, only about half of the Surinamese parents thought that their children had improved, whereas the parents of Dutch, Turkish, and Moroccan children evalu- ated the development of their son or daughter positively in two-thirds of the cases. Problems that, in the parents' opinion, had been least effectively dealt with where those in the areas of schooling and labor. So in this respect the parents clearly differed from the group leaders.

The hypothesis here is that, with regard to their children, goal- oriented attention focused on education and qualifying for work is one of the most important motives for immigrant parents if they are to agree to treatment in a home (see also Eldering, 1993). With regard to these issues in particular, they have high expectations and, therefore, disappointment may easily occur in this respect.

We conclude that it is of major importance to recognize the discrep- ancies between the clients and the workers in both the perception of problems and in expectations with regard to social care as early as possible and to try to bridge this gap through extensive information and communication (cf. also Arends & Jessurun, 1991; Kromhout, E1- dering, & Knorth, 1998). However, there is limited basis for optimism about this process. Immigrant clients are expected to go to Dutch so- cial care institutions, which represent the dominant culture. This of- ten forces the members of the family (children, parents) to adapt to this culture (cf. Weaver, 1990). An important issue here is the possi- bility of negotiating with the parents about the central child-rearing values that differ between the immigrant and Dutch cultures. Exam- ples are values such as the autonomy of the individual and equal opportunities for boys and girls (Eldering, 1993, 1998).

C o n c l u d i n g R e m a r k s

At the outset of this article we asked to what degree residential care addresses the problems of immigrant youth and their parents. Although immigrant children in the Netherlands have increasingly been placed in residential institutions over the last twenty years, only sparse scientific research is available to answer the questions raised.

Our first conclusion is that the placement process of immigrant youth seems to be more complicated for reasons concerning the spe- cific problems of these adolescents and reasons concerning the care

254 C h i l d & Youth C a r e F o r u m

institutions. It is unclear to what extent cultural differences have an impact on the placement process.

Secondly, we conclude that it olden proves to be difficult to involve immigrant parents in the placement process as well as in the treat- ment itself. This may be due to differences in clinical reality between workers and immigrant parents and children.

Although residential homes will probably never succeed in develop- ing a satisfying working relationship with all immigrant parents, just as this is not always feasible in the case of the parents of native chil- dren (Millham, Bullock, Hosie, & Haak, 1989; Conen, 1994; Smit & Knorth, 1997), it would be useful, both for the sake of theory and practice, to study the conditions under which parents of immigrant children can be more involved in residential care. This research should also try to identify differences in clinical reality between cli- ents and workers, including an exploration of how these differences may be bridged in order to make the treatment successful (Kromhout, Eldering, & Knorth, 1998).

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