One of the advantages to moving is that you get to find and organize all kinds of stuff you forgot you had. In the past, my office was short on storage space, so much of my sewing and ADN “stuff” was stored in two closets upstairs… making it very difficult to easily access books and fabric. Not so at our new house… the plan called for a huge master bedroom closet. We added a second closet for my husband (I vowed never to share closet space with him again after we built our first house in the early 90’s!) and added a door from the office into the closet. Now I can walk through this large walk-in closet and on into the bath area. I had the carpenters line the walls with shelving, and all my fabric and all my ADN library and other stuff can be in one centralized location. There is a saying… “He who dies with the most fabric wins!” I decided I would win… as much as I love to buy fabric, even I am blown away by how much I have accumulated. It is CRAZY!


At any rate, one of the books I found yesterday and will be placing on my newly-built shelves today is called Raising Cain; Caring for Troubled Youngsters/Repairing Our Troubled System and the author is Richard J. Delaney, Ph.D. I threw the book on my desk and decided I would see how the view of Dr. Delaney in the late 90’s compared with his views today. I randomly opened the book this morning and here is what I read (emphasis added just as it was in the book):

Traditionally, when we think about psychotherapy for children, conventional approaches come to mind: play therapy, behavior modification, and family therapy. We recall trips to the mental health clinic, the wait in the reception area, and the confidential confessional the child enters for his/her “fifty minute hour.” In this traditional model of mental health, the expert (the central change agent) and therapist are one and the same: the mental health professional.


As controversial as it sounds, traditional therapy is often times not a good match for children who live in foster homes, group facilities, special needs adoptive placements, and/or residential care. Indeed, in the worst case scenario, conventional psychotherapy may inadvertently undermine the stability of placements. At the least, orthodox psychotherapy may have little or no relevance to: 1) stabilizing the child’s life while in placement; 2) confronting acting-out behaviors which threaten the continuity of placement, or 3) addressing relationship issues in placement which are at the core of the child’s progress.


The concept of “invisible therapies” (as described by one Canadian foster care program) endorses the belief that the foster or placement family is the expert (the central change agents) and the true therapists to children in their care. Foster parents, legal risk foster/adoptive parents, group home parents, and special needs adoptive parents are lead members of the therapy team. Rather than being relegated to waiting in the reception area of a mental health clinic, these parents are actively included in therapy sessions. Issues arising in their homes with their children become important grist for the therapeutic mill. Strategies for managing the child’s acting-out behavior, for fostering better verbalization of emotion, for engendering negotiation and social skills, and for promoting positive relationships and healthier attachments to others are developed by the therapy teams (composed of agency worker, foster or adoptive parents, mental health counselor, and others, as needed).


Invisible therapy is ubiquitous in foster and adoptive placements. The child’s unvarnished emotion, habitual misbehaviors, cynical misperceptions of intimacy, and unrelenting problems with attachment formation, all emerge in full force. The potency of emotion which arises in family settings is unparalleled, and correctly channeled, allows for maximum gains by the child. Consultation with the therapy team allows the parents to apply invisible therapy to the child. Consistency and surprise, directness and paradox, and most fundamentally, the relationships which foster and adoptive parents supply, comprise the invisible therapy provided for children.

Here is a quote from the recent article by Dr. Delaney that I have been discussing:

...the child should live in a safe home and have, within that home environment, consistency, predictability and control. Divesting a child of all sense of control is contrary to sensitive parenting. Treatment of children with severe emotional and behavioral problems should provide a combination of mental health consultation to the parents and parent training.

Dr. Delaney goes on to acknowledge that parents provide the greatest catalyst for change. But here are my questions:


When did “consistency and surprise, directness and paradox” give way to a child having “consistency, predictability and control”? Did the kids change over this past 8 years? And when did parents go from being part of the treatment team and the biggest factor in healing a child to needing "mental health consultation"? No DOUBT we need training. And we do need mental health help, especially after the kids destroy our families... But the shift here of "the kids have the pathology" to "the parents have the pathology" is unmistakable. There are countless other discrepancies in the book and the article...


I LOVE what Dr. Delaney wrote in “Raising Cain.” That was the Dr. Delaney I knew. What happened?


I am all for change, all for tweaking what works and eliminating what doesn’t work. And Dr. Delaney is certainly entitled to change his views… Apparently, however, it is OK for folks to ignore or not acknowledge the changes made in the field of attachment therapy. So although some professionals can categorically change their approach and move in a different direction, the field in general is still being judged by standards and practices of two decades ago, or by the poor decisions and disastrous consequences made famous by a few therapists or parents. What a double standard.

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