To the End of June : The Intimate Life of American Foster Care (9780547999531) (24 page)

Tolightha had a BA in urban studies, which, she explained, helped her to look at child welfare from an economic perspective—but it didn't provide much assistance with the deep psychological trauma that her clients presented daily. She'd been thinking of going back to school to get a master's in social work, so she could offer them real therapy. Right now, there simply wasn't enough to meet the need.

“We have so many kids who come into care who have been physically or sexually abused—but you can't just make a referral to a psychologist or a psychiatrist that doesn't work in that area,” she said. “We have a good gynecologist if the child is pregnant, and a good substance abuse therapist—but you can't send every child to the same person.”

In fact, she said, the entire agency retained only three psychiatrists for all of its children—and most of their work was in medical prescriptions. There were no therapists practicing in the neighborhood of Bed-Stuy for outpatient referral, where about 45 percent of the population lived on some form of public assistance in 2008,
so when Tolightha wanted to send a child to a specialist, she had to send him to Schneider Children's Hospital in Long Island. Since many foster parents in New York don't drive, that's just too far away.

Still, she said, most of her clients didn't want clinical help. “They always say, ‘I don't need therapy; I'm not crazy,'” she said, smiling at first, then tightening up when she mentioned how many times her kids' privacy had been violated. They worried that their files were always available for any new stranger to see. “They say, ‘I don't want my business all over the agency. I'd rather talk to you.'”

 

A group of therapists in New York City, called the Fostering Connection, offer their time and services to foster kids, and their families, pro bono. Francine Cournos is on their board. The night after Barack Obama won the presidency in 2008, I went to one of their meetings, where a few psychologists were presenting case studies of their work in a plain gray conference room on West 57th Street, above a Gap.

It was a room full of mostly women, with kinky hair, funky earrings, and canvas bags. It was already stuffy and overheated when I settled in and listened to the opening remarks.

“Much the way lawyers have a mandate to give a portion of their time to pro bono work, we dreamed up the Fostering Connection ten years ago,” one of the cofounders said into a microphone. She claimed the idea was to provide long-term, consistent relationships from the “soothing” comforts of the therapist's private office—mostly located in Manhattan. I prickled at the presumption: one person's comfort may be another's inconvenience. And with foster kids, I knew, you had to go to them—very few, I imagined, would travel to unfamiliar neighborhoods to spill their sadness to yet another stranger.

The codirector confirmed my suspicions. “What we've found is that foster kids don't always want, or can't even imagine, a long-term, open-ended relationship,” she said, adding that the nonprofit often had more therapists on call than it had clients. I thought of Tolightha Smalls lamenting the dearth of qualified therapists in her neighborhood. “I now joke, ‘Build it and they
might
come.' There are many mismatches in terms of time, and respecting one's time.”

What this meant, according to the next speaker, was that patients just didn't show up. Their parents, or caseworkers, didn't bring them. She'd make calls to ACS, and nobody would return them; she'd set an appointment, and then sit in her empty office, frustrated. Why didn't people value what she was offering?

The mismatch, I thought, wasn't about time. It wasn't the gift they had that was wrong, nor, as one speaker insinuated, was it the recipients or their “cultural understanding of time.” It was the way that gift was packaged and presented. The final speaker, thankfully, reflected on some of these themes.

“We need to think about our assumptions,” she said, leveling her gaze across the room, “that when they don't show up they don't value it. We need to think about what people have internalized and what we represent.”

For kids, a therapist could represent a lot of things. A good percentage of foster children are on psychiatric medications to control their mood swings or hyperactivity and could view a therapist, with a raised eyebrow and a cocked hip, as yet another doctor in the lineup. Others, like the kids Tolightha encountered, were afraid of therapists spreading their private business around; respecting confidentiality hadn't been in their realm of experience. And others, like Fatimah at the Greens', wanted therapy, but wanted it to be convenient and familiar. Fatimah had been searching for a therapist, she said, to help her sort through the abuse and the jangle of memories so she could write her book, but she said, “I don't want to go somewhere far where a lot of white people will be looking at me like I'm crazy.”

A few years after this meeting, I spoke with a therapist who had been volunteering with the Fostering Connection for three and a half years; she had been seeing the same teenager the entire time, and he'd shown tremendous progress.
TFC's model worked, this therapist told me, though she had learned to be flexible: she found her client was more comfortable meeting her in a diner than at her office, so they talked, every week, over turkey burgers and omelets. This long-term, individualized therapy also worked, she said, because her client really wanted to be there. With the luxury of free weekly appointments over several years, they had time to build trust; at the beginning, they played cards and talked about snacks.

This kind of gentle start makes sense, as Francine Cournos says therapy might not always be the best idea for foster kids anyway—at least not while they're in the tumult of transitions. “When you're feeling unsafe, it's not a good time to explore your emotions; you're too enraged and disorganized to fall apart a little bit,” she said in her talk on foster care at the School of Social Work at Columbia. “These kids don't need uncovering therapy; they need adults who understand the natural processes of bereavement and trauma.”

It's the parents who are the real “healing agents,” as Francine called them; they're the soil into which the kids can root. But really, she said, anyone a child attaches to can do the trick; it's a matter of them “seeing in you the capacity to become something good.” It could be a teacher, a mentor, a therapist, a nun. It could even be an employee at a group home.

When I talked with Tolightha Smalls, she lamented the change in tide and the city's decision to close more of its group homes. Tolightha watched kids who lived with individual foster families struggle with all manner of psychological troubles, and she thought about service implementation. If the kids lived together in more cohesive groups, she thought, it might be easier to provide them with more consistent psychiatric care. And keep them under closer supervision.

“If we had better service delivery in the group homes, we wouldn't have all these kids running away, running out to prostitute, because they'd be in these therapeutic settings,” Tolightha said. Her concern about prostitution was especially serious. Domestic trafficking of minors for sex work is on the rise,
and pimps—in New York they're often gang leaders
—target girls in homeless shelters or group homes
where the adults in charge often have no training about these types of predators
who run brothels out of apartments. The number of teenage prostitutes in New York is hard to gauge (a recent estimate gathered by various state agencies was three thousand, but many experts claim that's too low
), but the district attorney's office in Brooklyn recently created a Sex Trafficking Unit to target people who sexually exploit women and girls.
I knew one foster girl in Brooklyn whose story was fairly typical.
She wanted to keep her identity a secret, but she told me that she was approached one day by another girl about her age who promised to take her somewhere for a job interview. The girl I know was locked in an apartment with several other kids and forced, via beatings and rape, to take Ecstasy and sleeping pills and have sex several times a day for no pay. She escaped six months later and ran from the foster care system entirely.

Tolightha believed that well-staffed group homes could counter all this. Behind her head a brightly colored poster advertised the “Five top reasons to foster parent a teen.” It promised a teen could teach you the latest trends and help you program your cell phone. “But we can't make the group homes look like storage. We have to implement services where kids can see they're being assisted—give them group therapy, family therapy, tutoring. A kid could go back to his family from one of these places.”

Unlike Francine and her sister, Francine's brother was placed in a group home, and he did fairly well there, Francine said to me during our talk. He found an employee with whom he could connect but wasn't expected to love on command, the way she was expected to love her new mother. But while services can be better consolidated and coordinated from a central location, Francine cautioned that the central service for a traumatized child will always be a primary, human attachment. In group homes, workers would have to be trained to offer this—and step up as family figures, with all the loyalty and consistency that implies.

From her experience, Kecia was skeptical that group homes could provide such a thing. “There are just too many kids in there, and group home staff changes every eight hours,” she said simply. OK, I pressed, but if they
were
to work, what would have to change?

Like Francine and Tolightha, and like the recommendations in the report on ACS, Kecia thought the solution depended on people more than place. “Why do we get away from the humanness of things? How do we get away from it and then expect it to work?” Kecia said, playing with a crease in her state-issued jeans. The trouble with group homes, or with any institutionalized care, she said, is that kids feel they're being thrown away. But a person, she believed, inside that institution could change that perception. “I do believe love conquers all. But that means you've gotta rock with the kid—whether it's a little baby or an older child—rock with whatever they get into, no matter how bad they get.”

It was dark outside the room where Kecia and I sat talking; we could hear the evening guard ordering takeout chicken just outside our door. Kecia said that if she passed the parole board in the coming spring, she would go back to live with her mom, who was failing in health. Probably sign up for some computer classes, try to get a job in tech support. She looked forward to the little things—like her skin clearing up, and her hair softening again; the dry air and state-issued soaps in prison were driving her crazy. She looked at the bare walls, the barred windows, at me. Healing could happen anyplace, she said: a group home, a foster home, a bio home. “It's very simple—it's just the way life is. You don't leave people,” she said. “You stay.”

9

B
RUCE AND ALLYSON GREEN
don't use Kecia's terminology, but they basically embody the mission of “rocking with kids, all the way.” Dominique, the curfew-skipping, trash-talking, angry teenager straight from a psychiatric hospital, was by far the toughest to rock with, but they were managing. Allyson had agreed to let Dominique enroll in some fashion design classes after school, and once, when I stopped by, Dominique confessed to regularly hanging out with Fatimah, who loved SpongeBob and sports and was undoubtedly a good influence. Things seemed to be settling.

But then, just after Dominique hit her seven-month mark at the Greens', the agency called. There had been a mistake. The Greens were supposed to be a temporary placement, since Bruce and Allyson weren't authorized to care for a child with documented therapeutic needs like Dominique. She would have to move.

Apparently it wasn't the first time Edwin Gould had tried to take Dominique away. “The first time we spoke up for Dominique, it was because we were out of compliance,” Bruce said. He was with Allyson and Dominique in the kitchen on a Saturday morning, wearing his customary baggy jeans and T-shirt. He pulled some orange juice from the refrigerator and poured himself a tall glass; Dominique watched him closely. “State rules say we can only have six [foster] children but we had seven, so they had to move her. This went on for weeks.”

“Dad, can I please have some juice?” Dominique asked from the kitchen barstool, tipping up her face. She was still in her pajamas. She looked pretty and soft, her almond-shaped eyes fluttering in a sleepy way.

“No,” Bruce answered. “You're watching your weight.” He turned back to me and explained that Tonya's sister had been living with them for a bit, but once her biological dad regained custody, he thought they were in the clear with Dominique.

“Can I please have some in a cup?” Dominique whined.

“No,” Bruce said. “At this point, Dominique was arguing with everybody in the house. I mean everybody. Even Russell. Even Allen. She'd argue with that spider crawling on the ceiling.”

Dominique was pouting. “I'm just thirsty.”

“She found a reason to dislike something about everybody. Turn up the TV, turn down the TV, turn the channel.” Bruce paused. “Drink some water if you're thirsty.”

Dominique slumped on the stool, but she stayed quiet. Bruce said a few more months passed, and slowly, quietly, a transformation began. Dominique's storms softened; she stopped reacting quite so bitterly; everybody went to bed a little earlier, slept a little better. And that's when the agency called: Dominique had to move not only to a different family, but to a different agency—one that had licensed therapeutic homes on its roster. It should have happened long ago, they said, but like all things in child welfare, the clocks are set in months, not minutes.

Bruce was angry. “Bad as Dominique may be—hardheaded, stubborn—she's gone through all her trials and tribulations here and become acclimated to this household and all its rules and regulations,” he said, setting his empty juice glass on the counter with a soft thud. “How can they just play with the emotions of a child?”