Do we always know what troubled children need ? Some comments on the thoughts of Hans Kornerup about “predictability”and the way we plan for the care of the ‘unintegrated child.’

This piece first appeared on the goodenoughcaring Home Page at http://www.goodenoughcaring.com on February 12th. 2011

There is a small but significant number of children, often described as emotionally “unintegrated”, whose behaviour is so deeply troubling and out of touch with social reality that they can no longer live with their birth family. These are children who have experienced traumatic disruptions in their lives from an early age.

Those who have been involved with working with children like this will have attended planning meetings where the received wisdom of the adults asserts, “What this child needs is predictability”. In the book “Milieu-therapy” with Children which he edited, Hans Kornerup makes some observations about this notion of predictability. He suggests however much the statement that a child has a need for predictability is intended to be an expression of the adults’ professional insight, it does not fully represent the child’s predicament let alone the child’s needs. Participants in such a meeting go on to plan conscientiously for the child to have a therapeutic experience which they believe will provide the child with predictability and therefore security. There are times, Kornerup believes, when this kind of statement and the plans which ensue from it might more accurately be understood otherwise. For Kornerup planning for predictability is not sufficient for children whose childhoods have been severely disrupted. For such children he writes,



‘their plans and expectations of the future are vague, almost non-existent, as they live in a timeless, here-and-now existence without prospects, filled with anxiety, confusion and chaos where every change to a new situation (structure) defined by adults creates more confusion, unrest and acting out. Based on this I am tempted to think that the spread of the concept of predictability is perhaps intended in a magical, and inexplicable manner to calm the adults who often find themselves in very difficult, confusing and unmanageable situations that make demands and raise questions regarding their own personality and attributes – “Am I capable of managing this?” ‘ *



For Kornerup unintegrated children ‘with an uncertain sense of their continued existence, can in no way experience surroundings as predictable, - even if they are - in the same way as they cannot contain inner continuity.’



In our view Hans Kornerup’s ideas helpfully demand that those who plan placements for deeply troubled children should not be seduced by spurious scripted, predicted and fixed solutions. Rather they should first hear the child, (with all his or her confusion, anxiety, fear, hate, lack of affect and so forth), second, they should ensure that there is a predictable nature to the structured physical, and material routines of care a child will receive, and, thirdly, they might also acknowledge and accept the unpredictable (to begin with at least) nature of the relationships and emotional containment which are at the core of therapeutic child care.





* From ‘On the Concept of Predictability’ in “Milieu-therapy" with Children: Planned Environmental Therapy in Scandinavia (ed. Kornerup, H.) Denmark Perikon pp279-288

This book is distributed in the United Kingdom by the National Children’s Bureau