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Feminist perspectives on group home care for sexually abused adolescent women : a case study of Phoenix… Walton, Victoria Merryanne 1989

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FEMINIST PERSPECTIVES ON GROUP HOME CARE FOR SEXUALLY ABUSED ADOLESCENT WOMEN: A CASE STUDY OF PHOENIX HOUSE. By VICTORIA MERRYANNE WALTON B.S.W., The University of Regina, 1979 THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SOCIAL WORK in THE FACULTY OF GRADUATE STUDIES The School of Social Work We accept t h i s thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA June 1989 © V i c t o r i a Merryanne Walton, 1989 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department The University of British Columbia Vancouver, Canada Date DE-6 (2/88) A b s t r a c t Recent r e s e a r c h about c h i l d s exual abuse has l a r g e l y focussed on treatment with f a m i l i e s or i n d i v i d u a l s . However, many s e x u a l l y abused a d o l e s c e n t s l i v e i n group homes. What kind of treatment do we provide f o r t h i s p o p u l a t i o n ? Do t r a d i t i o n a l models of group home care adequately meet the p a r t i c u l a r needs of t h i s p o p u l a t i o n ? T h i s q u a l i t a t i v e case study sought t o examine the components of care of a group home for s e x u a l l y abused female a d o l e s c e n t s . M u l t i p l e sources of data were used from a v a r i e t y of sources. T h i s i n c l u d e d nineteen i n t e r v i e w s with r e s i d e n t s , d i s c h a r g e d r e s i d e n t s , s t a f f and r e f e r r i n g agents, as w e l l as o b s e r v a t i o n s and document a n a l y s i s . T h i s i n n o v a t i v e model of group home care i s e s s e n t i a l l y a f e m i n i s t model of care based on mutual empowerment. The ad o l e s c e n t s i n t h i s study d e s c r i b e d a process of f e e l i n g cared f o r , opening up and t a k i n g charge d u r i n g t h e i r l i f e at Phoenix House. The s t a f f d e s c r i b e d three t h e r a p e u t i c t a s k s which meshed with the ad o l e s c e n t ' s themes; co n n e c t i n g , t e a c h i n g and c h a l l e n g i n g . T h i s model i s i n d i r e c t c o n t r a s t with a model which r e p l i c a t e s t h e abusive p r o c e s s . A e c o l o g i c a l model i s used as a framework to show how we r e p l i c a t e the abusive process on a v a r i e t y of l e v e l s i n our s o c i e t y . T h i s r e s e a r c h c h a l l e n g e s our d e f i n i t i o n s of abuse, our a t t i t u d e s about power, the nature of our r e l a t i o n s h i p s with a d o l e s c e n t s , and the way we s t r u c t u r e o r g a n i z a t i o n s . — i i i — T a b l e of C o n t e n t s A b s t r a c t T a b l e of C o n t e n t s L i s t of T a b l e s . L i s t of F i g u r e s . Acknowledgements P r e f a c e i i i i i . i v . v . v i v i i C hapter One: I n t r o d u c t i o n 1 D e f i n i t i o n s Purpose of t h e Study Chapter Two: L i t e r a t u r e Review 6 Nature of t h e Problem The P r e v a l e n c e A d o l e s c e n t Development Group Homes and Abuse Models of Care: A F e m i n i s t C r i t i q u e R a t i o n a l e and F u n c t i o n of t h e Research Chapter Three: Method 36 Design Sources of Data I m p l e m e n t a t i o n S t r a t e g y of Data A n a l y s i s Chapter Four: F i n d i n g s 46 Background I n f o r m a t i o n The Components of Care Changing R e p l i c a t i n g t h e A b u s i v e P r o c e s s Chapter F i v e : D i s c u s s i o n 109 T h e o r e t i c a l I m p l i c a t i o n s P r a c t i c a l I m p l i c a t i o n s I m p l i c a t i o n s f o r S o c i a l Work C o n c l u s i o n B i b l i o g r a p h y 126 A p p e n d i c e s : A. E t h i c a l A p p r o v a l and Consent from P h o e n i x House B. I n t e r v i e w Consent Form C. I n t e r v i e w Guide: A d o l e s c e n t s D. I n t e r v i e w Guide: Key I n f o r m a n t s E. Sample I n t e r v i e w F. Data D i s p l a y - i v-L i s t of Tables Table 1. Age and Placement History of Eight Female Adolescents in the Sample 48 - v -L i s t of F i g u r e s F i g u r e 1. Changing 72 F i g u r e 2. An E c o l o g i c a l Model of Abuse 95 - v i -Acknowledgements This study represents an integration of many issues which have been important in my l i f e . For t h i s , many thanks are in order. F i r s t , I would l i k e to thank the young women at Phoenix House who embody the true strength and r e s i l i a n c y of womanhood, and who have helped me to reclaim the wonderful energy of adolescence. Also, thanks to the s t a f f of Phoenix House who are not a f r a i d to care, and who made being at Phoenix House fun. Many thanks go to Carolyn, whose theory and work t h i s research i s a testimony to. Her powerful presence has shaken up my ideas about good s o c i a l work practice. Thanks also to Kathryn who has nudged me to see the strong connections between feminism and s o c i a l work, and whose support has helped me to come through t h i s year. F i n a l l y , thanks need to be acknowledged to my partner, Brian, who has been an u n f a i l i n g source of support and held the rest of my l i f e together so that I could create t h i s . Phoenix House was a haven for me t h i s past year. It was a place of safety and a source of nurture. Many of my frustrations were kneaded out in clay during the peaceful oasis of art therapy. The experience of being at Phoenix House always served to ground me in the essence of what l i f e i s a l l about - being in a reciprocal r e l a t i o n s h i p with another which both nurtures and nudges. The unconditional rela t i o n s h i p which Phoenix House offers i s t r u l y a g i f t . It is my hope for you, the reader, that t h i s unique home both inspires and challenges you, as i t has me. - v i i -P r e f a c e R e f l e c t i o n s o n P h o e n i x H o u s e A f t e r a w h i l e i t d i d n ' t s e e m l i k e a g r o u p h o m e . I t f e l t m o r e l i k e a f a m i l y - t h e w a y p e o p l e t r e a t e d y o u , t r u s t e d y o u , l e t y o u m a k e y o u r o w n d e c i s i o n s , l e t y o u s a y w h a t e v e r y o u w a n t t o . A f t e r a w h i l e y o u r e a l i z e , h e y , t h i s i s g r e a t I Y o u s t o p t a k i n g a d v a n t a g e o f i t a n d y o u u s e i t f o r y o u r o w n a d v a n t a g e . A d i s c h a r g e d a d o l e s c e n t . - 1 -Chapter One: I n t r o d u c t i o n C h i l d s e x u a l abuse has become a t o p i c of i n c r e a s i n g a t t e n t i o n i n our s o c i e t y i n t h e l a s t decade. As our awareness of t h i s p roblem has d e v e l o p e d , t h e r e have been many i n n o v a t i v e programs a t t e m p t i n g t o a d d ress t h i s i s s u e i n terms of p r e v e n t i o n and t r e a t m e n t . The l i t e r a t u r e documents a v a r i e t y of t r e a t m e n t s t r a t e g i e s such as e a r l y i n t e r v e n t i o n w i t h f a m i l i e s , p l a y t h e r a p y w i t h c h i l d v i c t i m s , groups f o r a d o l e s c e n t v i c t i m s , and i n t e r v e n t i o n s w i t h a d u l t s u r v i v o r s (Wachtel & L a w ton-Speert, 1983). What i s c o n s p i c u o u s l y absent i n t h e l i t e r a t u r e i s a d i s c u s s i o n of t h e t r e a t m e n t of s e x u a l l y abused a d o l e s c e n t s who a r e i n c a r e . A s e a r c h of t h e l i t e r a t u r e r e v e a l e d no r e s e a r c h r e g a r d i n g group c a r e f o r s e x u a l l y abused a d o l e s c e n t s . Why i s t h i s p a r t i c u l a r t a r g e t group o v e r l o o k e d ? I would suggest two p o s s i b l e e x p l a n a t i o n s . F i r s t , who r e a l l y c a r e s about k i d s i n c a r e ? As a s o c i e t y , we a r e more l i k e l y t o c h a r a c t e r i z e t h i s p o p u l a t i o n as "non-c o m p l i a n t " or " u n t r e a t a b l e " , r a t h e r t h a n as c h i l d v i c t i m s of a b u s i v e f a m i l i e s and an u n c a r i n g s o c i e t y . R i x Rogers, the S p e c i a l A d v i s o r t o t h e M i n i s t e r of H e a l t h and W e l f a r e on C h i l d S e x u a l Abuse i n Canada s t a t e s , For a l t h o u g h we l i k e t o t h i n k of o u r s e l v e s as p e o p l e who v a l u e c h i l d r e n , our a c t i o n s as a s o c i e t y have not always born t h i s o u t . Perhaps th e most d i s t u r b i n g example i s t h a t we have c o n t i n u e d t o a l l o w p h y s i c a l and s e x u a l abuse of c h i l d r e n t o o c c u r and have f a i l e d t o p r o v i d e t h e s e r v i c e s t h a t abused c h i l d r e n need t o escape abuse and overcome i t s trauma (Rogers, 1988, p . 3 ) . S e c o n d l y , t h e r e seems t o be an u n d e r l y i n g a ssumption t h a t - 2 -t h e t r a d i t i o n a l model of group home c a r e i s a p p r o p r i a t e f o r a l l c h i l d r e n and a d o l e s c e n t s i n c a r e , r e g a r d l e s s of t h e i r p a r t i c u l a r problems, and t h a t t h i s model c o n t a i n s w i t h i n i t an adequate t r e a t m e n t m i l i e u f o r s e x u a l l y abused a d o l e s c e n t s . I n r e a l i t y , s e x u a l l y abused a d o l e s c e n t s i n c a r e p r e s e n t a f o r m i d a b l e t a s k t o group homes. We know t h a t t h e s h o r t and l o n g - t e r m consequences of c h i l d s e x u a l abuse a r e s t a g g e r i n g . R e s e a r c h has a s s o c i a t e d c h i l d s e x u a l abuse w i t h problems such as c h e m i c a l d e p e n d e n c i e s , p r o s t i t u t i o n , a ttempted s u i c i d e , mental i l l n e s s , s e l f - d e s t r u c t i v e b e h a v i o r , d e l i n q u e n c y , r u n n i n g , and b e h a v i o r problems (Browne & F i n k e l h o r , 1986; Wachtel & S c o t t , 1988; Cohen & Mannarino, 1988). Are we p r o v i d i n g a p p r o p r i a t e t r e a t m e n t f o r t h i s p o p u l a t i o n w h i l e t h e y a r e i n c a r e ? Do t r a d i t i o n a l models of c a r e a d d r e s s t h e needs of t h i s p a r t i c u l a r p o p u l a t i o n ? I n our z e a l t o c u r e f a m i l i e s , we may have n e g l e c t e d a group of a d o l e s c e n t s who a r e d e s p e r a t e l y i n need of h e l p t o d e a l w i t h p a i n f u l i s s u e s from t h e i r p a s t . D e f i n i t i o n s B e f o r e p r o c e e d i n g , an e x a m i n a t i o n of the d e f i n i t i o n s of two terms used f r e q u e n t l y i n t h i s paper; " c h i l d s e x u a l abuse", and "a f e m i n i s t p e r s p e c t i v e " , a r e i n o r d e r . The meaning of c h i l d s e x u a l abuse has been a s o u r c e of disagr e e m e n t i n t h e arenas of c h i l d w e l f a r e , r e s e a r c h and the law. L o b b y i n g by c h i l d advocacy groups i n t h e wake of t h e Bad g l e y Report (1984) succeeded i n b r o a d e n i n g the d e f i n i t i o n -3-of c h i l d s e x u a l abuse i n the C r i m i n a l Code of Canada t o i n c l u d e s e x u a l i n t e r f e r e n c e , i n v i t a t i o n t o s e x u a l t o u c h i n g , and s e x u a l e x p l o i t a t i o n of c h i l d r e n ( S e c t i o n s 140, 141 & 146 of B i l l C-15, 1987). Thus, our l e g a l d e f i n i t i o n of what c o n s t i t u t e s c h i l d s e x u a l abuse now acknowledges the g r e a t e r r i s k i n r e l a t i o n s h i p s of t r u s t , and t h e p s y c h o l o g i c a l damage of i n v i t a t i o n s t o engage i n a c t s , as w e l l as t o u c h i n g . I n t h e r e a l m of r e s e a r c h , no one d e f i n i t i o n i s g e n e r a l l y agreed upon. In h i s r e v i e w of n i n e t e e n N o r t h American s t u d i e s of c h i l d s e x u a l abuse from 1929 t o 1985, F i n k e l h o r (1986, p. 24) found t h r e e major components t o t h e d e f i n i t i o n s ; an upper age l i m i t , t y p e s of b e h a v i o r , and d e f i n i n g c h a r a c t e r i s t i c s . The most common d e f i n i t i o n s i n c l u d e d an upper age l i m i t of 16 or 17 y e a r s of age; a wide range of c o n t a c t , i n c l u d i n g p h y s i c a l ; and an age d i f f e r e n c e of a t l e a s t f i v e y e a r s when t h e r e was no o v e r t c o e r c i o n i n v o l v e d . These d e f i n i t i o n s i n c l u d e d b o t h i n t r a f a m i l i a l and e x t r a f a m i l i a l c o n t e x t s . There i s c l e a r l y much c o n t r o v e r s y r e g a r d i n g t h e d e f i n i t i o n of c h i l d s e x u a l abuse. For t h e purposes of t h i s paper, t h e t e r m c h i l d s e x u a l abuse w i l l be used t o r e f e r t o any s e x u a l a c t i v i t y w i t h a c h i l d (a pers o n under 18 y e a r s of a g e ) , even i f a p p a r e n t l y c o n s e n s u a l , by a s u b s t a n t i a l l y o l d e r p e r s o n ( f i v e y e a r s or more); or any non-consensual a c t i v i t y w i t h a c h i l d by a peer ( l e s s t h a n two y e a r s o l d e r ) . T h i s d e f i n i t i o n i s an a d a p t a t i o n of Wachtel & S c o t t ' s (1988). A f e m i n i s t p e r s p e c t i v e w i l l a l s o be d e f i n e d . Feminism seeks e q u a l i t y f o r women i n a l l f a c e t s of l i f e t h r o u g h s o c i a l -4-change. A f e m i n i s t p e r s p e c t i v e t h e n , i s a s p e c i a l p o i n t of vi e w ; a female p o i n t of v i e w t h a t seeks e q u a l i t y ; one t h a t has a keen awareness of a h i s t o r y based on a male frame of r e f e r e n c e ( C a r t e r , 1985). A f e m i n i s t p e r s p e c t i v e names t h e h i s t o r i c a l o p p r e s s i o n of women and seeks t o broaden t h e w o r l d v i e w by i n c l u d i n g women's e x p e r i e n c e . As such i t becomes a new paradigm which c h a l l e n g e s t r a d i t i o n a l Western p a t t e r n s of th o u g h t . I t a f f i r m s t h e importance of t h e s u b j e c t i v e e x p e r i e n c e and sees t h i s as t h e f o c u s of r e s e a r c h ( S t a n l e y & Wise, 1983). A f e m i n i s t p e r s p e c t i v e i s a d e l i b e r a t e l y v a l u e - l a d e n approach t o r e s e a r c h based on f e m i n i s t t h e o r y and p r i n c i p l e s (McCormack, 1981). The n a t u r e of t h e s e p r i n c i p l e s w i l l be addr e s s e d l a t e r i n t h e paper. Purpose of t h e Study The purpose of t h i s s t u d y was t o add r e s s t h e needs of s e x u a l l y abused a d o l e s c e n t s i n c a r e . D e s p i t e t h e t h r u s t of f a m i l y t r e a t m e n t f o r c h i l d s e x u a l abuse, t h e r e remains a group of a d o l e s c e n t s who a r e unable or u n w i l l i n g t o r e t u r n home, o f t e n f o r r e a s o n s of s a f e t y . How can we p r o v i d e a p p r o p r i a t e t r e a t m e n t f o r t h i s p o p u l a t i o n w h i l e t h e y a r e i n c a r e ? In o r d e r t o a d d r e s s t h i s i s s u e , t h i s r e s e a r c h undertook a case s t u d y of a group home f o r s e x u a l l y abused a d o l e s c e n t women. T h i s i s an a r e a s o r e l y i n need o f r e s e a r c h . S o c i e t y ' s i n c r e a s i n g awareness of s e x u a l abuse has had l i t t l e impact upon group home r e s e a r c h . C o n s e q u e n t l y , t h i s s t u d y was q u a l i t a t i v e and e x p l o r a t o r y i n n a t u r e . T h i s s t u d y sought t o - 5 -b r i d g e an i m p o r t a n t gap i n t h e l i t e r a t u r e by d e s c r i b i n g t h e impact of a s p e c i f i c model of group home c a r e d e s i g n e d f o r s e x u a l l y abused a d o l e s c e n t s . As s u c h , i t c o u l d be c o n s i d e r e d a program e v a l u a t i o n . P a r l e t t and H a m i l t o n (1976, p. 144) have c o i n e d t h e p h r a s e , " i l l u m i n a t i v e e v a l u a t i o n " which seeks t o u n d e r s t a n d t h e i n n o v a t i v e program. They suggest t h a t such an e v a l u a t i o n seeks t o s t u d y how a unique program o p e r a t e s , what p a r t i c i p a n t s c o n s i d e r t o be i t s advantages and d i s a d v a n t a g e s , and what i t i s l i k e t o p a r t i c i p a t e i n t h e program. Pho e n i x House, t h e group home i n q u e s t i o n , was e s t a b l i s h e d as an i n n o v a t i v e program f o r s t r e e t - i n v o l v e d , a c t i n g - o u t a d o l e s c e n t s f o u r y e a r s ago. I n i t s most r e c e n t p r o p o s a l i t was funded w i t h a s i m i l a r mandate, ex c e p t t h a t the a d o l e s c e n t s were a l s o t o have a h i s t o r y of s e x u a l abuse, which may or may not have been d i s c l o s e d . T h i s came about i n r e c o g n i t i o n of t h e f a c t t h a t a l l of t h e a d o l e s c e n t s who l i v e d t h e r e had been abused, even though t h i s had not o r i g i n a l l y been r e c o g n i z e d . The mandate of Pho e n i x House i s u n u s u a l i n a tr e a t m e n t f i e l d l a r g e l y e c l e c t i c i n n a t u r e , and g e n e r a l l y l a c k i n g s p e c i f i c i n t a k e c r i t e r i a ( B a l c e r z a k , Mayer & Richman, 1977; M a l u c c i o & Marlow, 1972). Thus, t h i s r e s e a r c h attempted t o p r o v i d e an i l l u m i n a t i v e e v a l u a t i o n of Pho e n i x House. -6-Chapter Two: L i t e r a t u r e Review Mature of the P r p p ^ m The s e x u a l abuse of c h i l d r e n a t t h e hands of a d u l t s has a l o n g and s o r d i d h i s t o r y which has been v e i l e d i n a s h r o u d of s i l e n c e . F r e u d i a n t h i n k i n g has dominated t h e l i t e r a t u r e i n t h i s a r e a u n t i l q u i t e r e c e n t l y . T h i s paradigm was r e s p o n s i b l e f o r e x p l a i n i n g away i n c e s t as f a n t a s y and s e r v e d t o c l o a k the problem f o r many g e n e r a t i o n s (Rush, 1980). S o c i o l o g i c a l t h e o r i e s o f t h e f i f t i e s and s i x t i e s argued t h a t t h e i n c e s t taboo d i d indeed e x i s t and was f u n c t i o n a l f o r s o c i e t y ' s s u r v i v a l , g i v e n the g e n e t i c r i s k s o f p o t e n t i a l o f f s p r i n g ( P a r s o n s , 1954). The n e x t major f o c u s i n t h e l i t e r a t u r e was a d o c u m e n t a t i o n o f t h e i n d i v i d u a l c h a r a c t e r i s t i c s of v i c t i m s and p e r p e t r a t o r s ( F i n k e l h o r , 1979). F a m i l y systems t h e o r y s h i f t e d the f o c u s of a t t e n t i o n , a t t r i b u t i n g p a t h o l o g y t o t h e f a m i l y r a t h e r t h a n t o t h e i n d i v i d u a l ( P e l l e t i e r & Hardy, 1982). I n t h i s framework t h e mother was g e n e r a l l y seen as h a v i n g a r o l e due t o her absence or c o l l u s i o n (Cohen, 1983). More r e c e n t l y , e c o l o g i c a l approaches t o c h i l d m a l t r e a t m e n t have been d e v e l o p e d which examine t h e i n t e r a c t i o n between t h e environment and i n d i v i d u a l s , and p o i n t t o t h e r o l e of economics and r e s o u r c e s i n c h i l d abuse ( G a r b a r i n o , 1976). F e m i n i s t s have been i n s t r u m e n t a l i n r e f r a m i n g t h i s s u b j e c t i n t h e l a s t decade. Rush, a p s y c h i a t r i c s o c i a l w orker, p u b l i s h e d t h e f i r s t h i s t o r i c a l o v e r v i e w of i n c e s t from a f e m i n i s t p e r s p e c t i v e (1980). She t r a c e s t h e p a t r i a r c h a l -7-p a t t e r n s which have s a n c t i o n e d the s e x u a l v i o l a t i o n of c h i l d r e n from B i b l i c a l t i m e s , t h r o u g h a n c i e n t Greece and V i c t o r i a n t i m e s , t o the p r e s e n t . Herman has a n a l y z e d i n c e s t from a f e m i n i s t p e r s p e c t i v e (1981). She shows how i n c e s t was h i s t o r i c a l l y a v i o l a t i o n of men's p r o p e r t y r i g h t s and uses B i b l i c a l passages t o h i g h l i g h t t h i s . She s u g g e s t s t h a t t h e more r i g i d t h e s e x u a l d i v i s i o n of l a b o u r , and t h e g r e a t e r t h e d o m i n a t i o n of t h e f a t h e r , t h e g r e a t e r t h e l i k e l i h o o d t h a t f a t h e r s w i l l abuse t h e i r d a u g h t e r s . S t u d i e s showing t h e o f f e n d e r t o be t h e " f a m i l y t y r a n t " appear t o v a l i d a t e t h i s h y p o t h e s i s ( F i n k e l h o r , 1979; Herman & Hirshman, 1977). F e m i n i s t s see t h e problem of rape and i n c e s t as s i m i l a r i n o r i g i n ( B r o w n m i l l e r , 1975). F e m i n i s t s s t a t e t h a t the p a t r i a r c h a l n a t u r e of t h e f a m i l y p e r p e t u a t e s s e x u a l abuse by i n s t i t u t i o n a l i z i n g t h e p o w e r l e s s n e s s and dependency of women (Wattenberg, 1985). Thus, women and c h i l d r e n a r e both v i c t i m s of a p a t r i a r c h a l s o c i e t y . The c o r e i s s u e i n s e x u a l abuse, and o t h e r t y p e s of abuse, from a f e m i n i s t p e r s p e c t i v e , i s t h e misuse of power ( B u t l e r , 1978). Other e x p e r t s s u p p o r t the c e n t r a l i t y of power dynamics i n s e x u a l abuse ( F i n k e l h o r , 1983; S g r o i , 1982). The d e f i n i t i o n of c h i l d s e x u a l abuse adopted by t h e N a t i o n a l C e n t e r f o r C h i l d Abuse and N e g l e c t i n t h e U.S.A. names t h i s s p e c i f i c a l l y , C o n t a c t s or i n t e r a c t i o n s between a c h i l d and an a d u l t when the c h i l d i s b e i n g used f o r the s e x u a l s t i m u l a t i o n of t h e p e r p e t r a t o r or another p e r s o n when the p e r p e t r a t o r i s i n a p o s i t i o n of power or c o n t r o l over t h e v i c t i m (1978, p. 4 2 ) . Another w r i t e r who l o o k s a t s o c i e t y ' s v a l u e s r e g a r d i n g t h e use of power w i t h c h i l d r e n i s A l i c e M i l l e r (1983). She documents the " d e v a s t a t i n g consequences of t h e way power i s s e c r e t l y e x e r c i s e d under t h e d i s g u i s e of c h i l d - r e a r i n g " (p. 278) and p o s t u l a t e s t h a t t h i s i s a t t h e r o o t of v i o l e n c e i n our s o c i e t y . M i l l e r s u g g e s t s t h a t we as a s o c i e t y s t i l l b e l i e v e t h a t we need t o g a i n c o n t r o l over c h i l d r e n . She s u g g e s t s t h a t " c h i l d - r e a r i n g i s d i r e c t e d not towards t h e c h i l d ' s w e l f a r e , but towards s a t i s f y i n g t h e p a r e n t s ' needs f o r power and revenge" (p. 243). M i l l e r shows how we j u s t i f y our power games by r a t i o n a l i z i n g t o c h i l d r e n t h a t t h i s i s " f o r your own good" (p. x i ) . In a l a t e r book M i l l e r (1984) a d d r e s s e s s e x u a l abuse. She r e f r a m e s " a c t i n g o u t " (p. 14) i n a t h e r a p e u t i c r e l a t i o n s h i p as "re-enactment" of a s i t u a t i o n w hich was p a s s i v e l y endured i n c h i l d h o o d . She s u g g e s t s t h a t t h e i n d i v i d u a l cannot t a l k about t h e s i t u a t i o n i n words and i n s t e a d communicates i t t h r o u g h u n c o n s c i o u s b e h a v i o r which i s e s s e n t i a l l y a coded language. An example of t h i s i s l i f e as a p r o s t i t u t e which c o m p u l s i v e l y r e - e n a c t s the trauma of a s e x u a l l y abused c h i l d h o o d . The p r o s t i t u t e , she s u g g e s t s , a t t e m p t s t o r e v e r s e r o l e s by a t t e m p t i n g t o t a k e c o n t r o l of t h e e n c o u n t e r . Other s t u d i e s have a l s o l i n k e d p r o s t i t u t i o n t o a p r i o r h i s t o r y of s e x u a l abuse. S i l b e r t and P i n e s (1982) found t h a t 60% of t h e 200 j u v e n i l e and a d u l t female p r o s t i t u t e s t h e y i n t e r v i e w e d r e p o r t e d b e i n g s e x u a l l y abused. I n her s t u d y o f -9-42 juvenile prostitutes in Vancouver, Michaud (1988) found that 80% of the g i r l s reported a sexual abuse history. Edney (1988) suggests that the combination of women's s o c i a l i z a t i o n , c o n t r o l l i n g educational and s o c i a l service systems, dysfunctional family dynamics, and sexual abuse prepares a c h i l d for p r o s t i t u t i o n . Juvenile prostitutes themselves state that they gain a sense of control by l i v i n g on the streets and determining the terms of the i r l i a i s o n s ( S i l b e r t , 1984). Control i s a major theme in the l i t e r a t u r e regarding sexual abuse survivors. The Prevalence Given that c h i l d sexual abuse i s a problem, and that i n s t i t u t i o n s too can perpetuate abuse, what i s the prevalence of t h i s problem? As awareness about sexual abuse has increased, so have the s t a t i s t i c s about i t s prevalence. Herman (1981) reviewed f i v e studies of female c h i l d sexual abuse from 1940 -1978. These prevalence rates ranged from 4% to 12%. Russell (1986) completed the f i r s t study of incest based on a large random sample of women in the San Francisco Bay area (N=930). She found that 16% of the women had been sexually abused by a male r e l a t i v e before age 18. Prevalence rates vary according to the d e f i n i t i o n of abuse and the type of questions asked (Finkelhor, 1986). For example, the Badgley Report (1984, p. 1) found that one out of two females in Canada was the vict i m of an unwanted sexual act. Their largest category was -10-e x p o s u r e , which i s g e n e r a l l y not i n c l u d e d i n such d e f i n i t i o n s . A l t h o u g h p r e v a l e n c e r a t e s v a r y , t h e r e i s l i t t l e doubt t h a t c h i l d s e x u a l abuse i s a problem, e s p e c i a l l y f o r g i r l s . F i n k e l h o r (1986, p. 19) r e v i e w e d 19 s t u d i e s of c h i l d s e x u a l abuse and found t h a t r a t e s v a r i e d from 6% t o 62% f o r females and from 3% t o 31% f o r males. The B a d g l e y Report (1984) a l s o s u p p o r t s t h i s f i n d i n g t h a t females a r e a t a g r e a t e r r i s k t h a n males. Few s t u d i e s c o n s i d e r t h e e x t e n t of s e x u a l abuse among t h e group home p o p u l a t i o n . A major t r e n d i n group homes i s t h e growth of t h e p o p u l a t i o n of " e m o t i o n a l l y d i s t u r b e d " c h i l d r e n i n c a r e (Young, Dore & P a p e n f o r t , 1988). T h i s American s u r v e y of r e s i d e n t i a l c a r e f o r c h i l d r e n r e p o r t e d t h a t 51% of c h i l d r e n i n c a r e had been abused e i t h e r p h y s i c a l l y , s e x u a l l y , or e m o t i o n a l l y . S i s k i n d (1986) echoes t h i s f i n d i n g and p o s t u l a t e s t h a t over 50% of g i r l s i n c a r e may be v i c t i m s of s e x u a l abuse. He quotes a s t u d y by Brooks (1985) which documented t h a t 62% of g i r l s had a pre-placement h i s t o r y of s e x u a l abuse. I n Canada we have no n a t i o n a l body c o l l e c t i n g s t a t i s t i c s about c h i l d w e l f a r e s i n c e i t i s a p r o v i n c i a l r e s p o n s i b i l i t y . However, t h e Ba d g l e y R e p o r t (1984) undertook a N a t i o n a l C h i l d P r o t e c t i o n Survey which r e p o r t e d t h a t s e x u a l abuse was a p r e s e n t i n g problem i n 78.8% of a l l c h i l d p r o t e c t i o n c a s e s (p. 587). About h a l f of t h e s e c h i l d r e n were removed from t h e i r homes (p. 597). An e x a m i n a t i o n of t h e M i n i s t r y of S o c i a l S e r v i c e s and -11-Housing (M.S.S.H.) Annual Report f o r 1986-87 s t a t e s t h a t 1,804 c h i l d r e n were i n s u b s i d i z e d or s p e c i a l r e s o u r c e s i n B r i t i s h C olumbia a t t h e end of t h a t f i s c a l year (p. 2 8 ) . I t i s s i g n i f i c a n t t h a t M.S.S.H. changed t h e i r c o d i n g i n mid-1986 t o c r e a t e a c a t e g o r y e n t i t l e d " P r o t e c t i o n r e q u i r e d - s e x u a l abuse". I n t h e h a l f y e a r s i n c e t h i s c o d i n g was changed, 414 c h i l d r e n were t a k e n i n t o p r o t e c t i o n because of s e x u a l abuse. W h i l e t h e a c t u a l number of s e x u a l l y abused c h i l d r e n i n c a r e i s u n c l e a r , what i s c l e a r i s t h a t such a group e x i s t s , and by a l l e s t i m a t e s c o u l d be over h a l f t h e p o p u l a t i o n of group homes. What, t h e n , a r e the p a r t i c u l a r d e v e l o p m e n t a l needs of t h i s p o p u l a t i o n ? A d o l e s c e n t Development L i t e r a t u r e e x a m i n i n g a d o l e s c e n t development r e l i e s h e a v i l y on the work of E r i k E r i k s o n (1968). He proposed t h a t i n a d o l e s c e n c e one needs t o d e v e l o p a sense of i n d u s t r y and i d e n t i t y b e f o r e one can d e v e l o p m u t u a l l y s a t i s f y i n g r e l a t i o n s h i p s . H i s t h e o r y i s l i n e a r i n n a t u r e , i m p l y i n g t h a t each s t a g e must be r e s o l v e d b e f o r e a l a t e r s t a g e can be a c c o m p l i s h e d . G i l l i g a n (1982) n o t e s t h a t E r i c k s o n i d e n t i f i e d a d i f f e r e n t sequence f o r female a d o l e s c e n t s and y e t based h i s s t a g e s on t h e male e x p e r i e n c e . She shows how he proposed t h a t the t a s k s of the female a d o l e s c e n t i n v o l v e a f u s i o n of the s t a g e s of i d e n t i t y and i n t i m a c y . Thus, young women, E r i k s o n s u g g e s t e d , a c h i e v e i d e n t i t y t h r o u g h r e l a t i o n s h i p w i t h t h e i r f u t u r e male p a r t n e r . -12-In order to e s t a b l i s h a sense of i d e n t i t y i t has t r a d i t i o n a l l y been t h e o r i z e d t h a t a process of disengagement from the f a m i l y must occur (Deutsch, 1967; B i o s , 1979). For female c h i l d r e n , t h i s i s g e n e r a l l y seen as l o o s e n i n g the mother-daughter bond i n order to achieve i n d i v i d u a t i o n . An i n a b i l i t y t o detach o n e s e l f from one's mother i s t r a d i t i o n a l l y viewed as p a t h o l o g i c a l . T h i s model of s e p a r a t i o n as c e n t r a l to s e l f development i s c u r r e n t l y being r e p u d i a t e d by f e m i n i s t t h e o r i s t s . M i l l e r (1976) has developed a model of women's sense of s e l f as organized around making and m a i n t a i n i n g r e l a t i o n s h i p s . She p o i n t s out the problems of assuming t h a t models of male development are u n i v e r s a l , and suggests t h a t females " c a r r y " p a r t i c u l a r aspects of human experience. Where women have experienced estrangement, or emotional d i s t a n c e from t h e i r f a m i l y , M i l l e r suggests t h a t work should focus on understanding the consequences of the lack of a r e l a t i o n a l environment i n t h e i r l i f e , and a s s i s t a n c e i n i t s development (1984). Surrey (1987) expands t h i s theme of e x p l o r i n g women's development as s e l f - i n - r e l a t i o n . She proposes t h a t t h i s model s h i f t s the emphasis from i n d i v i d u a t i o n or the breaking of emotional t i e s , to a process of mutual growth w i t h i n r e l a t i o n s h i p , or r e l a t i o n s h i p - d i f f e r e n t i a t i o n . She s t a t e s , the adolescent does not n e c e s s a r i l y want to "separate" from her parents, but to change the form and content of the r e l a t i o n s h i p i n a way t h a t a f f i r m s her own developmental changes and allows new r e l a t i o n s h i p s to develop and take p r i o r i t y (p. 8). -13-In t h i s model growth i s d i r e c t e d towards " b e t t e r r e l a t e d n e s s " r a t h e r than towards g r e a t e r autonomy, and r e q u i r e s f l e x i b i l i t y and d i a l o g u e on the p a r t of both parent and c h i l d . Thus, the development of s e l f occurs i n a r e l a t i o n a l context where each i n d i v i d u a l a f f e c t s the growth of the other i n a mutually r e c i p r o c a l way. Empathy becomes c e n t r a l t o a mutually i n t e r a c t i v e r e l a t i o n s h i p . Surrey s t a t e s , " i t becomes as important to understand as t o be understood, to empower as to be empowered" (1987, p. 7). R e l a t i o n s h i p i n t h i s model e x i s t s as another u n i t , broader than the i n d i v i d u a l s themselves, where the s e l f experiences c a r i n g and l e a r n s to care f o r the other and the r e l a t i o n s h i p . S e l f and r e l a t i o n s h i p grow s i m u l t a n e o u s l y from " r e s p o n s i v i t y " to " r e s p o n s i b i l i t y " . Thus, to understand woman's sense of s e l f , one must e x p l o r e her experience of connectedness, and the meanings she has made of t h i s . Chodorow (1978) suggests t h a t the mother-daughter r e l a t i o n s h i p i s c r u c i a l i n the development of s e l f i n women. She suggests t h a t because women are g e n e r a l l y r e s p o n s i b l e f o r e a r l y c h i l d c a r e , boys and g i r l s encounter a d i f f e r e n t e a r l y c h i l d h o o d experience which p a r t l y accounts f o r d i f f e r e n c e s i n p e r s o n a l i t y development. G i r l s experience a s t r o n g i d e n t i f i c a t i o n with t h e i r mothers and experience development i n a context of connectedness, while boys are encouraged to d e f i n e themselves as separate and d i f f e r e n t . Chodorow proposes t h a t having a primary parent of the same gender r e s u l t s i n g i r l s having a s t r o n g sense of empathy b u i l t i n t o -14-t h e i r s e l f concept. She suggests t h a t boys do not n e c e s s a r i l y experience t h i s , g iven the f a c t t h a t t h e i r primary parent i s g e n e r a l l y the opp o s i t e gender. Gleason (1985) r e p o r t s the r e s u l t s of a random survey of 97 l a t e a d o l e s c e n t women i n c o l l e g e r e g a r d i n g changes i n the mother-daughter r e l a t i o n s h i p . The ad o l e s c e n t s g e n e r a l l y wanted more connec t i o n with t h e i r mothers on an a d u l t - t o - a d u l t l e v e l . Those i n c o n f l i c t with t h e i r mothers wanted t o f i n d ways to r e s o l v e i t . T h i s r e s e a r c h appears to support a r e l a t i o n a l model of development, not a model based on s e p a r a t i o n . Kaplan and K l e i n (1985) f u r t h e r e x p l o r e the s e l f - i n -r e l a t i o n model as i t a p p l i e s to l a t e a d o l e s c e n t women. They echo the theme t h a t a d o l e s c e n t s are seeking d i f f e r e n t (more mutual) and deeper r e l a t i o n s h i p s with t h e i r mothers r a t h e r than s e p a r a t i o n or d i s t a n c e . C o n f l i c t then i s reframed as a form of " i n t e n s e and a b i d i n g engagement", not a process of s e p a r a t i o n per se (p. 5). I t becomes a way to work out the d i f f e r e n c e s i n a r e l a t i o n s h i p . They suggest t h a t much of the c o n f l i c t of adolescence may be a consequence of parents who are, f i x e d on e a r l i e r , more c o n t r o l l i n g modes of r e l a t i o n s h i p , which c o n t r a s t with the daughter's age-appropriate expansion of spheres of a b i l i t y and competence (p. 6). What are the i m p l i c a t i o n s of s e l f - i n - r e l a t i o n t h e o r y f o r work with adolescent women? Kaplan and Surrey (1984) suggest t h a t a woman who f i n d s i t d i f f i c u l t t o express and act on her own needs has experienced a d e f i c i t of r e l a t i o n a l experience, -15-and needs a s s i s t a n c e t o b u i l d a network i n o r d e r t o l e a r n t h i s . T h i s model proposes c o l l a b o r a t i v e models of i n s t i t u t i o n s , r a t h e r t h a n c o m p e t i t i v e . A d o l e s c e n t s , who a r e moving towards deeper r e l a t i o n s h i p s w i t h p e e r s , would t h e n need an atmosphere which s u p p o r t s t h e development of con n e c t e d n e s s . T h i s model would ad v o c a t e f o r l e a r n i n g e x p e r i e n c e s f o r a d o l e s c e n t women which would emphasize mutual c o n c e r n s w i t h i n t h e c o n t e x t of a group e x p e r i e n c e . G i l l i g a n ' s (1982) r e s e a r c h has documented t h e moral development o f women which she s u g g e s t s r e v o l v e s around p r i n c i p l e s o f r e s p o n s i b i l i t y , c a r e , and n u r t u r a n c e , r a t h e r t h a n p r i n c i p l e s o f r i g h t s and r e a s o n based on a b s o l u t e moral p r i n c i p l e s . She d e s c r i b e s her e x p e r i e n c e of h e a r i n g two d i f f e r e n t v o i c e s d u r i n g her r e s e a r c h - two ways of c o n c e p t u a l i z i n g moral problems and t h e r e l a t i o n s h i p between s e l f and o t h e r . She s u g g e s t s t h a t t h e s e v o i c e s d i f f e r a l o n g gender l i n e s , w i t h women making c h o i c e s based on r e s p o n s i b i l i t y and men making c h o i c e s based on r i g h t s . G i l l i g a n ' s work has been c r i t i c i z e d as a d u a l i s t i c i n t e r p r e t a t i o n of male and female p e r s o n a l i t y development, based on t r a d i t i o n a l t r a i t s , and s u b j e c t t o o v e r -g e n e r a l i z a t i o n s ( G o u l d , 1988). D e s p i t e t h e s e c r i t i c i s m s , G i l l i g a n p r e s e n t s c l e a r examples of an i n t e r n a l i z e d e t h i c of c a r e i n t h e words of t h e women she i n t e r v i e w e d where d e c i s i o n s were made i n l i g h t of p e r c e i v e d r e s p o n s i b i l i t i e s i n a r e l a t i o n a l c o n t e x t . S e l f , f o r t h e women, was always d e s c r i b e d i n t h e c o n t e x t of r e l a t i o n s h i p . I n a l a t e r work, Lyons (1983) -16-p o s i t s t h a t a r e s p o n s i b i l i t y p e r s p e c t i v e f i t s w i t h a s e l f -c o n cept based on c o n n e c t e d n e s s , w h i l e a r i g h t s p e r s p e c t i v e f i t s w i t h a s e l f - c o n c e p t based on s e p a r a t i o n . T h i s work shows how men who have a concept of s e l f i n c o n n e c t i o n a l s o v i e w t h e i r d e c i s i o n s i n a r e s p o n s i b i l i t y r a t h e r t h a n a r i g h t s mode. B e l e n k y , C l i n c h y , G o l d b e r g e r and T a r u l e (1986) undertook l o n g - t e r m q u a l i t a t i v e r e s e a r c h w i t h 135 women of d i f f e r e n t ages, from d i f f e r e n t e t h n i c and c l a s s backgrounds, which f u r t h e r expands t h e l i t e r a t u r e on women's development of s e l f . Through t h e women's l i f e s t o r i e s t h e y show how women's development of s e l f , v o i c e , and mind i s woven t o g e t h e r t h r o u g h o u t t h e l i f e s p a n . They d i s c o v e r e d f i v e d i f f e r e n t ways i n which women v i e w t h e w o r l d and t h e m s e l v e s : s i l e n c e , r e c e i v e d knowledge, s u b j e c t i v e knowledge, p r o c e d u r a l knowledge, and c o n s t r u c t e d knowledge. The s i l e n t women a r e d e s c r i b e d g e n e r a l l y as v i c t i m s of f a m i l y v i o l e n c e who f e l t "deaf and dumb", p o w e r l e s s , dependent and t y p i c a l l y h e l d r i g i d s e x - r o l e s t e r e o t y p e s . These women had no sense of c o n n e c t i o n w i t h o t h e r s and g e n e r a l l y s u b m i t t e d t o t h e commands of a u t h o r i t i e s . The women who viewed t h e m s e l v e s as r e l y i n g on r e c e i v e d knowledge l e a r n e d by l i s t e n i n g and had l i t t l e c o n f i d e n c e i n t h e i r own a b i l i t y t o speak. They thought of a u t h o r i t i e s as s o u r c e s of t r u t h , which t h e y viewed as r i g h t and wrong. These women had l e a r n e d t h a t one can empower t h e s e l f by empowering o t h e r s . The s u b j e c t i v e knowers moved from p a s s i v i t y t o a c t i o n by r e l y i n g on t h e i r i n t u i t i o n , or "what f e e l s r i g h t " . They -17-g e n e r a l l y had e x p e r i e n c e d a " f a i l e d " male a u t h o r i t y , many th r o u g h e x p e r i e n c e s of s e x u a l harassment or abuse. Many of the women f e l t t h a t t h e y were un d e r g o i n g a p r o c e s s o f d r a m a t i c change. The women who r e l i e d on p r o c e d u r a l knowledge used t h e v o i c e of r e a s o n . They were g e n e r a l l y w h i t e , m i d d l e - c l a s s s t u d e n t s who thought b e f o r e t h e y spoke. T h i s group c o n t a i n e d b o t h s e p a r a t e knowers, l a r g e l y c o l l e g e s t u d e n t s who used an a d v e r s a r i a l mode, and connected knowers who b e l i e v e d t h a t knowledge comes from p e r s o n a l e x p e r i e n c e . F i n a l l y , t h o s e who p e r c e i v e d knowledge as c o n s t r u c t e d sought b a l a n c e and i n t e g r a t i o n of r e a s o n and i n t u i t i o n . They were r e f l e c t i v e , a r t i c u l a t e and had a p a s s i o n f o r l e a r n i n g . S e l f - a w a r e n e s s and c a r i n g were i m p o r t a n t themes f o r t h e s e women who were committed t o w o r k i n g towards a b e t t e r w o r l d . An o v e r r i d i n g theme f o r t h e women i n t h i s s t u d y was t h a t of " g a i n i n g a v o i c e " . T h i s appeared t o be a metaphor f o r t h e development of s e l f , i m p l y i n g d i a l o g u e and i n t e r a c t i o n . The themes of t h e s e women h o l d i m p l i c a t i o n s f o r i n s t i t u t i o n s a t t e m p t i n g t o en a b l e s e l f - d e v e l o p m e n t of women such a s ; e n c o u r a g i n g women t o f i n d and use t h e i r v o i c e , and pro m o t i n g t h e use of bo t h i n t u i t i o n and r e a s o n i n problem s o l v i n g . What does t h e l i t e r a t u r e s a y about d e v e l o p m e n t a l t a s k s i n r e l a t i o n t o s e x u a l l y abused c h i l d r e n ? F i n k e l h o r and Browne (1986) have c o n c e p t u a l i z e d f o u r t r a u m a g e n i c dynamics a t work i n c h i l d s e x u a l abuse which have c l e a r i m p l i c a t i o n s f o r de v e l o p m e n t a l t a s k s (Wachtel & S c o t t , 1988). These a r e t r a u m a t i c s e x u a l i z a t i o n , s t i g m a t i z a t i o n , b e t r a y a l and -18-p o w e r l e s s n e s s . T r a u m a t i c s e x u a l i z a t i o n r e s u l t s i n s e x u a l b e h a v i o r i n a p p r o p r i a t e t o t h e d e v e l o p m e n t a l l e v e l s u c h as p r o m i s c u i t y and p r o s t i t u t i o n . There i s c o n f u s i o n about sex norms, r o l e s , and i d e n t i t y as w e l l as c o n f u s i o n of sex w i t h l o v e . S t i g m a t i z a t i o n o c c u r s i n the c o n t e x t of d e n i g r a t i o n , blame, and p r e s s u r e f o r s e c r e c y . I t a f f e c t s t h e development of s e l f - c o n c e p t , and can r e s u l t i n g u i l t , shame, low s e l f -esteem, and a f e e l i n g of d i f f e r e n t n e s s . I t can m a n i f e s t i t s e l f i n i s o l a t i o n , s u b s t a n c e abuse, and s e l f - a b u s e . B e t r a y a l o c c u r s because of a v i o l a t i o n of t r u s t and a l a c k of c a r e and p r o t e c t i o n . I t r e s u l t s i n d e v e l o p m e n t a l d i f f i c u l t i e s w i t h r e l a t i o n s h i p s such as dependency, m i s t r u s t , and h o s t i l i t y which can be m a n i f e s t e d by c l i n g i n g , v u l n e r a b i l i t y t o r e -v i c t i m i z a t i o n , d i f f i c u l t y w i t h i n t i m a t e r e l a t i o n s h i p s , and a g g r e s s i v e b e h a v i o r . P o w e r l e s s n e s s h i n d e r s t h e d e v e l o p m e n t a l i s s u e of e f f i c a c y . S i n c e t h e c h i l d was u nable t o s t o p h i s or her b o u n d a r i e s from b e i n g invaded and l i k e l y e x p e r i e n c e d some l e v e l of c o e r c i o n and f e a r , t h e c h i l d may appear a n x i o u s , a f r a i d , v i e w h i s or her s e l f as a v i c t i m , or i d e n t i f y w i t h t h e a g g r e s s o r and need t o c o n t r o l . T h i s can appear as p h o b i a s , s o m a t i c c o m p l a i n t s , n i g h t m a r e s , d i s s o c i a t i o n , r u n n i n g , s c h o o l problems, or a b u s i v e b e h a v i o r . S e v e r a l good summaries of t h e s h o r t - t e r m and l o n g - t e r m consequences of c h i l d s e x u a l abuse now e x i s t i n t h e l i t e r a t u r e (eg. E v e r s t i n e and E v e r s t i n e , 1989; Wachtel & S c o t t , 1988; W o d a r s k i , 1987). There i s no doubt t h a t t h e consequences of c h i l d s e x u a l abuse b o t h p s y c h o l o g i c a l l y and d e v e l o p m e n t a l l y a r e s t a g g e r i n g and may -19-need t o be reworked a t v a r i o u s p o i n t s t h r o u g h o u t the l i f e -c y c l e . Newberger and De Vos (1988) s u g g e s t t h a t t h e e f f e c t s of v i c t i m i z a t i o n can be f e l t t h r o u g h o u t one's l i f e t i m e . They propose t h a t t h e meaning c h i l d r e n make of t h e abuse i n f l u e n c e s t h e i r r e a c t i o n s . Thus, t h e more t h a t c h i l d r e n b e l i e v e t h e y can e x e r t some power and c o n t r o l i n t h e s i t u a t i o n , t h e fewer n e g a t i v e consequences t h e y w i l l e x p e r i e n c e . Two i m p o r t a n t f a c t o r s i n t r e a t m e n t , t h e n , a r e u s i n g t h e environment t o e n a b l e t h e development of ma s t e r y and c o n t r o l , and a l t e r i n g f a u l t y b e l i e f s about t h e e v e n t s . L i n d b e r g and D i s t a d (1985) propose t h a t a d o l e s c e n t i n c e s t v i c t i m s use s e l f - d e s t r u c t i v e b e h a v i o r s t o a s s e r t some c o n t r o l over t h e i r sense o f h e l p l e s s n e s s c r e a t e d by t h e i n c e s t . The a u t h o r s c a t e g o r i z e d t h e s e as " a c t i n g o u t " b e h a v i o r s , s u g g e s t i n g t h a t the a d o l e s c e n t s use d i s t r u s t and d i s t a n c i n g as a p r o t e c t i v e s h i e l d , and a t t i m e s s u b s t i t u t e a p a i n t h a t t h e y can c o n t r o l f o r one t h a t t h e y c a n n o t . S e v e r a l i m p l i c a t i o n s f o r t h e r a p y a r e d i s c u s s e d , i n c l u d i n g t h e e s s e n t i a l n a t u r e of e s t a b l i s h i n g t r u s t ; r e - d e f i n i n g the c h i l d ' s r o l e i n t h e i n c e s t ; r e c o g n i z i n g t h e b e h a v i o r s as s u r v i v a l r e s p o n s e s ; and u s i n g t h i s new u n d e r s t a n d i n g i n the management of s e l f -d e s t r u c t i v e b e h a v i o r . E v e r s t i n e and E v e r s t i n e (1989) s t a t e t h a t a d o l e s c e n c e i s a time of d r a m a t i c c o g n i t i v e growth where p r e v i o u s s e x u a l trauma which has not been r e s o l v e d , s u r f a c e s . They s u g g e s t t h a t an a d o l e s c e n t w i l l more l i k e l y r e v e a l t h i s trauma t h r o u g h -20-h i s or her b e h a v i o r r a t h e r t h a n t h r o u g h d i r e c t d i s c l o s u r e . F u r t h e r m o r e , t h e a d o l e s c e n t may not u n d e r s t a n d t h e s e sudden changes i n b e h a v i o r and may p r o j e c t i t onto o t h e r s . Key f a c t o r s t o r e c o v e r y a r e t h a t an a p p r o p r i a t e a d u l t p r o v i d e s a sense of s a f e t y and s u p p o r t , and t h a t t h e c h i l d i s a s s i s t e d t o un d e r s t a n d and r e s o l v e t h e trauma i n a manner t h a t t h e c h i l d can g r a s p . They s u g g e s t t h a t o t h e r c r u c i a l t r e a t m e n t i s s u e s i n c l u d e p r o v i d i n g a s s i s t a n c e t o g a i n a sense of mas t e r y r a t h e r t h a n punishment f o r " b e i n g bad"; always l o o k i n g beyond t h e b e h a v i o r ; and r e c o g n i z i n g t h a t abused c h i l d r e n have been used t o p l e a s i n g a d u l t s and a r e r e a l l y s t a r v e d f o r n u r t u r a n c e . What a r e s t u m b l i n g b l o c k s i n t r e a t m e n t ? E v e r s t i n e and E v e r s t i n e (1989) s u g g e s t t h a t common e r r o r s i n t h e r a p y i n c l u d e a l a c k of awareness of t h e t h e r a p i s t ' s own i s s u e s ; i m p l y i n g t h e v i c t i m s e t up t h e s i t u a t i o n ; f o c u s s i n g s o l e l y on t h e b e h a v i o r and t h e r e f o r e f a i l i n g t o g r a s p i t s meaning; t h e use of t h r e a t s and g u i l t ; and t h e t h e r a p i s t who appears l i k e an u n c a r i n g p a r e n t . They d i s c u s s how some v i c t i m s a r e viewed as m a n i p u l a t i v e or a n n o y i n g , and warn a g a i n s t r e s p o n d i n g t o such b e h a v i o r w i t h anger and f r u s t r a t i o n because one cannot " c o n t r o l " t h e c l i e n t . I n r e f e r r i n g t o t h e importance of l o o k i n g beyond b e h a v i o r , t h e y r e f e r t o N e l s o n (1982), The c l i n i c i a n s h o u l d a l s o r e c o g n i z e t h a t some c l i e n t s ( i . e . t h o s e who have s u f f e r e d s e x u a l trauma as c h i l d r e n ) may be t r y i n g t o e x p r e s s the unspeakable by t h e i r b e h a v i o r ( c i t e d i n E v e r s t i n e & E v e r s t i n e , 1989, p. 154). I t appears from t h e l i t e r a t u r e t h a t a d o l e s c e n t women need a r e l a t i o n a l c o n t e x t i n which t o f u r t h e r t h e development of -21-t h e i r c o n c e p t of s e l f . A group s e t t i n g which f o c u s e s on m u t u a l i t y would be an i d e a l atmosphere. A d o l e s c e n t s w i t h a s e x u a l abuse h i s t o r y have p a r t i c u l a r d e v e l o p m e n t a l v u l n e r a b i l i t i e s r e g a r d i n g t h e i r s e x u a l i t y , s e l f - c o n c e p t , t r u s t and e f f i c a c y , and may a c t - o u t t h r o u g h t h e i r b e h a v i o r what t h e y cannot s a y . C o n s e q u e n t l y , work s h o u l d f o c u s f i r s t on e s t a b l i s h i n g a t r u s t i n g r e l a t i o n s h i p . Without t h i s , f u r t h e r growth may be i n h i b i t e d . Other themes f o r work would i n c l u d e a l t e r i n g f a u l t y b e l i e f s i n o r d e r t o b u i l d s e l f - w o r t h ; e n a b l i n g m a s t e r y and c o n t r o l ; and l o o k i n g beyond b e h a v i o r i n o r d e r t o promote new u n d e r s t a n d i n g r e g a r d i n g s e x u a l i t y and i n t i m a c y . Group Homes and Abuse How do t h e problems of s e x u a l l y abused a d o l e s c e n t s r e l a t e t o group homes? Not o n l y must group homes be s e n s i t i v e and knowledgeable about i s s u e s r e l a t e d t o abuse, t h e y must a l s o c o n s i d e r how t h e y as i n s t i t u t i o n s might u n i n t e n t i o n a l l y p e r p e t u a t e abuse t h r o u g h t h e i r misuse of power. D u r k i n (1982) s u g g e s t s t h a t v i c t i m s of i n s t i t u t i o n a l abuse a r e o f t e n t h o s e the most a g g r a v a t i n g t o t h e i r c a r e g i v e r . The c a r e g i v e r t y p i c a l l y v i e w s them as "scheming" or " r e s i s t a n t " . D u r k i n compares th e s i t u a t i o n of c h i l d c a r e workers t o t h a t of t h e a b u s i n g p a r e n t . He s u g g e s t s t h e y both a r e i s o l a t e d , u n d e r s u p p o r t e d and o v e r s t r e s s e d . F u r t h e r m o r e , t h e y a r e p o w e r l e s s e x c e p t f o r t h e i r power over c h i l d r e n . E l i a n a G i l (1982) s t a t e s t h a t when we p l a c e c h i l d r e n i n c a r e t h e r e i s t h e f a u l t y a ssumption t h a t we have p l a c e d them -22-i n a s a f e e nvironment, removed from danger. She d e s c r i b e s t h r e e t y p e s of abuse i n i n s t i t u t i o n s ; p h y s i c a l , program or system. P h y s i c a l abuse i n c l u d e s n e g l e c t and s e x u a l abuse. Program abuse i m p l i e s u n a c c e p t a b l e s t a n d a r d s , u n f a i r p o l i c i e s and h a r s h t e c h n i q u e s . Examples of t h i s would i n c l u d e o v e r m e d i c a t i o n , i s o l a t i o n , m e c h a n i c a l r e s t r a i n t s and d i s c i p l i n a r y t e c h n i q u e s . System abuse d e s c r i b e s t h e p r o c e s s of c h i l d r e n d r i f t i n g i n t o l o n g - t e r m c a r e because of a l a c k of p l a n n i n g , and a l a c k of a continuum of c a r e . She s u g g e s t s t h e s e t y p e s of abuse e x i s t because of t h e s t r e s s of t h e c a r e t a k e r s . S i s k i n d (1986) a l s o c o n s i d e r s t h a t c a r e g i v e r s t r e s s can c r e a t e a b u s i v e c o n d i t i o n s . He s u g g e s t s t h a t burn-out i s c r e a t e d when workers f e e l p o w e r l e s s and overworked. He s t a t e s t h a t when workers use "power d i f f e r e n t i a l s and m a n i p u l a t i o n t o i n t i m i d a t e and seduce t h e c h i l d r e n " t h a t abuse has o c c u r r e d . S i s k i n d a l s o quotes R i n d f l e i s c h who p r e s e n t e d a paper a t th e 1984 I n t e r n a t i o n a l Congress on C h i l d Abuse and N e g l e c t . He s u g g e s t s s e v e r a l f a c t o r s which i n f l u e n c e abuse i n r e s i d e n t i a l f a c i l i t i e s ; an a u t o c r a t i c d i r e c t o r ; s u b t l e p e r m i s s i o n t o c o n t r o l a t any c o s t ; a t h e o r e t i c a l model which d e v a l u e s r e l a t i o n s h i p s w i t h r e s i d e n t s ; an o p p r e s s o r m e n t a l i t y which p r o j e c t s h o s t i l i t y t o t h o s e w i t h l e s s s t a t u s ; a l a c k of programming; and gaps i n s t a f f i n g . Mercer (1982) s u g g e s t s t h a t i n s t i t u t i o n a l abuse o c c u r s when t h e r e i s a l a c k of adequate t r a i n i n g and s u p e r v i s i o n of d i r e c t c a r e w o r k e r s . He s u g g e s t s t h a t s t a f f g e n e r a l l y t r e a t - 2 3 -c h i l d r e n t h e w a y t h e y a r e t r e a t e d b y t h e f a c i l i t y . T h u s , " a n e x p l o i t a t i v e , u n r e s p o n s i v e a d m i n i s t r a t i o n c r e a t e s a n e x p l o i t a t i v e , u n r e s p o n s i v e s t a f f " ( p . 1 2 8 ) . H e v i e w s c h i l d c a r e j o b s a s d e a d - e n d j o b s , w i t h l o w s a l a r i e s a n d l o n g h o u r s . T h i s p r o m o t e s t h e m e s s a g e t h a t c h i l d c a r e w o r k i s n o t p a r t i c u l a r l y v a l u e d i n o u r s o c i e t y . R a b b ( 1 9 8 5 ) s u r v e y e d 6 3 0 r e s p o n d e n t s a n d h a d t h e m c a t e g o r i z e 2 4 s i t u a t i o n s o f c h i l d m a l t r e a t m e n t . T h e r e s p o n d e n t s c o n s i s t e d o f c h i l d r e n i n c a r e , c h i l d c a r e w o r k e r s , m a n a g e r s , c h i l d w e l f a r e w o r k e r s , b o a r d m e m b e r s a n d f o s t e r p a r e n t s . H e f o u n d t h a t t h e r e s p o n d e n t s h a d l o w e r s t a n d a r d s f o r t h e e m o t i o n a l t r e a t m e n t o f c h i l d r e n i f t h e y w e r e i n c a r e , t h a n i f t h e y w e r e l i v i n g w i t h f a m i l i e s ( e g . v i e w i n g i s o l a t i o n o r l o c k - u p a s a c c e p t a b l e ) . D a v i d G i l ( 1 9 7 7 ) s u g g e s t s t h a t t h e r e a r e m a n y l e v e l s o f m a n i f e s t a t i o n s o f c h i l d a b u s e . H e p r o p o s e s t h a t a b u s e c a n o c c u r o n a p e r s o n a l l e v e l a n d a n i n s t i t u t i o n a l l e v e l . H e t h e o r i z e s t h a t t h e r e a r e v a r i o u s l e v e l s o f c a u s a t i o n : a n o n -e g a l i t a r i a n s o c i a l p h i l o s o p h y ; a s o c i a l c o n s t r u c t i o n o f c h i l d h o o d a s a t i m e o f s u b m i s s i o n a n d c o n f o r m i t y , w i t h d i f f e r e n t r i g h t s f o r c h i l d r e n f r o m d i f f e r e n t b a c k g r o u n d s ; a n a t t i t u d e w h i c h l e g i t i m a t e s f o r c e a s a m e a n s t o a n e n d ; t r i g g e r i n g c o n t e x t s s u c h a s h i g h s t r e s s ; a n d i n t r a - p s y c h i c c o n f l i c t s . H e s u g g e s t s t h a t p r e v e n t i o n o f c h i l d a b u s e w o u l d r e q u i r e t h e t r a n s f o r m a t i o n o f o u r s o c i e t y a n d v i e w s t h i s e s s e n t i a l l y a s a p o l i t i c a l c h o i c e . G a r b a r i n o , S c h e l l e n b a c h & S e b e s ( 1 9 8 6 ) h a v e d e v e l o p e d a n -24-ecological framework for understanding adolescent maltreatment. Their framework portrays abuse as c o l l e c t i v e , i n s t i t u t i o n a l , and individual in nature. Although these authors are considering maltreatment, not just sexual abuse, the i r model suggests that a l l abuse has roots which go beyond the i n d i v i d u a l . Thus, to be f u l l y understood, abuse must be viewed in t h i s broader systems perspective. Garbarino et a l see the macrosystem as the broadest system, the very form of our society which provides the overriding context for a l l relationships within i t . They suggest that in our society t h i s system contains the ideologies of patriarchy and capitalism which through the b e l i e f of "family privacy" help to perpetuate abuse. The exosystem represents the ideology of po l i c y and practice in regards to adolescents in care. They suggest that a common ideology in practice i s "adolescent as perpetrator and parent as victim". Freud s t i l l influences our b e l i e f s , according to these authors, when we are unable to believe that adolescents can be victims. The mesosystem i s the r e l a t i o n a l context that surrounds us. This may be one's family or group home. Garbarino et a l suggest t h i s system often perpetuates the i s o l a t i o n of adolescents from their peers. The microsystem i s the immediate i n t e r a c t i o n a l r e l a t i o n s h i p that one i s a part of. It i s in the microsystem where we t y p i c a l l y view abuse as occurring. F i n a l l y , the authors consider the organism, the individual with his or her own degree of personal v u l n e r a b i l i t y . Thus, the macro, exo, and meso systems can create an abusive context which feeds -25-u n h e a l t h y i n t e r a c t i o n s i n our s o c i e t y . What about t h e p r e v a l e n c e of i n s t i t u t i o n a l abuse? R i n d f l e i s h (1984) r e p o r t s on s u r v e y i n f o r m a t i o n o f 1700 f a c i l i t i e s as w e l l as o n - s i g h t o b s e r v a t i o n s of r e s i d e n t m i s t r e a t m e n t . T h e i r s u r v e y had a c o m p l a i n t r a t e of about 4% of r e s i d e n t s i n c a r e , w h i l e t h e i r o n - s i t e v i s i t a t i o n s y i e l d e d a 20% c o m p l a i n t r a t e . The a u t h o r s d i s c u s s e d how h e s i t a n t p e o p l e a r e t o r e p o r t r e s i d e n t i a l m a l t r e a t m e n t , and e s t i m a t e d t h e problem t o be t w i c e as l a r g e as c o m p l a i n t s about f a m i l y m a l t r e a t m e n t . G i l (1982) s t a t e s t h a t when a g e n c i e s i n C a l i f o r n i a were r e q u i r e d t o r e g i s t e r c o m p l a i n t s about i n s t i t u t i o n a l abuse t h a t s e v e n t y - f i v e c a s e s were r e p o r t e d i n two y e a r s . Three q u a r t e r s of t h e s e c a s e s c o n s t i t u t e d p h y s i c a l abuse or n e g l e c t , w h i l e o n e - q u a r t e r were c a s e s of s e x u a l abuse. There i s l i t t l e w r i t t e n about t h e p r e v a l e n c e of i n s t i t u t i o n a l abuse. However, t h e r e p o r t e d i n c i d e n c e of t h i s phenomena w i l l l i k e l y i n c r e a s e as awareness about i t a l s o i n c r e a s e s . C l e a r l y , t h e r e i s abuse happening i n s u p p o s e d l y " p r o t e c t e d " e n v i r o n m e n t s . F l e t c h e r n o t e s t h a t t h e r e a r e p a r t i c u l a r r i s k s i n v o l v e d w i t h t r e a t m e n t of c h i l d abuse. I s h o u l d l i k e t o s t r e s s t h a t whenever a group o f p e o p l e become i n v o l v e d w i t h the problem of c h i l d abuse such a group i s a t r i s k - a t r i s k of d e v e l o p i n g an a b u s i v e c y c l e s i m i l a r t o t h e c y c l e of abuse which e x i s t s w i t h i n a b u s i v e f a m i l i e s (1982, p. 245). F l e t c h e r s u g g e s t s t h a t when p r o f e s s i o n a l s a r e s u b j e c t t o : d e p r i v a t i o n of knowledge or s u p p o r t ; h o l d u n r e a l i s t i c e x p e c t a t i o n s ; and f e e l i s o l a t e d ; t h a t a c r i s i s ( l i k e a -26-r e f e r r a l of an a b u s i v e f a m i l y ) can p r e c i p i t a t e r o l e - r e v e r s a l where t h e worker's need f o r p r o f e s s i o n a l r e a s s u r a n c e t a k e s precedence over t h e f a m i l y ' s needs. T h i s she s t a t e s can r e s u l t i n mismanagement and sometimes d e s t r u c t i v e i n t e r v e n t i o n s . I t appears from t h e l i t e r a t u r e t h a t group homes which t r e a t s e x u a l l y abused a d o l e s c e n t s need t o be p a r t i c u l a r l y s e n s i t i v e t o i s s u e s of power and c o n t r o l , and be c o n s c i o u s of t h e i r own p o t e n t i a l t o p o s s i b l y r e v i c t i m i z e t h e i r c l i e n t s b o th i n d i v i d u a l l y and s t r u c t u r a l l y . Models of Carer A F e m i n i s t C r i t i q u e What models of c a r e does group home l i t e r a t u r e promote as e f f e c t i v e l y meeting t h e needs of c h i l d r e n and a d o l e s c e n t s ? M a l u c c i o and Marlow (1972) document t h e h i s t o r i c l a c k of s u c c e s s i n d e t e r m i n i n g e f f e c t i v e t r e a t m e n t i n group homes and u n d e r s c o r e t h e need f o r more e v a l u a t i v e r e s e a r c h . Upon exam i n i n g models of c a r e i n t h e l i t e r a t u r e , f o u r main t y p e s emerge; psychodynamic, b e h a v i o r a l , g r o u p - c e n t e r e d and e c l e c t i c (Cohen, 1986; M a l u c c i o & Marlow, 1972; W h i t t a k e r , 1979). The m a j o r i t y of group homes f a l l under t h e e c l e c t i c c a t e g o r y ( B a l c e r z a k , Mayer & Richman, 1977). There i s a l s o some d i s c u s s i o n about an i n t e g r a t e d model which views c h i l d c a r e workers as i n t e g r a l t o t r e a t m e n t . T h i s model uses an e c o l o g i c a l p e r s p e c t i v e and s t r e s s e s l i n k s w i t h p a r e n t s and t h e l a r g e r community ( M a i e r , 1987; W h i t t a k e r , 1979). There i s l i t t l e i n d i c a t i o n i n t h e l i t e r a t u r e r e g a r d i n g t h e -27-e f f e c t i v e n e s s of each model. Cohen's (1986) s t u d y of q u a l i t y of c a r e i n 33 group homes found t h a t a l l of t h e homes u s i n g a psychodynamic a p p r o a c h , which f o c u s s e d on i n t r a - p s y c h i c problems, (N=10) were a s s e s s e d as h a v i n g a h i g h q u a l i t y of c a r e , w h i l e o n l y about 20% of t h o s e u s i n g b e h a v i o r m o d i f i c a t i o n , which f o c u s s e d on o v e r t b e h a v i o r , (N=6) were viewed as p r o v i d i n g h i g h q u a l i t y c a r e by a d m i n i s t r a t o r s . The s t u d y a l s o r e v e a l e d t h a t t h e r e was a c l e a r s e p a r a t i o n o f t r e a t m e n t from d a i l y l i v i n g i n t h e homes. Cohen su g g e s t e d t h a t q u a l i t y of c a r e was n e g a t i v e l y i n f l u e n c e d by h i g h s t a f f t u r n - o v e r and o v e r l y l a r g e s e t t i n g s (more th a n 12 c h i l d r e n ) . He found a " v i c i o u s c y c l e o f i n s u f f i c i e n t f u n d i n g " f o r programming and d i s c o v e r e d t h a t t h e most d i f f i c u l t t o p l a c e y o u t h s were c o n c e n t r a t e d i n p o o r l y funded homes who were s t r u g g l i n g f o r f i n a n c i a l s u r v i v a l . What i s i n t e r e s t i n g i n t h e l i t e r a t u r e i s t h a t most s t u d i e s of t h e e f f e c t i v e n e s s of group homes d i d not ask the consumers t h e i r p e r s p e c t i v e , but r e l i e d on o p i n i o n s of t h e s t a f f ( B a l c e r z a k , Mayer & Richman, 1977; Cohen, 1986). Where consumers were a s k e d , t h e i r o p i n i o n s were g i v e n l i t t l e w e i g h t . K a s o w s k i , S i n g e r , T a y l o r & T s a l t a s (1976) d e s c r i b e a group home f o r a d o l e s c e n t g i r l s where t h e y d i d f o l l o w up i n t e r v i e w s . They p r e s e n t t h e home as " s u c c e s s f u l " d e s p i t e t h e f a c t t h a t t h e m a j o r i t y of t h e g i r l s were v e r y c r i t i c a l of t h e home, c i t i n g over r e g i m e n t a t i o n and u n c a r i n g s t a f f . I t appears t h a t t h e v o i c e s of t h e a d o l e s c e n t s a r e r a r e l y heard i n r e s e a r c h . What a r e t h e c h a r a c t e r i s t i c s of c h i l d r e n who do not do -28-w e l l i n our system, as e v i d e n c e d by m u l t i p l e placements? Pardeck (1985) s u g g e s t s t h a t c h i l d r e n who e x p e r i e n c e u n s t a b l e c a r e a r e g e n e r a l l y o l d e r , have e m o t i o n a l and b e h a v i o r a l p roblems, and have a h i s t o r y of abuse or n e g l e c t by t h e i r p a r e n t s . From h i s d e s c r i p t i o n , s e x u a l l y abused a d o l e s c e n t s a r e a t prime r i s k f o r u n s t a b l e p l a c e m e n t s . He s u g g e s t s t h a t f u r t h e r f a c t o r s r e l a t e d t o c a s e w o r k e r s i n c l u d e a h i g h r a t e of t u r n o v e r , l a c k of r a p p o r t and l i m i t e d c o n t a c t . F a c t o r s a s s o c i a t e d w i t h t h e c a r e g i v e r s i n c l u d e i n s u f f i c i e n t t r a i n i n g , and a l a c k of m o t i v a t i o n , competency, and r a p p o r t . Do t r a d i t i o n a l models of group home c a r e a d e q u a t e l y meet th e needs of s e x u a l l y abused a d o l e s c e n t s ? A 1985 r e p o r t by th e M a n i t o b a A d v i s o r y C o u n c i l on t h e S t a t u s of Women recommends t h e "development o f s p e c i a l group homes f o r s e x u a l l y abused c h i l d r e n w i t h p r o v i s i o n s f o r i n t e n s i v e house t h e r a p y " (1985, p. 2 3 ) . There appears t o be some p r o f e s s i o n a l r e c o g n i t i o n t h a t s e x u a l abuse s u r v i v o r s need an e x t e n s i v e program of t r e a t m e n t i n t h e i r p l a c e m e n t s . I n a d d i t i o n , l i t e r a t u r e g e n e r a l l y s u g g e s t s t h a t group home c a r e r a t h e r than f o s t e r f a m i l y c a r e i s t h e placement of c h o i c e f o r a d o l e s c e n t s g i v e n t h e i r d e v e l o p m e n t a l t a s k of a c h i e v i n g e m o t i o n a l independence, and t h e i n c r e a s i n g importance of p e e r s ( D a v i s , 1985; G a r b a r i n o , Guttmann & S e e l e y , 1986). The importance of peer s c l e a r l y enhances t h e u t i l i t y of group i n t e r v e n t i o n w i t h a d o l e s c e n t v i c t i m s of s e x u a l abuse. Herman (1981) goes on t o sugg e s t t h a t group t r e a t m e n t bypasses some of t h e ways i n which i n d i v i d u a l t r e a t m e n t can p a r a l l e l t h e i n c e s t u o u s -29-r e l a t i o n s h i p by b e i n g more open ( l e s s s e c r e t ) and by p r o v i d i n g many, d i f f e r i n g r e l a t i o n s h i p s , not j u s t t h e one-up power r e l a t i o n s h i p of t r a d i t i o n a l t h e r a p y . G a g l i a n o (1987) and S g r o i (1982) s u g g e s t t h a t group t h e r a p y i s t h e most e f f e c t i v e method of t r e a t i n g s e x u a l l y abused a d o l e s c e n t s . I t appears from t h e l i t e r a t u r e t h a t a group t r e a t m e n t m i l i e u f i t s t h e needs of a d o l e s c e n t s e x u a l abuse s u r v i v o r s . Are t h e r e o t h e r p a r t i c u l a r needs of abuse s u r v i v o r s which may be n e g l e c t e d or problems which may be e x a c e r b a t e d i n c e r t a i n s e t t i n g s ? I t i s my c o n t e n t i o n t h a t t h i s i s t h e c a s e . For example, r e l i a n c e on b e h a v i o r a l methods o f c o n t r o l may r e s u l t i n f u r t h e r " a c t i n g o u t " b e h a v i o r on t h e p a r t of abuse s u r v i v o r s because of t h e i r s e n s i t i v i t y t o i s s u e s of p o w e r l e s s n e s s and c o n t r o l . What about t h e s i t u a t i o n i n B r i t i s h Columbia? How many c h i l d c a r e r e s o u r c e s a r e funded t o p r o v i d e t r e a t m e n t ? The Annual R e p o r t of t h e M i n i s t r y of S o c i a l S e r v i c e s and Housing from 1986-1987 s t a t e s t h a t o n l y 19 out of 827 c h i l d c a r e r e s o u r c e s i n B r i t i s h Columbia p r o v i d e " i n t e n s i v e " s e r v i c e s f o r " s e v e r e l y d i s t u r b e d c h i l d r e n " u s i n g an i n t e r -m i n i s t r y approach (p. 28-29). In t h e s e c a s e s , M.S.S.H. p r o v i d e s t h e " r e s i d e n t i a l component of t h e s e r v i c e " . I n a d d i t i o n , t h e r e p o r t s t a t e s t h a t group homes may be c o n t r a c t e d t o p r o v i d e o t h e r s e r v i c e s , such as f a m i l y c o u n s e l l i n g . Thus, i t i s not c l e a r how many group homes a r e a c t u a l l y p r o v i d i n g some k i n d of t r e a t m e n t , a l b e i t , t h e numbers appear few. Treatment c o u l d be viewed as p a r t of t h e mandate of c h i l d -30-p r o t e c t i o n w o r k e r s , g i v e n t h e broad d i s c r e t i o n a r y powers g i v e n t o t h e S u p e r i n t e n d e n t i n t h e B r i t i s h Columbia F a m i l y and C h i l d S e r v i c e s A c t of 1981. However, a t a r e c e n t workshop on c h i l d s e x u a l abuse, t h e c u r r e n t S u p e r i n t e n d e n t , L e s l i e A r n o l d , s t a t e d t h a t t r e a t m e n t f o r c h i l d v i c t i m s i s c o n s i d e r e d t o be under t h e domain of M e n t a l H e a l t h , not M.S.S.H. ( A r n o l d , 1989). How many a d o l e s c e n t s i n c a r e t h e n a r e a l s o b e i n g seen by mental h e a l t h workers f o r i n d i v i d u a l or group t h e r a p y ? The answer t o t h i s q u e s t i o n i s unknown, a l t h o u g h one might s u s p e c t t h a t t h e numbers would be s m a l l g i v e n r e c e n t c u t b a c k s . G i v e n t h e v i t a l importance of t r e a t m e n t f o r s e x u a l abuse s u r v i v o r s and t h e l o g i c of d e l i v e r i n g i t t o groups of c h i l d r e n and a d o l e s c e n t s i n group l i v i n g s i t u a t i o n s , why i s t h i s p a r t i c u l a r avenue of t r e a t m e n t n e g l e c t e d i n t h e l i t e r a t u r e ? I would s u g g e s t t h a t t h e r e a r e s e v e r a l h i s t o r i c a l r e a s o n s why group home t r e a t m e n t of s e x u a l l y abused a d o l e s c e n t s has not been a d d r e s s e d . These a r e p a r t i c u l a r l y e v i d e n t from a f e m i n i s t s o c i a l work p o s i t i o n of a n a l y s i s . F i r s t , our s o c i e t y w i t h i t s emphasis on t h e s a n c t i t y of t h e f a m i l y has l a r g e l y been embarrassed by t h e pre s e n c e of group homes. w o l i n s s u g g e s t s t h a t , "group c a r e f o r young c h i l d r e n and i n f a n t s was, l i k e e a t i n g g a r l i c , j u s t not r i g h t i n a s e l f - r e s p e c t i n g s o c i e t y " (1974, p. 9 ) . We as a s o c i e t y deny t h e f a c t t h a t a t t i m e s t h e f a m i l y i s t h e u n i t of o p p r e s s i o n . S e c o n d l y , t h e low s t a t u s a f f o r d e d t o c h i l d c a r e work and t h e l a c k of t r a i n i n g of c h i l d c a r e workers may p a r t l y account f o r t h e l a c k of c o n s i d e r a t i o n of group home c a r e as t r e a t m e n t i n t h e -31-l i t e r a t u r e . We as a s o c i e t y have h i s t o r i c a l l y under v a l u e d c h i l d c a r e l a b o u r . T h i s i s i l l u s t r a t e d by t h e economic p o w e r l e s s n e s s of t h e work of m o t h e r i n g i n our s o c i e t y . I t f o l l o w s t h e n , t h a t c h i l d c a r e w o rkers who a r e p a i d t o do mother-work would have l i t t l e s t a t u s . T h i r d l y , s o c i e t y ' s n e g a t i v e v i e w of a d o l e s c e n c e may a l s o l e a d us t o n e g l e c t t h i s group as a v i a b l e t r e a t m e n t p o p u l a t i o n . What p e r s p e c t i v e does f e m i n i s m b r i n g t o models of c a r e ? C a r i n g , a c c o r d i n g t o f e m i n i s t s , can be viewed as two d i s t i n c t a f f e c t i v e e x p e r i e n c e s ; " c a r i n g f o r " and " c a r i n g about". The former i s t h e t a s k of c a r e t a k i n g w h i l e t h e second r e f l e c t s f e e l i n g s f o r t h e o t h e r (Graham, 1983). D a l l e y (1988) d i s c u s s e s how t h e s e two forms come t o g e t h e r i n motherhood, and ar e t h e r e f o r e assumed t o be i n t e g r a l t o womanhood. Thus, a woman i s c o n s i d e r e d d e v i a n t i f she a t t e m p t s t o s p l i t t h e s e two r o l e s . I n c o n t r a s t , b a i l e y shows how s o c i e t y s a n c t i o n s men's d e c i s i o n s t o d i v i d e t h e s e r o l e s . She s t a t e s t h a t men g e n e r a l l y c a r e about o t h e r s w i t h o u t c a r i n g f o r them. The consequence f o r women the n i s what Land and Rose (1985) d e s c r i b e as "compulsory a l t r u i s m " . T h i s e x p e c t a t i o n t h a t women s h a l l p r e f o r m t h e c a r e g i v i n g r o l e becomes an assumption on which s o c i a l p o l i c y i s based. Thus, community c a r e means c a r e i n t h e f a m i l y , which e s s e n t i a l l y means c a r e by women. T h i s emphasis on t h e f a m i l y a l s o becomes a way t o j u s t i f y l a r g e numbers of placements i n o r d e r t o f i n d t h e a p p r o p r i a t e " f a m i l y e x p e r i e n c e " f o r c h i l d r e n i n c a r e ( W h i t e , 1986). D a l l e y goes on t o show how t h e rewards o f c a r i n g f o r -32-women a r e low pay and low s t a t u s . D a v i s and Brooks (1985) s u p p o r t t h i s and c i t e how a " m o t h e r l y " approach t o c h i l d c a r e work i s viewed as "amateur and e m o t i o n a l " t o many a d m i n i s t r a t o r s i n s o c i a l work, who a r e p r e d o m i n a n t l y male (p. 2 1 ) . D a l l e y (1988) s u g g e s t s a l t e r n a t i v e forms of c o l l e c t i v e c a r e based on p r i n c i p l e s which r e l a t e t o t h e s t y l e of t h e r e l a t i o n s h i p between t h e c a r e r s and t h e c a r e d f o r . She p o s i t s f i v e such p r i n c i p l e s : t h e dependent per s o n must be g i v e n r e s p o n s i b i l i t y f o r h i s or her l i f e c h o i c e s ; t h e c a r e s h o u l d be f l e x i b l e enough t o meet the i n d i v i d u a l ' s needs; t h e r e s h o u l d be an o p p o r t u n i t y f o r a wide range of r e l a t i o n s h i p s ; t h e r e s h o u l d be t h e o p p o r t u n i t y t o d e v e l o p s k i l l s ; and f i n a l l y , dependent p e o p l e s h o u l d be e c o n o m i c a l l y s e c u r e (pp. 115-116). An a p p l i c a t i o n of t h e s e would i m p l y an emphasis on group i n t e r a c t i o n , s h a r e d c a r e , development of group c o n c e r n , and ungendered r o l e s . D a l l e y shows t h a t t h e consequences of i n t e g r a t i n g c a r i n g and group l i v i n g a r e empowering. There have been o c c a s i o n s on which c h i l d r e n i n c h i l d r e n ' s homes have grouped t o g e t h e r t o defend t h e i r way of l i f e , a r g u i n g t h a t t h e y p r e f e r t o l i v e t o g e t h e r r a t h e r t h a n t o be d i s p e r s e d t o i n d i v i d u a l , s e p a r a t e f o s t e r f a m i l i e s . Young peopl e i n E n g l a n d have them s e l v e s formed an a s s o c i a t i o n ( N a t i o n a l A s s o c i a t i o n of Young P e o p l e i n Care) wh i c h , amongst o t h e r t h i n g s , has a d v i s e d c h i l d r e n on how t o c o u n t e r l e g a l moves t o c l o s e t h e i r homes; i n s e v e r a l c a s e s , c h i l d r e n have succeeded i n b l o c k i n g such moves (p. 126). S t i v e r (1985) e x p l o r e s t h e concept of c a r i n g i n t h e t h e r a p e u t i c r e l a t i o n s h i p . She s u g g e s t s t h a t a " c a r e t a k i n g " r o l e a l l o w s t h e t h e r a p i s t t o m a i n t a i n d i s t a n c e and an -33-imbalance of power i n t h e r e l a t i o n s h i p . " C a r i n g about", she c o u n t e r s , i m p l i e s an e m o t i o n a l i n v e s t m e n t and can be a more e g a l i t a r i a n r e l a t i o n s h i p . For h e r , t h i s means " b e i n g t h e r e " on a v e r y deep l e v e l f o r t h e o t h e r , which does not p r e c l u d e c o n f r o n t a t i o n . F e m i n i s t l i t e r a t u r e about c a r i n g p r e s e n t s a c l e a r v i s i o n of t h e a p p l i c a t i o n of s e l f - i n - r e l a t i o n t h e o r y t o models of group c a r e . T h i s i n n o v a t i v e model i s based on m u t u a l l y empowering r e l a t i o n s h i p s i n f u s e d w i t h a f e m i n i s t e t h i c of c a r e . R a t i o n a l e and F u n c t i o n of t h e R e s e a r c h E v e r y model of t r e a t m e n t has f e l t t h e impact of t h e growing awareness of t h e e x t e n t and consequences of c h i l d s e x u a l abuse. Group homes must not be an e x c e p t i o n . G i v e n t h e h i g h p r o p o r t i o n of v i c t i m s of s e x u a l abuse on p r o t e c t i o n w orker's c a s e l o a d s , workers need i n f o r m a t i o n about models of c a r e which a s s i s t h e a l i n g r a t h e r t h a n p e r p e t u a t e abuse. Group homes a l s o need t h i s i n f o r m a t i o n s i n c e i t appears t h a t about h a l f of t h e i r r e s i d e n t s may be v i c t i m s . H o p e f u l l y , t h e p e o p l e who w i l l b e n e f i t t h e most from t h i s s t u d y w i l l be a d o l e s c e n t s i n c a r e , whose c r i t i c a l v o i c e s have t o o o f t e n been s i l e n c e d . C o n t i n u i n g t o i g n o r e t h i s problem w i l l r e s u l t i n v e r y r e a l human and s o c i a l c o s t s . The d i r e c t o r of an a l t e r n a t i v e s c h o o l i n Vancouver e s t i m a t e s t h a t one s t r e e t - k i d i n t h e i r l i f e t i m e can c o s t t h e t a x p a y e r up t o one m i l l i o n d o l l a r s f o r t i m e i n j a i l , i n d e t o x c e n t e r s , f o r c o u n s e l l i n g and f o r w e l f a r e -34-b e n e f i t s (Banks, 1989). A d d r e s s i n g t h i s problem e a r l y and a d e q u a t e l y can reduce t h e monetary c o s t s of t h i s p o p u l a t i o n , and more i m p o r t a n t l y , t h e tremendous s o c i a l and e m o t i o n a l c o s t s which t h e s e a d o l e s c e n t s bear w i t h t h e i r l i v e s . The t o p i c of group c a r e f o r s e x u a l l y abused a d o l e s c e n t s i s v e r y p e r t i n e n t f o r s o c i a l work. S o c i a l workers have h i s t o r i c a l l y been i n v o l v e d w i t h many f a c e t s of group home l i f e as r e f e r r a l agents ( p r o t e c t i o n w o r k e r s ) , a d m i n i s t r a t o r s and group l e a d e r s . S o c i a l workers have a l s o c o n t r i b u t e d t o t h e development of r e s i d e n t i a l t r e a t m e n t models ( M a l u c c i o & Marlow, 1972, p. 234). Cohen (1986, p. 490) found t h a t 51% of t r e a t m e n t s t a f f i n group homes i n Los An g e l e s had s o c i a l work t r a i n i n g . Thus, s o c i a l work as a p r o f e s s i o n has a h i g h i n v e s t m e n t i n t h e adequacy and outcome o f group home t r e a t m e n t . The p r i m a r y f u n c t i o n of t h i s r e s e a r c h was e x p l o r a t o r y i n o r d e r t o map t h e components o f c a r e of an i n n o v a t i v e group home f o r s e x u a l l y abused a d o l e s c e n t women. G i v e n t h e p a u c i t y of l i t e r a t u r e on t h i s s u b j e c t , an e x p l o r a t o r y s t u d y appeared a p p r o p r i a t e ( A r k a v a & Lane, 1983). W h i t t a k e r (1978) d i s c u s s e s t h e s l o w p r o g r e s s i o n of t h e development of a t h e o r y of i n t e r v e n t i o n f o r group home c a r e and s u g g e s t s , a c o n t i n u e d p e r i o d of e x p e r i m e n t a t i o n w i t h many d i f f e r e n t models and an e s s e n t i a l l y i n d u c t i v e r a t h e r t h a n d e d u c t i v e approach t o t h e development of a t h e o r y of i n t e r v e n t i o n (p. 2 8 ) . T h i s s t u d y w i l l be a c o n t r i b u t i o n t o t h e i n d u c t i v e development of a t h e o r y of i n t e r v e n t i o n w i t h s e x u a l l y abused a d o l e s c e n t s i n c a r e . - 3 5 -The r e s e a r c h q u e s t i o n s proposed by t h i s s t u d y i n c l u d e d t h e f o l l o w i n g : 1. What a r e t h e components of c a r e i n a group home f o r a d o l e s c e n t women who have been s e x u a l l y abused? 2. What p a r t i c u l a r a s p e c t s of group home l i f e do t h e p a r t i c i p a n t s i n t h e s t u d y t h i n k a r e e f f e c t i v e i n a s s i s t i n g t h e a d o l e s c e n t s t o a c h i e v e s e c o n d - o r d e r change ( i . e . t r a n s f o r m a t i o n o f b e h a v i o r , c o g n i t i o n and a f f e c t ) ? 3. How can group homes m i n i m i z e t h e r e p l i c a t i o n of abuse? 4. What would a f e m i n i s t p e r s p e c t i v e b r i n g t o group home t r e a t m e n t of female a d o l e s c e n t s e x u a l abuse s u r v i v o r s ? -36-Chapter Three: Method D e s i g n T h i s r e s e a r c h was un d e r t a k e n as a q u a l i t a t i v e case s t u d y . Q u a l i t a t i v e r e s e a r c h has been acknowledged as p a r t i c u l a r l y u s e f u l i n p o r t r a y i n g t h e h o l i s t i c n a t u r e of group home c a r e and t h e unique p e r s p e c t i v e of each p a r t i c i p a n t ( E i s i k o v i t s & K a s h t i , 1987). P a t t o n (1980) v i e w s q u a l i t a t i v e r e s e a r c h as a p p r o p r i a t e where t h e d e c i s i o n makers of t h e program a r e i n t e r e s t e d i n u n d e r s t a n d i n g t h e s t r e n g t h s and weaknesses of t h e program, t h e p r o c e s s o f t h e program and want t o improve t h e program. He a l s o s t a t e s t h a t q u a l i t a t i v e r e s e a r c h has an u n o b t r u s i v e q u a l i t y t o i t which g e n e r a t e s low r e a c t i v i t y i n p a r t i c i p a n t s . S i t u a t i o n s where no p r e v i o u s s t a n d a r d i z e d i n s t r u m e n t has been found t o be c a p a b l e of measuring program outcome a r e a l s o a p p r o p r i a t e . These c r i t e r i a f i t w i t h t h e group home i n q u e s t i o n much b e t t e r t h a n a q u a n t i t a t i v e d e s i g n , which g e n e r a l l y c o l l e c t s d a t a on a s p e c i f i c h y p o t h e s i s i n a s t a n d a r d i z e d way, w h i l e t h e r e s e a r c h e r s u p p o s e d l y remains o b j e c t i v e and a v o i d s i n t e r p r e t a t i o n s ( R e i d & S m i t h , 1981). For example, Mordoch (1986) d e s c r i b e d h i s group home's f a i l u r e t o measure " s u c c e s s " or "change" i n c h i l d r e n by r e l y i n g on t e s t s . He su g g e s t e d t h e s e measures f l u c t u a t e d w i t h t h e measurer's p e r c e p t i o n s . M a l u c c i o and Marlow (1972) a l s o warn t h a t measuring s u c c e s s of c h i l d r e n i n group homes i s e l u s i v e , and has g e n e r a l l y been atte m p t e d by a s s e s s i n g adequate f u n c t i o n i n g a f t e r d i s c h a r g e . They suggest t h a t t h e r e i s a -37-g r e a t need t o d i s c o v e r t h e elements which produce change i n c h i l d r e n . I t appears t h a t a q u a l i t a t i v e d e s i g n a l l o w s f o r a more d e p t h and r i c h n e s s of d a t a t h a n a q u a n t i t a t i v e d e s i g n . Q u a l i t a t i v e r e s e a r c h a l s o f i t s w i t h a f e m i n i s t p e r s p e c t i v e because each p a r t i c i p a n t ' s p e r s p e c t i v e i s viewed as a v a l i d s o u r c e of knowledge f o r t h e r e s e a r c h e r ( S t a n l e y & Wise, 1983). F e m i n i s t r e s e a r c h has been d e s c r i b e d as i n t e r a c t i v e , i m p l y i n g a two-way p r o c e s s where t h e r e l a t i o n s h i p i s e s s e n t i a l t o t h e q u a l i t y of t h e i n f o r m a t i o n ( O a k l e y , 1981). F e m i n i s t r e s e a r c h i s a l s o d e s i g n e d t o be u s e f u l t o t h e p a r t i c i p a n t s . Because t h e a d m i n i s t r a t o r of t h e home i d e n t i f i e s h e r s e l f as a f e m i n i s t , one c o u l d deduce t h a t her v a l u e s i n f l u e n c e d t h e way she d e s i g n e d t h e program. Thus, a f e m i n i s t p e r s p e c t i v e f i t s w i t h t h e home i n q u e s t i o n , as w e l l as b e i n g consonant w i t h t h e r e s e a r c h e r ' s p e r s p e c t i v e , and the r e s e a r c h d e s i g n . A s i n g l e case s t u d y d e s i g n was chosen because i t a l l o w s f o r t h e e x p l o r a t i o n of m u l t i p l e a n g l e s of group home l i f e w hich i s u s e f u l i n o r d e r t o see t h e whole p i c t u r e o f a complex i n s t i t u t i o n ( B u l l o c k & M i l l h a m , 1987). A case s t u d y i s a l s o u s e f u l when t h e s u b j e c t i s examined i n i t s r e a l l i f e c o n t e x t ; where b o u n d a r i e s between t h e phenomena and t h e c o n t e x t a r e not c l e a r ; and where m u l t i p l e s o u r c e s of d a t a a r e used ( Y i n , 1986). Y i n s t a t e s t h a t t h e s t r e n g t h of a case s t u d y l i e s i n i t s a b i l i t y t o use m u l t i p l e s o u r c e s of d a t a as e v i d e n c e . He s u g g e s t s t h a t t h i s t e c h n i q u e adds t o the v a l i d i t y of t h e r e s u l t s . -38-K a z d i n (1981) c o n c u r s t h a t case s t u d i e s can a c h i e v e s t r o n g e r i n t e r n a l v a l i d i t y when t h e y i n c l u d e t h e f o l l o w i n g : o b j e c t i v e i n f o r m a t i o n (eg. d a t a r e g a r d i n g o v e r t b e h a v i o r ) , c o n t i n u o u s a s s e s s m e n t s , d o c u m e n t a t i o n of immediate and marked changes, a l o n g h i s t o r y of t h e problem, and t h e use of m u l t i p l e c a s e s . He s u g g e s t s t h a t a d d i n g t h i s t y p e of d a t a t o a n e c d o t a l d a t a adds v a l i d i t y t o c l a i m s t h a t change has been a c h i e v e d . K a z d i n a l s o s u g g e s t s t h a t a case s t u d y i s a good way of e x p l o r i n g i n n o v a t i v e t r e a t m e n t methods, and i s a u s e f u l b r i d g e between c l i n i c a l p r a c t i c e and r e s e a r c h . Sources of Data P h o e n i x House, a group home f o r a d o l e s c e n t women gave i t s p e r m i s s i o n f o r t h i s s t u d y (see Appendix A ) . As p r e v i o u s l y mentioned, i t has been i n o p e r a t i o n f o r f o u r y e a r s and i s one of t h e o n l y group homes i n Vancouver whose a d m i s s i o n c r i t e r i a s p e c i f i e s a h i s t o r y of s e x u a l abuse. The r e s e a r c h e r was engaged i n a f i e l d placement t h e r e f o r e i g h t months and was g r a n t e d a c c e s s t o i n d i v i d u a l s and documents a s s o c i a t e d w i t h t h e home. T h i s s t u d y c o n s i d e r e d d a t a from s e m i - s t r u c t u r e d i n t e r v i e w s , documents, and p a r t i c i p a n t o b s e r v a t i o n s . I n t e r v i e w s a r e c o n s i d e r e d t o be an i n d i s p e n s a b l e s o u r c e of d a t a f o r case s t u d i e s ( Y i n , 1986). Y i n s t a t e s t h a t t h e y a r e an e x c e l l e n t s o u r c e of i n s i g h t i n t o t h e s u b j e c t m a t t e r , even though t h e y a r e s u b j e c t t o problems of b i a s , poor r e c a l l and poor or i n a c c u r a t e a r t i c u l a t i o n (p. 8 5 ) . N i n e t e e n i n t e r v i e w s -39-were c a r r i e d out w i t h the r e s i d e n t s ( f i v e ) , s t a f f ( f i v e f u l l -t i m e and one c a s u a l ) , d i s c h a r g e d r e s i d e n t s ( t h r e e ) and r e f e r r i n g a g ents ( f i v e ) . Consents f o r t h e i n t e r v i e w s were o b t a i n e d from each i n d i v i d u a l , as w e l l as t h e a d o l e s c e n t s ' p a r e n t or g u a r d i a n (see Appendix B ) . Two d i f f e r e n t i n t e r v i e w g u i d e s were d e s i g n e d , one f o r t h e a d o l e s c e n t s and one f o r t h e s t a f f and r e f e r r i n g agents (see Appendices C & D). An i n t e r v i e w g u i d e was chosen f o r i t s f l e x i b i l i t y i n o b t a i n i n g s i m i l a r i n f o r m a t i o n from a number of peopl e w i t h d i f f e r e n t p e r s p e c t i v e s ( P a t t o n , 1980, p. 200). Q u e s t i o n s f o c u s s e d on t h e i r p e r c e p t i o n s of Ph o e n i x House, of i t s impact on the l i v e s of t h e a d o l e s c e n t s , and of t h e r e p l i c a t i o n o f abuse. The i n t e r v i e w s w i t h t h e a d o l e s c e n t s were a p p r o x i m a t e l y 45 minutes l o n g , w h i l e t h e o t h e r i n t e r v i e w s ranged from one t o two hours i n l e n g t h (see Appendix E f o r a sample i n t e r v i e w ) . P e r m i s s i o n was sought t o a u d i o - t a p e t h e i n t e r v i e w s . The i n t e r v i e w g u i d e s were adapted a f t e r feedback from two p r o f e s s i o n a l s , and c l a s s m a t e s . F u r t h e r m o d i f i c a t i o n s were made on t h e b a s i s of a c t u a l i n t e r v i e w s . The documents were used t o c o r r o b o r a t e t h e i n t e r v i e w d a t a . Y i n s t a t e s t h a t documents a r e u s e f u l t o c o n f i r m and expand o t h e r d a t a (1986, p. 8 0 ) . He warns t h a t t h e y s h o u l d not be t a k e n as l i t e r a l r e c o r d s . I n s t e a d , one s h o u l d t a k e i n t o a ccount t h e a u d i e n c e f o r whom t h e document was w r i t t e n . The documents examined i n c l u d e d two of t h e most r e c e n t p r o p o s a l s of t h e home, n o t e s from a workshop by t h e a d m i n i s t r a t o r on group work w i t h s e x u a l l y abused a d o l e s c e n t s , -40-a random sample of t h e d a i l y l o g notes ( e v e r y 15 pages over t h e l a s t two y e a r s ) , and t h e n o t e s of t h e a r t t h e r a p i s t r e g a r d i n g one c a s e . The workshop notes c o u l d be c o n s i d e r e d a p u b l i c s t a t e m e n t r e g a r d i n g t h e p h i l o s o p h y , g o a l s and t r e a t m e n t methods of t h e home. The p a r t i c i p a n t o b s e r v a t i o n s were a l s o d e s i g n e d t o c o r r o b o r a t e the i n t e r v i e w d a t a . They sampled t h e day - t o - d a y l i f e of t h e home a t d i f f e r e n t t i m e s , i n c l u d i n g t h e groups. F i e l d n o t e s were c o m p i l e d on o b s e r v a t i o n s from seven s e s s i o n s of a r t t h e r a p y and seven s e s s i o n s of group t h e r a p y from October 1988 t o March 1989. Notes were a l s o made d u r i n g an o v e r n i g h t s h i f t a t t h e home. These f i e l d n o t e s p r o v i d e d f u r t h e r d a t a . P a t t o n s u g g e s t s t h a t o b s e r v a t i o n a l d a t a a s s i s t one t o un d e r s t a n d t h e c o n t e x t of the program; a l l o w one t o be i n d u c t i v e ; p r o v i d e t h e o p p o r t u n i t y t o see t h i n g s t h a t go u n n o t i c e d ; a l l o w one t o l e a r n about t h i n g s which i n d i v i d u a l s may be r e l u c t a n t t o t a l k about i n i n t e r v i e w s ; and a l l o w one t o move beyond t h e s e l e c t i v e p e r c e p t i o n s o f o t h e r s t o e x p e r i e n c e a program f i r s t h a n d (1980, p. 125). M c C a l l and Simmons (1969) a l s o s u g g e s t t h a t p a r t i c i p a n t o b s e r v a t i o n s h e l p t o d e a l w i t h problems of i n f e r e n c e t h a t may a r i s e from i n t e r v i e w s , t h u s , a d d i n g t o t h e a c c u r a c y of t h e d a t a . A problem w i t h p a r t i c i p a n t o b s e r v a t i o n , t h e y s u g g e s t , i s over i d e n t i f i c a t i o n , which r e s u l t s i n l o s i n g one's r e s e a r c h p e r s p e c t i v e . P a t t o n s u g g e s t s t h a t t h e advantage of u s i n g s e v e r a l methods i s t h a t one can u t i l i z e t he s t r e n g t h s of one method t o compensate f o r -41-the weaknesses of an o t h e r method (1980). He s u g g e s t s t h a t u s i n g m u l t i p l e methods i n c r e a s e s b o t h t h e r e l i a b i l i t y and t h e v a l i d i t y of the r e s e a r c h . I m p l e m e n t a t i o n As mentioned e a r l i e r , n i n e t e e n i n t e r v i e w s were c a r r i e d out w i t h t h e a d o l e s c e n t s , d i s c h a r g e d a d o l e s c e n t s , s t a f f , and r e f e r r i n g a g ents a s s o c i a t e d w i t h P h o e n i x House. D u r i n g t h e co u r s e of t h e r e s e a r c h t h r e e a d o l e s c e n t s moved out of t h e home and two new r e s i d e n t s moved i n . Ten i n t e r v i e w s were planned w i t h r e s i d e n t and d i s c h a r g e d a d o l e s c e n t s however, o n l y e i g h t were c a r r i e d o u t . There was c o n s i d e r a b l e d i f f i c u l t y l o c a t i n g and c a r r y i n g out i n t e r v i e w s w i t h t h e d i s c h a r g e d a d o l e s c e n t s . A l t h o u g h i n t e r v i e w s were a r r a n g e d w i t h two a d d i t i o n a l d i s c h a r g e d r e s i d e n t s , t h e s e were r e p e a t e d l y c a n c e l l e d by t h e i n d i v i d u a l s . One of t h e i n d i v i d u a l s moved back home d u r i n g t h e c o u r s e of t h e r e s e a r c h and m a i n t a i n e d l i m i t e d c o n t a c t w i t h t h e group home. She was d e s c r i b e d as h a v i n g d i f f i c u l t y s p e a k i n g about h e r s e l f and her problems. Another i n d i v i d u a l was approached t h r o u g h a s t a f f member who m a i n t a i n e d c o n t a c t w i t h h e r . She e x p e r i e n c e d t h e d e a t h of a f r i e n d and underwent a move d u r i n g the time we attem p t e d t o g e t t o g e t h e r . One of th e d i s c h a r g e d r e s i d e n t s who has l i t t l e c o n t a c t w i t h t h e home was i n t e r v i e w e d a t a l o c a l h o s p i t a l . Her f r i e n d , who had a l s o been i n t e r v i e w e d , o f f e r e d t o c o n t a c t her about t h e i n t e r v i e w , accompany me t o t h e h o s p i t a l and i n t r o d u c e me t o he r . Another i n t e r v i e w was h e l d w i t h a r e s i d e n t two weeks -42-f o l l o w i n g her d i s c h a r g e . The f i n a l i n t e r v i e w was h e l d w i t h a r e s i d e n t who had been d i s c h a r g e d f o r one y e a r , but who s t i l l a t t e n d s group t h e r a p y a t Pho e n i x House r e g u l a r l y . I n o r d e r t o ensure t h e c o n f i d e n t i a l i t y of t h e one male s t a f f p e r s o n , a n o t h e r i n t e r v i e w was h e l d w i t h a p a r t - t i m e male s t a f f p e r s o n . Thus, t h e s t a f f i n t e r v i e w sample i n c r e a s e d from f i v e t o s i x . R e g a r d i n g t h e r e f e r r i n g a g e n t s , f o u r i n t e r v i e w s were h e l d w i t h c h i l d p r o t e c t i o n workers who r e f e r r e d f i v e of t h e a d o l e s c e n t s i n t h e sample. They had been p r e v i o u s l y c o n t a c t e d i n p e r s o n when t h e i r p e r m i s s i o n was o b t a i n e d t o i n t e r v i e w t h e a d o l e s c e n t s . At t h a t t i m e t h e y were asked i f t h e y would be i n t e r e s t e d i n b e i n g i n t e r v i e w e d f o r t h i s s t u d y . C o n s e q u e n t l y , t h i s f i r s t c o n t a c t was f o l l o w e d up w i t h a t e l e p h o n e c o n t a c t t o s e t up t h e i n t e r v i e w . The f i f t h p e r s o n i n t h i s s u b s e t was t h e l i a i s o n worker whose p o s i t i o n w i t h t h e M i n i s t r y of S o c i a l S e r v i c e s and Housing i s t o s c r e e n r e f e r r a l s t o t h i s group home and a c t as an advo c a t e on b e h a l f of t h e group home w i t h c h i l d c a r e w o r k e r s . The i n t e r v i e w g u i d e was a l t e r e d f o l l o w i n g t h e f i r s t t h r e e i n t e r v i e w s w i t h t h e a d o l e s c e n t s and a d u l t s because I was not g e t t i n g c e r t a i n s p e c i f i c i n f o r m a t i o n . I a l s o found t h a t I de v e l o p e d more of a c o n v e r s a t i o n a l s t y l e as I became more c o m f o r t a b l e w i t h t h e i n t e r v i e w . I n d i v i d u a l s were asked a t t h e end o f t h e I n t e r v i e w f o r feedback about t h e i r e x p e r i e n c e and whether any o t h e r i n f o r m a t i o n was s i g n i f i c a n t f o r them. The s t a f f f e l t t h a t t h e i n t e r v i e w s were v e r y l o n g and t i r i n g . -43-Thus, i n subsequent i n t e r v i e w s I t r i e d t o keep t h e d i a l o g u e more f o c u s e d . The r e m a i n i n g i n t e r v i e w s were between s i x t y and n i n e t y minutes i n l e n g t h . The p a r t i c i p a n t o b s e r v a t i o n s proved t o be t h e most d i f f i c u l t . I p e r s o n a l l y found i t d i f f i c u l t t o be bo t h a p a r t i c i p a n t and an o b s e r v e r . I n i t i a l l y , I managed t h i s by r u s h i n g home t o w r i t e up f i e l d n o tes f o l l o w i n g t h e o b s e r v a t i o n s . P h o e n i x House i s a v e r y busy and p u b l i c p l a c e , c o n s e q u e n t l y , i t was d i f f i c u l t t o f i n d a p r i v a t e p l a c e t o make n o t e s . When I l o o k e d a t t h e s i x s e t s of no t e s which span from October 1988 t o J a n u a r y 1989, t h e y were m o s t l y t h e m a t i c , r e c a l l i n g c o n t e n t . These n o t e s a l s o seemed t o r e f l e c t t h e problem o f over i d e n t i f i c a t i o n . C o n s e q u e n t l y , I took c o p i o u s n o t e s d u r i n g a subsequent t h e r a p y group i n o r d e r t o code f o r the p r o c e s s . The note t a k i n g was so time consuming t h a t I c o u l d not p a r t i c i p a t e i n t h e group. C l e a r l y , p a r t i c i p a n t o b s e r v a t i o n i s a s k i l l which t a k e s p a t i e n c e and p r a c t i c e . D u r i n g my f i r s t i n t e r v i e w , t h e t a p e became h o p e l e s s l y t a n g l e d i n t h e machine, and because I d i d not n o t i c e , I ended up w i t h no d a t a and had t o redo t h e i n t e r v i e w . I n subsequent i n t e r v i e w s I took notes i n a d d i t i o n t o t h e t a p e s . Two i n t e r v i e w s from each s u b s e t were t r a n s c r i b e d . For t h e r e m a i n i n g i n t e r v i e w s I l i s t e n e d t o the ta p e s and e l a b o r a t e d on the n o t e s t a k e n d u r i n g t h e i n t e r v i e w . The t r a n s c r i p t i o n s and the n o t e s were t h e n coded. -44-S t r a t e q y of Data A n a l y s i s G i v e n t h e l a r g e amount of d a t a and t h e t i m e c o n s t r a i n t s t h e d a t a was s e l e c t i v e l y coded f o r t h r e e themes c o n t a i n e d w i t h i n t h e r e s e a r c h q u e s t i o n s : t h e components of c a r e , t h e p r o c e s s of change, and r e p l i c a t i n g t h e a b u s i v e p r o c e s s . M i l e s and Huberman (1984) d i s c u s s t h e use of a p r e l i m i n a r y s e t of codes drawn from t h e t h e o r e t i c a l framework. T h i s framework was used f l e x i b l y so t h a t new c o n c e p t s c o u l d emerge. Two a d d i t i o n a l themes d i d emerge which c o n t a i n e d s i g n i f i c a n t d a t a : gender, and s t y l e s of group home c a r e . These themes w i l l be e x p l o r e d i n t h e f i n d i n g s s e c t i o n . The s t y l e of c o d i n g t h a t was c a r r i e d out w i t h t h e i n t e r v i e w d a t a was a t y p e of c o d i n g s i m i l a r t o t h a t d e s c r i b e d by S t r a u s s (1987). The d a t a was coded by s e n t e n c e or p a r a g r a p h f o r themes. At t h i s i n d u c t i v e s t a g e t h e words of t h e i n d i v i d u a l s were used wherever p o s s i b l e f o r t h e codes. S t r a u s s r e f e r s t o t h i s as " i n v i v o " c o d i n g (1987). A f t e r a f i r s t o r d e r of codes emerged from t h e d a t a , t h e s e were s o r t e d and c a t e g o r i z e d u s i n g a c o n s t a n t c o m p a r a t i v e method i n o r d e r t o d e v e l o p a s e c o n d - o r d e r of codes a t a more a b s t r a c t l e v e l . These codes were examined t o d i s c o v e r t h e p a t t e r n of t h e i r r e l a t i o n s h i p t o each o t h e r . The c o r e c a t e g o r i e s were t h e major themes around which t h e d a t a was s e l e c t i v e l y coded. (See Appendix F f o r an example of t h e c o d i n g ) . The f i e l d n o tes were coded f o r c o n t e n t and f o r p r o c e s s . The documents have been s u b j e c t t o a c o n t e n t a n a l y s i s . The d a t a from t h e i n t e r v i e w s , o b s e r v a t i o n s and documents has been t r i a n g u l a t e d i n o r d e r t o f i n d c o r r o b o r a t i o n s and i n c o n s i s t e n c i e s , as w e l l as t o compare d i f f e r e n t p e r s p e c t i v e s ( P a t t o n , 1980, p. 330). C h e c k i n g f o r c o r r o b o r a t i o n i n documents and o b s e r v a t i o n s i s one method of c h e c k i n g t h e v a l i d i t y of d a t a from i n t e r v i e w s . F u r t h e r i s s u e s r e l a t e d t o r e l i a b i l i t y and v a l i d i t y i n c l u d e t h e skewing e f f e c t s o f t h e r e s e a r c h e r on t h e d a t a . Having a r o l e as s t u d e n t i n t h e home f o r s e v e r a l months has h o p e f u l l y l e s s e n e d t h a t p a r t i c u l a r problem, as I had an o p p o r t u n i t y t o d e v e l o p r e l a t i o n s h i p s w i t h most of t h e a d o l e s c e n t s and t h e s t a f f . F i n a l l y , i t was c l e a r l y s t a t e d t h a t t h i s r e s e a r c h would be unde r t a k e n from a f e m i n i s t p e r s p e c t i v e , which a s s e r t s t h a t none of us can approach r e s e a r c h i n an g e n u i n e l y u n b i a s e d way. The i m p o r t a n t t h i n g i s t o be c l e a r and open about one's v a l u e base. In summary, t h e methodology of t h i s r e s e a r c h i n v o l v e d a q u a l i t a t i v e c a s e s t u d y , i n c o r p o r a t i n g m u l t i p l e s o u r c e s of d a t a and u s i n g a v a r i e t y of methods of d a t a c o l l e c t i o n . T h i s d e s i g n a l l o w e d me t o c a p t u r e t h e h o l i s t i c n a t u r e of t h e group home and a t t h e same ti m e t o show t h e v a r i o u s p e r s p e c t i v e s of th e d i f f e r e n t p l a y e r s . The s t u d y was approached from a f e m i n i s t p e r s p e c t i v e which s u p p o r t s t h e v a l i d i t y of each person's p e r c e p t i o n s and r e f l e c t s a c o l l a b o r a t i v e p r o c e s s where f i n d i n g s a r e geared t o be u s e f u l t o t h e p a r t i c i p a n t s . The m u l t i p l e s o u r c e s of d a t a p r o v i d e d f o r checks f o r v a l i d i t y and r e l i a b i l i t y . Thus, t h e weak p o i n t s of one method were checked t o a degree by t h e s t r o n g p o i n t s o f t h e o t h e r methods. -46-Chapter F o u r : F i n d i n g s Background I n f o r m a t i o n P h o e n i x House i s a l a r g e o l d t w o - s t o r e y house on t h e B a s t s i d e of Vancouver. I t l i e s w i t h i n a r e s i d e n t i a l a r e a , a c r o s s t h e s t r e e t from a park and a community c e n t e r . The house i t s e l f o c c u p i e s a s m a l l p i e c e of p r o p e r t y , which i t s h a r e s w i t h an o l d garage. Upon e n t e r i n g t h e b u i l d i n g you would t h i n k t h a t you were e n t e r i n g an o r d i n a r y f a m i l y home on t h e b l o c k . A l a r g e l i v i n g room and k i t c h e n which a r e t h e hub of a c t i v i t y dominate th e main f l o o r . A l s o on t h e main f l o o r i s a s m a l l o f f i c e b e l o n g i n g t o t h e manager, a s t a f f bedroom w i t h two s i n g l e beds i n i t ( j u s t i n c a s e a r e s i d e n t i s a f r a i d t o s l e e p a l o n e ) , and a bathroom. Down a narrow f l i g h t of s t a i r s you w i l l f i n d a n o ther bathroom, t h r e e bedrooms, and a r e c room. I n t h e c e n t e r of t h e r e c room i s a l a r g e t a b l e around which a r t t h e r a p y t a k e s p l a c e . There i s a l s o a f o l d - o u t couch here f o r v i s i t o r s ( o f t e n p r e v i o u s r e s i d e n t s ) . U p s t a i r s t h e r e a r e two more bedrooms. The f i v e a d o l e s c e n t s who l i v e a t t h e house a t any one t i me a r e between 13 and 18 y e a r s of age and a t t h e moment a r e a l l f e m a l e . The house was o r i g i n a l l y d e s i g n e d t o be co-ed, but t h e r e has not been a male r e s i d e n t f o r some t i m e . The g i r l s who l i v e t h e r e have a l l been t e c h n i c a l l y r e f e r r e d by c h i l d p r o t e c t i o n workers from t h e M i n i s t r y of S o c i a l S e r v i c e s and H ousing. I n r e a l i t y some of t h e young women a c t u a l l y chose th e placement t h e m s e l v e s , based on i n f o r m a t i o n from -47-£rlends. One of t h e r e s i d e n t s went so f a r as t o c a l l t he Ombudsman i n o r d e r t o g e t i n t o t h e house. I n t a k e c r i t e r i a s p e c i f i e s t h a t t h e a d o l e s c e n t s have a h i s t o r y of s t r e e t -i n v o l v e m e n t , n o n - c o m p l i a n t b e h a v i o r , and p r e v i o u s s e x u a l abuse which may be u n d i s c l o s e d . The a d o l e s c e n t s who p a r t i c i p a t e d i n t h i s s t u d y i n c l u d e d f i v e r e s i d e n t s and t h r e e former r e s i d e n t s . They had l i v e d a t Pho e n i x House anywhere from two months t o f o u r y e a r s (see T a b l e 1 ) . T h e i r average age a t a d m i s s i o n was 14.5 y e a r s . The a d o l e s c e n t s had, on ave r a g e , e i g h t placements b e f o r e moving i n t o P h o e n i x House. There was a wide range i n t h e numbers of p r e v i o u s p l a c e m e n t s , as i n d i c a t e d i n T a b l e 1. The a d o l e s c e n t who had e x p e r i e n c e d 17 placements had done so i n a span of 11 months. The h i g h numbers of p r e v i o u s placements i n d i c a t e t h a t t h i s i s a p o p u l a t i o n which has been d i f f i c u l t t o s e r v e . A l l of t h e young women had l i v e d on t h e s t r e e t s b e f o r e and o f t e n in-between p l a c e m e n t s . They were a l l p r e v i o u s l y i n v o l v e d i n p r o s t i t u t i o n . The g i r l s l e f t home, i . e . r a n away from home, were k i c k e d out of home, or were apprehended, on ave r a g e , when t h e y were t h i r t e e n and o n e - h a l f y e a r s o l d . -48-Table 1 Age and Placement H i s t o r y of E i g h t Female A d o l e s c e n t s i n the Sample Range Mean Age when f i r s t 1 2 - 1 6 13.5 l e f t home Number of p r e v i o u s 2 - 1 7 placements Age a t a d m i s s i o n 1 3 - 1 7 14.5 t o P h o e n i x House Length of s t a y a t P h o e n i x House 2 months t o 4 y e a r s 1.5 y e a r s -49-A l l e i g h t a d o l e s c e n t s had h i s t o r i e s of c h i l d h o o d s e x u a l abuse, a l t h o u g h one a d o l e s c e n t had not d i s c l o s e d t h e d e t a i l s . The o f f e n d e r s were g e n e r a l l y f a t h e r f i g u r e s or male f r i e n d s of th e f a m i l y . These i n c l u d e d one g r a n d f a t h e r , f o u r s t e p -f a t h e r s , one f a t h e r and two male a c q u a i n t a n c e s . The e x p e r i e n c e s of s e x u a l abuse a l l took p l a c e over an extended p e r i o d of t i m e . One o f t h e g i r l s had been m u l t i p l y abused by s e v e r a l o f f e n d e r s . The m a j o r i t y of t h e g i r l s were a c t i v e l y engaged i n p r o s t i t u t i o n and s u b s t a n c e abuse when t h e y came t o Pho e n i x House. One was seen as a t h i g h r i s k f o r s u i c i d e . Three had been l a b e l l e d as " v i o l e n t " c h i l d r e n i n c a r e . P h o e n i x House i s a d m i n i s t e r e d by a s o c i a l worker w i t h a Ma s t e r s Degree, who has a background i n w o r k i n g w i t h f a m i l i e s and s t r e e t - k i d s . She d e s i g n e d t h e model of t h e home and i s r e s p o n s i b l e f o r i t s a d m i n i s t r a t i o n , i n t a k e , group l e a d e r s h i p , s t a f f h i r i n g and s u p e r v i s i o n . Her r o l e c o u l d a l s o be seen as l i a i s o n w i t h M.S.S.H. and advocate f o r t h e a d o l e s c e n t s . P h o e n i x House employs t h r e e f u l l - t i m e c h i l d c a r e w o r k e r s , and f o u r a c t i v e r e l i e f w o r k e r s . P r e s e n t l y , t h e s e c o n s i s t of f i v e f e males and two males. Three f u l l - t i m e s t a f f and one r e l i e f worker were i n t e r v i e w e d ( t h r e e females and two m a l e s ) . T h e i r backgrounds v a r y g r e a t l y b oth i n terms of e d u c a t i o n and l i f e e x p e r i e n c e . T h e i r f o r m a l e d u c a t i o n ranges from u n i v e r s i t y degrees t o i n c o m p l e t e grade t w e l v e . F i v e a r e p r e s e n t l y e n r o l l e d i n f u r t h e r e d u c a t i o n . Work e x p e r i e n c e v a r i e s from p r e v i o u s c h i l d c a r e work, t o work w i t h handicapped a d u l t s and w i t h b a t t e r e d women. One of t h e s t a f f grew up on -50-the s t r e e t s and i n c a r e . The s t a f f a r e a l l s i n g l e and under age 35. F u l l - t i m e work v a r i e s from two, t w e n t y - f o u r hour or t h i r t y - t h r e e hour s h i f t s per week. S t a f f a r e p a i d a monthly wage. Only one s t a f f p e r s o n i s on d u t y a t a t i m e . A l l s t a f f a r e encouraged t o a t t e n d t h e weekly house group t h e r a p y s e s s i o n . P h o e n i x House has a l s o employed a p a r t - t i m e a r t t h e r a p i s t f o r t h e p a s t y e a r . A r t t h e r a p y group i s s c h e d u l e d once a week. The t h e r a p i s t h o l d s a B.A. and a Diploma i n A r t Therapy. She p r e s e n t l y h o l d s a n o t h e r j o b as a s e x u a l abuse c o u n s e l o r w i t h f a m i l i e s . P h o e n i x House was funded as a t r e a t m e n t r e s o u r c e f o r t h e f i r s t t i me i n t h e f a l l of 1988. T h i s o c c u r r e d a f t e r t h r e e y e a r s of l o b b y i n g , and r e s u l t e d i n i n c r e a s e d wages and b e n e f i t s f o r the s t a f f . The s t a f f b e l i e v e t h a t t h e y w a i t e d so l o n g t o be d e s i g n a t e d as a t r e a t m e n t r e s o u r c e because of t h e i r i n n o v a t i v e a p p r o a c h , which i s o f t e n m i s u n d e r s t o o d , and does not f i t w i t h t r a d i t i o n a l models of t r e a t m e n t . I've had p e o p l e s a y t o me, i f you want t o be funded as t r e a t m e n t , t h e n you have t o g i v e us a p l a n , what the k i d s a r e d o i n g a t 7:30, and 7:45, and i t a l l has t o do w i t h c o n t r o l . So, I'd g i v e them an e m p i r i c a l framework based on not r e p l i c a t i n g t h e a b u s i v e p r o c e s s , and based on m u t u a l i t y , and p e o p l e don't t h i n k t h a t ' s t r e a t m e n t . The model a t P h o e n i x House appears t o r e p r e s e n t a r e l a t i o n a l approach t o c h i l d c a r e work, which i s a t odds w i t h t r a d i t i o n a l models. I n most a g e n c i e s men a r e t h e a d m i n i s t r a t o r s , so t h e y p e r c e i v e t h i s work i n c e r t a i n ways - r o l e s and s t a t u s and a l l t h a t . Women a r e t h e ones d o i n g t h e work and t h e y p e r c e i v e t h e work i n terms of a -51-r e l a t i o n s h i p o r i e n t a t i o n . What t h e n a r e t h e p a r t i c u l a r components of c a r e t h a t c o n s t i t u t e t h i s r e l a t i o n a l model of group c a r e ? The Components of Care The P h i l o s o p h y P h o e n i x House has two s t r i k i n g a s p e c t s of i t s d e s i g n which i n f l u e n c e b oth t h e c o n t e n t and the p r o c e s s of the t r e a t m e n t model. I t i s b u i l t on a model of mutual r e l a t i o n s h i p where th e f o c u s i s on u n d e r s t a n d i n g t h e e f f e c t s of abuse. As t h e manager s t a t e s , "The p r o c e s s i s always r e f l e c t i v e of a m u t u a l i t y - of a new way of b e i n g which doesn't have a n y t h i n g t o do w i t h abuse." The model of m u t u a l i t y a t P h o e n i x House was d e s c r i b e d by th e p a r t i c i p a n t s as a r e l a t i o n a l c o n t e x t of " u n c o n d i t i o n a l a c c e p t a n c e " . T h i s i m p l i e s " a c c e p t i n g t h e k i d s where t h e y a r e a t " , r a t h e r t h a n i n s i s t i n g t h a t t h e k i d s f i t t h e program. For t h i s p a r t i c u l a r p o p u l a t i o n , i t a l s o means "a tremendous t o l e r a n c e of b e h a v i o r " w h i c h , a c c o r d i n g t o t h e p a r t i c i p a n t s i n the s t u d y , i s both a s t r e n g t h of P h o e n i x House and a p r i n c i p l e w h ich d i s t i n g u i s h e s i t from o t h e r group homes. The r e f e r r i n g a g e nts g e n e r a l l y agreed t h a t t h i s approach r e s u l t s i n Phoenix House s e r v i n g a d o l e s c e n t s who a r e l a b e l l e d by t h e system as " d i f f i c u l t " , " e m o t i o n a l l y damaged", or " a c t i n g - o u t " , a group which i s seen as "not f i t t i n g " t r a d i t i o n a l r e s o u r c e s . The p r i n c i p l e s of a c c e p t a n c e , r e s p e c t , and n o r m a l i z a t i o n work t o g e t h e r t o r e f r a m e t h e way t h a t P h o e n i x House v i e w s -52-b e h a v i o r . A l l b e h a v i o r i s viewed as normal, g i v e n the i n d i v i d u a l ' s h i s t o r y , and s u r v i v a l s k i l l s . B e h a v i o r i s a l s o seen as a m e t a p h o r i c a l means of communication, which i n d i v i d u a l s a r e encouraged t o l o o k u n d e r n e a t h , i n o r d e r t o u n d e r s t a n d . We r e g a r d b e h a v i o r as i n f o r m a t i o n . What a r e you t r y i n g t o s a y by your b e h a v i o r ? How does your b e h a v i o r make sense? That's p a r t of them d o i n g t h e i r work. Rather t h a n go a f t e r t h a t b e h a v i o r and n e g a t i v e l y r e i n f o r c e i t t o g e t r i d of i t , we b r i n g i t out as i n f o r m a t i o n f o r work. One of t h e i n t e g r a l components of m u t u a l i t y i s s a f e t y . The house a t t e m p t s t o c r e a t e an atmosphere of t r u s t so t h a t t h e a d o l e s c e n t s f e e l s a f e enough t o work on t h e i r i s s u e s , and b e g i n t o see how t o b u i l d s a f e t y i n t o t h e i r own l i v e s . Assuming i n t h e i r f a m i l y t h e r e was no such t h i n g as s a f e t y , we want them t o l e a r n s a f e t y mechanisms. We want t o g i v e them a sense of s a f e t y . A c ceptance and r e s p e c t h e l p t o b u i l d s a f e t y , as do ho n e s t y and openness. I n f a m i l i e s s e c r e t - k e e p i n g i s r e a l l y b i g , so we r e a l l y emphasize p e o p l e not k e e p i n g s e c r e t s . We t r y t o have e v e r y t h i n g open, t h a t ' s why we m o s t l y do group work. Openness i s found not o n l y i n t h e commitment t o group work, but i n the system of r e c o r d i n g . The d a i l y l o g book i s p l a c e d on t h e k i t c h e n cupboard where everyone has a c c e s s t o i t . Both s t a f f and r e s i d e n t s w r i t e i n i t , documenting appointments and c u r f e w s , as w e l l as a d d r e s s i n g i n t e r p e r s o n a l i s s u e s such as t h e f t . Notes from group t h e r a p y , which t y p i c a l l y i d e n t i f y t h e i s s u e s t h a t i n d i v i d u a l s a r e w o r k i n g on, a r e a l s o i n c l u d e d i n t h e book. T h i s l e v e l of openness and -53-h o n e s t y i s i n d i r e c t c o n t r a s t t o t h e way i n which r e c o r d i n g was e x p e r i e n c e d by some of t h e a d o l e s c e n t s i n o t h e r group homes. And t h e y watch e v e r y t h i n g you do - r e a l l y - and w r i t e i t down i n t h i s book. You know, l i k e how many ti m e s you go t o t h e bathroom, what you do, how many ti m e s you t a l k on the t e lephone...They s i t t h e r e a l l t h e t i m e . They watch you. Another key component of m u t u a l i t y i s e q u a l i t y . The a d o l e s c e n t s a t P h o e n i x House a r e viewed as i n d i v i d u a l s who have the r i g h t t o g i v e , as w e l l as r e c e i v e feedback, and t o n e g o t i a t e about r u l e s . Thus, t h e r e i s an attempt t o e s t a b l i s h a two-way f l o w of power w i t h t h e a d o l e s c e n t s r a t h e r t h a n a one-way f l o w of power over them. T h i s i s s u e s t o o d out f o r s e v e r a l of t h e a d o l e s c e n t s as b e i n g s i g n i f i c a n t l y d i f f e r e n t t h a n a t o t h e r group homes. One of t h e a d o l e s c e n t s sums i t up, "You a r e r e a l l y t r e a t e d e q u a l l y h e r e . That's been i m p o r t a n t , t o be t r e a t e d as e q u a l s . " An example of t h i s p r o c e s s i s t h e manner i n which case c o n f e r e n c e s a r e h e l d . The k i d s a r e i n charge of t h e i r own t r e a t m e n t meetings h e r e . They p r e s e n t t h e problems, and t h e y a r e e x p e c t e d t o have a s o l u t i o n . The k i d s hand out t h e r e p o r t s and s i g n them. I t s a way of s h a r i n g knowledge and s h a r i n g r e s p o n s i b i l i t y . A l o n g w i t h t h i s s h a r i n g of knowledge and r e s p o n s i b i l i t y , comes a s h a r i n g of power, or empowerment. The f i n a l i n t e g r a l component of m u t u a l i t y which was mentioned by a l l p a r t i c i p a n t s was t h a t of n u r t u r i n g . N u r t u r i n g was d e s c r i b e d by t h e p a r t i c i p a n t s as " c a r i n g " , " c o n n e c t i n g " , or " s u p p o r t " . I t was imaged as b e i n g " l i k e a c a r i n g f a m i l y " . The a d o l e s c e n t s s t a t e d t h a t t h e c a r e t h e y - 5 4 -e x p e r i e n c e d a t Phoenix House was s i g n i f i c a n t l y d i f f e r e n t t h a n what t h e y had e x p e r i e n c e d a t o t h e r group homes. N u r t u r i n g was viewed as more th a n e m o t i o n a l c a r i n g . I t was a l s o seen t o encompass a r e s p e c t f u l c o n f r o n t a t i o n which e n a b l e s r e s p o n s i b i l i t y t o d e v e l o p . What we m a i n l y do i s p r o v i d e an atmosphere of n u r t u r i n g a c c e p t a n c e , and I t h i n k , c h a l l e n g e . There's a f e e l i n g t h a t p e o p l e c a r e f o r you h e r e , no m a t t e r what. P e o p l e may a l s o c h a l l e n g e your b e h a v i o r . One o f t h e r e f e r r i n g agents s u g g e s t e d t h a t i n p a r t i c u l a r , f o r s t r e e t - k i d s w i t h a h i s t o r y of abuse, They need t o know t h a t f o o d , and by e x t e n s i o n , e m o t i o n a l s u p p o r t w i l l be o f f e r e d u n s t i n t i n g l y , t h a t t h e r e i s no end t o i t . Thus, n u r t u r i n g i s a v i t a l f a c t o r i n t h i s model of m u t u a l i t y . The model of mutual r e l a t i o n s h i p a t P h o e n i x House i s p e r c e i v e d as i n c o r p o r a t i n g p r i n c i p l e s of u n c o n d i t i o n a l a c c e p t a n c e , r e s p e c t , n o r m a l i z a t i o n , h o n e s t y , openness, e q u a l i t y and n u r t u r a n c e . These p r i n c i p l e s work t o g e t h e r t o c r e a t e an atmosphere of s a f e t y and c a r e where t h e a d o l e s c e n t s a r e encouraged t o make r e s p o n s i b l e c h o i c e s . The p r i o r i t y i s t o t e a c h k i d s s k i l l s t o make t h e b e s t c h o i c e s t h e y can - c h o i c e s t h a t t h e y a r e h e l d r e s p o n s i b l e f o r . W i t h i n t h i s r e l a t i o n a l c o n t e x t i s a c o n s t a n t e d u c a t i o n a l p r o c e s s about t h e e f f e c t s of abuse. As a s t a f f p e r s o n s t a t e d , The f o c u s here i s on abuse i s s u e s . When someone i s abused i t e f f e c t s e v e r y p a r t of who you a r e . On a c o n t e n t l e v e l , abuse and t h e e f f e c t s of abuse a r e c o n s t a n t l y d i s c u s s e d w i t h t h e a d o l e s c e n t s i n r e l a t i o n t o how t h i s a f f e c t s t h e i r p r e s e n t sense of s e l f and r e l a t i o n s h i p s . -55-The r e f e r r i n g agents saw t h i s as a model of " s a t u r a t i o n " which was u s e f u l i n d i f f u s i n g a v o i d a n c e . I t was noted t h a t abuse becomes a d a i l y t o p i c of c o n v e r s a t i o n , o f t e n c a r r i e d out w i t h a g r e a t d e a l o f humor. T h i s f o c u s on abuse was another d i s t i n g u i s h i n g c h a r a c t e r i s t i c of Pho e n i x House, a c c o r d i n g t o a l l p a r t i c i p a n t s . I t was acknowledged t h a t some group homes ad d r e s s abuse on a " b a s i c l e v e l " , such as p u t t i n g a c r o s s t h e message t h a t " i t was not your f a u l t " . However, t h e r e was a g e n e r a l consensus t h a t a l l group homes s h o u l d be a d d r e s s i n g t h e i s s u e o f abuse more a d e q u a t e l y . S e n s i t i v i t y t o abuse not o n l y permeates t h e c o n t e n t of th e program, but a l s o t h e p r o c e s s . The c a r d i n a l p r i n c i p l e here i s " t h a t t h e t r e a t m e n t model doesn't r e p l i c a t e t h e p r o c e s s of abuse". T h i s i m p l i e s an awareness and a v o i d a n c e of s t y l e s of i n t e r r e l a t i n g which a r e b r o a d l y d e f i n e d as " a b u s i v e " , because t h e y a r e c o n d i t i o n a l r e l a t i o n s h i p s . The c o n d i t i o n s of t h e s e r e l a t i o n s h i p s a r e t h a t t h e a d o l e s c e n t i s p l a c e d i n a p o s i t i o n o f , accommodating t o t h e needs of t h e p o w e r f u l s t a f f p e r s o n and succumbing t o t h e i r power, much the same as she d i d i n p a s t r e l a t i o n s h i p s w i t h a b u s e r s . C o n d i t i o n a l r e l a t i n g i s viewed by some of t h e p a r t i c i p a n t s as when t h e " s t a f f may f e e l needy and wants t o f e e l i m p o r t a n t t o t h e k i d " . T h i s can l e a d t o a r e l a t i o n s h i p of "co-dependency" where t h e a d o l e s c e n t s ' c h o i c e s r e f l e c t an attempt t o p l e a s e t h e s t a f f , and t h e s t a f f encourages t h i s . I n most o t h e r group homes k i d s a r e i m m e d i a t e l y put back i n t o a s i t u a t i o n t h a t reminds them of an a b u s i v e s i t u a t i o n . Somebody's i n c o n t r o l , somebody's made t h e r u l e s f o r them t h a t t h e y weren't -56-a p a r t o f . T h e y ' l l have t o f i n d out what t h a t o t h e r person's r u l e s a r e and p l e a s e them. That whole b u s i n e s s from t h e minute you walk i n t o most group homes, i t s your j o b t o f i n d out what p l e a s e s t h e s t a f f and make s u r e t h a t you do i t , t h e r e ' s n o t h i n g more a b u s i v e t h a n t h a t . C o n d i t i o n a l r e l a t i n g then i s seen t o be e s s e n t i a l l y a b u s i v e . Other s t y l e s t h a t a r e viewed as e s s e n t i a l l y abuse i n c l u d e t h e use o f power as c o n t r o l , and i n v a d i n g p e r s o n a l b o u n d a r i e s . One of t h e a d o l e s c e n t s d e s c r i b e s her e x p e r i e n c e of b e i n g c o n t r o l l e d i n an o t h e r group home which she i n t e r p r e t s as a b u s i v e . And t h e y power t r i p w i t h you t o o , l i k e , " I r u n t h i s p l a c e and you have t o do what I s a y , when I s a y i t and how I s a y i t . " You don't s t a n d up t o them because you a r e s c a r e d of them. I t ' s j u s t a form of abuse. A s t a f f member d e s c r i b e s how r o u t i n e l y c h i l d r e n ' s b o u n d a r i e s a r e invaded when t h e y a r e i n c a r e . We w i l l go t h r o u g h t h e i r d r a w e r s , and re a d t h e i r m a i l and t h e y have no p r i v a c y , and pe o p l e t h i n k t h a t ' s p e r f e c t l y r e a s o n a b l e . Then t h e y wonder why the k i d s don't l e a r n t o s e t b o u n d a r i e s and sa y , "No, you c a n ' t s e x u a l l y abuse me". The p h i l o s o p h y o f Pho e n i x House, t h e n , i s a model of mutual r e l a t i o n s h i p , where u n d e r s t a n d i n g t h e dynamics and e f f e c t s of abuse a r e paramount. T h i s p h i l o s o p h y c r e a t e s a t h e r a p e u t i c m i l i e u , a whole way of b e i n g w i t h t h e s e k i d s , a whole l i f e e x p e r i e n c e f o r them, t h a t a l l o w s them t o work t h e e f f e c t s of t h e i r abuse t h r o u g h . T h i s b r i n g s us t o examine f u r t h e r how t h e p h i l o s o p h y i n f l u e n c e s t h e p o l i c i e s and p r o c e d u r e s of t h e home. -57-P o l i c i e s and P r o c e d u r e s There a r e few r u l e s t h a t a r e n o n - n e g o t i a b l e a t Pho e n i x House because of i t s p h i l o s o p h y of m u t u a l i t y . However, t h e r e axe s i x n o n - n e g o t i a b l e s which a r e viewed as s a f e t y i s s u e s . They a r e : no s e x , v i o l e n c e , a l c o h o l , drugs or s t e a l i n g on t h e p r e m i s e s , and no smoking i n t h e bedrooms. There a r e a l s o two t a c i t r u l e s : t h a t you r e s o l v e any c o n f l i c t s and t h a t s t a y i n g a t t h e home i s not c o n d i t i o n a l upon your b e h a v i o r . These two p r i n c i p l e s were p e r c e i v e d as d i f f e r e n t from t r a d i t i o n a l models. The a d o l e s c e n t s a l l s t a t e d t h a t t h e y never l e a r n e d t o r e s o l v e i s s u e s i n o t h e r p l a c e m e n t s . As one a d o l e s c e n t s a i d , Other p l a c e s , you go t h e r e and t h e y j u s t punch each o t h e r o u t . N o t h i n g ever g e t s r e s o l v e d . There's no p r i v a c y and no c o n s i d e r a t i o n f o r anybody. The f a c t t h a t s t a y i n g i s not c o n d i t i o n a l was viewed as p a r t i a l l y r e s p o n s i b l e f o r t h e f a c t t h a t a d o l e s c e n t s don't r u n from P h o e n i x House. One t h i n g t h a t t h e y a r e v e r y c l e a r about i s t h a t you don't l e a v e P h o e n i x House the way you l e a v e o t h e r p l a c e s . Most p l a c e s you know t h a t sooner or l a t e r i f you break t h a t l i s t o f r u l e s t h a t t h e y gave you, you can be gone. You can make them d i s a p p e a r out of your l i f e and prove t o y o u r s e l f t h a t t h e s e a d u l t s a r e n ' t t r u s t w o r t h y e i t h e r , t h a t t h e y won't s t i c k t o you. I t s much ha r d e r f o r k i d s t o g e t t h a t message a t P h o e n i x House. I've seen how t h e y s t i c k t o p e o p l e . A l l o t h e r i s s u e s , i n c l u d i n g c u r f e w s , a r e s u b j e c t t o n e g o t i a t i o n . When a n o n - n e g o t i a b l e i s broken, t h i s i s viewed as s e r i o u s , and an assumption i s made t h a t t h e pe r s o n i s " a s k i n g f o r h e l p " , or "doesn't want t o l i v e h e r e " . A meeting i s t h e n c a l l e d where t h e meaning b e h i n d t h i s b e h a v i o r i s examined, and s o l u t i o n s t o t h e problem e x p l o r e d . -58-In r e a l i t y t h e s e i n f r a c t i o n s a r e sometimes o v e r l o o k e d . At t i m e s we know t h e r e ' s drugs i n t h e house and no one says a n y t h i n g . You g e t t i r e d of s a y i n g i t . I t s hard t o be s t a f f s a r g e a n t a l l t h e t i m e . Another s t a f f p e r s o n s a i d " I t depends on t h e e x t e n t t o which i t i s b r o k e n " as t o whether t h e y would c a l l a m e e t i n g . T h i s i s because " i t s hard t o g e t everybody ( t h e manager, s o c i a l w o rker, c h i l d c a r e s t a f f and r e s i d e n t ) t o g e t h e r f o r a m e e t i n g " . T h i s worker s t a t e d t h a t "immediacy" becomes an i s s u e i n t h i s model where n e g o t i a t i o n i s t h e o n l y o p t i o n . The r e f e r r i n g agents agreed w i t h t h i s , and f e l t , as the s t a f f d i d , t h a t a t t i m e s t h e s t a f f " l e a v e s t h i n g s t o o l o n g " . Where meetings a r e h e l d , t h e y a r e p e r c e i v e d as s u c c e s s f u l i n r e s o l v i n g i s s u e s by a l l p a r t i c i p a n t s . The r e f e r r i n g a g ents i n p a r t i c u l a r f e l t t h a t t h i s p r o c e s s of i n c l u d i n g them was a s t r e n g t h , and saw t h e home as open t o t h e i r f eedback. The i s s u e of c u r f e w s brought t h e g r e a t e s t c o n c e r n from t h e s t a f f . Curfews a r e n e g o t i a b l e i n d i v i d u a l l y . Because most of t h e a d o l e s c e n t s have been on t h e s t r e e t r e c e n t l y , t h e y a r e accustomed t o k e e p i n g l a t e h o u r s . The model a t t h e house i s t o i n i t i a l l y a c c e p t t h i s , but t o g r a d u a l l y p l a c e g r e a t e r and g r e a t e r r e s p o n s i b i l i t y on t h e a d o l e s c e n t s t o be s a f e . T h i s i m p l i e s coming i n e a r l i e r . T h i s i n d i v i d u a l i z e d p r o c e s s by which t h e program f i t s t h e a d o l e s c e n t i s viewed as a s t r e n g t h of t h e program, but " t a k e s a l o t more energy" on t h e p a r t of t h e s t a f f . F u r t h e r m o r e , because no consequences but n e g o t i a t i n g a r e used, t h e s t a f f has t o f a c e i t s own p o w e r l e s s n e s s when cu r f e w s a r e b r o k e n , or k i d s r e f u s e t o g e t - 5 9 -out of bed. Because we don't use consequences, the house can sometimes be l i k e a motel. I t s hard f o r k i d s who haven't yet learned t o take r e s p o n s i b i l i t y . I t i s s i g n i f i c a n t t h a t a l l of the a d o l e s c e n t s thought t h a t the r u l e s were f a i r . The r u l e s are good. I f you break them you t a l k about i t i n group or have meetings. You l e a r n to r e s o l v e i t by t a l k i n g about i t . Only one of the d i s c h a r g e d a d o l e s c e n t s thought t h a t the curfew was too l a t e f o r the younger a d o l e s c e n t s . There was a gen e r a l uncomfortableness v o i c e d by some of the a d u l t s i n regards to the p e r c e i v e d "lack of s t r u c t u r e " of the home. Although i t was acknowledged t h a t t h i s was a s t r e n g t h of the program because i t enabled f l e x i b i l i t y , an i n d i v i d u a l i z e d focus and encouraged s e l f - r e s p o n s i b i l i t y , i t was a l s o seen as a d i f f i c u l t i s s u e f o r the new r e s i d e n t s who had no sense of s a f e t y or r e s p o n s i b i l i t y . These a d o l e s c e n t s were viewed as g e t t i n g i n t o more dangerous behavior when they f i r s t came to the home, because they d i d not yet have a s t r o n g "connection" or investment i n the r e l a t i o n s h i p s t h e r e . Furthermore, i t was suggested t h a t some a d o l e s c e n t s i n t e r p r e t a lack of s t r u c t u r e to mean a lack of c a r i n g . T h i s o p i n i o n was supported by the newest r e s i d e n t , who s t a t e d , "Here when you break curfew, they don't c a r e " . Dangerous behavior i s t h e r e f o r e addressed by an focus on b u i l d i n g r e l a t i o n a l bonds. T h i s i s a r a d i c a l s h i f t , from t r a d i t i o n a l models which would respond with consequences and c o n d i t i o n s designed to c o n t r o l . - 6 0 -The Manager The manager of Pho e n i x House was seen as a b s o l u t e l y i n t e g r a l t o t h e program by a l l p a r t i c i p a n t s . The main s t r e n g t h of t h e program i s t h e manager -the p h i l o s o p h y , s k i l l and e x p e r i e n c e she's brought t o i t . Her knowledge and s k i l l as an e x p e r i e n c e d s o c i a l work g r a d u a t e were i d e n t i f i e d as u n u s u a l f o r her p o s i t i o n . She was viewed as a s t r o n g r o l e model f o r s t a f f and r e s i d e n t s . Her s k i l l s as group l e a d e r were c h a r a c t e r i z e d as e x c e p t i o n a l . Her r o l e as s u p e r v i s o r was seen as e s s e n t i a l f o r "debugging t h e system". Many c o l o r f u l words were used by t h e s t a f f and a d o l e s c e n t s t o d e s c r i b e t h e manager's r o l e . Prom t h e s t a f f : "She's t h e d r i v e r of t h e bus." "She's t h e rock of G i b r a l t a r . " "She i s _ P h o e n i x House." "She's t h e mother around h e r e , v e r y n u r t u r i n g . " Prom t h e a d o l e s c e n t s : "She's l i k e t h e p a r e n t of us a l l . " " I j u s t l o v e h e r . " " I l i k e how she runs t h e p l a c e . She made me loo k a t my p a s t . " A l l of t h e p a r t i c i p a n t s d e s c r i b e d her r o l e as one of " s u p p o r t " . Other d e s c r i p t o r s were " c o n n e c t i n g w i t h t h e g i r l s " , " s h a r i n g knowledge", and " m e d i a t i n g " . C l e a r l y , t h e manager i s c e n t r a l i n s h a p i n g t h e unique atmosphere of t h e house, p r o v i d i n g n u r t u r a n c e , knowledge and d i r e c t i o n f o r t h e a d o l e s c e n t s and s t a f f . There was some c o n c e r n e x p r e s s e d t h a t t h e program was t o o dependent on h e r . I f she's not around, t h e s t a f f can g e t o f f t r a c k and i t s h a r d e r f o r them t o g e t i t back because t h e y r e a l l y depend on h e r . T h i s i s s u e was r a i s e d by t h e manager h e r s e l f who s t a t e d t h a t -61-" r e s o u r c e s tend t o r e f l e c t the p e r s o n r u n n i n g i t " . She s t a t e d t h a t p a r t of t h e problem was t h e l a c k of t r a i n i n g of c h i l d c a r e w o r k e r s . She t r i e d t o a d d r e s s t h i s i s s u e t h r o u g h s t a f f i n s e r v i c e m e e t i n g s . The C h i l d Care Workers The c h i l d c a r e p o s i t i o n s have been s e t up as i n d i v i d u a l h o u s e p a r e n t s . The manager s t a t e s , I t r y s p e c i f i c a l l y not t o d u p l i c a t e t h e n u c l e a r f a m i l y . . . I t h i n k t h a t a s ks f o r d y s f u n c t i o n a l p a t t e r n s . The r e f e r r i n g agents echoed t h i s c o n c e r n , and saw p a r e n t c o u n s e l o r r e s o u r c e s as g e n e r a l l y l e s s a b l e t o work e f f e c t i v e l y w i t h t h i s p o p u l a t i o n because t h e y more e a s i l y got hooked i n t o p a r e n t a l p o s i t i o n s of c o n t r o l . At P h o e n i x House, one s t a f f p e r s o n i s on s h i f t a t a t i m e . One s t a f f p e r s o n saw t h i s as a d e f i n i t e advantage. When you have more s t a f f on 24 hours a day, t h e n you have t o s t a y awake a l l n i g h t . The k i d s see you as a g u a r d , and t h e house l i k e a j a i l . I t s more l i k e normal l i f e h e r e . The c h i l d c a r e workers a r e r e s p o n s i b l e f o r a wide range of i n s t r u m e n t a l and t h e r a p e u t i c t a s k s . T h e i r i n s t r u m e n t a l t a s k s i n c l u d e t h e p h y s i c a l upkeep of t h e house and van. T h i s i n c l u d e s s h o p p i n g , meal p r e p a r a t i o n , c l e a n i n g and b u d g e t i n g . I n t h i s r e l a t i o n a l model a major r o l e becomes m o d e l l i n g h e a l t h y r e l a t i o n s h i p s . T h i s means " n u r t u r i n g " , " c o n f r o n t i n g " , " b e i n g t h e r e f o r e v e r y k i d " , and " a d m i t t i n g when t h e y make m i s t a k e s " . The c h i l d c a r e s t a f f a l s o f e l t t h e y s e r v e d as " l i f e s k i l l s c o a c h " , "sounding b o a r d " , and " a s s e s s i n g and -62-s h a r i n g i n f o r m a t i o n about th e k i d s " . How do the workers f e e l about t h e i r r o l e ? A l l of t h e s t a f f s t a t e d t h a t t h e y e n j o y e d th e j o b , but s t a t e d t h a t i t had i t s down s i d e . " I t s r e w a r d i n g . " " I l o v e i t h e r e . " " I t s a h e a l i n g , n u r t u r i n g p l a c e . " " I t s c h a l l e n g i n g . " A l o n g w i t h t h e p o s i t i v e comments were f r u s t r a t i o n s . " I t s t i r i n g , e s p e c i a l l y t h e s h i f t work." " I t s d r a i n i n g , we're always g i v i n g . " "I'm more c y n i c a l now, e s p e c i a l l y about men." "There's a f e e l i n g of i s o l a t i o n from t h e mainstream." The work f o r them i s c l e a r l y engaging and r e w a r d i n g , but comes w i t h an e m o t i o n a l c o s t . The i n n o v a t i v e n a t u r e of t h e work i s d o u b l e - s i d e d because i t i m p l i e s b oth e x c i t e m e n t and i s o l a t i o n . The d i s c u s s i o n about pay r e v e a l e d t h a t on t h e whole t h i s group was not t o o c o n cerned about money. However t h e y r e c o g n i z e d t h a t t h e i r poor pay was a r e f l e c t i o n of low p r i o r i t y on t h e p a r t of government towards the needs of c h i l d r e n . F u r t h e r m o r e , t h a t t h e s e p a r t i c u l a r c h i l d r e n , a d o l e s c e n t s t r e e t - k i d s , a r e t h e l o w e s t p r i o r i t y . S t r e e t k i d s t e n d t o be throw-away k i d s . S o c i e t y ' s a t t i t u d e i s g e n e r a l l y t h a t a c t i n g - o u t t e e n a g e r s j u s t need a k i c k i n t h e b u t t . They t h i n k , t h e y ' r e s t r e e t k i d s , t h e r e ' s n o t h i n g you can do w i t h them. How d i d t h e a d o l e s c e n t s p e r c e i v e t h e r o l e of t h e c h i l d c a r e w o r k e r s ? E v e r y a d o l e s c e n t responded t h a t t h e y f e l t t h e s t a f f " c a r e d " . T h i s was s i g n i f i c a n t f o r them because t h e y g e n e r a l l y f e l t t h i s was not t h e case a t o t h e r group homes. Most p l a c e s don't c a r e i f you a r e on t h e s t r e e t as l o n g as you're i n by c u r f e w . Here t h e y c a r e about what you do, and you i n g e n e r a l . A l o n g w i t h t h e c a r i n g were f e e l i n g s of b e i n g t r e a t e d as -63-e q u a l s and b e i n g r e s p e c t e d . The s t a f f a r e n ' t j u s t here d o i n g t h e i r work, t h e y ' r e more l i k e your f r i e n d s , and t h e y c a r e about you. Two a d d i t i o n a l comments p o i n t t o o t h e r i s s u e s . One of the r e s i d e n t s f e l t t h a t one s t a f f person always put her down. She had d i s c u s s e d t h i s w i t h t h e s t a f f and a meeting was t o be c a l l e d t o d e a l w i t h i t . Another a d o l e s c e n t s a i d t he f o l l o w i n g : I t h i n k t h a t t h e s t a f f s h o u l d get t o g e t h e r a l o t more and d e a l w i t h t h e i r s t u f f , because t h e r e ' s a l o t of f r i c t i o n sometimes between s t a f f members. Some of t h e s t a f f and t h e r e f e r r i n g a g ents a l s o mentioned t h a t t h e s t a f f s h o u l d t r y meeting more o f t e n as a group, f o r s u p e r v i s i o n and t r a i n i n g . That c o u l d be done more here - a p l a c e f o r s t a f f t o hash out t h e i r problems t o g e t h e r . Maybe we c o u l d have group s e s s i o n s w i t h s t a f f once a month t o work on our own i s s u e s . A l l of t h e s t a f f s t a t e d t h a t t h e y needed s e l f - a w a r e n e s s i n o r d e r t o do t h i s work. T h i s work c h a l l e n g e s my i s s u e s w i t h i n m y s e l f . I have t o be a b l e t o l i v e i t as w e l l as s a y i t . The i s s u e s i n my l i f e can cause me t o be b l i n d . You have t o c o n t i n u a l l y work on s e l f i n o r d e r t o keep your p e r s p e c t i v e s t r a i g h t . The l a s t i s s u e c o n c e r n i n g s t a f f was t h e impact of t h e i r gender. The women on s t a f f t a l k e d about t h i s work as "mo t h e r i n g " , and "as an e x t e n s i o n of m y s e l f " . T h e i r a b i l i t y t o n u r t u r e i n a r e l a t i o n a l c o n t e x t was c l e a r l y p a r t of t h e i r s e l f - c o n c e p t . The men and the women both f e l t t h a t t h e men p l a y e d an i m p o r t a n t p a r t as a " h e a l t h y r o l e model", or a " n u r t u r i n g male". The men f e l t t h a t t h e i r gender was an -64-advantage. L a t e r on i n t h e c a r e p r o c e s s I t h i n k i t s good t o have men i n v o l v e d , because f o r t h e s e g i r l s anyway, most of t h e men t h a t t h e y have been i n v o l v e d w i t h have been a b u s e r s . So t h e r e ' s a whole r o l e model t h i n g . Yes, t h e r e i s an a l t e r n a t i v e . A few o f t h e workers c a u t i o n e d t h a t men i n p a r t i c u l a r need t o be aware of t h e i r s e x u a l i t y and "what t u r n s them on" i n o r d e r t o do t h i s work. One p e r s o n f e l t t h a t the g i r l s " shut down a b i t " around men. There i s no doubt t h a t male s t a f f need t o be v e r y s e n s i t i v e t o i s s u e s of gender i n t h e i r work w i t h t h i s p o p u l a t i o n . One of t h e r e f e r r i n g a g ents f e l t t h a t t h e s t a f f a t t i m e s " d i d n ' t i n t e r v e n e a s s e r t i v e l y enough". She f e l t t h a t t h e s t a f f had d i f f e r e n t l e v e l s of e x p e r i e n c e , energy and commitment and t h a t a t t i m e s s t a f f was " u n a v a i l a b l e " . One o t h e r r e f e r r i n g agent s t a t e d t h a t t h e r e was a l a c k of communication a t t i m e s w i t h t h o s e o u t s i d e t h e house. G e n e r a l l y , t h e s t a f f were seen as good r o l e models who t h e m s e l v e s had made p e r s o n a l growth t h r o u g h t h e i r a s s o c i a t i o n w i t h P h o e n i x House. In summary, t h e c h i l d c a r e workers a r e r e s p o n s i b l e f o r m a i n t a i n i n g a n u r t u r i n g , a c c e p t i n g atmosphere i n the m i d s t of t h e i r many d u t i e s . They f i n d t h i s r e w a r d i n g , but t i r i n g and a t t i m e s i s o l a t i n g . I t i s acknowledged t h a t workers need t o be aware of t h e m s e l v e s and t h e i r own i s s u e s t o do t h e work w e l l . T h i s c o u l d be f a c i l i t a t e d by more f r e q u e n t s t a f f m e e t i n g s . The a d o l e s c e n t s f i n d t h a t t h e c h i l d c a r e s t a f f g e n e r a l l y meet t h e i r needs f o r n u r t u r i n g . -65-The Peer Group The peer group a t Ph o e n i x House i s viewed as h a v i n g a d u a l purpose; r e d u c i n g i s o l a t i o n and mutual empowerment. I t i s seen as "the most p o w e r f u l t h i n g a t P h o e n i x House" by many of the s t a f f . They're i s o l a t e d because t h e y ' r e abused k i d s . They l e a r n t h e y ' r e not a l o n e . They s t a r t t o see each o t h e r as a l l i e s . They become l i k e s i s t e r s - p r o t e c t i v e of each o t h e r . I t ' s l i k e t h e y ' r e f a m i l y . They s a y , " I went th r o u g h t h a t . " The a d o l e s c e n t s and r e f e r r i n g agents echo t h e s e comments. One a d o l e s c e n t d e s c r i b e d t h e t h i n g t h a t s t o o d out t h e most f o r her a t t h e home. The t o g e t h e r n e s s , and t h e f e e l i n g l i k e a f a m i l y . Sometimes you're not d o i n g t o o w e l l w i t h your own f a m i l y , and i t h e l p s . A l o n g w i t h t h e s u p p o r t , comes c o n f r o n t a t i o n as t h e g i r l s b e g i n t o see t h e i r i s s u e s r e f l e c t e d i n t h e o t h e r s , and s t a r t t o " c a l l each o t h e r " . The r e l a t i o n s h i p of t h e g i r l s i s unique. The c o n f r o n t a t i o n t h a t goes on i s amazing, and y e t t h e y s t a y f r i e n d s a f t e r w a r d s . The g i r l s a r e good a t not l e t t i n g i s s u e s go unchecked. They p i n p o i n t each o t h e r ' s problems, but t h e y c a n ' t always see t h e i r own l i v e s t h a t c l e a r l y . The a d o l e s c e n t s t o o see t h i s c o n n e c t i o n between c a r i n g and c o n f r o n t i n g . Everybody has arguments. T h i s whole p l a c e i s l i k e a f a m i l y . A danger i n t h e tone of t h e c o n f r o n t a t i o n was mentioned by two s t a f f . They r e a l l y jump on each o t h e r . Sometimes i t -66-b o r d e r s on b e i n g a b u s i v e . You have t o t e l l them t o s a y i t d i f f e r e n t l y . The peer group a t P h o e n i x House i s seen as a p o w e r f u l , g e n e r a l l y p o s i t i v e i n f l u e n c e on t h e a d o l e s c e n t s , who l e a r n t o i d e n t i f y w i t h each o t h e r and push each o t h e r t o grow, a l t h o u g h a t t i m e s t h e y need h e l p t o s o f t e n t h e i r manner. A r t Therapy A r t t h e r a p y happens once a week i n t h e r e c room, around a l a r g e t a b l e . G e n e r a l l y t h e a r t t h e r a p i s t s e t s out p a i n t s , c l a y and d r a w i n g s u p p l i e s . The s e s s i o n always b e g i n s w i t h s n a c k s , a symbol of n u r t u r a n c e . I t i s a low key e v e n t , w i t h subdued l i g h t i n g where everyone unwinds. There i s g e n e r a l c h a t t e r as p e o p l e r e l a t e what i s g o i n g on i n t h e i r l i v e s . I t f e e l s s a f e . Some of t h e k i d s s t a y , o t h e r s come and go. The s t u d e n t s and sometimes th e s o c i a l workers and t h e manager p a r t i c i p a t e . There i s no p r e s s u r e h e r e . You a r e i n v i t e d t o i n t e r p r e t your a r t , but never f o r c e d t o . Sometimes th e t h e r a p i s t w i l l o f f e r t e n t a t i v e i n t e r p r e t a t i o n s when she i s a s k e d . The a d o l e s c e n t s t a l k about t h e i r dreams, t h e i r r e l a t i o n s h i p s and s c h o o l . Anger, d e p r e s s i o n and s u i c i d e a r e common themes. The i s s u e of abuse al m o s t always comes up. The s t a f f a l l agreed t h a t a r t t h e r a p y was u s e f u l . They see i t as a way f o r "those who a r e n ' t v e r b a l t o e x p r e s s t h e i r f e e l i n g s " . They v i e w i t as " c r e a t i v e " and a "chance t o l e t them p l a y a g a i n " . S e v e r a l f e l t t h a t i t was a " r e l e a s e " . " I t ' s a g r e a t anger o u t l e t - h o p e f u l l y i t c u t s down on a c t i n g -o u t . " One of t h e r e f e r r i n g agents f e l t t h a t i t had e n a b l e d her -67-c l i e n t t o make c o g n i t i v e c o n n e c t i o n s about her abuse and her r e l a t i o n s h i p s . The a d o l e s c e n t s a g a i n echo t h e s e themes: I l o v e a r t t h e r a p y . I t f e e l s so good t o j u s t l e t go. I l i k e i t . I t s f u n . You can g e t your f e e l i n g s out on paper. I t d i g s a t you. A r t t h e r a p y , t h e n , i s viewed as a p l a c e t o r e l e a s e , and i s seen as e s p e c i a l l y b e n e f i c i a l f o r t h o s e who cannot v e r b a l l y a r t i c u l a t e . The themes t h a t come t h r o u g h i n t h e a r t a r e o f t e n t h e same as t h e themes t h a t t h e a d o l e s c e n t s work on i n group. G e n e r a l l y , t h e s e themes a r e p e r c e i v e d as s u r f a c i n g f i r s t i n the a r t . Thus, t h e a r t h e l p s t h e a d o l e s c e n t s b r i n g i n t o awareness t h e i s s u e s t h a t t h e y a r e s t r u g g l i n g t o make sense o f . T h i s l e a d s us t o t h e l a s t component of c a r e a t Phoenix House where t h e g i r l s * themes a r e c r y s t a l l i z e d - group t h e r a p y . Group Therapy Group t h e r a p y i s viewed by a l l t h e s t a f f as " v e r y i m p o r t a n t " , and " v e r y p o w e r f u l " . There i s one f o r m a l group a week, f o l l o w i n g a r t t h e r a p y . S t a f f meet t o g e t h e r b e f o r e group t o s e t a f l e x i b l e agenda of " a n y t h i n g t h a t h a s n ' t been d e a l t w i t h d u r i n g t h e week". The group i s l e d by t h e manager, who g e n e r a l l y " d i r e c t s t h e f o c u s " of t h e meeting. She b e g i n s a p r o c e s s of nudging each a d o l e s c e n t t o lo o k a t t h e meaning b e h i n d t h e i r b e h a v i o r . The g o a l of t h e group i s t h a t " the k i d s l e a r n p r o b l e m - s o l v i n g s k i l l s " i n a r e l a t i o n a l c o n t e x t . -68-In o t h e r words, Group i s a way t h a t t h e y l e a r n n e g o t i a t i o n as a problem s o l u t i o n . They l e a r n t h a t r e l a t i o n s h i p s a r e p o s s i b l e w i t h o u t g e t t i n g c o n t r o l l e d . I t i s a model of l e a r n i n g from each o t h e r s ' e x p e r i e n c e . They can watch somebody work t h r o u g h an i s s u e and r e a l i z e i t g e t s r e s o l v e d . Then maybe t h e y t r y i t t h e m s e l v e s . One of t h e u n u s u a l a s p e c t s of t h e group i s t h a t i t i s open. C o n s e q u e n t l y , t h e r e a r e sometimes more a d u l t s p r e s e n t t h a n a d o l e s c e n t s . The a d u l t s i n c l u d e s t u d e n t s , s o c i a l w o r k e r s , s t a f f and sometimes v i s i t o r s . For example, i n one group meet i n g which was observed t h e r e were 22 p e o p l e : 7 a d o l e s c e n t s , 7 s t a f f , 3 s t u d e n t s , 3 s o c i a l workers and 2 g u e s t s . Of t h i s group, o n l y 12 p a r t i c i p a t e d ( a d o l e s c e n t s and s t a f f ) . T h i s l e f t a number of p e o p l e as o b s e r v e r s . T h i s l a r g e a group w i t h many n o n - p a r t i c i p a n t s might appear t o be i n c o n t r a d i c t i o n w i t h t h e program's o b j e c t i v e of m u t u a l i t y . What i s t h e r e a s o n f o r t h i s s t y l e of group? B a s i c a l l y , i t s always been i d e n t i f i e d t o them t h a t t h e a d u l t s a r e t h e r e t o l e a r n . A l l of a sudden, t h e y a r e t h e p e o p l e who know, t h e y a r e t h e t e a c h e r s . In t h a t s e n s e , t h e y a r e empowered....I want t h e k i d s t o p r a c t i c e h o l d i n g t h e i r own i n f r o n t of a d u l t s . The r e a l i t y i s t h a t a d u l t s w i l l d e t e r m i n e t h e i r l i v e s f o r q u i t e a w h i l e . Thus, t h e a d o l e s c e n t s g a i n c o n f i d e n c e w i t h t h i s k i n d of a model. F u r t h e r m o r e , i t i s a way t o expose o t h e r s i n t h e c h i l d c a r e f i e l d t o t h i s i n n o v a t i v e model. What do t h e s t a f f and r e s i d e n t s t h i n k of t h i s ? The s t a f f r e a c t i o n s t o an open group were mixed. I t v i o l a t e s the k i d s b o u n d a r i e s . I t i n t i m i d a t e s some of t h e k i d s , e s p e c i a l l y t h e new ones. The k i d s seem t o adapt t o i t . - 6 9 -The a d o l e s c e n t r e s p o n s e s were a l s o mixed. There's no p r i v a c y when t h e r e ' s so many p e o p l e . E s p e c i a l l y p e o p l e you don't know. I used t o f e e l l i k e i n v a d e d . Now, I'd r a t h e r have them. Another a d o l e s c e n t d i s c u s s e d her p e r c e p t i o n t h a t t h e group s h o u l d a l s o r e f l e c t t h e model of m u t u a l i t y . In o t h e r words, t h e a d u l t s s h o u l d a l s o s h a r e t h e i r i s s u e s . I f someone (an a d u l t ) l o o k s l i k e t h e y ' r e h a v i n g a problem and t h e y don't s a y a n y t h i n g , t h a t b o t h e r s me. I f t h e r e ' s t h i n g s happening i n t h e i r l i f e , t h e y s h o u l d t a l k about i t . T h at's what groups a r e f o r . C l e a r l y t h e r e a r e advantages and d i s a d v a n t a g e s t o t h e open model of t h e group. I t i s d i f f i c u l t i n i t i a l l y f o r t h e a d o l e s c e n t s and c o u l d be viewed as an i n v a s i o n of t h e i r p r i v a c y . On t h e o t h e r hand, t h e a d o l e s c e n t s appear g e n e r a l l y t o adapt t o the e x p e r i e n c e ( t h e n e g a t i v e comments about group came from t h e newest r e s i d e n t s ) and i n t h e p r o c e s s d e v e l o p c o n f i d e n c e i n n e g o t i a t i n g w i t h a d u l t s . The manager r e c o u n t s an example of t h i s . One of t h e k i d s who's had groups w i t h me f o r f o u r y e a r s , can go w i t h me t o a workshop where we're t e a c h i n g f o r t y t h e r a p i s t s about how t o work w i t h abused k i d s . She s a i d i n t h e m i d d l e of one, "I'm t e l l i n g t h e s e guys how t o do i t ! " T hat's empowerment. How do t h e a d o l e s c e n t s g e n e r a l l y f e e l about group? I t i s s i g n i f i c a n t t h a t a l l but one of t h e a d o l e s c e n t s s a i d t h a t group was good f o r them. T h i s p e r s o n i s t h e newest r e s i d e n t i n the home. The f o l l o w i n g i l l u s t r a t e t h e i r comments. Group i s h a r s h . They d i g down deep. I t s good. Then you f i n d out why you're d o i n g s t u f f . I n group you can s a y your f e e l i n g s about o t h e r -70-p e o p l e ' s i s s u e s and about your own. So you h e l p someone e l s e and r e l a t e i t t o your own. I don't l i k e group. I don't l i k e t o f e e l put on t h e s p o t . I t ' s t o o i n t e n s e . One a d o l e s c e n t e x p l a i n e d how t h e p r o c e s s of group h e l p e d her l e a r n t o r e s o l v e i s s u e s . You s o r t of f e e l o b l i g a t e d t o s i t and t a l k . I t s l i k e , you don't r e a l l y want t o be t h e r e , but you won't g e t up and l e a v e . You s t a y , and the n you s t a r t t a l k i n g . Group i s seen as a p o w e r f u l t o o l f o r t e a c h i n g problem-s o l v i n g s k i l l s , and f o r d e v e l o p i n g i n s i g h t . I t i s not always a c o m f o r t a b l e p l a c e , but i t f o c u s e s t h e a d o l e s c e n t s on t h e themes i n t h e i r l i v e s (eg. k e e p i n g y o u r s e l f s a f e , l e a r n i n g t o t r u s t ) and h e l p s them t o b u i l d c o n f i d e n c e i n t h e i r a b i l i t i e s t o f i n d s o l u t i o n s and t o e n a b l e o t h e r s . As one s t a f f p e r s o n s a i d , "Group i s what makes Pho e n i x House work." The v a r i o u s components of c a r e a t Pho e n i x House work t o g e t h e r t o form a p o w e r f u l and c a r i n g m i l i e u which a f f e c t s everyone a s s o c i a t e d w i t h t h e home. One theme t h a t s t o o d out i n t h e f i n d i n g s was t h e r e m a r k a b l e c o n s i s t e n c y of t h e d a t a from t h e v a r i e t y of s o u r c e s . T h i s i s c l e a r l y i l l u s t r a t e d i n t h e d a t a r e g a r d i n g t h e elements of change. The a d o l e s c e n t s , s t a f f and r e f e r r i n g a gents a l l d e s c r i b e d a d i s t i n c t p a t t e r n of change t h a t t h e a d o l e s c e n t s e x p e r i e n c e a t the home. L e t us now examine t h a t p r o c e s s . -71-Chanaina The a d o l e s c e n t s c l e a r l y a r t i c u l a t e d t h r e e s i g n i f i c a n t t y p e s o f e x p e r i e n c e s which were e s p e c i a l l y m e a n i n g f u l f o r them. When t h e s e themes were compared w i t h t h e d a t a from t h e o b s e r v a t i o n s and t h e r e m a i n i n g i n t e r v i e w s , a p a t t e r n emerged where t h e t h r e e major t a s k s o f t h e s t a f f meshed w i t h t h e t h r e e t u r n i n g p o i n t s of t h e a d o l e s c e n t s (see F i g u r e 1 ) . The t h r e e themes f o r t h e s t a f f ' s t a s k s were: c o n n e c t i n g , t e a c h i n g and c h a l l e n g i n g p a t t e r n s . These d o v e t a i l e d w i t h t h e t h r e e themes of t h e a d o l e s c e n t s which were: f e e l i n g c a r e d f o r , opening up, and t a k i n g charge (see Appendix F f o r Data D i s p l a y ) . Bach of t h e s e themes w i l l be e x p l o r e d i n d e t a i l t o i l l u s t r a t e t h e s i m i l a r i t i e s and d i f f e r e n c e s i n i n d i v i d u a l e x p e r i e n c e s . The p e r c e p t i o n s of t h e a d o l e s c e n t s about t h e m s e l v e s when t h e y f i r s t came t o Pho e n i x House w i l l be r e c o u n t e d as a b a s e l i n e f o r t h e changes t h a t t h e y and t h e key i n f o r m a n t s p e r c e i v e d . Figure 1. Changing. -73-The H e r s t o r t e s When asked what t h e y were l i k e when t h e y f i r s t came t o Phoenix House, t h e a d o l e s c e n t s a l l p a i n t e d a b l e a k p o r t r a i t of t h e m s e l v e s . They d e s c r i b e d a v e r y n e g a t i v e v i e w of s e l f e s t r a n g e d from a r e l a t i o n a l c o n t e x t which was v i o l e n t and u n c a r i n g . I t comes as no s u r p r i s e t h e n t h a t t h e y d i d n ' t t r u s t anyone. I l i s t e n e d t o nobody but m y s e l f . I d i d n ' t t a k e f a v o r s from anybody. A d v i c e , I would never t a k e a d v i c e . I would t e l l them where t o s t i c k t h e i r a d v i c e . I d r e s s e d s l e a z y . I d i d n ' t know my own v a l u e s . I d i d n ' t know what I was w o r t h . Angry. B a s i c a l l y what any k i d would f e e l when t h e y ' r e on t h e s t r e e t s . I would never t r u s t p e o p l e cause you c a n ' t r e a l l y t r u s t p e o p l e on t h e s t r e e t s . You g e t r e a l l y h a r d . Another a d o l e s c e n t d e s c r i b e s her low sense of s e l f - w o r t h . B e f o r e I f e l t I wasn't worth v e r y much. L i k e , b o y f r i e n d s c o u l d j u s t use me and t r e a t me whichever way t h e y wanted t o . Underneath t h e veneer of toughness was a h u r t and v u l n e r a b l e c h i l d who was o f t e n f r i g h t e n e d and c o n f u s e d . I was s c a r e d , I d i d n ' t f e e l s a f e . I was w o r k i n g t h e s t r e e t s . I was d o i n g w e i r d t h i n g s - l i k e I was s u i c i d a l and a n o r e x i c . I. was t h e problem. I was a l i t t l e p i p - s q u e a k . I f e l t a l l on my own, ex c e p t f o r my Grandma." A l t h o u g h t h e young women can now d e s c r i b e how t h e y f e l t b e f o r e coming t o P h o e n i x House, i t i s s i g n i f i c a n t t h a t a t t h e time of a d m i s s i o n many of them c o u l d n o t . T h i s was c l e a r l y d e s c r i b e d by b o t h t h e r e f e r r i n g agents and t h e a d o l e s c e n t s t h e m s e l v e s , who r e c a l l e d t h a t t h e y were " v e r y q u i e t " , had o n l y a " g l o b a l sense of f e e l i n g s " , and i n most c a s e s d i d n ' t t h i n k t h e y had any problems. The most r e c e n t r e s i d e n t t y p i f i e s -74-t h i s . When asked about her s t r e n g t h s she r e p l i e d " I don't know." I n res p o n s e t o a q u e s t i o n about her f e e l i n g s she s t a t e d , " I t s l i k e I don't have any. I t doesn't b o t h e r me." One of t h e r e f e r r i n g a g ents d e s c r i b e s t h e a d o l e s c e n t she p l a c e d . When she went i n , t h i s k i d a c t e d dumb. You'd s a y , why d i d you do t h a t ? She'd s a y , uh, and b l i n k her eyes. As p r e v i o u s l y mentioned, t h e s e young women were g e n e r a l l y w o r k i n g the s t r e e t s and immersed i n s u b s t a n c e abuse. Two of them d e s c r i b e d b e i n g r e g u l a r l y abused by t h e i r pimps. Three came w i t h documented h i s t o r i e s as v i o l e n t c h i l d r e n i n c a r e . The a d o l e s c e n t s now u n d e r s t a n d t h e i r v i o l e n c e as t r i g g e r e d by s i t u a t i o n s s i m i l a r t o t h e i r abuse, and as a l e a r n e d p a t t e r n of b e h a v i o r . They ke p t t r y i n g t o c o n t r o l me, my l i f e and e v e r y t h i n g . I t reminds me t o o much of my mom. We'd ge t i n t o arguments and t h e y ' d s a y t h e y c a n ' t handle me and l e t me go. In one p l a c e I c o m p l e t e l y d e s t r o y e d t h e house because I was u p s e t . I was v e r y v i o l e n t . I used t o f i g h t everybody, beat p e o p l e up. I'd abuse t h e s t a f f m e n t a l l y , I'd make them c r y . I got t h a t from my mother. With t h i s c h a o t i c l i f e s t y l e , i t i s not s u r p r i s i n g t h a t o n l y one of t h e a d o l e s c e n t s was a t t e n d i n g s c h o o l when she moved t o t h e home. Two of t h e young women s a i d t h a t t h e y r e l i e d on no one f o r s u p p o r t when t h e y came t o Phoenix House. S i x of them had one pe r s o n t h e y f e l t t h e y c o u l d count on. G e n e r a l l y t h e s e were not f a m i l y members. As p r e v i o u s l y documented, t h e s e a d o l e s c e n t s had a h i s t o r y of f a i l e d p lacements added on t o p r e v i o u s a b u s i v e r e l a t i o n s h i p s . I t i s -75-w i t h t h i s h i s t o r y of pr o f o u n d m i s t r u s t i n r e l a t i o n s h i p s t h a t t h e a d o l e s c e n t s came t o Ph o e n i x House. C o n n e c t i n g / F e e l i n g Cared For " C a r i n g , t h e r e ' s not a l o t of i t i n t h i s w o r l d . " These were t h e words of one of t h e d i s c h a r g e d a d o l e s c e n t s who f e l t s t r o n g l y t h a t t h e s i g n i f i c a n t moments f o r her a t Ph o e n i x House were e x p e r i e n c i n g genuine c a r e . However, t h i s e x p e r i e n c e d i d not come q u i c k l y or e a s i l y . The a d o l e s c e n t s c l e a r l y d e s c r i b e d t h e i r i n a b i l i t y t o t r u s t o t h e r s when t h e y f i r s t came t o t h e house. T h i s l e d them t o f i r s t "check i t o u t " , t o see i f t h e y would be s a f e , and the n t o " t e s t " , t o see i f the s a f e t y and c a r e e x h i b i t e d by t h e s t a f f was gen u i n e . I t appeared t o be a f t e r t h e s e two s t e p s t h a t t h e a d o l e s c e n t s d e v e l o p e d enough t r u s t t o be a b l e t o f u l l y e x p e r i e n c e c a r e . C h e c k i n g I t O u t / G e t t i n g Hooked The f i r s t s t e p t h a t t h e a d o l e s c e n t s d e s c r i b e d was t o "check o u t " the home and t h e i n d i v i d u a l s t o see i f t h e y would be s a f e . They d e s c r i b e d t h i s as a ti m e of " w a t c h i n g " , where t h e y would be " q u i e t " and g e n e r a l l y f e l t " u n c o m f o r t a b l e " . When I f i r s t came I d i d n ' t r e a l l y s a y t o o much. I r e a l l y kept t o my s e l f and I j u s t k i n d of watched and s o r t of observed everybody t o see what t h e y were l i k e . One of t h e r e f e r r i n g a g ents d e s c r i b e d t h e way a d o l e s c e n t s "check o u t " homes l i k e t h i s : These k i d s have l e a r n e d t h a t you a v o i d placements t h a t a r e unsafe - t h a t ' s why t h e y ' r e s t r e e t k i d s -t h e y got away from an u n h e a l t h y s i t u a t i o n . So t h e i r - 7 6 -l i t t l e c r a p d e t e c t o r s a r e w o r k i n g b e a u t i f u l l y . They walk t h r o u g h t h e do o r , t h e y hear i t , t h e y go, oh, oh, a n o t h e r one of t h e s e . And as soon as i t s p o l i t e t o do s o , because t h e y wouldn't want t o o f f e n d t h e i r s o c i a l worker - t h e s e a r e p o w e r f u l p e o p l e - t h e y l e a v e . T h i s worker went on t o sug g e s t t h a t one of t h e re a s o n s k i d s " r u n " i s t h a t group homes a r e g e n e r a l l y poor a t " c o n n e c t i n g " . She s a i d t h a t she c o u l d t e l l when i t would be a s h o r t placement when t h e c h i l d was i g n o r e d d u r i n g i n t a k e , or g r e e t e d w i t h a l o n g l i s t of r u l e s l a y i n g out t h e " c o n d i t i o n s " of t h e i r l i f e a t the home. How does Ph o e n i x House approach t h i s ? The f i r s t t h i n g we do i s a t t e n d t o c o n n e c t i n g i s s u e s . . . A t i n t a k e t h e y come e x p e c t i n g t o be c o n t r o l l e d , and f o r me t o o u t l i n e t h e c o n t r o l , and t h a t t h e y a r e g o i n g t o be n o n - c o m p l i a n t . So you p l a n around t h a t . They r e a l i z e t h a t t h e y can conne c t because t o s t a y here doesn't mean t h e y a r e g o i n g t o have t o g i v e up t h e i r power. So we a t t e n d t o c o n n e c t i n g , and g e t v e r y n u r t u r i n g . . . t r y i n g t o communicate i t s s a f e t o be h e r e . C o n n e c t i n g t h e n i m p l i e s m o d e l i n g an u n c o n d i t i o n a l r e l a t i o n s h i p , f r e e from c o n t r o l or power-over. I t a l s o means n u r t u r i n g by f o c u s s i n g on t h e h e a l t h and p h y s i c a l c o m f o r t of th e a d o l e s c e n t . D u r i n g t h i s s t a g e , t h e a d o l e s c e n t ' s b e h a v i o r i s a l s o reframed as " u n d e r s t a n d a b l e " and " a c c e p t a b l e " . The f o c u s i s on c o n n e c t i n g s t r o n g l y enough w i t h t h e pe r s o n t h a t t h e y a r e g o i n g t o choose t o s t a y . P a r t of the t a s k t h e n i s t o "hook" t h e a d o l e s c e n t , t o a p p e a l t o t h e i r c u r i o s i t y , t o a p p e a l t o t h e i r hope. One of t h e f i r s t hooks a t Phoenix House, a c c o r d i n g t o a l l t h e p a r t i c i p a n t s , a r e t h e i n d i v i d u a l l y n e g o t i a t e d r u l e s . W e l l , a t f i r s t I thought i t was w e i r d , I found i t - 7 7 -s i l l y . These groups and s t u f f . I thought a l l the groups were s t u p i d and t h e r e was no p o i n t t o them, but I t h o u g h t , I l i k e t h i s p l a c e . I t s c o o l , t h e r e a r e n ' t many r u l e s . The most r e c e n t r e s i d e n t s t i l l echoed t h i s c u r i o s i t y when asked about t h e r u l e s . " I t s w e i r d . I don't u n d e r s t a n d i t . " The manager d e s c r i b e d t h e way k i d s g e t hooked d u r i n g i n t a k e by t h e way t h e r u l e s and t h e dynamics of power a r e r e f r a m e d . She r e c o u n t e d an example d u r i n g t h e workshop t h a t was a t t e n d e d where a g i r l come i n t o t h e i n t a k e i n t e r v i e w s a y i n g , " I don't e a t a t group homes." The manager's response was t o w r i t e her s t a t e m e n t c l e a r l y i n r e d pen on t h e i n t a k e form and ask her what she d i d e a t . She responded w i t h s u r p r i s e , " I o n l y e a t I t a l i a n s andwiches." T h i s t o o was w r i t t e n i n r e d i n k on t h e form. The manager t h e n s t a t e d t h a t t h e r e was d e l i down t h e s t r e e t where she c o u l d buy t h e s a n d w i c h e s , and t h a t she would be g i v e n money e v e r y mealtime t o e n a b l e her t o purchase t h e f o o d . The g i r l was c l e a r l y s h ocked. However, she f a i t h f u l l y went t o t h e d e l i e v e r y mealtime f o r t h e f i r s t week. G r a d u a l l y , she began s t a y i n g f o r t h e house meals. W i t h i n two weeks she was e a t i n g e x c l u s i v e l y a t t h e group home. The manager s t a t e d t h a t by s i d e s t e p p i n g t h e i n i t i a l i n v i t a t i o n t o a power s t r u g g l e , she was r e l a y i n g t h e message t h a t t h e g i r l c o u l d remain i n c o n t r o l d u r i n g t h i s placement. T h i s e n a b l e s th e c h i l d t o v i e w t h e house as a s a f e p l a c e . Thus, by e m p h a s i z i n g th e absence of " c o n t r o l o v e r " , and by m o d e l i n g from th e b e g i n n i n g r e s p e c t and n e g o t i a t i o n , t h e a d o l e s c e n t s e x p e r i e n c e a p o w e r f u l r eframe of t h e dynamics of power i n r e l a t i o n s h i p s . - 7 8 -Two r e f e r r i n g agent f e l t t h a t t h e openness and the h o n e s t y of t h e s t a f f was a l s o a d e f i n i t e hook. I t h i n k i t shocks them t h a t p e o p l e a r e as f r a n k as t h e y a r e . There's a l l t h e s e p e o p l e who a r e o b v i o u s l y v e r y b r i g h t and v e r y c a r i n g , but t h e y speak d i r e c t l y t o t h e i s s u e . . . T h a t openness w o r r i e s them, i t i n t r i g u e s them, i t hooks the k i d s . They're i n t e r e s t e d t o see what w i l l happen n e x t . Thus, t h e mutual s t y l e of r e l a t i o n s h i p m o d e l l e d a t P h o e n i x House t h r o u g h b o t h t h e i n t e r a c t i o n s and t h e p r o c e d u r e s f o s t e r s a r e l a t i o n a l c o n n e c t i o n w i t h t h e a d o l e s c e n t s which appears t o e n a b l e them t o f e e l s a f e enough t o remain. What happens a f t e r t h e i n i t i a l c o n n e c t i o n i s made? T e s t i n g / F e e l i n g Cared For And a f t e r a w h i l e , I s t a r t e d t e s t i n g them t o see how much I c o u l d g e t away w i t h . The n e x t theme f o r t h e a d o l e s c e n t s was t e s t i n g t h e i r r e l a t i o n s h i p s w i t h t h e s t a f f . For most of them i t meant p u s h i n g t h e s t a f f on i s s u e s of power and c o n t r o l . Why do t h e a d o l e s c e n t s i n v i t e power s t r u g g l e s ? The k i d s t e s t out t o see i f you r e a l l y mean t h a t t h e y ' r e not g o i n g t o be c o n t r o l l e d . So t h e y do a l l t h e s t u f f t h a t t h e y ' v e done i n t h e p a s t , t h a t p e o p l e have s a i d would be f i n e , and t h e n t h e y got booted f o r . The a d o l e s c e n t s comments su g g e s t t h a t t h e y were p u s h i n g t o see i f t h e y c o u l d r e a l l y t r u s t t h i s new r e l a t i o n s h i p t o be d i f f e r e n t t h a n t h e u n s a f e ones t h e y came t o e x p e c t . I pushed o t h e r s . I was t e s t i n g t o see who would be a b u s i v e and who wouldn't be, who I c o u l d t r u s t . I found out a l o t of p e o p l e a r e l i k e my dad. P h o e n i x House responds t o t e s t i n g by d i r e c t l y naming i t . -79-I t i s n o t u n u s u a l t o s e e t h i s k i n d o f b e h a v i o r o p e n l y n a m e d a n d e x p l o r e d i n g r o u p . " S o . y o u ' r e t e s t i n g o u r l i m i t s , a r e y o u ? W h a t ' s t h a t a b o u t ? " T h i s b e h a v i o r i s o f t e n r e f r a m e d a s w o r k i n g o n " k e e p i n g y o u r s e l f s a f e " . T h u s t h e a d o l e s c e n t i s n o t c h a s t i s e d f o r t h e b e h a v i o r , b u t c o m m e n d e d o n t h e h e a l t h y r e a s o n b e h i n d t h i s b e h a v i o r , a s w e l l a s e n c o u r a g e d t o e x p l o r e o t h e r w a y s o f k e e p i n g s a f e . W h a t d i d t h e a d o l e s c e n t s d i s c o v e r a s a r e s u l t o f t h i s t e s t i n g ? T h e p r i m a r y r e s u l t o f t h e w o r k o f c o n n e c t i n g w a s t h a t t h e a d o l e s c e n t s , o f t e n f o r t h e f i r s t t i m e , e x p e r i e n c e d a s a f e , c a r i n g r e l a t i o n s h i p . T h i s d e e p r e l a t i o n a l f e e l i n g o f b e i n g g e n u i n e l y " c a r e d f o r " w a s a t u r n i n g p o i n t d e s c r i b e d b y t h e s e v e r a l o f t h e y o u n g w o m e n . T h e d a y I a d m i t t e d m y s e x u a l a n d p h y s i c a l a b u s e t o L . ( t h e m a n a g e r ) w e s a t d o w n a n d c r i e d t o g e t h e r . I t f e l t l i k e s o m e b o d y r e a l l y c a r e d f o r m e , n o t m y p h y s i c a l b e i n g , t h e r e a l m e i n s i d e . M o s t p l a c e s d o n ' t c a r e i f y o u a r e o n t h e s t r e e t s a s l o n g a s y o u a r e i n b y c u r f e w . H e r e , t h e y c a r e a b o u t w h a t y o u d o , t h e t h i n g s y o u d o , y o u i n g e n e r a l . E x p e r i e n c i n g a s t r o n g r e l a t i o n a l c o n n e c t i o n w i t h a t l e a s t o n e o f t h e s t a f f m e a n t t h e e s t a b l i s h m e n t o f a r e l a t i o n s h i p o f t r u s t a n d c a r e . T h i s a p p e a r e d c r u c i a l f o r t h e s e a d o l e s c e n t s b e f o r e t h e y c o u l d m o v e t o w a r d s g r e a t e r s e l f d e v e l o p m e n t . T h i s i s e v i d e n c e d b y t h e n e w e s t r e s i d e n t w h o d o e s n o t y e t f e e l c a r e d f o r , a n d w h o h a s n o t y e t e x p l o r e d h o w h e r h i s t o r y o f a b u s e a f f e c t s h e r c u r r e n t r e l a t i o n s h i p s . E x p e r i e n c i n g c o n n e c t i o n t h e n i s a f i r s t s t e p w h i c h d o e s n o t e n d , b u t f l o w s t o g e t h e r w i t h t h e n e x t s t a g e s , r e m a i n i n g a c o n s t a n t t h e m e t h r o u g h o u t t h e l i f e o f t h e r e s i d e n t s . I t w o u l d a p p e a r , -80-though, that l a t e r work hinges on t h i s i n i t i a l connection. This brings us to the second theme; teaching/opening up. Teaching/Opening Up The s t a f f described a second stage where the basis for a re l a t i o n s h i p had been founded and teaching about the e f f e c t s of abuse takes on greater importance. As soon as your through the connecting issues you s t a r t getting i r r i t a b l e with yourself and others. You s t a r t parading your symptoms of abuse in front of us. You'll drug yourself; y o u ' l l bring your "boyfriend" around the house; you do a l l these things to make i t r e a l l y obvious. Then our task i s to help you understand what you're doing as quickly as possible. Helping an adolescent to understand the a f f e c t s of abuse on her s e l f concept, her behavior and her relationships is v i t a l to t h i s stage. This work i s geared to expanding knowledge and s h i f t i n g the cognitive frameworks of the adolescents. Thus, the meaning they have made of the abuse i s explored and reframed so that the strengths of the young women are highlighted. During t h i s stage much emphasis i s placed on normalcy and safety. Abuse becomes a d a i l y topic of conversation to the point of "saturation". What i s the response of the adolescents to t h i s dose of information? Starting to Talk One of the themes of the adolescents at t h i s stage was "s t a r t i n g to t a l k " . This seemed to be a part of "opening up". The r e l a t i o n a l work continues to deepen throughout t h i s stage. One of the adolescents who i s in the midst of t h i s stage -81 -d e s c r i b e d i t f o r h e r s e l f . " B e f o r e I d i d n ' t t a l k about f e e l i n g s . Here, I'm opening up. I'm l e a r n i n g t o t r u s t p e o p l e . " A l l of t h e a d o l e s c e n t s s t a t e d t h a t the one t h i n g t h a t t h e y l e a r n e d a t P h o e n i x House was " t o t a l k about t h i n g s " , and " t o work out problems". T h i s i s t h e f i r s t home I've been i n where we r e a l l y t a l k e d about t h e s e i s s u e s . The o t h e r p l a c e s won't r e a l l y t a l k about i t . They t a l k about your a c t i o n , not what causes i t . " R e a l l y t a l k i n g " f o r t h e a d o l e s c e n t s s y m b o l i z e d two t h i n g s : naming f e e l i n g s / i s s u e s and r e s o l v i n g d i f f e r e n c e s , both i n a genuine manner. The power of language as a t o o l f o r problem s o l v i n g was a new d i s c o v e r y f o r most of the a d o l e s c e n t s who had l e a r n e d t o handle d i f f e r e n c e s w i t h s i l e n c e , a v o i d a n c e or v i o l e n c e . I'd j u s t s t a n d t h e r e and t a k e what t h e y would s a y t o me and not do a n y t h i n g t o make them want t o h i t me. L i k e , i f you s t a n d t h e r e and someone i s mad a t you and t h e y ' r e s c r e a m i n g a t you, and you don't s a y a n y t h i n g , t h e n you g i v e them no r e a s o n t o come up and h i t you. One of t h e major p a r t s of "opening up" t h e n , was moving from s i l e n c e t o v o i c e . U n d e r s t a n d i n g / S e e i n g In a d d i t i o n t o f i n d i n g t h e i r v o i c e , t h e a d o l e s c e n t s d e s c r i b e d a change i n t h e i r l e v e l of u n d e r s t a n d i n g about themselves and o t h e r s . I r e a l i z e now when I'm r e a c t i n g t o my abuse because someone has t r i g g e r e d a memory. Mow I t h i n k about what's b e h i n d p e o p l e ' s a c t i o n s . I t can have a l o t t o do w i t h a l o t of t h i n g s from when t h e y were younger, l i k e my p a r e n t s . I r e a l i z e - 8 2 -t h a t the way t h e y a c t has a l o t t o do w i t h t h e i r c h i l d h o o d . I don't judge p e o p l e so q u i c k l y . U n d e r s t a n d i n g seemed t o i m p l y moving from c o n f u s i o n towards c l a r i t y , e s p e c i a l l y r e g a r d i n g a b u s i v e p a t t e r n s of r e l a t i o n s h i p s . The s t a f f d e s c r i b e d many t a s k s of t h i s phase: s t a r t i n g t o s h a r e , s t a r t i n g t o u n d e r s t a n d t h e dynamics of abuse, r e c o g n i z i n g i s s u e s , s t a t i n g i s s u e s , c h a l l e n g i n g o t h e r s , and r e c o g n i z i n g f a m i l y p a t t e r n s . A l l of t h e a d u l t s noted t h a t t h e a d o l e s c e n t s "see i s s u e s i n o t h e r s " b e f o r e t h e y see t h e same i s s u e s i n t h e m s e l v e s . D u r i n g t h i s t ime f e e l i n g s about t h e i r f a m i l y emerge and t h e y b e g i n t o " a c c e p t t h e i r p a r e n t s as l i m i t e d p e o p l e " . At t h i s p o i n t t h e y e x p e r i e n c e themselves as " c h a n g i n g " , and t h e i r s e l f - c o n c e p t b e g i n s t o s h i f t as t h e y g a i n awareness, c l a r i t y and c o n f i d e n c e . When asked t o d e s c r i b e her s t r e n g t h s , one a d o l e s c e n t s t a t e d , My a b i l i t y t o see t h i n g s more c l e a r l y , t o see something f o r what i t i s , not what I want i t t o be. Another a d o l e s c e n t d e s c r i b e s how she began t o "see" more c l e a r l y , I used t o change b o y f r i e n d s l i k e c l o t h e s , b a s i c a l l y . T hat's badt And we worked i n g r o u p s , and I worked on t h e s e i s s u e s w i t h t h e manager, and I s t a r t e d s e e i n g what a h e a l t h y r e l a t i o n s h i p was. S e v e r a l of t h e s t a f f and r e f e r r i n g agents mentioned t h a t d u r i n g t h i s phase, th e a d o l e s c e n t ' s b e h a v i o r t y p i c a l l y worsens. There i s an u n c o m f o r t a b l e t i m e when t h e a d o l e s c e n t s " s t a r t t o s e e " t h e i r s e l f - a b u s e i n a d i f f e r e n t l i g h t and y e t c o n t i n u e d o i n g i t . I t g e t s r e a l bad b e f o r e i t g e t s good. T h e y ' l l p a r t y -83-and d r i n k . When t h e y a r e h u r t t h e y ' l l h i t the s t r e e t . They see i t i n o t h e r s f i r s t . They s t a r t t o change t h e i r t h i n k i n g , but t h e y s t i l l do s t r e e t a c t i v i t i e s and a c c e p t a b u s i v e b e h a v i o r . When t h i s happens t h e r e i s g e n e r a l l y a response of a n x i e t y and f e a r on t h e p a r t of t h e r e f e r r i n g a gents and s t a f f because of t h e l e v e l of dangerous a c t i v i t y t h e a d o l e s c e n t s engage i n . T h i s appears t o be t h e p o i n t where t h e r e i s a c a l l f o r " s t r u c t u r e " on t h e p a r t of some of t h e a d u l t s , because, "I thought she c o u l d e a s i l y be l o s t " . F o r example, d u r i n g t h i s phase one a d o l e s c e n t t o l d t h e s t a f f about h i t c h h i k i n g w i t h a man who had s e v e r a l guns i n h i s v e h i c l e . She would f r e q u e n t l y become i n v o l v e d i n e x c l u s i v e l y male p a r t i e s where she would be v i r t u a l l y gang r a p e d . At t h e i n s t i g a t i o n of her t h e r a p i s t and the l i a i s o n worker, meetings were h e l d t o emphasize t h e danger of her a c t i v i t y , and t o t r y t o encourage more c o n n e c t i o n w i t h her a t t h e home. Group a t t e n t i o n was a l s o f o c u s s e d on her and she e v e n t u a l l y committed h e r s e l f t o " k e e p i n g h e r s e l f s a f e " . F o l l o w i n g t h i s i n t e n s e r e l a t i o n a l f o c u s on t h i s a d o l e s c e n t , her l e v e l of dangerous a c t i v i t y has g r a d u a l l y d i m i n i s h e d . I t i s i n t e r e s t i n g t h a t i t was not t h e " s t r u c t u r e " o r o u t e r l i m i t s t o her b e h a v i o r which e n a b l e d her t o t a k e s e l f - r e s p o n s i b i l i t y , but r a t h e r t h e i n c r e a s e d i n t e n s i t y of t h e r e l a t i o n a l c o n t e x t . T h i s example i l l u s t r a t e s t h a t a f t e r t h e work of " c o n n e c t i n g " and " t e a c h i n g " , comes " c h a l l e n g i n g p a t t e r n s of b e h a v i o r " , which l e a d s n a t u r a l l y i n t o " t a k i n g r e s p o n s i b i l i t y " on t h e p a r t of t h e a d o l e s c e n t . T h i s b r i n g s us t o t h e f i n a l theme, which t h i s example b r i d g e s : c h a l l e n g i n g p a t t e r n s / t a k i n g c h a r g e . - 8 4 -C h a l l e n g l n q P a t t e r n s / T a k i n g Charge Making D e c i s i o n s I l o o k f o r w a r d t o my f u t u r e now. I can do something, be somebody. Not l i k e b e f o r e - a l l I am i s a p r o s t i t u t e , I'm n o t h i n g , I'm j u s t a s t a t i s t i c . These peo p l e made me f e e l l i k e I was a p e r s o n , t h a t I had a mind of my own, t h a t I c o u l d t h i n k and make d e c i s i o n s . These words embody t h e empowerment t h a t t h e a d o l e s c e n t s who had e x p e r i e n c e d t h i s s t a g e v o i c e d . A l l of the a d o l e s c e n t s , e x c e p t t h e newest, spoke about s t a r t i n g t o "make my own d e c i s i o n s " . Some, who had j u s t begun t h i s phase, had t e n t a t i v e v o i c e s and d e s c r i b e d one or two d e c i s i o n s which t h e y had made, but s l i p p e d back on. O t h e r s , who had s e v e r a l examples of d e c i s i o n s t h a t t h e y had made and c a r r i e d o u t , spoke w i t h s t r e n g t h and p r i d e about t h e m s e l v e s . I can put my mind t o do t h i n g s now. I'm t h i n k i n g s m a r t e r , l e a r n i n g t o make the r i g h t d e c i s i o n s and l e a r n i n g t o a c t on them. How d i d t h e a d o l e s c e n t s come t o t h i s p o i n t of t a k i n g c harge? The s t a f f d e s c r i b e d a t h i r d s e t of t a s k s where t h e f o c u s was on c h a l l e n g i n g t h e p a t t e r n s t h a t t h e y saw i n the a d o l e s c e n t s . T h i s was d e s c r i b e d as t h e "work" phase, which was viewed as s i m i l a r t o t h e work phase i n a t h e r a p e u t i c r e l a t i o n s h i p w i t h an a d u l t . The k i d s b e g i n t o r e c o g n i z e t h e i r p a t t e r n s . Work i s the s t r u g g l e t o t a k e charge and change t h e i r p a t t e r n s . Many themes were noted t o occur d u r i n g t h i s phase: r e c o g n i z i n g t h a t i n s i g h t i s not enough; e x p l o r i n g what we g e t out of our u n h e a l t h y p a t t e r n s t h a t keeps us a d d i c t e d t o them; - 8 5 -f e a r s of abandonment by f a m i l y i f we g i v e up our o l d p a t t e r n s ; r e l e a r n i n g i n t i m a c y w i t h o u t abuse; and g i v i n g up t h e s e l f -c o n cept t h a t goes a l o n g w i t h b e i n g a v i c t i m . T h i s phase i s v i v i d l y e n c o untered i n group t h e r a p y where the c o n n e c t i n g , t e a c h i n g and c h a l l e n g i n g go on s i m u l t a n e o u s l y . I s s u e s a r e brought f o r w a r d by t h e s t a f f and a d o l e s c e n t s a l i k e , and t h e r e i s a c o n c e r t e d e f f o r t t o engage i n t h e p r o c e s s of c h a l l e n g i n g and u n d e r s t a n d i n g , a l l w i t h i n t h e r e l a t i o n a l c o n t e x t . I n one group where t h e theme was d r u g s , each a d o l e s c e n t was asked why t h e y use drugs and how t h a t might be r e l a t e d t o t h e i s s u e s t h a t t h e y were w o r k i n g on. The a d o l e s c e n t s found i t d i f f i c u l t t o v o i c e t h e meaning b e h i n d t h i s b e h a v i o r , but a f t e r s e v e r a l a t t e m p t s t o a v o i d , a few t r i e d t o do s o . What k i n d of d e c i s i o n s d i d t h e a d o l e s c e n t s make? Kee p i n g M y s e l f S a f e "Keeping m y s e l f s a f e " was a major t a s k t h a t a l l the a d o l e s c e n t s began t o u n d e r t a k e d u r i n g t h e i r s t a y a t P h o e n i x House. I t was a theme t h a t a l l t h e p a r t i c i p a n t s r e f e r r e d t o as c r u c i a l t o t h e work of P h o e n i x House. The manager t a u g h t me how t o s a y no, e s p e c i a l l y i f guys j u s t want s e x . . . . P h o e n i x House t a u g h t me how t o t a k e c a r e of m y s e l f , p h y s i c a l l y and e m o t i o n a l l y . L e a r n i n g how t o keep o n e s e l f s a f e t h u s i m p l i e s s e t t i n g b o u n d a r i e s , becoming a s s e r t i v e and l e a r n i n g how t o c a r e f o r o n e s e l f . T h i s a b i l i t y t o c a r e f o r t h e s e l f i m p l i e s a growing sense of s e l f - w o r t h , t h e a b i l i t y t o r e c o g n i z e one's own needs, -86-and t h e b e l i e f t h a t one " d e s e r v e s b e t t e r " . As t h e a d o l e s c e n t s began t o c a r e f o r t h e m s e l v e s , a s h i f t i n t h e i r s e l f - c o n c e p t began. F e e l i n g B e t t e r A s t r i k i n g change i n t h e a d o l e s c e n t s ' s e l f - c o n c e p t s and f e e l i n g s about r e l a t i o n s h i p s o c c u r r e d d u r i n g t h e i r l i f e a t P h o e n i x House. They d e s c r i b e d t h e m s e l v e s as " f e e l i n g b e t t e r about m y s e l f " and "working on r e l a t i o n s h i p s " ( a l l the a d o l e s c e n t s e xcept t h e n e w e s t ) . A g a i n , t h e r e were t h o s e w i t h t e n t a t i v e v o i c e s , t h o s e whose s e l f - c o n c e p t was j u s t b e g i n n i n g t o grow, and t h o s e w i t h s t r o n g v o i c e s who had more s e l f c o n f i d e n c e . I'm not as s u i c i d a l . My f e e l i n g s a r e i m p r o v i n g , t h e y ' r e good a t t i m e s . I t changed me so I f e e l good about d o i n g t h i n g s . My s e l f - e s t e e m was r e a l l y low, a l m o s t a t z e r o . Now, i t ' s a l m o s t as h i g h as i t can go. One a d o l e s c e n t d e s c r i b e d how her c h a n g i n g v i e w of s e l f o c c u r r e d i n t h e c o n t e x t of t h e r e l a t i o n s h i p s a t P h o e n i x House, and i n f l u e n c e d her e x p e c t a t i o n s of r e l a t i o n s h i p s w i t h o t h e r s . B e f o r e I f e l t l i k e I wasn't wort h v e r y much. B o y f r i e n d s c o u l d j u s t use me and t r e a t me whatever way t h e y wanted t o . I have l e a r n e d t h a t I'm worth more th a n t h a t and I don't d e s e r v e i t . So I won't put up w i t h t h a t now. I t took me a l o n g t i m e t o work on t h a t . I used t o change b o y f r i e n d s l i k e c l o t h e s , b a s i c a l l y . T hat's bad! We worked i n g r o u p s , and I worked on t h e s e i s s u e s w i t h L. ( t h e manager) and I s t a r t e d s e e i n g what a h e a l t h y r e l a t i o n s h i p w a s . . . l i k e t h e r e l a t i o n s h i p between me and L., and me and t h e o t h e r g i r l s and t h e s t a f f . I t s l i k e wherever t h e r e ' s a r e l a t i o n s h i p you have t o be f r i e n d s b e f o r e you can be b o y f r i e n d and g i r l f r i e n d . That's what a l l of us a r e . I f I can be f r i e n d s w i t h a guy and have r e s p e c t f o r him and h i s -87-s p a c e , l i k e how we do i t a t t h e house, t h e n , t o me, t h a t would be t h e most h e a l t h y r e l a t i o n s h i p t o t r y . T h i s example i l l u s t r a t e s how one's sense of s e l f can grow i n r e l a t i o n s h i p . Changing The s t a f f and r e f e r r i n g a gents saw t h e a d o l e s c e n t s as " e x p e r i m e n t i n g " w i t h new s t y l e s of r e l a t i o n s h i p s . G e n e r a l l y t h i s o c c u r r e d w i t h p e e r s , however, f o r a l l but one a d o l e s c e n t whose mother had d i e d t h e r e was a d e s i r e t o e x p e r i e n c e r e -c o n n e c t i o n i n a d i f f e r e n t way w i t h f a m i l y , e s p e c i a l l y w i t h t h e i r mothers. S e v e r a l a d o l e s c e n t s t r i e d t o r e - c o n n e c t w i t h t h e i r mothers. A c c o r d i n g t o t h e r e f e r r i n g a g e n t s , most of t h e g i r l s had d e a l t w i t h t h e i r own i s s u e s t o a g r e a t e r degree than t h e i r mothers, who had o f t e n been v i c t i m s of abuse which t h e y had never d e a l t w i t h . The a d o l e s c e n t s t a l k e d about b e i n g "more open" w i t h t h e i r mothers and were h o p e f u l t h a t t h e y would become c l o s e r t o them i n t h e f u t u r e . Another outgrowth o f t h i s c h a n g i n g v i e w of s e l f was a change i n b e h a v i o r . I've q u i t d o i n g drugs and smoking and hanging around th e E a s t I n d i a n s ( g a n g s ) . I don't get m y s e l f i n t o s h i t . I'm s t a y i n g here more. I'm c l e a n e r . I'm g o i n g t o s c h o o l r e g u l a r l y . I go out w i t h my b o y f r i e n d t o movies and b o w l i n g now. A l t h o u g h s e v e r a l a d o l e s c e n t s s t a t e d t h a t t h e y had q u i t drugs i t was s t i l l a problem f o r t h r e e of them. A l c o h o l use was a n o t h e r problem t h a t one young woman s t a t e d she was a t t e m p t i n g t o a d d r e s s , a l t h o u g h her b e h a v i o r was s t i l l q u i t e e r r a t i c . The m a j o r i t y of t h e a d o l e s c e n t s s t a t e d t h a t t h e y were not - 8 8 -p r o s t i t u t i n g anymore, a l t h o u g h s e v e r a l were s t i l l i n v o l v e d w i t h c o n t r o l l i n g b o y f r i e n d s . One of t h e d i s c h a r g e d a d o l e s c e n t s who was s t i l l i n v o l v e d i n h o o k i n g e x p l a i n e d why. I go now f o r t h e money. B e f o r e , I used t o go t o f i n d someone who would l o v e me. S c h o o l was a mixed i s s u e . A l t h o u g h a l l t h e a d o l e s c e n t s had r e t u r n e d t o s c h o o l , one a f t e r b e i n g away f o r f i v e y e a r s , s e v e r a l were h a v i n g d i f f i c u l t y w i t h r e g u l a r a t t e n d a n c e . One of t h e s t a f f s u g g e s t s t h a t t h e s h i f t i n g s e l f - c o n c e p t of the a d o l e s c e n t s means a t t i m e s t h e y have l i t t l e c o n f i d e n c e i n t h e m s e l v e s i n t h e i r new r o l e s , and so may f a l l back on o l d p a t t e r n s l i k e a v o i d a n c e . Y. w i l l s a y , " I want t o work t h e s t r e e t s . When I go t o s c h o o l I f e e l h a r s h l y c o n f u s e d , l i k e an i d i o t . When I work t h e s t r e e t I f e e l more s u r e of myself.' 1 D u r i n g t h e a d o l e s c e n t s ' e x p e r i m e n t s w i t h change, some had d i s c o v e r e d t h a t t h e power of empowerment. Mut u a l Empowerment D u r i n g t h e p r o c e s s of m u t u a l l y c h a l l e n g i n g each o t h e r ' s p a t t e r n s some of t h e a d o l e s c e n t s e x p e r i e n c e d mutual empowerment. They l e a r n e d t h a t t o h e l p a n o t h e r i s t o h e l p t h e m s e l v e s . T h i s was observed by s t a f f , and d e s c r i b e d as a t u r n i n g p o i n t f o r two of t h e a d o l e s c e n t s . H e l p i n g o t h e r s r e c o g n i z e t h e i r own i s s u e s and l o o k i n g a t my own. I t s e a s i e r t o see t h e o t h e r ' s f i r s t . I wouldn't l o o k a t m y s e l f b e f o r e . The more I h e l p e d o t h e r s , t h e more I r e a l i z e d my own i s s u e s . T h i s a d o l e s c e n t d e s c r i b e d how by her example she had i n f l u e n c e d a nother a d o l e s c e n t t o r e t u r n t o s c h o o l a f t e r many -89-y e a r s . Another a d o l e s c e n t d e s c r i b e d t h i s a s , I t ' s l i k e everybody s o r t of i n f l u e n c e s everybody around h e r e . She d e s c r i b e d an o c c a s i o n i n group where she was i n f l u e n t i a l i n h e l p i n g o t h e r s t o b e g i n t o t a l k about t h e i r p a s t abuse. What i s s u e s d i d t h e a d o l e s c e n t s see them s e l v e s as w o r k i n g on now? C u r r e n t I s s u e s O n l y two i s s u e s were d i f f e r e n t from i s s u e s a l r e a d y d i s c u s s e d . These were, "moving o u t " and " h e a l t h " . D u r i n g t h e p r o c e s s of t h i s r e s e a r c h t h r e e a d o l e s c e n t s moved out of Pho e n i x House. T h i s was a p a i n f u l p r o c e s s f o r a l l of them. Two of t h e a d o l e s c e n t s r e t u r n e d home w i t h o u t much r e - c o n n e c t i n g work done between t h e y and t h e i r f a m i l i e s . I t i s not s u r p r i s i n g t h e n t h a t t h e r e a r e a l r e a d y s i g n s of d i f f i c u l t i e s t h e r e . One a d o l e s c e n t moved i n t o independent l i v i n g a f t e r a l o n g p e r i o d of u n c e r t a i n t y . She e x p e r i e n c e d a h e a l t h c r i s i s w i t h her mother and was a l s o charged w i t h an o f f e n s e s h o r t l y f o l l o w i n g her d i s c h a r g e . A l t h o u g h t h e s t a f f and r e s i d e n t s a r e e n d e a v o r i n g t o remain i n c o n t a c t w i t h h e r , she i n i t i a l l y r e a c t e d t o t h e s e c r i s e s by i s o l a t i n g h e r s e l f . C l e a r l y , d i s c h a r g e i s a ti m e of c r i s i s w hich o f t e n throws one back i n t o o l d , l e s s e f f e c t i v e p a t t e r n s of c o p i n g . Of t h e two a d o l e s c e n t s i n t e r v i e w e d who had been d i s c h a r g e d a year or more ago, one s t i l l a t t e n d e d group r e g u l a r l y and one had l i t t l e c o n t a c t w i t h t h e home. The former s t a t e s , When I moved out everybody r e a l l y missed me. I t made me f e e l good. They wanted me t o come back e v e r y week. They'd phone me and s a y , why don't you come tomorrow? I t made me f e e l good t o have p e o p l e c a r e about me t h a t much. So, I came back, and I s t i l l do. The a d o l e s c e n t w i t h l i t t l e c o n t a c t d e s c r i b e d her b e s t f r i e n d s t o be two d i s c h a r g e d a d o l e s c e n t s who had l i v e d a t t h e house when she d i d . She s t a t e d t h a t "memories" of P h o e n i x House and what she l e a r n e d t h e r e keep her g o i n g and t h a t she wished she had c l o s e r c o n t a c t w i t h t h e home. T r a n s p o r t a t i o n and " a v o i d a n c e " , she s t a t e d , had stopped her from m a i n t a i n i n g c o n n e c t i o n . The two a d o l e s c e n t s who s t a t e d t h a t h e a l t h was an i s s u e f o r them have both been d i a g n o s e d as HIV p o s i t i v e . C o n s e q u e n t l y , t h e i r f u t u r e i s u n c e r t a i n . When asked what she saw f o r h e r s e l f i n t h e f u t u r e , one s t a t e d , Death. They've g i v e n me two and one h a l f y e a r s t o l i v e . . . I ' m not as c e r t a i n about th e f u t u r e as b e f o r e . I p l a n a year a t a t i m e now. I can h a n d l e t h a t . P o v e r t y was a l s o a major problem f o r h e r . I've l o s t t h r e e j o b s because I'm HIV p o s i t i v e . W e l f a r e j u s t doesn't c u t i t . I f I was p r e g n a n t , I'd g e t $45. a month f o r a food supplement. With t h i s I g e t $20. The d i e t I get i n here ( i n h o s p i t a l ) would c o s t me $200. per month. The consequence of t h i s f i n a n c i a l b i n d i s t h a t t h i s i n d i v i d u a l r e s o r t s t o p r o s t i t u t i o n , her o n l y s u r e means of s u p p o r t , t o supplement her income. The o t h e r a d o l e s c e n t i s open w i t h her f r i e n d s about her s i t u a t i o n , not w a n t i n g t o put anyone a t any u n n e c e s s a r y r i s k . She s t a t e s , however, I f e e l a l o n e a l o t . A l o t o f p e o p l e know, everybody -91-here ( P h o e n i x House). They h e l p me, but t h e y don't know how t o r e a c t . Both of t h e s e young women were i n f e c t e d by a male who knew he was a c a r r i e r , but d i d not d i s c l o s e t h i s . T h i s phase of " t a k i n g c h a r g e " by making d e c i s i o n s t o change p a t t e r n s and the n c a r r y i n g t h e s e t h r o u g h , was c h a r a c t e r i z e d by changes i n s e l f , b o th i n t r a - p s y c h i c and b e h a v i o r a l l y , i n t h e c o n t e x t o f r e l a t i o n s h i p s . T h i s phase has no end. As one a d o l e s c e n t s a i d , "You have i s s u e s f o r t h e r e s t of your l i f e . " T h i s p r o c e s s o f f e e l i n g c a r e d f o r , opening up and t a k i n g c h a rge was not l i n e a r , and had no c o n s i s t e n t speed. Some of t h e r e f e r r i n g agents d e s c r i b e d s l o w u n p r e d i c t a b l e p a t h s of change, o t h e r s saw f a s t and s t e a d y p a t h s . At tim e s t h e a d o l e s c e n t s took a z e s t from t h i s p r o c e s s and were d e s c r i b e d as b e i n g on a " p l a t e a u " . At t i m e s t h e y r e t u r n t o o l d p a t t e r n s . One of t h e d i s c h a r g e d women t y p i f i e d t h i s when she s t a t e d , " I ' v e been a v o i d i n g f o r about a year now." The t h r e e themes of t h e work of t h e s t a f f , c o n n e c t i n g , t e a c h i n g and c h a l l e n g i n g , a r e a l s o not d i s c r e t e or l i n e a r . R a t h e r , t h e y f l o w t o g e t h e r l i k e t h r e e t r i b u t a r i e s , becoming the most p o w e r f u l when t h e y merge and s w i r l t o g e t h e r . The work ebbs and f l o w s a c c o r d i n g t o each young woman's rhythms and needs. I t becomes a r e c i p r o c a l e x p e r i e n c e , w i t h the workers i n v i t i n g , and engagi n g , always t a k i n g t h e i r cues from th e young women. The young women res p o n d , h e s i t a n t l y , and th e n w i t h more a s s u r a n c e . W i t h i n t h e r e l a t i o n s h i p , each p e r s o n i s empowered, and the n moves o f f t o e x p l o r e new s t y l e s of r e l a t i o n s h i p s w i t h o t h e r s . - 9 2 -The r e c i p r o c a l n a t u r e of the r e l a t i o n s h i p means t h a t t h e worker's e x p e r i e n c e i s not l i m i t e d t o engaging and c h a l l e n g i n g . D u r i n g t h i s p r o c e s s t h e worker, t o o , i s n u r t u r e d and c h a l l e n g e d t o change o l d p a t t e r n s . As one of t h e a d u l t s s t a t e d , B e i n g a t P h o e n i x House n u r t u r e s me. I t s a l s o h e l p s me w i t h my own a d o l e s c e n t s . I don't get i n t o the power s t u f f now. I n t h e p a s t when I consequenced them a f t e r t h e y s t a y e d out l a t e , t h e r e was always t h i s f e e l i n g of d i s t a n c e a f t e r . Now, I ask them when t h e y ' r e p l a n n i n g t o come i n , and ask them i f t h e y t h i n k t h e i r d e c i s i o n i s w i s e , g i v e n what t h e y have t o do t h e next day. We a r e v e r y c l o s e . A l l of t h e s t a f f named s i m i l a r p e r s o n a l b e n e f i t s and c h a l l e n g e s t h e y r e c e i v e d from w o r k i n g a t t h e house. One of t h e r e f e r r i n g agents observed t h i s and s t a t e d , I t s s u p p o r t i v e , so t h e y don't have th e u s u a l s t a f f burn o u t . A l o t of f a c i l i t i e s g e t and l o s e s t a f f a t an i n c r e d i b l e r a t e . Because t h e s e s t a f f a r e making p e r s o n a l growth w h i l e t h e y a r e h e r e , t h e y seem t o h o l d on l o n g e r . Thus, t h e r e c i p r o c a l model of P h o e n i x House means t h a t t h r o u g h c o n n e c t i o n w i t h t h e home, one comes t o new u n d e r s t a n d i n g about t h e n a t u r e of h e a l t h y r e l a t i o n s h i p s . W i t h t h i s new u n d e r s t a n d i n g , one i s c h a l l e n g e d and empowered t o change one's own p a t t e r n s . Throughout t h e i n t e r v i e w s t h e p a r t i c i p a n t s r e f e r r e d t o o t h e r l i f e e x p e r i e n c e s which t o them were d i a m e t r i c a l l y opposed t o t h e i r e ncounter w i t h P h o e n i x House. I n o r d e r t o f u l l y u n d e r s t a n d t h i s i n n o v a t i v e model i t i s u s e f u l t o c o n t r a s t i t w i t h a model w h i c h , a c c o r d i n g t o t h e p a r t i c i p a n t s , " r e p l i c a t e s t h e a b u s i v e p r o c e s s " . -93-R e p l l e a t i n g t h e A b u s i v e P r o c e s s The a d o l e s c e n t s , s t a f f and r e f e r r i n g agents a l i k e t a l k e d about i n c i d e n t s t h a t t h e y had w i t n e s s e d i n group homes which were i n a broad s e n s e , a b u s i v e . D u r i n g t h e p r o c e s s of c o d i n g , i t appeared t h a t t h e y were e x p l a i n i n g t h e v a r i o u s l e v e l s a t which abuse can be r e p l i c a t e d i n an o r g a n i z a t i o n a l s e t t i n g . C o n s e q u e n t l y , a model emerged from t h e d a t a which e x p l a i n s how s e v e r a l v a r i a b l e s i n t e g r a l t o group home o p e r a t i o n can work t o g e t h e r t o c r e a t e a c l i m a t e r i p e f o r damaging i n t e r a c t i o n s . The v a r i a b l e s f i t t h e e c o l o g i c a l model of a d o l e s c e n t m a l t r e a t m e n t p r e v i o u s l y d e s c r i b e d where or g a n i s m , m i c r o -system, mesosystem, exosystem and macrosystem work t o g e t h e r t o p e r p e t u a t e abuse ( G a r b a r i n o , S c h e l l e n b a c h , & Sebes, 1986). In t h i s model t h e i d e o l o g y of our s o c i e t y , t h e macrosvstem. and the i d e o l o g y of our p r a c t i c e w i t h a d o l e s c e n t s , t h e exosvstem. can p e r p e t u a t e v a l u e s w h i c h j u s t i f y a b u s i v e r e l a t i o n s h i p s . The mesosystem. or t h e r e l a t i o n a l g r o u p i n g i n which one l i v e s , can a l s o s e r v e t o i s o l a t e a d o l e s c e n t s , making them v u l n e r a b l e t o abuse. On a more m i c r o l e v e l , an a b u s i v e i n t e r a c t i o n may o c c u r between a t l e a s t two i n d i v i d u a l s i n t h e m i c r o s y s t e m , each of whom b r i n g s a p a r t i c u l a r s e t of h i s t o r y , b e l i e f s , and p e r c e p t i o n s as p a r t of t h e i r o rganism. The exchange i t s e l f becomes e s s e n t i a l l y a b u s i v e when power t a c t i c s which p a r a l l e l t h e o r i g i n a l abuse a r e used as d e f e n s e mechanisms i n t h e attempt t o c o n t r o l t h e o t h e r . T h i s evokes a l e a r n e d c o p i n g response which has h e l p e d the person i n t h e p a s t t o s u r v i v e - 9 4 -t h e i r abuse. C o n v e r s e l y , t h e v i c t i m of p r e v i o u s abuse can a l s o " i n v i t e power s t r u g g l e s " w h i c h , s i m i l a r l y , can be responded t o out of a d e f e n s i v e p o s i t i o n which a t t e m p t s t o c o n t r o l . T h i s c o u l d be seen as a dance of t r a n s f e r e n c e and c o u n t e r t r a n s f e r e n c e . I n t h i s exchange t h e r e a r e a l s o a c c i d e n t a l v a r i a b l e s which a f f e c t t h e i n d i v i d u a l . F a c t o r s s uch as s t r e s s , which can o r i g i n a t e i n any system, r e n d e r us l e s s e f f i c i e n t and more v u l n e r a b l e t o r e a c t i n g r a t h e r t h a n i n t e r a c t i n g . T h i s e c o l o g i c a l model w i l l s e r v e as a framework t h r o u g h which t h e theme of r e p l i c a t i n g t h e a b u s i v e p r o c e s s w i l l be e x p l o r e d . A p i c t o r i a l r e p r e s e n t a t i o n of t h i s model h e l p s t o i l l u s t r a t e t h e i n t e r r e l a t i o n s h i p s of t h e s e many systems (see F i g u r e 2 ) . F i g u r e 2. An E c o l o g i c a l Model of Abuse. -96-The Macrosvstem: S o c i e t a l V a l u e s A l l of t h e s t a f f commented on t h e way our v a l u e s as a s o c i e t y se up t h e c o n d i t i o n s t o r e p l i c a t e abuse. Three p a r t i c u l a r v a l u e s were n o t e d : our v a l u e s about t h e r o l e s of women and men; our a t t i t u d e s about power; and our a t t i t u d e s about s t r e e t - k i d s . The way t h a t men and women have t r a d i t i o n a l l y been s o c i a l i z e d i n t h i s s o c i e t y , t h e p a r t i c i p a n t s n o t e d , i s t o h o l d unequal r o l e s i n terms of power and s t a t u s . Women's t r a d i t i o n a l s o c i a l i z a t i o n , aimed a t dependency and p o w e r l e s s n e s s p r e p a r e s us f o r a r o l e as v i c t i m , w h i l e men's s o c i a l i z a t i o n as independent and " i n c h a r g e " s e t s them up t o be o f f e n d e r s . I s t r u g g l e w i t h women because a l o t of them a r e r e a l l y a c t i n g out v i c t i m s t u f f . And I s t r u g g l e w i t h men because a l o t of them a r e r e a l l y a c t i n g out v i c t i m i z e r s t u f f . These r i g i d r o l e s a r e o f t e n p l a y e d out i n a b u s i v e f a m i l i e s (Herman, 1981), a l t h o u g h none of us a r e immune t o t h e i r i n f l u e n c e . We a l l know t h e dance. We were r a i s e d i n i t . I t s our c u l t u r e . One of t h e r e f e r r i n g a g ents l i n k e d t h i s i s s u e w i t h t h e gender of s t a f f i n group homes. There a r e n ' t t h a t many f e m i n i s t men around. I f you're w a n t i n g t o model good r e l a t i o n s h i p s between men and women, t h a t ' s what you need. You don't need peop l e on power t r i p s who see women i n t r a d i t i o n a l t e r ms. These k i d s have had enough of t h a t . They don't need more. R e l a t e d t o t h i s a r e dominant c a p i t a l i s t v a l u e s about power i n t h i s s o c i e t y . - 9 7 -We equate power and c o n t r o l i n t h i s s o c i e t y . We don't see power w i t h o u t c o n t r o l . That s e t s up t h e b u l l i e s and t h e v i c t i m s . Not o n l y do we equate power and c o n t r o l , but we see power as s t a t u s . Thus, power becomes something we seek t o g a i n , and we t r y t o a v o i d l o s i n g . A t t i t u d e s and v a l u e s i n our s o c i e t y a r e p a r t of t h e problem. They a r e p a r t of t h e r e a s o n we don't want t o do t r e a t m e n t t h a t works. Because t h e n w e ' l l have t o g i v e up c o n t r o l . We t h e n succeed i n d i c h o t o m i z i n g t h e problem: e i t h e r I have a l l t h e power or you have a l l t h e power. V i e w i n g s i t u a t i o n s as w i n - l o s e power s t r u g g l e s s e t s us up t o abuse o t h e r s . One of t h e s t a f f commented, "We a r e s t i l l an a b u s i v e s o c i e t y towards c h i l d r e n . " Our a t t i t u d e s about c o n t r o l i n t e r f a c e w i t h our v i e w of a d o l e s c e n c e as a t ime when k i d s a r e out of c o n t r o l t o c r e a t e a j u s t i f i c a t i o n f o r p a r e n t i n g which e q u a l s c o n t r o l . As one r e f e r r i n g agent s t a t e d , They t h i n k t h e y s h o u l d be c o n t r o l l i n g t h e k i d s f o r t h e i r own good. In our s o c i e t y , p a r e n t s c o n t r o l t h e k i d s and p r e t e n d t h e y a r e l o o k i n g a f t e r them. T h i s n e g a t i v e v i e w of a d o l e s c e n c e becomes f u r t h e r warped when s e x u a l i t y i s c o n s i d e r e d . S t r e e t - k i d s who a r e p r o s t i t u t e s a r e blamed f o r t h e i r h i g h l e v e l of s e x u a l i z a t i o n and c r i m i n a l i z e d w h i l e t h e ongoing p e r p e t r a t o r s a r e i g n o r e d . We have d i f f e r e n t r e s p o n s e s t o c h i l d abuse i f t h e y a r e s t r e e t - k i d s r a t h e r t h a n k i d s i n f a m i l i e s . We a r r e s t them and see t h e i r b e h a v i o r as c r i m i n a l because t h e y have been s e x u a l i z e d , and a c t i t out as p r o s t i t u t e s . We as a s o c i e t y r e v i c t i m i z e a d o l e s c e n t p r o s t i t u t e s who a r e s e x u a l abuse v i c t i m s . Thus, our c a p i t a l i s t and p a r t i a r c h a l s o c i e t y p r o p a g a t e s - 9 8 -v a l u e s which promote unequal and a b u s i v e r e l a t i o n s h i p s between t h e s e x e s , and between a d u l t s and a d o l e s c e n t s . The Exosystem; The I d e o l o g y of P o l i c y and P r a c t i c e A l l of t h e s t a f f and r e f e r r i n g a g ents were asked t h e i r p e r c e p t i o n s of t h e p o l i c y of t h e M i n i s t r y of S o c i a l S e r v i c e s and Housing i n r e g a r d s t o t h e i d e o l o g y of group home c a r e t h a t was promoted i n Vancouver. Of t h e e l e v e n t o whom t h i s q u e s t i o n was d i r e c t e d , t h e o p i n i o n of e i g h t was t h a t t h e M i n i s t r y f a v o r e d " b e h a v i o r a l management" models of c a r e , w h i l e t h r e e s t a t e d t h a t t h e y thought "the new f a d " was "p a r e n t c o u n s e l o r " homes. C r i t i q u e s of t h e b e h a v i o r a l management homes i n c l u d e d ; "they a r e l i k e a warden and i n s t i t u t i o n a l model" , t h e y a r e l a r g e l y f o c u s s e d on " c o n t r o l l i n g b e h a v i o r " and " t h e y c o n t a i n t h e k i d s , t h e y don't t r e a t them". Two of t h e r e f e r r i n g agents f e l t t h i s model c o u l d work i f t h e k i d s had e x p e r i e n c e d a l a c k of e x t e r n a l s t r u c t u r e a t home, and had become i n v o l v e d i n d e l i n q u e n t a c t i v i t i e s . The p a r e n t c o u n s e l o r homes, a l t h o u g h viewed as f a d d i s h , were viewed as e f f e c t i v e f o r "the k i d s t h a t f i t " . Those a d o l e s c e n t s who do not f i t e i t h e r model were g e n e r a l l y seen t o be " a c t i n g - o u t abused k i d s " , or "emotionally-damaged k i d s " . There were some e x c e p t i o n s t o t h i s o p i n i o n . Some f e l t t h a t a "tr e a t m e n t m i l i e u " was needed f o r a l l c h i l d r e n i n c a r e w i t h an e x t e n s i v e abuse h i s t o r y , not o n l y a c t i n g - o u t k i d s . One p e r s o n f e l t s t r o n g l y t h a t "adding on" an hour of i n d i v i d u a l t r e a t m e n t - 9 9 -a week was not enough t o work t h r o u g h the d i f f i c u l t i s s u e s t h a t s e v e r e l y abused c h i l d r e n f a c e . The gap i n s e r v i c e f o r s e v e r e l y abused a d o l e s c e n t s was noted e s p e c i a l l y by the r e f e r r i n g a g e n t s . The r e s p o n s e s of t h e p a r t i c i p a n t s s uggest t h a t t h e p e r c e i v e d p o l i c y of t h e M i n i s t r y towards group home c a r e i s based on " c o n t r o l l i n g " v a l u e s about a d o l e s c e n t s and a t r a d i t i o n a l i d e o l o g y of t h e n u c l e a r f a m i l y . W h i l e t h i s may or may not be t h e a c t u a l i d e o l o g y promoted by t h e M i n i s t r y , t h e p e r c e p t i o n s of i t s employees a r e s i g n i f i c a n t . I t i s a l s o s i g n i f i c a n t t h a t a l l t h e a d o l e s c e n t s , who had e x p e r i e n c e d both of t h e s e two models, o v e r w h e l m i n g l y p o r t r a y e d them as e x p e r i e n c e s of b e i n g " c o n t r o l l e d " . I t a p p e a r s , t h e n , t h a t t h e common i d e o l o g y and p r a c t i c e of group home c a r e i s p e r c e i v e d by t h e p a r t i c i p a n t s of t h i s s t u d y t o p a r a l l e l t h e v a l u e s t h a t our s o c i e t y promotes about a d o l e s c e n t s . The Mesosystem; The Group Home The n e x t l a y e r i n t h i s c o n c e p t u a l i z a t i o n i s the p a r t i c u l a r model of group home. Any o r g a n i z a t i o n or i n s t i t u t i o n c o u l d f i t a t t h i s l e v e l . The p a r t i c u l a r model of group home which f u r t h e r s e t s t h e s t a g e f o r t h e r e p l i c a t i o n of abuse was p e r c e i v e d as a " h i e r a r c h i c a l " s t r u c t u r e , which " i n v e s t s power and c o n t r o l i n one body of pe o p l e over a n o t h e r " . There i s a "one-way f l o w of power" down t h e pyramid. I t i s a model which g i v e s t h e message t h a t " c o n t r o l l i n g k i d s " i s l e g i t i m a t e i n some c i r c u m s t a n c e s . -100-F u r t h e r m o r e , i t s e t s up a one-way p r o c e s s of feedback where t h e r e i s no n e g o t i a t i o n . Without n e g o t i a t i o n , t h e system becomes r i g i d . The a d o l e s c e n t s and s t a f f d e s c r i b e d how " r i g i d r u l e s , e n f o r c e d i n a c o n t r o l l i n g way" were i n t h e i r o p i n i o n , a b u s i v e . Two a d o l e s c e n t s r e c a l l t h e i r e x p e r i e n c e s i n another group home: E v e r y t h i n g was l o c k e d up everywhere. You had t o l o c k up a l l you s t u f f i n your bedroom. You got a c e r t a i n amount of f o o d . You c a n ' t e a t e x t r a s . You c a n ' t e a t p a s t a c e r t a i n t i m e . You c a n ' t make phone c a l l s a f t e r a c e r t a i n t i m e . You c a n ' t have p e o p l e i n t h e house, u n l e s s t h e y l o o k a c e r t a i n way. Some p l a c e s l o c k t h e f r i d g e , l o c k you i n your room a f t e r a c e r t a i n hour, send you t o bed, and c o n t r o l you. Most group homes, a l l t h e y do i s c o n t r o l , c o n t r o l , c o n t r o l . . . You've been c o n t r o l l e d a l l your l i f e , and i t f e e l s l i k e t h a t a l l over a g a i n . A l l of t h e a d o l e s c e n t s had s t o r i e s t o t e l l l i k e t h i s . Some t a l k e d about group homes b e i n g " l i k e a j a i l " . From t h e p e r s p e c t i v e of t h e s e a d o l e s c e n t s , c o n t r o l l i n g a c t i o n s e s s e n t i a l l y f e l t a b u s i v e . What t h e n i s t h e a p p e a l of such a model? One s t a f f member put s f o r w a r d an e x p l a n a t i o n . When you have an i n s t i t u t i o n a l atmosphere r a t h e r t h a n a home i t s e a s i e r f o r t h e s t a f f . And i t can be e a s i e r f o r t h e k i d s . The day i s p l a n n e d . You don't have t o t a k e r e s p o n s i b i l i t y . You don't have t o make c h o i c e s , because you're conseguenced. There's an appearance of c h o i c e s , but t h e r e ' s no r e a l c h o i c e . An o r g a n i z a t i o n a l s t r u c t u r e which promotes unequal r e l a t i o n s h i p s and power-over o t h e r s , as p e r c e i v e d by t h e s e p a r t i c i p a n t s , i s one where t h e r e i s a one-way f l o w of power and feedback. I t a l s o e i t h e r e x p l i c i t l y or i m p l i c i t l y s u p p o r t s t h e p r i n c i p l e of c o n t r o l l i n g t h e r e c e i v e r s of t h e s e r v i c e . -101-The M i c r o s y s t e m : The I n t e r a c t i o n of the S t a f f and the  A d o l e s c e n t The n e x t l e v e l of t h i s model i s t h e i n t e r a c t i o n between the s t a f f and the a d o l e s c e n t . What a r e some of t h e i n t e r a c t i o n a l p a t t e r n s which r e p l i c a t e t h e a b u s i v e p r o c e s s ? One type of i n t e r a c t i o n which t h e a d o l e s c e n t s , s t a f f and r e f e r r i n g a gents viewed as a b u s i v e i n v o l v e d a t t e m p t s by t h e s t a f f t o use t h e i r power t o f o r c e t h e a d o l e s c e n t s do what t h e s t a f f wanted. The e s s e n t i a l element here i s t h e c o e r c i o n , t h e l a c k of a r e a l c h o i c e . The a d o l e s c e n t s , f o r example, r e c o u n t e d examples of " t h r e a t s " and p h y s i c a l a l t e r c a t i o n s between them s e l v e s and s t a f f members. As w e l l as c o e r c i o n , i n v a s i o n of b o u n d a r i e s was f e l t t o be a b u s i v e . D e s c r i p t i o n s of b e i n g "watched", and s t a f f " w a l k i n g i n w i t h o u t k n o c k i n g " were examples of t h i s . I s o l a t i o n was e x p e r i e n c e d as a l i e n a t i n g and u n c a r i n g . The a d o l e s c e n t s p e r c e i v e d s t a f f who " d i d n ' t t a l k " t o them as e s s e n t i a l l y w i t h h o l d i n g n u r t u r a n c e , an a b u s i v e s t a n c e . " L o c k s " were a l s o e x p e r i e n c e d as c o n t r o l l i n g and a b u s i v e . In p a r t i c u l a r t h e a d o l e s c e n t s r e a c t e d t o l o c k s on f r i d g e s , and th e o u t s i d e door b e i n g l o c k e d a t a r e g u l a r t i m e when t h e y had no key. These a c t i o n s c o u l d be viewed s y m b o l i c a l l y as w i t h h o l d i n g n u r t u r a n c e and r e j e c t i n g t h e a d o l e s c e n t . I t i s not hard t o see how t h e above i n t e r a c t i o n s c o u l d be e x p e r i e n c e d as a b u s i v e . What o t h e r t y p e s of i n t e r a c t i o n s were viewed as a b u s i v e even though the c o n t e n t might be more p o s i t i v e ? -102-The main type of u n h e a l t h y i n t e r a c t i o n which c o u l d have a p o s i t i v e c o n t e n t was seen t o be " c o n d i t i o n a l r e l a t i n g " . As d e s c r i b e d i n t h e f u n d i n g p r o p o s a l f o r Pho e n i x House, c o n d i t i o n a l r e l a t i n g i s , accommodating t o t h e needs of t h e ( p o w e r f u l ) s t a f f p e r s o n and succumbing t o t h e i r power much t h e same as he/she d i d i n p a s t r e l a t i o n s h i p s w i t h a b u s e r s . When s t a f f r e l a t e c o n d i t i o n a l l y t o c h i l d r e n , t h e " s t a f f may f e e l needy and wants t o f e e l i m p o r t a n t t o t h e k i d " . The s t a f f might need t o t a k e c a r e of p e o p l e . Some pe o p l e c a l l i t " d o i n g f o r " , or "co-dependency"... T h i s i s r e p l i c a t i n g t h e p r o c e s s of abuse, even i f the c o n t e n t i s p o s i t i v e . One o f t h e s t a f f d e s c r i b e d her e x p e r i e n c e i n d i s c o v e r i n g t h a t by o v e r - g i v i n g she t o o was c o n t r o l l i n g t h e s i t u a t i o n i n the same way t h a t the f a m i l y d i d . T h i s f a m i l y wanted t o do e v e r y t h i n g f o r t h e i r c h i l d r a t h e r than l e t t i n g her f e e l t h e consequences of her own b e h a v i o r . And I s u d d e n l y r e a l i z e d by t h e amount of time I'm s p e n d i n g w i t h them t h a t I'm t r y i n g t o do e v e r y t h i n g f o r them and save them from t h e consequences of t h e i r a c t i o n s because t h e y ' v e been abused. Thus, o v e r - g i v i n g , which c r e a t e s a sense of d e b t , can a l s o be a way i n which we attempt t o m a i n t a i n c o n t r o l . One of t h e r e f e r r i n g agents d e s c r i b e d a s i m i l a r i s s u e she e x p e r i e n c e d w i t h a needy a d o l e s c e n t which she i d e n t i f i e d as " o v e r -p r o t e c t i o n " . F o r h e r , t h i s meant a l a c k of r e s p e c t f o r t h e i n d i v i d u a l ' s b o u n d a r i e s . What a r e t h e e f f e c t s of t h e s e i n t e r a c t i o n s on t h e a d o l e s c e n t s , and what i s t h e i r r o l e i n t h e p r o c e s s ? The a d o l e s c e n t s e l o q u e n t l y s t a t e d t h e i r r e a c t i o n s t o t h e use of c o n t r o l l i n g power t a c t i c s . -103-A l o t of t h e o t h e r p l a c e s p l a y e d a u t h o r i t y t r i p s on you, "We're a u t h o r i t y , you've got t o l i s t e n t o us. We're r i g h t , you're wrong." That was e x a c t l y what i t was l i k e a t home f o r me and t h a t ' s what made me l e a v e a l l t h o s e p l a c e s . As soon as t h a t happened, I was gone. I t ( b e i n g c o n t r o l l e d ) g i v e s you more a n x i e t y and you want t o do i t ( a c t out) more, and t h a t g e t s you i n more t r o u b l e . You've been c o n t r o l l e d a l l your l i f e and i t f e e l s l i k e t h a t a l l over a g a i n . A l t h o u g h t h e r e a c t i o n s of t h e a d o l e s c e n t s v a r i e d , t h e consequence of b e i n g c o n t r o l l e d t r i g g e r e d f e e l i n g s s i m i l a r t o t h o s e t h a t t h e y f e l t when t h e y were b e i n g abused. Some f e l t " h e l p l e s s " and " s c a r e d " . O t h e r s s t a t e d t h e y f e l t "more r e b e l l i o u s " . Two s t a t e d t h a t t h e y "got v i o l e n t " . Another s t a t e d t h a t she f e l t " a n x i o u s " and t h a t something was wrong w i t h h e r . S e v e r a l of t h e a d o l e s c e n t s s a i d t h a t t h e s e i n t e r a c t i o n s would cause them " t o r u n " . Thus, t h e a d o l e s c e n t s i n t e r p r e t e d t h e s e a c t i o n s as a t h r e a t and the n r e a c t e d i n o r d e r t o p r o t e c t t h e m s e l v e s . The r e a c t i o n s of t h e a d o l e s c e n t s g e n e r a l l y seemed t o be f i g h t or f l i g h t . When t h e y would " r e b e l " or "get v i o l e n t " , t h e c o n f l i c t would e s c a l a t e , and g r e a t e r power t a c t i c s were needed on t h e p a r t of t h e s t a f f t o keep t h i n g s under c o n t r o l . The c y c l e of abuse has now been r e p l i c a t e d . The Organism: The Stance of t h e S t a f f and t h e A d o l e s c e n t The l a s t component of t h i s model i s t h e i n d i v i d u a l s t a n c e t a k e n by t h e s t a f f and t h e a d o l e s c e n t s . The p o s i t i o n as d e s c r i b e d here r e p r e s e n t s an extreme on a continuum. There ar e a number of f a c t o r s r e l a t e d t o b o t h t h e s t a f f and -104-a d o l e s c e n t s which i n c r e a s e t h e l i k e l i h o o d of a b u s i v e i n t e r a c t i o n s . The S t a f f ' s Stance The s t a n c e of t h e s t a f f p e r s o n i s f i r s t l y a f f e c t e d by h i s or her own h i s t o r y . When w o r k i n g w i t h abuse s u r v i v o r s many of t h e a d u l t s s t a t e d t h a t a p e r s o n needs t o have examined them s e l v e s i n r e l a t i o n t o t h e i r e x p e r i e n c e s of abuse. I t happens ( r e p l i c a t i n g abuse) when you don't s t e p back and see what r o l e abuse p l a y e d i n your l i f e . Thus, i n o r d e r t h a t one's h i s t o r y does not get i n t h e way of the r e l a t i o n s h i p , a s t a t e of s e l f - a w a r e n e s s i s needed. Another f a c t o r which i n c r e a s e s t h e r i s k of abuse i s a l a c k of knowledge about abuse. A l l of t h e s t a f f and r e f e r r i n g a gents f e l t t h a t knowledge was c r u c i a l i n o r d e r t o p r e v e n t p o t e n t i a l l y damaging i n t e r a c t i o n s . One's v a l u e s t a n c e was a l s o seen as c r u c i a l t o one's i n t e r a c t i o n s . A v a l u e s t a n c e which f i t s w i t h t h e s o c i a l v a l u e s p r e v i o u s l y mentioned was a l s o viewed as c o n t r i b u t i n g t o u n h e a l t h y i n t e r a c t i o n s (eg. a d o l e s c e n t s need t o be c o n t r o l l e d ; power e q u a l s c o n t r o l ) . Thus, t h e p a r t i c u l a r h i s t o r y , v a l u e s , and t h e knowledge t h a t s t a f f h o l d w i l l a f f e c t t h e i r p e r c e p t i o n s about a d o l e s c e n t s , and w i l l a f f e c t t h e l i k e l i h o o d of them i n t e r a c t i n g a b u s i v e l y . The s t a f f a l s o r e f e r r e d t o t i m e s when t h e y m o m e n t a r i l y , " l o s t i t " . What a r e some of t h o s e t i m e s t h a t r e n d e r a l l of us v u l n e r a b l e t o a c t i n g i n p o t e n t i a l l y a b u s i v e ways? One of t h e -105-s t a f f members e x p l a i n s how i t happens. I've been sucked i n t o p l a y i n g out d y s f u c t i o n a l f a m i l y p a t t e r n s of i n t e r a c t i o n , or p a t t e r n s s i m i l a r t o my own f a m i l y . I t r e a l l y r e q u i r e s s e l f -e x a m i n a t i o n ( t o a v o i d r e p l i c a t i n g a b u s e ) . E s p e c i a l l y when c o n f l i c t e s c a l a t e s , t h e n you have t o sa y , "What am I d o i n g ? Are t h e k i d s a c t i n g out t h e i r f a m i l y d y namics?" I t t a k e s owning r a t h e r t h a n b l a m i n g . Then you s a y , "Whoa, l e t s t r y t h i s a g a i n . " I t would f o l l o w t h e n t h a t an i n a b i l i t y t o be s e l f -r e f l e c t i v e and a l a c k of awareness of one's own i s s u e s , e s p e c i a l l y i n t h e m i d s t of c o n f l i c t , would r e n d e r one more v u l n e r a b l e t o r e s p o n d i n g a b u s i v e l y . Other s t a f f echo the importance of k e e p i n g one's p e r s p e c t i v e , and b e i n g aware t h a t f e e l i n g a ngry may be a warning s i g n a l . I t ' s hard t o keep your p e r s p e c t i v e . I always f a l l i n t o s i t u a t i o n s where the k i d s m a n i p u l a t e you, where t h e y t r y t o make you angry t o a l i e n a t e you. They're a f r a i d of peop l e g e t t i n g c l o s e , so t h e y f i n d some way t o push you away when t h e y f e e l you're g e t t i n g c l o s e . I t s hard not t o t a k e c o n t r o l when you're angry. You want t o l o c k them up, t h r e a t e n them. When i s i t t h a t we a r e most l i k e l y t o be angry? Anger i s viewed by some c o g n i t i v e t h e r a p i s t s as a r e a c t i o n t o a p e r c e i v e d t h r e a t (Buckman, 1988). I n s i t u a t i o n s where we a r e a f r a i d we w i l l l o s e something which we h i g h l y v a l u e , whatever t h a t i s , eg. s t a t u s , c o n t r o l , p a r t of o u r s e l v e s , or a r e l a t i o n s h i p , we may l a s h out i n anger i n o r d e r t o p r o t e c t what i t i s we v a l u e . Thus, when we a c t on the b a s i s of our f e a r s , t r y i n g t o p r o t e c t o u r s e l v e s , we a r e more l i k e l y t o use our power i n a h u r t f u l way. When our r e s o u r c e s a r e a l r e a d y low, we may f e e l even more v u l n e r a b l e . Thus, s t a f f r e f e r r e d t o t i m e s when t h e y were f e e l i n g "pushed", "overwhelmed", or when " I wasn't g e t t i n g f u e l e d from t h e o u t s i d e " as t i m e s when -106-t h e y were p a r t i c u l a r l y v u l n e r a b l e t o " l o s i n g i t " . They a l l p o i n t e d t o t h e need f o r s u p e r v i s i o n and s t a f f meetings i n o r d e r t o p r e v e n t problems. One pers o n s t r e s s e d t h e importance of l e t t i n g go of t h e d e n i a l t h a t keeps us from s e e i n g how we can use our power d e s t r u c t i v e l y . You need t o ex p e c t i t t o happen. I t keeps you more aware. Then d e n i a l i s n ' t a problem. E x p e c t t o have power s t r u g g l e s w i t h a d o l e s c e n t s . Then i t ' s not so d i f f i c u l t t o t a l k about i t . I n summary, t h e p a r t i c u l a r h i s t o r y , b e l i e f s , p e r c e p t i o n s and knowledge which s t a f f h o l d were p e r c e i v e d by t h e p a r t i c i p a n t s t o a f f e c t t h e p o t e n t i a l f o r one t o engage i n an a b u s i v e p r o c e s s w i t h an a d o l e s c e n t i n c a r e . I n p a r t i c u l a r , when s t a f f members a r e e x p e r i e n c i n g s t r e s s or d e n y i n g t h e i r own problems the p a r t i c i p a n t s f e l t t h a t t h e y would be more l i k e l y t o l o s e t h e i r p e r s p e c t i v e and t o a c t i n h u r t f u l ways. The A d o l e s c e n t ' s Stance The a d o l e s c e n t s , t o o , come t o a r e l a t i o n s h i p w i t h a p a r t i c u l a r c o n s t e l l a t i o n of v a l u e s , knowledge and p e r c e p t i o n s which i s a f f e c t e d by t h e i r h i s t o r y , and t h e i r d e v e l o p m e n t a l s t a g e . T h e i r h i s t o r y as an abuse s u r v i v o r means t o t h e s t a f f t h a t t h e y l i k e l y have " t r o u b l e w i t h t h e i r b o u n d a r i e s " and have s u f f e r e d a " l a c k of n u r t u r i n g " . The s t a f f s t a t e d t h a t the k i d s may "expect o t h e r s t o save them", or "expect o t h e r s t o be r e s p o n s i b l e f o r t h e i r f e e l i n g s " . Because of t h e i r abuse h i s t o r y , " t h e y may do what t h e o t h e r p e r s o n wants, t o p l e a s e them". Two p a r t i c u l a r p o s i t i o n s were d e s c r i b e d by t h e s t a f f . They e i t h e r i n v i t e power s t r u g g l e s or t h e y come i n -107-g i v i n g a l l t h e i r power t o you. Power i s acknowledged as a major i s s u e f o r t h e a d o l e s c e n t s because of t h e i r e x p e r i e n c e s of p o w e r l e s s n e s s as abuse v i c t i m s , and t h e i r d e v e l o p m e n t a l s t a g e . T h i s i s d i s c u s s e d i n t h e f u n d i n g p r o p o s a l of Ph o e n i x House which s t a t e s , The d e v e l o p m e n t a l t a s k s of a d o l e s c e n c e demand t h a t t h e y f o c u s upon t h e e s t a b l i s h m e n t of t h e l o c u s of p o w e r / c o n t r o l more i n t h e s e l f . By i n v i t i n g power s t r u g g l e s t h e y may a c t u a l l y be t r y i n g t o t a k e s e l f - c o n t r o l , a l b e i t i n a d y s f u n c t i o n a l way. They t o o may v i e w power and c o n t r o l as synonymous, and see i t as an a l l or n o t h i n g s i t u a t i o n . These a d o l e s c e n t s may e n t e r a r e s o u r c e t h i n k i n g , "You're not g o i n g t o c o n t r o l me!". The a d o l e s c e n t s whose s t a n c e i s t o g i v e t h e i r power away, a c c o r d i n g t o t h e s t a f f , may t r y hard t o p l e a s e . They may be v e r y needy, and may expect o t h e r s t o save them. The a d o l e s c e n t ' s p a r t i c u l a r s t a n c e f u r t h e r p r e p a r e s the s i t u a t i o n f o r abuse t o o c c u r . T h e i r s e n s i t i v i t y t o i s s u e s of power and c o n t r o l and t h e i r l e a r n e d p a t t e r n s of c o p i n g may make them v u l n e r a b l e e i t h e r t o r e v i c t i m i z a t i o n or t o a b u s i n g o t h e r s . Are t h e r e a l s o moments when t h e a d o l e s c e n t s a r e more l i k e l y t o r e a c t i n h u r t f u l ways? I t would f o l l o w f o r the a d o l e s c e n t s , t o o , t h a t moments of s t r e s s , n e e d i n e s s , and f e e l i n g t h r e a t e n e d , c o u l d a l s o t r i g g e r them t o a c t i n h u r t f u l ways which c o u l d p r e c i p i t a t e t h e c y c l e . In summary, t h e d a t a from t h e p a r t i c i p a n t s of t h i s s t u d y , -108-the documents, and the o b s e r v a t i o n s provided a r i c h a r r a y of i n f o r m a t i o n which f i t i n t o an e c o l o g i c a l framework of c h i l d maltreatment. T h i s model helps us to understand how our macro and micro-systems i n t e r f a c e t o r e p l i c a t e the process of abuse i n the v e r y o r g a n i z a t i o n s which are supposed to t r e a t t h i s problem. T h i s leads us t o c o n s i d e r the i m p l i c a t i o n s of the f i n d i n g s of t h i s study. -109-Chapter F i v e : D i s c u s s i o n The o r i g i n a l r e s e a r c h q u e s t i o n s which formed t h e b a s i s f o r t h e s t u d y f o c u s s e d on d i s c o v e r i n g t h e components of c a r e a t P h o e n i x House, t h e p r o c e s s of change t h a t t h e a d o l e s c e n t s e x p e r i e n c e d , ways t h a t group homes can m i n i m i z e t h e r i s k of r e p l i c a t i n g abuse, and what a f e m i n i s t p e r s p e c t i v e c o u l d b r i n g t o group home c a r e . The key component of c a r e t h a t c o m p r i s e s P h o e n i x House i s i t s i n n o v a t i v e p h i l o s o p h y based on p r i n c i p l e s of m u t u a l i t y and f o c u s s e d on u n d e r s t a n d i n g t h e e f f e c t s of abuse. The p h i l o s o p h y on which t h i s model r e s t s i s i n d i r e c t c o n t r a s t w i t h a model which r e p l i c a t e s t h e a b u s i v e p r o c e s s . M u t u a l i t y i m p l i e s e q u a l i t y , r e s p e c t , and n u r t u r a n c e i n an open system where t h e r e i s a two-way f l o w of feedback and power. I n t h i s s ystem, power i m p l i e s empowerment, not c o n t r o l - o v e r . T h i s new model of r e l a t i o n s h i p as mutual and t h i s new v i s i o n of power as empowerment a r e e s s e n t i a l i n g r e d i e n t s i n t h i s i n n o v a t i v e model of group home c a r e . T h e o r e t i c a l I m p l i c a t i o n s When comparing t h e p h i l o s o p h y of P h o e n i x House w i t h t h e l i t e r a t u r e , i t i s c l e a r t h a t the model r e f l e c t s what i s c u r r e n t l y b e i n g d i s c u s s e d as a f e m i n i s t framework of c a r e . The e s s e n t i a l p r i n c i p l e s of m u t u a l i t y and empowerment a r e d i s c u s s e d by S u r r e y (1987) when she d e s c r i b e s a f e m i n i s t model of t r e a t m e n t . D a l l e y ' s (1988) d i s c u s s i o n of a f e m i n i s t model of c a r e which promotes r e s p o n s i b i l i t y and f l e x i b i l i t y , -110-and focuses on d e v e l o p i n g r e l a t i o n s h i p s , s k i l l s , and s e c u r i t y , appears to m i r r o r the p r i n c i p l e s of Phoenix House. A p h i l o s o p h y which cannot be o p e r a t i o n a l i z e d , however, remains hollow. The second key to Phoenix House, then, i s t h a t i t s p h i l o s o p h y has been brought to l i f e w i t h i n a r e l a t i o n a l context which nu r t u r e s and c h a l l e n g e s i n d i v i d u a l s to grow. The s t a f f c a r r i e s t h i s out through an ongoing process of d i a l o g u e and n e g o t i a t i o n which teaches problem s o l v i n g s k i l l s and p r o v i d e s an a l t e r n a t i v e r o l e model. The s t a f f are r e s p o n s i b l e f o r t h r e e primary t h e r a p e u t i c t a s k s ; c o n n e c t i n g , t e a c h i n g and c h a l l e n g i n g . By o p e r a t i o n a l i z i n g i t s p h i l o s o p h y i n a r e l a t i o n a l c o n t e x t , Phoenix House i s demonstrating an a p p l i c a t i o n of s e l f - i n - r e l a t i o n t heory. The work of Surrey (1987), and Kaplan and K l e i n (1985) document t h i s model of s e l f - g r o w t h through c o n n e c t i o n . The recommendation of M i l l e r (1984) and Kaplan and Surrey (1984), t h a t where there has been a d e f i c i t of r e l a t i o n a l experience t h i s needs to be experienced i n order  f o r the s e l f to continue to strengthen and grow, comes to l i f e i n the work of Phoenix House. The primary importance t h a t the a d o l e s c e n t s i n the study placed on t h e i r experience of " f e e l i n g cared f o r " f u r t h e r supports the c e n t r a l tenants of s e l f - i n - r e l a t i o n t heory. I t was o n l y when the young women f e l t t h a t they c o u l d t r u s t the s t a f f , t h a t they d e s c r i b e d "opening up". Thus, the c r u c i a l v a r i a b l e which determined f u r t h e r growth was the establishment of a s a f e , c l o s e r e l a t i o n s h i p . The f a c t t h a t a l l of the - I l l -a d o l e s c e n t s wanted a c l o s e r connection with t h e i r mothers d e s p i t e t h e i r p a i n f u l h i s t o r y with them supports the work of Gleason (1985) and Kaplan and K l e i n (1985). T h i s deep need f o r c o n n e c t i o n with o t h e r s , and e s p e c i a l l y , as women, with our mothers, was e l o q u e n t l y expressed by the a d o l e s c e n t s . "We're always c h a s i n g our mothers," was the way one of the ado l e s c e n t s d e s c r i b e d i t . The v o i c e s of the ad o l e s c e n t s i n t h i s study a l s o r e f l e c t the work of Belenky, C l i n c h y , Goldberger and T a r u l e (1986) as d e s c r i b e d i n Chapter Two. They d e s c r i b e d the women i n t h e i r study " f i n d i n g a v o i c e " . A f t e r the young women experienced s a f e t y and c a r i n g at Phoenix House, they too began to f i n d a v o i c e . I t i s i n t e r e s t i n g t h a t these i n i t i a l l y s i l e n t a d o l e s c e n t s were v i c t i m s of v i o l e n c e , as were the " s i l e n t " women i n the study of Belenky et a l . The newest r e s i d e n t i s s t i l l i n a p o s i t i o n of r e l a t i v e s i l e n c e . Some of the a d o l e s c e n t s r e f l e c t e d the p o s i t i o n of " r e c e i v e d knower" as they l e a r n e d the power of empowerment. Others spoke l i k e " s u b j e c t i v e knowers", v i v i d l y d e s c r i b i n g themselves as "changing" and "becoming the r e a l me". When the ad o l e s c e n t s spoke of "making d e c i s i o n s " and " t a k i n g charge" of t h e i r l i v e s , they spoke i n tones r e m i n i s c e n t of the work of G i l l i g a n (1982). Her t h e s i s t h a t women's v o i c e s resonate with an e t h i c of r e s p o n s i b i l i t y based on a s e l f - c o n c e p t of connectedness and c a r i n g echoes what the ado l e s c e n t s i n t h i s study were beginning t o move towards. The theme of t a k i n g charge r e f l e c t e d a process of becoming -112-more r e s p o n s i b l e f o r one's b e h a v i o r and engaging i n more r e s p o n s i b l e r e l a t i o n s h i p s w i t h o t h e r s . The a d o l e s c e n t s ' p e r c e p t i o n s changed from v i e w i n g themselves as a l o n e and a t t i m e s v i o l e n t , t o d e s c r i b i n g t h e m s e l v e s as "more c a r i n g " . T h i s seems t o s i g n i f y a s h i f t from estrangement t o r e s p o n s i b l e r e l a t i o n s h i p . How does t h e t h e o r e t i c a l model of r e p l i c a t i n g abuse which emerged from t h e d a t a f i t w i t h o t h e r t h e o r i e s i n the l i t e r a t u r e ? As p r e v i o u s l y mentioned t h e d a t a s u p p o r t e d t h e e c o l o g i c a l framework of a d o l e s c e n t m a l t r e a t m e n t d e s i g n e d by G a r b a r i n o , S c h e l l e n b a c h and Sebes (1986) which a n a l y z e s t h e many l a y e r s of a b u s i v e c o n d i t i o n s i n our s o c i e t y . One might ask what i s t h e importance of a d d r e s s i n g t h e r e p l i c a t i o n of abuse i n a s t u d y concerned w i t h s e x u a l l y abused a d o l e s c e n t s i n c a r e ? S t u d i e s a r e now showing t h a t i t i s common f o r women who have had a h i s t o r y of s e x u a l abuse t o become r e v i c t i m i z e d by rape or by w i f e - b a t t e r i n g ( R u s s e l l , 1986; Browne & F i n k e l h o r , 1986). T h i s v u l n e r a b i l i t y t o r e v i c t i m i z a t i o n i m p l i e s t h a t c a r e - g i v e r s must be v e r y s e n s i t i v e t o t h e i r own misuse of power w i t h c l i e n t s who have an abuse h i s t o r y . T h i s model i l l u s t r a t e s j u s t how d i f f i c u l t t h i s i s i n a s o c i e t y which p e r p e t u a t e s a b u s i v e r e l a t i o n s h i p s a c r o s s gender and age d i f f e r e n t i a l s , or e s s e n t i a l l y , a c r o s s any power d i f f e r e n t i a l . The p a r t i c i p a n t s i n t h i s s t u d y viewed t h e i d e o l o g i e s of p a t r i a r c h y and c a p i t a l i s m as p a r t of t h e l a r g e r problem of s e x u a l abuse. F u r t h e r m o r e , t h e y p e r c e i v e d t h a t the i d e o l o g y of t h e macrosystem was f i r m l y e n t r e n c h e d i n t o t h e v e r y -113-p r i n c i p l e s o f p r a c t i c e w i t h c h i l d r e n i n c a r e . T h i s i s a f r i g h t e n i n g f i n d i n g . I t l e a d s one t o c o n s i d e r t o what e x t e n t government funded i n s t i t u t i o n s which d e l i v e r s o c i a l s e r v i c e s m i r r o r t h e same p h i l o s o p h y as t h e government, r e g a r d l e s s of how e f f e c t i v e , or how a n t i t h e t i c t o p r o f e s s i o n a l v a l u e s , t h i s p h i l o s o p h y i s . The mesosystem was t h a t system which G a r b a r i n o viewed as p o t e n t i a l l y r e s p o n s i b l e f o r p e r p e t u a t i n g i s o l a t i o n from p e e r s . T h i s i s an i n t e r e s t i n g p o i n t t o ponder as one r e f l e c t s upon the c u r r e n t l y p o p u l a r model of p a r e n t c o u n s e l o r homes. Does t h i s model of c a r e a c t u a l l y l e a v e a d o l e s c e n t s more v u l n e r a b l e t o abuse? The f i n d i n g s of t h i s s t u d y would appear t o s u g g e s t t h i s might be s o , i n p a r t i c u l a r w i t h t h o s e a d o l e s c e n t s l a b e l l e d as " a c t i n g - o u t " . T h i s c l e a r l y i s an a r e a which needs f u r t h e r i n v e s t i g a t i o n . T h i s e c o l o g i c a l framework s u g g e s t s t h a t t h e l e v e l of t h e m i c r o s y s t e m i s one p l a c e where the i n t e r g e n e r a t i o n a l c y c l e of abuse can be h a l t e d . T h i s r e l a t i o n a l l e v e l i s t h e p o i n t a t which a g r e a t d e a l of t h e work a t Phoenix House t a k e s p l a c e . T h i s s t u d y would s u g g e s t t h a t t h e s t y l e or p r o c e s s of i n t e r a c t i o n between a t l e a s t two i n d i v i d u a l s i s c r u c i a l i n e i t h e r p e r p e t u a t i n g a b u s i v e p a t t e r n s or b r e a k i n g them. There i s an u r g e n t need f o r l o n g t e rm f o l l o w up s t u d i e s of a d o l e s c e n t s i n c a r e . Only w i t h t i m e w i l l we know i f t h e c y c l e of abuse has t r u l y been broken f o r t h e s e young women. L a s t l y , G a r b a r i n o e t a l p o i n t t o t h e d i f f e r e n t i a l degree of v u l n e r a b i l i t y of each i n d i v i d u a l which u l t i m a t e l y -114-i n f l u e n c e s t h e impact t h a t the abuse w i l l have. T h i s s t u d y would s u g g e s t t h a t t h e s t r e n g t h s and r e s i l i e n c y of each i n d i v i d u a l a r e a l s o a f a c t o r a t t h i s l e v e l which cannot be d i s c o u n t e d . " A c t i n g o u t " reframed as "re-enactment" s h o u l d a l e r t us t h a t t h e s e a d o l e s c e n t s a r e t r y i n g t o t e l l us about t h e i r p a i n , which t h e y cannot b r i n g t o v o i c e . Running, t o o , c o u l d be reframed as an a c t of s t r e n g t h , s e e k i n g s a f e t y i n a t o o o f t e n dangerous w o r l d . The w e a k n e s s e s / s t r e n g t h s of t h e s e a d o l e s c e n t s may be i n the eye of t h e b e h o l d e r , w a i t i n g t o be named f o r what t h e y r e a l l y a r e . I t appears from t h e f i n d i n g s t h a t P h o e n i x House c o u l d be viewed as a f e m i n i s t model of c a r e which o p e r a t i o n a l i z e s s e l f -i n - r e l a t i o n t h e o r y . T h i s i s an i m p o r t a n t f i n d i n g as f e m i n i s t s a r e j u s t now b e g i n n i n g t o document how t h e y would o p e r a t i o n a l i z e new models of c a r e . To my knowledge, t h e r e i s no d o c u m e n t a t i o n i n t h e l i t e r a t u r e p o r t r a y i n g a f e m i n i s t model of group home c a r e . P r a c t i c a l I m p l i c a t i o n s One of t h e e s s e n t i a l components of c a r e which c o m p r i s e s P h o e n i x House r e f l e c t s a c a r e f u l c o n s i d e r a t i o n of what c o n s t i t u t e s e f f e c t i v e t r e a t m e n t f o r a d o l e s c e n t s e x u a l abuse s u r v i v o r s . The emphasis on groups and t h e use of a r t t h e r a p y a r e both documented as e f f e c t i v e modes of work w i t h t h i s p o p u l a t i o n (eg. G a g l i a n o , 1987; Herman, 1981; & S g r o i , 1982). The t h r e e t a s k s of the s t a f f which emerged f i t w i t h l i t e r a t u r e documenting t h e p r o c e s s and g o a l s of t r e a t m e n t w i t h abuse -115-s u r v i v o r s . T h i s l i t e r a t u r e u n d e r l i n e s t h e importance of e s t a b l i s h i n g a r e l a t i o n s h i p of t r u s t and v i e w i n g " a c t i n g - o u t 1 1 b e h a v i o r as a s u r v i v a l r e s p o n s e . (eg. E v e r s t i n e & E v e r s t i n e , 1989; L i n d b e r g & D i s t a d , 1985). I n p a r t i c u l a r , e x p l o r i n g t h e meaning of b e h a v i o r r a t h e r t h a n f o c u s i n g on e x t i n g u i s h i n g the b e h a v i o r i s s t r o n g l y s u p p o r t e d by E v e r s t i n e and E v e r s t i n e . The s e n s i t i v i t y t o i s s u e s of power and c o n t r o l a t Ph o e n i x House i s a l s o w e l l s u p p o r t e d by d e v e l o p m e n t a l l i t e r a t u r e r e g a r d i n g s e x u a l l y abused a d o l e s c e n t s (eg. F i n k e l h o r & Browne, 1986; Newberger & De Vos, 1988). T h i s f i n d i n g s u g g e s t s t h a t e f f e c t i v e t r e a t m e n t f o r s e x u a l abuse s u r v i v o r s can be t r a n s f o r m e d i n t o a t h e r a p e u t i c m i l i e u when i n t e g r a t e d i n t o a group c a r e s e t t i n g . T h i s can be a c c o m p l i s h e d w i t h an emphasis on d e v e l o p i n g m u t u a l l y empowering r e l a t i o n s h i p s where b e h a v i o r i s r eframed and the meaning beh i n d i t e x p l o r e d . The a d o l e s c e n t s ' l i f e s t o r i e s p l a c e i n s h a r p r e l i e f t h e f o u r traumagenic e f f e c t s of s e x u a l abuse o u t l i n e d by Browne and F i n k e l h o r (1986); t r a u m a t i c s e x u a l i z a t i o n , s t i g m a t i z a t i o n , b e t r a y a l , and p o w e r l e s s n e s s . They p a i n f u l l y d e s c r i b e d how t h e i r s e x u a l i z a t i o n p r e p a r e d them f o r p r o s t i t u t i o n and l e f t them w i t h low s e l f - w o r t h , an i n a b i l i t y t o t r u s t o t h e r s and a s e n s i t i v i t y t o p o w e r l e s s n e s s . The a d o l e s c e n t s i n t h i s s t u d y d i d not remain i n t h i s v i c t i m i z e d p o s i t i o n , however. They p e r c e i v e d t h a t an ou t g r o w t h of l i v i n g a t P h o e n i x House f o r them was t h a t , o f t e n f o r t h e f i r s t t i m e , t h e y were a b l e t o b e g i n t o t r u s t o t h e r s . In t h i s c o n t e x t t h e y d e s c r i b e d themselves "opening up", b e g i n n i n g t o " r e a l l y t a l k " , and then -116-" s e e i n g more c l e a r l y " how b e i n g abused had a f f e c t e d t h e i r v i e w of t h e m s e l v e s and t h e i r r e l a t i o n s h i p s . As t h e a d o l e s c e n t s g a i n e d c l a r i t y t h e y began t o "take c h a r g e " of t h e i r l i v e s , making d e c i s i o n s t o break o l d p a t t e r n s of u n h e a l t h y b e h a v i o r and r e l a t i o n s h i p s . One of t h e changes t h a t a l l t h e a d o l e s c e n t s d e s i r e d was t o have a b e t t e r r e l a t i o n s h i p w i t h t h e i r f a m i l i e s , and p a r t i c u l a r l y t h e i r mothers. The d i f f i c u l t y t h a t t h e a d o l e s c e n t s had i n r e c o n n e c t i n g w i t h t h e i r f a m i l i e s i n more h e a l t h y ways p o i n t s t o t h e g r e a t need f o r i n t e r v e n t i o n w i t h t h i s subsystem w h i l e c h i l d r e n a r e i n c a r e . The l a c k of any t h e r a p e u t i c s e r v i c e f o r f a m i l i e s whose c h i l d r e n a r e i n c a r e c r e a t e s f u r t h e r problems f o r a d o l e s c e n t s when t h e y a r e r e a d y t o c o n s i d e r moving back home. As one worker s t a t e d , a l t h o u g h the a d o l e s c e n t s have t o prove i n c o u r t t h a t t h e y a r e now w i l l i n g t o obey t h e i r p a r e n t s , t h e p a r e n t s do not have t o prove t h a t t h e i r p a r e n t i n g s k i l l s have improved. C o n s e q u e n t l y , c h i l d r e n may r e t u r n t o f a m i l y s i t u a t i o n s w hich remain e m o t i o n a l l y a b u s i v e . There i s c l e a r l y a need f o r s e r v i c e s t o p a r e n t s t o s u p p o r t them i n c h a n g i n g t h e i r r e l a t i o n s h i p w i t h t h e i r a d o l e s c e n t , and p o s s i b l y t o p r e p a r e them f o r t h e a d o l e s c e n t ' s r e t u r n home. One l a s t component of c a r e a t P h o e n i x House needs t o be more f u l l y a d d r e s s e d . T h i s i s t h e impact of t h e manager. The i n d i v i d u a l who i n t e g r a t e s and models t h i s i n n o v a t i v e p h i l o s o p h y i s t h e group home manager. The manager c l e a r l y i s . Phoenix House, as one p a r t i c i p a n t responded. Her v i s i o n , -117-knowledge and unique p e r s o n a l i t y work t o g e t h e r t o i n s p i r e i n the s t a f f and a d o l e s c e n t s a l i k e , a new way of c a r i n g . I t i s not u n u s u a l t h a t the manager s h o u l d have such a profound i n f l u e n c e on t h e home. Diamond (1984) documents how t h e p h i l o s o p h y , p e r s o n a l i t y and a c t i o n s of t h e a d m i n i s t r a t o r d i r e c t l y i n f l u e n c e t h e e f f e c t i v e n e s s of t h e t h e r a p e u t i c m i l i e u . T h i s f i n d i n g l e a d s one t o suggest t h a t one c o u l d not s i m p l y r e p l i c a t e P h o e n i x House. I n s t e a d , group home managers s h o u l d be chosen because t h e y demonstrate a w e l l d e v e l o p e d s e t of p r i n c i p l e s , knowledge, and s k i l l about t h e needs of c h i l d r e n and about what c o n s t i t u t e s good t r e a t m e n t f o r abused c h i l d r e n and a d o l e s c e n t s . The system s h o u l d be r e s p o n s i b l e f o r p r o m o t i n g t h e development of t h e s e s k i l l s when t h e y a r e l a c k i n g . F u r t h e r m o r e , t h e p a r t i c u l a r s t y l e of t h e a d m i n i s t r a t o r w i l l have a prof o u n d i n f l u e n c e on t h e s t a f f and r e s i d e n t s a l i k e . What t h e n i s t h e t y p e of a d m i n i s t r a t i v e s t y l e t h a t the manager a t Phoenix House employs? The a d m i n i s t r a t i v e s t y l e of t h e manager a t Ph o e n i x House f i t s w i t h what has been documented as a f e m i n i s t model. Hooyman and Cunningham (1986) c o m p i l e d d a t a from 200 q u e s t i o n n a i r e s s e n t t o f e m i n i s t o r g a n i z a t i o n s i n t h e U n i t e d S t a t e s and conducted a s t u d y of 20 o r g a n i z a t i o n s t o e x p l o r e what a f e m i n i s t a d m i n i s t r a t i v e s t y l e i m p l i e s . They s u g g e s t t h a t a f e m i n i s t s t y l e i s n o n - h i e r a r c h i c a l , r e c o n c e p t u a l i z e s and r e d i s t r i b u t e s power, r e l i e s on j o i n t problem s o l v i n g , encourages t h e s e l f - d e t e r m i n a t i o n of i n d i v i d u a l s r a t h e r t h a n c o n t r o l l i n g o t h e r s , and v a l u e s p r o c e s s , which i m p l i e s -118-promoting l o n g - t e r m e f f e c t i v e n e s s r a t h e r t h a n s h o r t - t e r m e f f i c i e n c y . These themes c l e a r l y f i t w i t h t h e observed c h a r a c t e r i s t i c s of the manager's p a r t i c u l a r s t y l e and s e t of v a l u e s . There i s no doubt t h a t t h e manager's p a r t i c u l a r s t y l e has p r o f o u n d l y shaped the development of t h i s unique group home. What a r e t h e p r a c t i c a l i m p l i c a t i o n s of t h i s model which a t t e m p t s t o a v o i d r e p l i c a t i n g t h e a b u s i v e p r o c e s s ? T h i s model c h a l l e n g e s our v e r y d e f i n i t i o n of abuse. I t pushes us t o loo k beyond i n t e r p e r s o n a l c o n f l i c t a t t h e same time as c h a l l e n g i n g our i n t e r p r e t a t i o n of h e a l t h y i n t e r p e r s o n a l r e l a t i o n s h i p s . F i r s t , on t h e i n t r a - p s y c h i c l e v e l we must examine our a t t i t u d e s about e q u a l i t y , c h i l d r e n and t h e use of f o r c e ? When do we see i t as j u s t i f i e d t o use our power over c h i l d r e n and a d o l e s c e n t s ? What a r e t h e s p e c i f i c s i t u a t i o n s t h a t t r i g g e r our anger? T h i s model i m p l i e s t h a t a l l p r a c t i t i o n e r s s h o u l d have a w o r k i n g knowledge about t h e e f f e c t s of abuse, and be pre p a r e d t o d i s c u s s i t w i t h a d o l e s c e n t s when t h e i r b e h a v i o r i n d i c a t e s a p o s s i b l e h i s t o r y . T h i s a l s o i m p l i e s t h a t we as p r a c t i t i o n e r s must be p r e p a r e d t o look a t t h e r o l e abuse has p l a y e d i n our p e r s o n a l l i v e s . On an i n t e r p e r s o n a l l e v e l we must be w i l l i n g t o t a l k about how we use our power d e s t r u c t i v e l y i n r e l a t i o n t o t h e c l i e n t s we work w i t h , i n p a r t i c u l a r w i t h abuse s u r v i v o r s . We must become aware of t h e power t a c t i c s which we use t o g a i n c o n t r o l w i t h o t h e r s . F u r t h e r m o r e , we must be a l e r t f o r th e w a r n i n g s i g n s t h a t t e l l us t h a t when we may be v u l n e r a b l e -119-t o " l o s i n g i t " , such as f e e l i n g a n g r y , o v e r l y r e s p o n s i b l e , and b u r n t - o u t . T h i s model pushes us beyond t h e i n t e r p e r s o n a l l e v e l . I t a l s o c h a l l e n g e s t h e way i n which we s t r u c t u r e o r g a n i z a t i o n s . Do group homes i n v i t e a two-way f l o w of feedback? Does t h e home model n e g o t i a t i o n by i n v o l v i n g a d o l e s c e n t s i n the d e c i s i o n s which a f f e c t them (eg. c o n f e r e n c e s ) ? Does t h e group home g i v e t h e message t h a t i t i s not l e g i t i m a t e t o c o n t r o l c h i l d r e n ? Does t h e home model a s t y l e of r e l a t i o n s h i p which i s c a r i n g , e g a l i t a r i a n and p r o f o u n d l y r e s p e c t f u l f o r the i n d i v i d u a l and t h e i r b e h a v i o r ? Does t h e home nudge a d o l e s c e n t s t o examine t h e meaning beh i n d t h e i r b e h a v i o r ? F i n a l l y , do t h e s t a f f r e a l l y t a l k about abuse i s s u e s ? The e x p e r i e n c e of t h e a d o l e s c e n t s i n t h i s s t u d y was t h a t v i r t u a l l y no one i n group homes had ever t a l k e d w i t h them about abuse b e f o r e . T h i s was s u p p o r t e d by the o b s e r v a t i o n s of t h e s t a f f and t h e r e f e r r i n g a g e n t s . Even i f t h i s f i n d i n g cannot be g e n e r a l i z e d , i t i s s t i l l s h o c k i n g * G i v e n t h e p r e v a l e n c e of th e problem of abuse i n our s o c i e t y , and among a d o l e s c e n t s i n c a r e , i t s h o u l d be a r o u t i n e t o p i c a t group homes. The s t a g g e r i n g number of placements t h a t t h e s e e i g h t a d o l e s c e n t s e x p e r i e n c e d (63 i n t o t a l ) i s a c l e a r i n d i c a t i o n t h a t t h e system has abused them. What p o l i c i e s e x i s t which a l l o w such a l e v e l of r e v i c t i m i z a t i o n of a d o l e s c e n t s who have a l r e a d y been abused? I would suggest t h a t an i n v e s t i g a t i o n i n t o t h e causes of u n s t a b l e c a r e be c a r r i e d out so as t o un d e r s t a n d t h i s phenomena and t o work towards i t s p r e v e n t i o n . -120-The r e s u l t s of t h i s s t u d y would suggest t h a t one of the causes of m u l t i p l e placements i s t h a t abuse s u r v i v o r s a r e e s s e n t i a l l y reabused i n c a r e . F u r t h e r r e s e a r c h here i s c l e a r l y needed. I n a d d i t i o n , p r o c e d u r e s t o r e p o r t i n s t i t u t i o n a l abuse s h o u l d be i n s t i t u t e d i n B r i t i s h Columbia. C h i l d r e n i n c a r e s h o u l d a l s o be t o l d of t h e i r r i g h t s , as i n p r o v i n c e s l i k e O n t a r i o , where t h e s e r i g h t s a r e e n s h r i n e d i n l e g i s l a t i o n . B r i t i s h Columbia's F a m i l y and C h i l d S e r v i c e s A c t i s i n g r e a t need of r e v i s i o n t o b r i n g i t up t o the s t a n d a r d s of o t h e r p r o v i n c e s i n Canada. What a r e t h e broader i m p l i c a t i o n s of t h e s e f i n d i n g s f o r s o c i a l work? I m p l i c a t i o n s f o r S o c i a l Work S o c i a l work, as p r e v i o u s l y mentioned, has a g r e a t i n v e s t m e n t i n t h e group home c a r e f i e l d . T h i s s t u d y s u g g e s t s t h a t when t h e r e i s a t t e n t i o n f o c u s s e d on t h e s p e c i f i c d e v e l o p m e n t a l needs of s e x u a l l y abused a d o l e s c e n t s w i t h i n a framework which s t r e s s e s p r i n c i p l e s of e f f e c t i v e t r e a t m e n t f o r t h i s p o p u l a t i o n , t h a t even t h o s e a d o l e s c e n t s who a r e t h e most d i f f i c u l t t o p l a c e can l e a r n t o t r u s t and b e g i n a p r o c e s s of s e l f - d i s c o v e r y i n a group c a r e s e t t i n g . Thus, group homes need t o ensure t h a t t h e y a r e mode l i n g h e a l t h y r e l a t i o n s h i p s w i t h i n a f l e x i b l e program which b r i n g s a d o l e s c e n t s t o speech, encourages s e l f - u n d e r s t a n d i n g , and r e s p e c t f u l l y c h a l l e n g e s . The r e s e a r c h and t h e l i t e r a t u r e b o th s u g g e s t t h a t f o c u s s i n g s o l e l y on b e h a v i o r , e s p e c i a l l y w i t h s e x u a l l y abused a d o l e s c e n t s , i s a common e r r o r which s e r v e s t o breed m i s t r u s t . -121-T h i s f i n d i n g l e a d s one t o q u e s t i o n the r e c e n t emphasis on b e h a v i o r management programs f o r a d o l e s c e n t s , and t o p o s t u l a t e t h a t t h e s e w i l l be i n e f f e c t i v e w i t h s e x u a l l y abused a d o l e s c e n t s who " a c t - o u t " . T h i s i s an avenue of r e s e a r c h which remains t o be e x p l o r e d . Even more b a s i c t h a n t h e s p e c i f i c t r e a t m e n t model, t h i s s t u d y s u g g e s t s t h a t t h e r e i s a need f o r deeper e d u c a t i o n r e g a r d i n g t h e e f f e c t s of s e x u a l abuse and t h e d e v e l o p m e n t a l needs of abused a d o l e s c e n t s f o r both s o c i a l workers and c h i l d c a r e workers i n t h e c h i l d p r o t e c t i o n system. The anecdotes of the p a r t i c i p a n t s s u g g e s t t h a t t h e r e i s an urgen t need f o r th o s e w i t h i n t h e system t o g r a s p a broader p e r s p e c t i v e about the p r o c e s s of abuse. Indeed, i t appears as i f a paradigm s h i f t has o c c u r r e d among t h e p a r t i c i p a n t s of t h i s s t u d y . Most of t h e p a r t i c i p a n t s c o u l d a n a l y z e abuse i n a s y s t e m i c way. T h i s e n a b l e d them t o r e f l e c t upon t h e i r own a c t i o n s which p e r p e t u a t e u n h e a l t h y r e l a t i o n s h i p s as w e l l as t h e ways i n which t h e system can abuse i n d i v i d u a l s . The a b i l i t y t o r e f l e c t upon t h e many di m e n s i o n s of the problem i s c r u c i a l f o r t h o s e who p r o v i d e c a r e t o abuse s u r v i v o r s . As w e l l as e d u c a t i o n about abuse, t h i s r e s e a r c h s u g g e s t s t h a t t h e r e i s a need t o i n t r o d u c e e d u c a t i o n a l m a t e r i a l r e g a r d i n g t h e s e l f - i n - r e l a t i o n d e v e l o p m e n t a l model f o r women i n t o c h i l d development c u r r i c u l a f o r b o t h s o c i a l w orkers and c h i l d c a r e w o r k e r s . F u r t h e r r e s e a r c h w i t h t h i s model i s a l s o needed i n o r d e r t o see more c l e a r l y t h e d e v e l o p m e n t a l i s s u e s of d i f f e r e n t ages and how d e v e l o p m e n t a l d e l a y s can be -122-overcome. Another recommendation t h a t a r i s e s from t h i s r e s e a r c h c o n c e r n s e v a l u a t i o n s of group homes. Such e v a l u a t i o n s s h o u l d h i g h l i g h t t h e v o i c e s of t h e c h i l d r e n and a d o l e s c e n t s i n c a r e . For t o o l o n g t h i s r e s e a r c h has f o c u s s e d e x c l u s i v e l y on the o p i n i o n s of a d m i n i s t r a t o r s , and a t t i m e s t h e c a r e g i v e r s . A l t h o u g h t h e s e o p i n i o n s a r e v a l i d , more c r u c i a l a r e the v o i c e s of consumers, no matter what t h e i r age. The a d o l e s c e n t s i n t h i s s t u d y v i v i d l y remind us of what i s e s s e n t i a l l y i m p o r t a n t i n t h e i r l i v e s , t h e presence of a ge n u i n e , c a r i n g r e l a t i o n s h i p which both n u r t u r e s and c h a l l e n g e s them. T h i s q u a l i t a t i v e s t u d y was conducted w i t h t h e a d o l e s c e n t s and s t a f f of one i n n o v a t i v e group home over a e i g h t month p e r i o d . One of t h e s h o r t c o m i n g s i s t h a t t h e r e s e a r c h was not lo n g - t e r m , and i n c l u d e d m i n i m a l f o l l o w up of d i s c h a r g e d r e s i d e n t s . Thus, we do not know t h e e x t e n t of l o n g - t e r m change of t h i s p o p u l a t i o n . Another f e a t u r e of the sample was t h a t a l l of t h e a d o l e s c e n t s were fema l e . A l t h o u g h t h i s a s s i s t e d comparisons t o t h e o r y about women's development, i t must be noted t h a t t h e s e r e s u l t s cannot n e c e s s a r i l y be g e n e r a l i z e d t o t h e e x p e r i e n c e s of a d o l e s c e n t males i n group homes. T h i s c o u l d be a f u r t h e r avenue f o r r e s e a r c h . P h o e n i x House was s e t up s p e c i f i c a l l y f o r s e x u a l l y abused s t r e e t k i d s . T h i s s t u d y does not r e v e a l whether t h i s model would work as e f f e c t i v e l y w i t h a d o l e s c e n t s who have d i f f e r e n t h i s t o r i e s , or w i t h younger c h i l d r e n . T h i s new model of group home c a r e i s c r y i n g out t o be -123-t e s t e d c o m p a r a t i v e l y , a l t h o u g h t h i s would be a d i f f i c u l t t a s k . How would t h i s model measure up a g a i n s t more t r a d i t i o n a l models i n terms of the p e r c e p t i o n s of t h e p a r t i c i p a n t s , and t h e b e h a v i o r a l outcomes of t h e r e s i d e n t s ? The t h e o r e t i c a l model of r e p l i c a t i n g t h e a b u s i v e p r o c e s s c o u l d a l s o be t e s t e d out c o m p a r a t i v e l y i n o t h e r s e t t i n g s f o r c h i l d abuse s u r v i v o r s i n o r d e r t o f u r t h e r expand the t h e o r e t i c a l model. T h i s r e s e a r c h i s an a d d i t i o n t o t h e growing body of knowledge about f e m i n i s t models of c a r e which a r e based on s e l f - i n - r e l a t i o n t h e o r y . I t a l s o s u p p o r t s an e c o l o g i c a l model of a d o l e s c e n t m a l t r e a t m e n t , f u r t h e r c l a r i f y i n g t h e r o l e of the many v a r i a b l e s which have a hand i n p e r p e t u a t i n g abuse i n our s o c i e t y . The f i n d i n g s about t h e p r o c e s s of change and t h e framework of r e p l i c a t i n g abuse can be g e n e r a l i z e d t o s o c i a l work p r a c t i c e i n o t h e r c o n t e x t s (eg. p s y c h i a t r i c wards) where t h e i r u t i l i t y remains t o be t e s t e d . C o n c l u s i o n T h i s r e s e a r c h c h a l l e n g e s t r a d i t i o n a l models of group home c a r e , and s u g g e s t s t h a t a l l group homes examine t h e i r v a l u e s and p r a c t i c e about t h e use of power w i t h a d o l e s c e n t s who a r e abuse s u r v i v o r s . I t d a r e s us t o examine t h e v e r y s t y l e of r e l a t i o n s h i p we have w i t h a d o l e s c e n t s , and s u g g e s t s t h i s i s p i v o t a l t o t h e r a p e u t i c work. Treatment need not be s e p a r a t e from group home c a r e , but i n f a c t i s c a r r i e d out t h r o u g h t h e  n a t u r e and the p r o c e s s of t h e r e l a t i o n s h i p s w i t h i n the home. David G i l (1977) s u g g e s t s i n h i s a r t i c l e t h a t p r i m a r y -124-p r e v e n t i o n of c h i l d s e x u a l abuse must be a p o l i t i c a l c h o i c e because t h e c a u s a l c o n t e x t has r o o t s i n our v e r y form of s o c i e t y . F e m i n i s t s would agree w i t h t h i s i m p l i c a t i o n , as we t o o see t h e p a t r i a r c h a l n a t u r e of our s o c i e t y as t h e c e n t r a l problem. S o c i a l work, h i s t o r i c a l l y , has a l s o acknowledged the i n t e r p l a y between t h e m i c r o and macrosystem. However, t h e r e may be more than one form of s o l u t i o n t o t h i s p e r s i s t e n t problem. F e m i n i s t s l i k e Shaef (1987) s u g g e s t a new paradigm of change based on a h o l o g r a p h where e v e r y change i n p a r t of t h e system i n f l u e n c e s t h e whole system. T h i s model would s u g g e s t t h a t p o l i t i c a l change i s one t y p e of change, but t h a t i n d i v i d u a l s w o r k i n g i n new ways w i l l a l s o g r a d u a l l y a f f e c t t h e whole. Thus, t h e r e a r e many arenas f o r change, i n t r a - p s y c h i c and i n t e r p e r s o n a l , i n s t i t u t i o n a l and s o c i e t a l . We need t o work towards change on a l l l e v e l s i n o r d e r t o e r a d i c a t e abuse i n our s o c i e t y . The p e r s o n a l i s t r u l y t h e p o l i t i c a l . F i n a l l y , t h i s r e s e a r c h r e i t e r a t e s t h a t s o c i a l work and f e m i n i s m i n t e r s e c t a t s e v e r a l c r u c i a l j u n c t u r e s . As Van Den Bergh and Cooper (1986) s t a t e , the Code of E t h i c s f o r s o c i a l w o rkers " m i r r o r s " f e m i n i s t p r i n c i p l e s and commitment t o a m e l i o r a t e t h e l i v e s of t h o s e who a r e oppressed by t h i s s o c i e t y , and t o work towards c h a n g i n g t h a t same s o c i e t y . Feminism a l s o p r o v i d e s a model which i n t e g r a t e s the h i s t o r i c dilemma of s o c i a l work - i n d i v i d u a l v e r s u s s o c i a l change ( M o r e l l , 1987). T h i s r e s e a r c h shows t h a t p r i n c i p l e s of f e m i n i s m can be o p e r a t i o n a l i z e d i n a group c a r e s e t t i n g , and -125-i n doing so, r e f l e c t good s o c i a l work p r a c t i c e . Not o n l y does the p r a c t i c e enable i n d i v i d u a l change, but i t a l s o c o n f r o n t s the s o c i a l order with a new v i s i o n of s o c i a l o r g a n i z a t i o n and f r e s h p o l i c y p e r s p e c t i v e s . As Van Den Bergh and Cooper s t a t e , Examining s o c i a l work through f e m i n i s t v i s i o n s p r o v i d e s a focus f o r p r o f e s s i o n a l p r a c t i c e and e ducation t h a t i s i n t e g r a t i v e , h o l i s t i c and e c o l o g i c a l . As such, these p e r s p e c t i v e s can be a s y n e r g i s t i c f o r c e a l l o w i n g f o r an accomplishment of s o c i a l work's unique m i s s i o n - f a c i l i t a t i n g s o c i a l change i n order to improve the q u a l i t y of l i f e (p. 25). -126-Bibliography Arkava, Morton & Lane, Thomas. (1983). Beginning s o c i a l work  research. Boston: Allyn & Bacon. Arnold, L e s l i e . (March, 1989). The role of the c h i l d care worker. In, Child Sexual Abuse Workshop. Symposium conducted by the Dept. of Continuing Education, U.B.C. Balcerzak, E., Mayer, M. & Richman, L. (1977). Group care of  children. New York: Child Welfare League of America. Banks, Kerry. (1989, Feb.). M i l l i o n Dollar Kids. 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Caring for troubled children. San Francisco: Jossey-Bass. Wodarski, John. (1987). Social work practice with children  and adolescents. S p r i n g f i e l d : Charles C. Thomas. Wolins, M. (1974). Successful group care. Berkeley: Aldine. Yin, Robert. (1986). Case study research: Design and methods. Beverly H i l l s : Sage. Young, T., Dore, M. & Pappenfort, D. (1988). Residential group care for children considered emotionally disturbed, 1966-1981. Social Service Review, March, 158-170. -133-Appendix A: E t h i c a l Approval and Consent from Phoenix House -136-Appendix B: Interview Consent Form - 1 3 8 -Appendix C: Interview Guide: Adolescents -139-I n t e r v i e w Guide: Adolescents P e r c e p t i o n s of Phoenix House 1. What's i t l i k e to l i v e at Phoenix House? 2. Where e l s e have you l i v e d ? 3. What's d i f f e r e n t about P.H. from other group homes? 4. What's good about P.H.? 5. What should be changed at P.H.? 6. T e l l me about some of the t u r n i n g p o i n t s f o r you a t P.H., moments t h a t stand out f o r you? In the preceding q u e s t i o n s probe f o r o p i n i o n s about the p h y s i c a l s t r u c t u r e of the house; the r o l e of the s t a f f , manager, and peer group; the r u l e s ; and the ways behavior, f e e l i n g s and abuse i s s u e s are addressed. P e r c e p t i o n s of s e l f i n the past 7. T e l l me about y o u r s e l f when you f i r s t came to P.H. (Probe f o r i s s u e s , f e e l i n g s , behavior, support network, and reason f o r placement.) 8. Think f o r a minute about when you l i v e d i n other group homes. What were problems f o r you, and how were these d e a l t with? (Probe f o r f e e l i n g s , behavior and i s s u e s r e l a t e d to abuse.) P e r c e p t i o n s of s e l f i n the present 9. Think about y o u r s e l f now. How would your best f r i e n d d e s c r i b e you? (Probe f o r age, i n t e r e s t s , a c t i v i t i e s , support network, f a m i l y s t r e n g t h s , weaknesses, and f e e l i n g s . 10. What i s s u e s are you working on know? Pe r c e p t i o n s of s e l f i n the f u t u r e 11. Take a minute and imagine y o u r s e l f f i v e years from now. What w i l l l i f e be l i k e f o r you? (Probe f o r s e l f -d e s c r i p t i o n , a c t i v i t i e s , and r e l a t i o n s h i p s . ) Impact of Phoenix House on t h e i r l i v e s 12. How has l i v i n g at P.H. changed you? 13. What's one t h i n g you learned at P.H. t h a t stands out f o r you. 14. What helps you now to cope with i s s u e s a r i s i n g from your abuse? 15. What advic e would you g i v e someone moving i n t o P.H.? 16. What other comments do you have about P.H. t h a t you would l i k e to make? Discharged a d o l e s c e n t s o n l y 17. How long ago d i d you leave P.H.? What were your reasons f o r l e a v i n g ? 18. What's your present l i v i n g arrangement? (Probe f o r a c t i v i t i e s , support network, f e e l i n g s , and i s s u e s . ) 19. Do you have any c o n t a c t with P.H. now? (Probe f o r nature and frequency of c o n t a c t . ) -140-Appendix D: Interview Guide: Key Informants -141-Interview Guide: Key Informants P e r c e p t i o n s of Phoenix House 1. What's i t l i k e to be a ( p o s i t i o n ) at P.H.? (Probe f o r the impact of t h e i r gender.) 2. There are many components of care i n a group home, f o r example, the philosophy; the r o l e of the manager, c h i l d c a r e s t a f f , and peer group; the p o l i c i e s and procedures; the group therapy and the a r t therapy. L e t s t a l k about some of these. (Probe f o r d e s c r i p t i o n s and p e r c e i v e d i n f l u e n c e . ) 3. In your o p i n i o n , what are the s t r e n g t h s of P.H.? What would you see as the weaknesses? P e r c e p t i o n s of the impact of P.H. 4. What changes do you see i n the ad o l e s c e n t s who l i v e at P.H./who you have r e f e r r e d to P.H.? (Probe f o r changes i n c o g n i t i v e p a t t e r n s , behavior and f e e l i n g s . ) Have you seen any p a r t i c u l a r p a t t e r n of change? What do you a t t r i b u t e the changes to? 5. In your o p i n i o n , what are the d i f f e r e n c e s t h a t you see between P.H. and other group homes. (Probe f o r ways a c t i n g out behavior, f e e l i n g s and abuse i s s u e s are addressed.) General p e r c e p t i o n s about group homes 6. Do you thin k there should be s p e c i f i c group homes f o r s e x u a l l y abused a d o l e s c e n t s ? Why or why not? (Probe f o r co-ed v s . gender s p e c i f i c . ) 7. What do you t h i n k are key i s s u e s i n group home treatment f o r s e x u a l abuse s u r v i v o r s ? 8. In your o p i n i o n , what does the M.S.S.H. promote as an e f f e c t i v e model f o r group home care? (Probe f o r o p i n i o n and suggestions.) 9. D i f f e r e n t people have d i f f e r e n t ideas about what an e f f e c t i v e group home i s . In your o p i n i o n , how do you know when a group home i s being e f f e c t i v e ? How do you know when P.H. i s being e f f e c t i v e ? 10. Some l i t e r a t u r e suggests t h a t there i s a r i s k of g e t t i n g hooked i n an abusive c y c l e (eg. power s t r u g g l e s ) when working with abuse s u r v i v o r s . What do you thin k about t h i s ? ( I f agree) How have you experienced t h i s ? How can group homes a v o i d t h i s ? 11. What other comments do you have about P.H. or group homes i n g e n e r a l ? Background Data - p o s i t i o n - education - l e n g t h of employment - p r e v i o u s work experience - what l e d you to t h i s type of work? - R e f e r r i n g agents: c l a r i f y f a c t s r e g a r d i n g t h e i r c l i e n t -142-Appendix E: Sample Interview - 1 4 3 -Sample Interview with a Discharged Adolescent The i n t e r v i e w began with a d i s c u s s i o n of the reasons f o r the i n t e r v i e w and the process of the i n t e r v i e w . The consent forms were e x p l a i n e d and sig n e d . I n t e r v i e w e r : How long d i d you l i v e at Phoenix House? Adolescent: Four y e a r s . I: And where d i d you l i v e b efore t h a t ? A: When they took me away from my dad I l i v e d i n a r e c e i v i n g home. From there I went t o a f o s t e r home. From the f o s t e r home I ran away. I was on the s t r e e t f o r s i x months, j u s t on my own. From there I went to another f o s t e r home, a group home, and an emergency home. There was t h i s other one, I was on l y there f o r about f i v e minutes before I decided I wasn't s t a y i n g t h e r e . And then I went back t o the s t r e e t s and got i n t o the emergency home. I: So how d i d you get to Phoenix House? A: Well, I was at the emergency home, and there was a lady who worked f o r L. (the manager). She t o l d me a b i t about Phoenix House and s a i d would I l i k e to come to a couple of the groups and see what i t was l i k e . And I s a i d O.K. I: So how many groups d i d you come to? A: Well they s o r t of messed up on t h a t . I went t o the f i r s t group and when I came home a l l my s t u f f was packed i n bags on the s t a i r s , and they moved me r i g h t i n . I wasn't supposed t o be i n f o r another three days. I: Hm. So you d i d n ' t have a l o t of time t o get used to the p l a c e . A: No. I: So what kept you moving to a l l the d i f f e r e n t group homes? A: We l l . I never r e a l l y l i k e d group homes. A l l I ever wanted was to be i n my own p l a c e . But t h a t wasn't p o s s i b l e . B a s i c a l l y I was l o o k i n g f o r some pl a c e t h a t I l i k e d . I: So you d i d n ' t l i k e the other p l a c e s . Do you have any ideas why? A: Because of the r u l e s and s t u f f . I: So what was i t l i k e f o r you to l i v e at Phoenix House? -144-A: W e l l , when I f i r s t moved i n i t was w e i r d , a l l t h e groups and s t u f f . I thought a l l t h e groups were s t u p i d and t h e r e was no p o i n t t o them. But I t h o u g h t , t h i s p l a c e i s c o o l , you can get away w i t h murder h e r e . I : So i t a p p e a l e d t o you t h a t t h e r e weren't a l o t of r u l e s ? A: Yeah. Everybody was n i c e and f r i e n d l y . And t h e r e weren't to o many r u l e s . I t h o u g h t , I ' l l t r y i t out f o r a w h i l e . I : So how was i t f o r you a f t e r you had l i v e d here f o r a w h i l e ? A: I l i k e d i t . W e l l , what happened a t the emergency home, what t h e y do t h e r e i s you have t o be i n e a r l y or t h e y l o c k t h e d o o r s . You can o n l y smoke i n t h e l i v i n g room, t h a t ' s i t . And you c a n ' t h e l p y o u r s e l f i n t h e f r i d g e , you have t o ask f i r s t . You have t o get up a t 9:00 i n t h e morning. But you can f i g h t w i t h them and not get up, but a t 12:00 t h e y get you up a g a i n . And t h e second t i m e , i f t h e y have t o p u l l you out of bed t o get you up, t h a t ' s what t h e y do. They never knock on your doors b e f o r e t h e y come i n . And t h e y watch e v e r y t h i n g you do, r e a l l y , and w r i t e i t down i n t h i s book. L i k e how many t i m e s you go t o t h e bathroom, what you do, how many t i m e s you t a l k on t h e phone. I : You f e l t l i k e you were b e i n g watched? A: Oh, I was. They s i t t h e r e a l l t h e time - t h e y watch you. I : Sounds p r e t t y u n c o m f o r t a b l e . A: Yeah. And then the g i r l s were g o i n g i n t o my room and g e t t i n g my c l o t h e s , and I c o u l d n ' t go i n t o t h e i r room and t a k e them back. So, i t wasn't t o o f a i r t h e r e . I : What was i t l i k e t o come here then? A: I t was r e a l l y d i f f e r e n t . I : What do you t h i n k i s d i f f e r e n t about P h o e n i x House from o t h e r group homes? A: For one t h i n g , you g e t a key t o t h e door so i t doesn't matter what time you come i n . You can always g e t i n t o the house. I : So what does t h e key mean t o you? A: L i k e i t s your p l a c e , not j u s t a group home. I : Where you f e e l some owne r s h i p , some r e s p o n s i b i l i t y ? A: Yeah. -145-I: So what else i s d i f f e r e n t ? A: You can help yourself to food and s t u f f . They don't turn the T.V. off at a cer t a i n time and make you go to bed. You don't have to get up at a cer t a i n time in the morning. There aren't too many rules. I: Any differences related to the s t a f f ? A: Yeah. The s t a f f aren't just here to do their work. They're more l i k e your friends and they care about you and what you're doing. I: And that wasn't the same in other places? A: No. The s t a f f here f e e l l i k e they are your roommates - l i k e i t s just a bunch of people l i v i n g together. Other places they play power t r i p s with you and s t u f f . Like, "I'm running the place and you've got to do what I say," and s t u f f l i k e that. I: So how did that make you feel? A: It just...mmmm (shakes f i s t ) . I: You f e l t angry? A: Yeah, I don't l i k e people who play power t r i p s with me. I: Was there anything d i f f e r e n t about the manager of the home? A: The manager of t h i s home i s r e a l l y good. Its hard to explain. Its l i k e she knows where everybody's coming from, how they are f e e l i n g and what's r e a l l y going on. She doesn't pressure you. Like, she s i t s back and gets to know you and s t u f f before she pushes anything on you, which i s good. I: So you f e e l safe then? A: You s t a r t getting to know her and by t h i s time she knows you and she knows how far she can push you to get you to talk and s t u f f . Other places, they just come up and they s t a r t asking you questions and you t e l l them to drop dead and just mind t h e i r own business. I: So, what's missing there at the other places? A: They don't care. They don't, r e a l l y . They just do the paper work. That's a l l they're worried about. I: What about differences in the groups? A: Well, other places don't have groups. Here, they have groups, and i f anything's bothering you, you can bring i t up. Other places they just punch each other out. Or nothing ever -146-g e t s r e s o l v e d . T h e r e ' s n o p r i v a c y a n d t h e r e ' s n o r e a l c o n s i d e r a t i o n f o r a n y b o d y . I : H o w i s i t t h a t t h i n g s g e t r e s o l v e d h e r e ? A : W e l l , b e c a u s e e v e r y b o d y s i t s a n d t a l k s a b o u t i t - t h e y h a v e t o t a l k a b o u t i t - y o u s o r t o f f e e l o b l i g a t e d . W e a r e o n l y a t g r o u p o n c e a w e e k , a n d e v e r y b o d y g e t s t o g e t h e r a n d y o u s i t d o w n a n d i t s l i k e y o u d o n ' t r e a l l y w a n t t o b e t h e r e , b u t y o u w o n ' t g e t u p a n d l e a v e . Y o u s t a y a n d t h e n y o u s t a r t t a l k i n g , a n d t h e n i t j u s t s o r t o f c o m e s . I : D o y o u e v e r f e e l u n c o m f o r t a b l e i n t h e g r o u p ? A : S o m e t i m e s I d o . S o m e t i m e s I f e e l f r u s t r a t e d b e c a u s e t h e y ' r e ( s o m e o f t h e n e w k i d s ) r e p e a t i n g t h e s a m e t h i n g s o v e r a n d o v e r . L i k e ( o n e o f t h e k i d s ) i s n ' t d o i n g a n y t h i n g , a n d t h e r e ' s o t h e r p e o p l e w h o r e a l l y n e e d h e l p . I : D o e s i t b o t h e r y o u t o h a v e s o m a n y a d u l t s i n t h e g r o u p w h o d o n ' t p a r t i c i p a t e ? A : I f s o m e o n e l o o k s l i k e t h e y ' r e h a v i n g a p r o b l e m a n d t h e y d o n ' t s a y n o t h i n g , t h e n t h a t b o t h e r s m e . T h e r e ' s t h i n g s h a p p e n i n g i n t h e i r l i f e a n d t h e y ' r e n o t t a l k i n g a b o u t i t , a n d t h a t ' s w h a t g r o u p s a r e f o r . I : S o y o u r e x p e c t a t i o n s a r e t h a t t h e a d u l t s w i l l s h a r e i s s u e s t h a t t h e y ' r e w o r k i n g o n t o o ? A : Y e a h , I t h i n k t h a t t h e y s h o u l d . I : D o e s t h a t g e n e r a l l y h a p p e n ? A : N o t u s u a l l y , s o m e t i m e s i t d o e s . I : I s t h e r e a r t t h e r a p y i n o t h e r g r o u p h o m e s ? A : N o , n o t a r t t h e r a p y . I : S o t h e r e ' s n o g r o u p s a t a l l i n t h e o t h e r p l a c e s ? A : T h e r e ' s n o g r o u p s - t h e r e ' s n o t h i n g t h e r e . N o t h i n g t o h e l p y o u w o r k o n y o u r p a s t - t o h e l p y o u g e t o v e r s t u f f - t h e y d o n ' t h a v e a n y o f t h a t . I : D o o t h e r p l a c e s t a l k t o y o u o n e - o n - o n e ? A : E v e n o n e ' s t h a t d o , b u t n o t v e r y m a n y , t h e y c o m e u p t o y o u a n d s a y , d o y o u w a n t t o w o r k o n y o u r p a s t ? A n d y o u s a y , n o . A n d t h e n t h a t ' s i t . T h e y d o n ' t p u s h i t w i t h y o u . T h e y j u s t l e a v e i t l i k e t h a t . I : A n y d i f f e r e n c e s w i t h t h e g r o u p o f k i d s h e r e a s c o m p a r e d t o -147-other p l a c e s ? A: At other p l a c e s they tend to be r i g h t i n t o working the s t r e e t s , and j u s t i n to doing drugs and p a r t y i n g . L i k e they're not i n t o going to s c h o o l or anything l i k e t h a t . I: Is t h a t p a r t of what happens here? A: W e l l , when I f i r s t got here, i t took me two years before I even s t a r t e d t h i n k i n g about s c h o o l . But I was working on i s s u e s and s t u f f t h a t I have with myself. I: So, was t h a t the same or d i f f e r e n t , t o work on i s s u e s ? A: That was r e a l l y d i f f e r e n t . I: Had you had t h a t o p p o r t u n i t y before? A: No. I d i d most of my work on my i s s u e s a l l on my own. I: Did you ever run i n t o s t r e e t workers when you were on the s t r e e t s ? A: No. I: Well, what do you t h i n k i s good about Phoenix House? L i k e , i f you were running a group home, what would you do the same? A: Well, I would have the groups, d e f i n i t e l y . I'd probably have the same r u l e s . I: What r u l e s ? A: Rules l i k e , no a l c o h o l and drugs i n the house, and no people i n a f t e r midnight, no guys i n you room, t h a t ' s about i t . I: Anything e l s e t h a t you'd have the same? A: Well, I'd make the environment the same. L i k e we a l l have our boundaries. L i k e , my room i s my room, and the s t a f f don't go i n . They ask me f i r s t . I: So you've got p r i v a c y , and your own space, and t h a t ' s important? A: Yeah. I: Does i t f e e l l i k e enough space here? A: Well, sometimes i t gets crowded, but then you can j u s t go to your own room, and t h a t ' s l i k e , your own p l a c e . I: So, does t h i s f e e l l i k e your place? - 1 4 8 -A: Yeah. I've moved out now, but i t ' s s t i l l my home and I'm mis s i n g i t . I: Anything e l s e t h a t stands out f o r you about Phoenix House? A: The manager, and the s t a f f . I: So, they make a b i g d i f f e r e n c e ? A: Yeah. I: Okay. What t h i n g s do you thin k should be changed at Phoenix House? A: I can't r e a l l y t h i n k of anything. Um, the budget should be bi g g e r . I: What would you do with a bigger budget? A: Well, i t leaves more money f o r t h i n g s t h a t we need and t h i n g s we'd l i k e t o do. I: Anything e l s e you'd change? A: Um, no. I: What are some of the times t h a t stand out f o r you at Phoenix House, maybe a t u r n i n g p o i n t f o r you, or a memory that f e e l s important. A: Along time ago, one g i r l s t o l e a bunch of c l o t h e s , and they blamed me. I s a i d I d i d n ' t take i t , so we had t h i s huge group. What came down was t h a t I knew who took i t , but I co u l d n ' t say. We t a l k e d about a l o t of s t u f f , and by the end of the group I had everybody c r y i n g , and t a l k i n g about t h e i r p a s t s . I t was r e a l l y neat because a l o t of the g i r l s hadn't s a i d anything t o anybody about any of i t . I t was a r e a l l y good group. I: What f e l t good about i t ? A: Well, my f r i e n d was th e r e , and she hadn't t a l k e d to anyone about anything, and she r e a l l y needed t o work on her s t u f f , about g u i l t . Well I learned s t u f f from L. (the manager) and I used t h a t on her, and t h a t made me f e e l good to know t h a t I cou l d do t h a t . I: So you were l e a r n i n g t h a t you c o u l d h e l p other people? A: Yeah. I: And t h a t f e l t l i k e a t u r n i n g p o i n t f o r you? -149-A: Yeah. I: Good f o r you. Anything e l s e t h a t f e l t l i k e a moment of change f o r you? A: I used to go out and p a r t y a l o t with my f r i e n d s and I never d i d anything, s t u d y i n g , or g e t t i n g a job, or going to s c h o o l . I f e l t l i k e an i d i o t because I was j u s t s i t t i n g t here watching T.V. a l l day or s l e e p i n g a l l day. And i t made me r e a l i z e t h a t I had to do something with my l i f e , and I d i d end up going to s c h o o l . I: Did you f e e l pressured i n t o i t , or was i t your d e c i s i o n ? A: I t was my d e c i s i o n . But when you see everybody e l s e doing something, you want to do something too. I t s l i k e everybody i n f l u e n c e s everybody around here. I: That's neat. So you see how other people have i n f l u e n c e d you and i n t u r n you can see how you i n f l u e n c e other people. A: And you see L. (the manager) too. People go up to her and t e l l her how t h e i r day went at s c h o o l or something, and s h e ' l l say, oh, t h a t ' s good. And s h e ' l l pat them on the back, and l i k e you want t h a t too. I: You want to f e e l c l o s e r t o her? A: Yeah. I: Do you remember ways i n which your behavior was t r e a t e d d i f f e r e n t l y at other p l a c e s , whether i t was breaking the r u l e s , or doing what you weren't supposed to do? A: Well, t h i s one p l a c e I l i v e d , I remember I always stayed out l a t e and t h i s guy, him and h i s wife ran the p l a c e , he'd s i t up a l l n i g h t and he'd wait f o r me to come i n . At one p o i n t he n a i l e d my window shut so I c o u l d n ' t crawl out my window. What I ended up doing then was to go i n t o the guy's room next door and go out h i s window. So, he caught on to t h a t and what he f i n a l l y d i d was to move me to the room u p s t a i r s , t o the room r i g h t beside t h e i r s so I c o u l d n ' t get out. I: How d i d t h a t f e e l ? A: L i k e I was being locked up, b a s i c a l l y . I: So i t d i d n ' t f e e l good at the time. A: No. I can see now t h a t he r e a l l y cared about me. L i k e to him I was s o r t of l i k e one of h i s own daughters. L i k e I was the o n l y one he ever waited up f o r , he never d i d t h a t f o r any of the other g i r l s . -150-I: So how would that behavior be t r e a t e d here, i f you stayed out r e a l l a t e ? A: Well, here i t s d i f f e r e n t . You have your key and you can come i n . I t depends how o f t e n you do i t . L i k e i f you do i t a l o t , the s t a f f and L. (the manager) w i l l come and t a l k t o you and say, you're not showing us t h a t you want to be here. So i f you do want t o , y o u ' l l have t o change and s t a r t spending more time a t home. Otherwise, i f you want t o move out, w e ' l l f i n d another group home f o r you. When most k i d s come here they s t a r t spending more time at home because they don't want to move out. I: So, how about f e e l i n g s ? When you had st r o n g f e e l i n g s at other p l a c e s , anger, sadness, how was that t r e a t e d compared to Phoenix House? A: Well, at the emergency home i f you got mad they'd j u s t w r i t e i t down i n the l o g . They w r i t e down e v e r y t h i n g you do and e v e r y t h i n g you say. I: They d i d n ' t t a l k to you about i t ? A: No, they don't. They j u s t w r i t e i t down and i t makes you, l i k e you break s t u f f t h e r e . They freak out and they don't r e a l l y do nothing about i t . I mean, here, they t r y to calm you down and t a l k about i t and d e a l with i t . They t r y to f i n d out what's r e a l l y b o t h e r i n g you, what's making you l i k e t h i s . I: And how about abuse i s s u e s ? Are there d i f f e r e n c e s i n how you see people's past abuse d e a l t with i n other p l a c e s , as compared to here? A: They don't r e a l l y d e a l with i t out t h e r e . A c t u a l l y , they c o n t r i b u t e an awful l o t too, by the way they run t h e i r p l a c e s . I: How does t h a t happen? A: Well, a l o t of the p l a c e s , i t s l i k e you're i n a j a i l . A l o t of them have rooms with more than one bed i n i t , and you have to s l e e p with a l l these strange g i r l s t h a t you don't know. And you have no c h o i c e i n t h a t matter. There's no p r i v a c y . And when you've been abused t h a t ' s what you want a l o t , p r i v a c y . You want t o f e e l l i k e t h i s i s your room and t h i s i s your own s t u f f . L i k e with me, my Dad used to take my s t u f f away from me. Me and my brother would be o u t s i d e , and I found a f l a s h l i g h t . My Dad would take i t and say " I t ' s mine now." So my space here i s v e r y p r i v a t e t o me. I never used to have t h a t . I: So, i n other homes, t h a t f e e l s l i k e abuse, the way they i n f r i n g e on your boundaries? A: Yeah. And they p o w e r - t r i p with you too. L i k e , I run t h i s -151-p l a c e and you have to do what I say, when I say i t and how I say i t . You don't stand up t o them because you are scared of them. I t s j u s t a form of abuse. I: That's r e a l l y i n t e r e s t i n g . What happens here i n r e l a t i o n to t h i s ? A: Well, they don't power-trip with you here, at a l l . I: How do they not do t h a t ? A: Well, we have our few r u l e s and t h a t ' s i t . They don't say s t u f f to you, l i k e you have to do t h i s and you have to do t h a t . They don't say t h a t , r i g h t ? L i k e i f you want your allowance then you do chores f o r i t . Now, t h a t ' s reasonable. Nothing i s f o r f r e e , t h a t ' s reasonable t o me. I f you thin k the chore i s too b i g f o r the amount of money you're g e t t i n g then you can say, w e l l I don't want t o do i t , I t h i n k i t s worth t h i s much, r i g h t ? And you can stand up f o r y o u r s e l f and say what you t h i n k . I: Think f o r a minute about y o u r s e l f . Can you t e l l me a b i t about y o u r s e l f when you f i r s t came to Phoenix House, what some of the i s s u e s were t h a t you had, or your f e e l i n g s , or what kind of t h i n g s you were doing then? A: Well, when I f i r s t came I d i d n ' t r e a l l y say too much. I kept to myself and I j u s t kind of watched and s o r t of observed everybody to see what they were l i k e . A f t e r a while I s t a r t e d t e s t i n g them to see how much I c o u l d get away with, r i g h t ? I: So what d i d you f i n d out? A: I co u l d get away with p r e t t y much anything. I: How d i d t h a t make you f e e l ? A; I t made me f e e l good. Not i n a way that I c o u l d be t o t a l l y bad i f I wanted t o , but to know t h a t I can get away with t h i s much means they're not going to come down on me f o r e v e r y t h i n g I do. So, i t made me f e e l good. I: More i n c o n t r o l ? A: Yeah. I: How about the f e e l i n g s you had when you f i r s t moved in? A: Well, I was s o r t of worried about i t , i f I was going to l i k e the p l a c e , and i f the g i r l s were going to l i k e me, i f we were going to get along. I d i d n ' t know what to expect. I d i d n ' t know what the r u l e s were and I d i d n ' t know how anybody t r e a t e d anybody e l s e . -152-I: How about your behavior when you came? You mentioned you s t a r t e d t e s t i n g ? A: Well, I d i d n ' t s t a r t t e s t i n g f o r a couple of months. I was j u s t r e a l l y q u i e t and kept to myself. I was e i t h e r out or I was i n my room. I: Did t h a t change over time? A: Yeah. J u s t being on the phone and being i n f r o n t of the T.V. a l l of the time. I: Who d i d you have t h a t you c o u l d t u r n to f o r help when you f i r s t moved in? A: Well, mostly I went to L. (the manager). I: Before you met the manager? A: Before I met her I d i d n ' t go to anybody. I kept to myself. But then I s t a r t e d t r u s t i n g L. so I used to t u r n to her. And then a f t e r a while I s t a r t e d going to some of the s t a f f . I: So i t took a while to l e a r n t h a t t r u s t ? A: Yeah. I: What helped you to l e a r n t o t r u s t her? A: Well, i t s not what's h e l p i n g me, i t ' s what making me t r u s t her. L i k e , she's got to show me t h a t I can t r u s t her i n my books, r i g h t ? I don't have to show her n o t h i n g . She has to show me. I: So she earned your t r u s t ? Okay. Think f o r a minute about when you l i v e d i n other group homes. What were some of the problems f o r you, and how were they d e a l t with? A: Well at the emergency home the g i r l s s t o l e a bunch of my c l o t h e s . I wanted to go to t h e i r rooms and take them back and the s t a f f wouldn't l e t me. They s a i d , "Wait t i l l the g i r l s get home and w e ' l l t e l l them t o g i v e them back." I never d i d get my c l o t h e s back. So t h a t was never d e a l t with. When I was at another group home I o n l y had a s w e a t s h i r t , and a p a i r of jeans when they moved me i n t h e r e . I t needed to be washed and I had nothing e l s e t o wear, so they had t h i s l o s t - a n d -found t h i n g downstairs with a l l these e x t r a c l o t h e s . We went through t h a t and found t h i s p e r f e c t jumpsuit t h a t f i t me. I was wearing t h a t while my c l o t h e s were being washed and one of the g i r l s came home and she freaked out because i t was hers, r i g h t ? She's screaming, "You s t o l e i t , you s t o l e i t ! " I s a i d I d i d n ' t take i t . The s t a f f s a i d i t was downstairs so we gave i t to her to wear. She says "Well, take i t o f f r i g h t now." I s a i d I have nothing e l s e to put on and can I wear i t u n t i l my -153-c l o t h e s are dry. She freaked out and we s t a r t e d f i g h t i n g . I ended up having to go u p s t a i r s and wrap a blanket around me and s i t i n my room u n t i l my c l o t h e s were dry. I: Were th e r e any times i n other p l a c e s where you ended up i n s i t u a t i o n s where e i t h e r someone was h i t t i n g you or you were h i t t i n g someone e l s e ? A: Not r e a l l y . I wasn't r e a l l y too much of a f i g h t e r . I u s u a l l y e i t h e r walked away from f i g h t s or I j u s t t a l k e d my way out of i t . Or, I'd j u s t stand t h e r e and take what they would say to me and not do anything to make them want to h i t me. L i k e i f you stand t h e r e and someone i s mad at you, and they're screaming at you, and you don't say anything, then you g i v e them no reason to come up and h i t you. They won't u n l e s s you u s u a l l y say something a g a i n s t what they're s a y i n g . I j u s t kind of not say anything. I: What about y o u r s e l f now? How would you d e s c r i b e y o u r s e l f ? A: S t a b l e . I f I make a promise to people I keep them. I'm there f o r my f r i e n d s , i f my f r i e n d s have any problems. I ' l l always t r y t o help them. And they know t h a t I'm always here f o r them. I: Any p a r t i c u l a r i n t e r e s t s t h a t you have r i g h t now? A: Well, I want to get my grade twelve. I: You're i n s c h o o l r i g h t now? Where are you at? A: E l e v e n . I: How long have you been back t o s c h o o l ? A: A year now. I t ' l l be a year i n September. I: Good f o r you. When d i d you leave s c h o o l ? A: I was twelve, i n grade e i g h t . I t ' s been f i v e y e a r s . I: Wow! That must have been r e a l l y something to go back to s c h o o l a f t e r f i v e y e ars. A: I t was r e a l l y hard. I: Good f o r you. What about your support network now? Who do you r e l y on f o r help now? A: My f r i e n d s , the other k i d s here, the s t a f f . I: What do you think are your s t r e n g t h s ? A: My s t r e n g t h s ? Um, I'm v e r y s t r o n g . I f I have a problem no -154-matter how bad i t i s I can always d e a l with i t . I get through i t , I don't j u s t break down. I'm v e r y determined to not j u s t break down. And I know what I want, and I j u s t go a f t e r i t . I: Is t h a t a change f o r you? A: Yeah. I: What was i t l i k e before? A: Before I d i d n ' t know what I wanted to do. I j u s t wanted to p a r t y . I d i d n ' t want to go to s c h o o l . I d i d n ' t want a job. I wanted money, but I d i d n ' t want a job. I: Any other s t r e n g t h s t h a t you can t h i n k of? A: Well, I care a l o t about people. A l o t of people are e a s i l y a t t r a c t e d t o me. They're v e r y open with me. I guess there's something I show on the o u t s i d e or something. I: So people can t r u s t you? A: Yeah. The way I present myself makes people f e e l l i k e t h a t . I t h i n k t h a t ' s r e a l l y good cause a l o t of people aren't l i k e t h a t so i t s r e a l l y hard f o r you to approach people, but with me i t ' s not. I: What would you say are your weaknesses, areas you s t i l l need to work on? A: My own problems. I have problems. I don't r e a l l y l i k e to t a l k about my own problems very much, but I do of i t r e a l l y bothers me. Not j u s t l i t t l e t h i n g s . I don't have to t a l k about those cause they're not very important. I: So with the b i g t h i n g s , you would t u r n t o someone? A: Oh yeah. I: What about your f e e l i n g s ? How do you f e e l about y o u r s e l f now? A: I f e e l b e t t e r . Before, I f e l t l i k e I wasn't worth v e r y much. B o y f r i e n d s c o u l d j u s t use me and t r e a t me whichever way they wanted t o . I have lea r n e d t h a t I'm worth more than t h a t and I don't deserve i t . So, I won't put up with t h a t now. I: How d i d you l e a r n t h a t ? That's a b i g l e s s o n . A: Well, i t took me a long time to work on t h a t . I used to change b o y f r i e n d s l i k e c l o t h e s , b a s i c a l l y . That's badl We worked i n groups, and I worked on these i s s u e s with L. and I s t a r t e d s e e i n g what a h e a l t h y r e l a t i o n s h i p was. I worried about h e a l t h y r e l a t i o n s h i p s , what's r i g h t and what's not. -155-I: What r e l a t i o n s h i p s d i d you see then t h a t were healthy? A: L i k e the r e l a t i o n s h i p between us, l i k e me and L., and me and the other g i r l s , and the s t a f f . I: Was t h a t a kind of model f o r you? A: Yeah. I t s l i k e wherever t h e r e ' s a r e l a t i o n s h i p you have to be f r i e n d s before you can be b o y f r i e n d and g i r l f r i e n d . That's what a l l of us are. I f I can be f r i e n d s with a guy and have r e s p e c t f o r him and h i s space, l i k e we do i t at the house, then, to me, t h a t would be the most h e a l t h y r e l a t i o n s h i p to t r y . I: What i s s u e s are you working on now? A: Um, my mom. I: How's t h a t going? A: Well, i t ' s not too bad. I t c o u l d be b e t t e r . I: Are you having more t o do with her than before? A: Not r e a l l y ? I'm j u s t being more open with her, and t a l k i n g to her. I: Has she changed i n her response to you? A: Sometimes she does and sometimes she doesn't. I: Any other i s s u e s f o r you besides your mom? A: Well, the s t a f f w o r r i es about me now t h a t I've moved out because they t h i n k I'm going to get bored. When I get bored I have a tendency to go out and meet people. Sometimes they're not always the best people to be with. I'm watching f o r t h a t . I: So t h a t ' s an i s s u e f o r you now, l e a r n i n g how to l i v e independently, p u l l i n g away from here a b i t too? A: Yeah. I r e a l l y have to watch myself now because i t ' s my own p l a c e , r i g h t ? Before, t h e r e was a group home, so i t s l i k e I don't r e a l l y have to worry too much because I'm s a f e here, t h e r e ' s a l o t of people here. On my own i t s not. I can meet the wrong guy and he can f i n d out where I l i v e and t h a t would cause problems f o r me. I: Do you f e e l s a f e i n your apartment? A: Yeah. I have the l a n d l a d y downstairs and t h e r e ' s a g i r l i n the room r i g h t beside me. The doors are always locked. -156-I: I'd l i k e you to take a minute and think about y o u r s e l f f i v e years from now, when you're twenty-three. What do you t h i n k y o u ' l l be l i k e then? A: I hope t o be working. I: What kind of job would you l i k e ? A: I'm not sure. I don't r e a l l y know what I'm going to do with my l i f e . I want to have my own p l a c e . I want to be f a i r l y w e l l - o f f with a job t h a t I l i k e working a t , and to have a r e a l l y good r e l a t i o n s h i p with a guy. I: Any other f r i e n d s h i p s ? A: I'd l i k e t o have a l l my f r i e n d s . I: That sounds p r e t t y good. Do you look forward t o the fu t u r e ? A: Yeah. I want t o get married, I want to have k i d s , I want to have a house...(laughs). But, I want to have the house and the marriage before I have some k i d s . I: Yes! (both laugh) Okay. So, how do you th i n k l i v i n g at Phoenix House has changed you? A: Well, f o r one t h i n g , they've helped me work on my r e l a t i o n s h i p s , and without t h a t , I'd be doing p r e t t y bad r i g h t now, a c t u a l l y . I would have a bad b o y f r i e n d , so t h a t ' s good. They a l s o taught me how to keep myself s a f e . Without t h a t I co u l d have ended up dead. They taught me how to open up, or l e t my f e e l i n g s go and to care about someone e l s e . And to t r u s t people i n g e n e r a l . I: That's a l o t . Anything e l s e f o r you? Has i t made a d i f f e r e n c e i n how you f e e l about y o u r s e l f ? A: Yeah. I t made me f e e l b e t t e r . Before, I f e l t l i k e I can't t r u s t anybody. I t ' s j u s t me I can t r u s t , t h a t ' s i t . So you're always being v e r y c a r e f u l about what you say and do. I: That must have f e l t v e ry l o n e l y . A: Yeah, i t was. I: Do you f e e l t h a t way now? A: No. I've got a l l my f r i e n d s . I: Okay. Is there one t h i n g i n p a r t i c u l a r t h at stands out f o r you t h a t you lear n e d here? A: No. There's too many. -157-I: Too many. So not j u s t one t h i n g . Was there more than you j u s t t o l d me? A: Well, no. I: So what helps you now t o cope with i s s u e s a r i s i n g from your past, and your past abuse? A: My t r u s t does. I have my f r i e n d s and i f s t u f f comes up with me I can always t a l k with my f r i e n d s . I t r u s t them enough t h a t I can t e l l them t h i n g s . And I'm always welcome back here. I can c a l l people or t a l k to them. I f I'm scared or something I can come over and spend the n i g h t . So, i t s helped me a l o t because I know that I'm not being k i c k e d out, even though we're s a y i n g good-bye. I am on my own, but I have a plac e where I can come back to and people I can come back to i f I need h e l p . I: What advice would you g i v e someone moving i n t o Phoenix House? A: W e l l , i t depends on the person. I f they want to work on the i s s u e s and get t h e i r l i f e together then I w i l l t e l l them to go f o r i t and move i n . But i f they weren't i n t o working on those i s s u e s I'd say to them t h a t they should j u s t wait u n t i l they are ready before they even t h i n k about moving i n . I: Do you ever see k i d s who aren't i n t o working on t h e i r i s s u e s changing? A: They change a l i t t l e b i t , but not enough. They end up g e t t i n g out anyway. They e i t h e r end up making i t so t h a t the house k i c k s them out, or they j u s t pack up t h e i r s t u f f and leave cause they're not ready to d e a l with s t u f f y e t . You have to be j u s t even a l i t t l e b i t ready before you move i n otherwise you j u s t push everybody away. I've seen a l o t of g i r l s come i n so I've n o t i c e d t h i s a l o t . I: Any other comments t h a t you have about Phoenix House? A: There should be more. They should a l l be run by L. I: Okay. I have j u s t a couple more qu e s t i o n s to ask about your move out of the house. You l e f t Phoenix House when? A: March f i r s t . I: So t h a t was about two weeks ago. What were your reasons f o r l e a v i n g ? A: I wanted t o be on my own. My b i r t h d a y comes up t h i s year. I ' l l be n i n e t e e n , and t h e r e w i l l be a time when I have to leave so I'm going to do i t now, so I'm prepared f o r i t l a t e r . - 1 5 8 -I: So that way you're i n c o n t r o l of i t ? A: Well, I d i d n ' t know what t o expect when I move out so I'd r a t h e r t r y i t now, than to wait t i l l when I d i d n ' t have the house t o f a l l back onto. I: So you've got more support r i g h t now. What i s your present l i v i n g arrangement? A: I t ' s an apartment, a c t u a l l y i t ' s a s u i t e at the top of a house. I: And you're l i v i n g t h e r e alone? A: Yeah. I: Are there others i n the house? A: Yeah. I: But you make your own meals? A: Yeah. They're a l l separated i n t o d i f f e r e n t s u i t e s . The on l y t h i n g we share i s the bathroom and the entrance. I: Was i t hard to f i n d a place? A: I looked on my own f o r two months. I t was r e a l l y hard. And then I got a l i f e s k i l l s worker and the f i r s t day I got a p l a c e . I: What was the d i f f e r e n c e ? A: J u s t the f a c t he was there and he knew what he was t a l k i n g about. A l s o the l a n d l o r d was r e a l l y n i c e , he r e a l l y l i k e s me. He's got other g i r l s s t a y i n g there t h a t are s t u d e n t s . People are v e r y wary of s t u d e n t s . I: How do you f e e l about where you are l i v i n g ? A: I l i k e my p l a c e . I t ' s comfortable. I t ' s warm. I t ' s br i g h t . I: That's g r e a t . W e l l , do you have any other comments t h a t you'd l i k e to make? A: No. I: W e ll, thanks f o r your time. I r e a l l y a p p r e c i a t e you s h a r i n g your o p i n i o n s and your experiences with me. -159-Appendix F: Data Display -160-Data D i s p l a y Theme: Chang i ng " F e e l i n g Cared F o r / T r u s t e d " - Second Order Code A. "Checking i t out" - F i r s t Order Code when I f i r s t came, I d i d n ' t say too much. I j u s t kind of watched and s o r t of observed everybody to see what they were l i k e . (A-16). I'd go and s t a y i n my room f o r two days and come out to eat. I d i d n ' t t a l k . (B-7). I would never t r u s t people. (C-12). I was s c a r e d . I d i d n ' t f e e l s a f e . (D-7). I f e l t on my own, except f o r my Grandma. (E-7). B. " G e t t i n g hooked" - F i r s t Order Code I thought a l l the groups were s t u p i d and t h e r e was no p o i n t to them, but I thought, I l i k e t h i s p l a c e . I t s c o o l , t here a r e n ' t many r u l e s . ( A - 4 ) . No one pushed me. They l e t me take my own time. (B-2) I t s a l o t more easy going. The curfews are not l i k e nine and ten o ' c l o c k . So you get enough time to go out and do t h i n g s . And space, they g i v e you space. (C-3). They don't t r e a t you l i k e k i d s . They don't lock the f r i d g e and the door. They don't c o n t r o l you. (D-3). The r u l e s are good. They're not unreasonable. (E-3). The curfew here depends on your age and your r e s p o n s i b i l i t y . Most group homes lock f r i d g e s . Here you can eat when you want. That's b e t t e r . ( F - 3 ) . I had more freedom there to choose my own hours, to choose what and when to e a t . (G-3) I t ' s (the r u l e s ) weird. I don't understand i t . (H-l) C. " T e s t i n g " - F i r s t Order Code And a f t e r a w h i l e , I s t a r t e d t e s t i n g them to see how much I co u l d get away wi t h . (A-16) I went back to the s t r e e t , two weeks at a time. (B-2) I took advantage of the curfew. (D-9) I wasn't home. I wasn't going to s c h o o l . I was d r i n k i n g and doing drugs. (F-7) I pushed o t h e r s . I was t e s t i n g t o see who would be abusive and who wouldn't be, who I c o u l d t r u s t . (G-2) -161-D. " F e e l i n g cared f o r / t r u s t e d / s a f e " - F i r s t Order Code - I c o u l d get away with p r e t t y much anything. I t made me f e e l good, ( i t ) means t h a t they're not going to come down on me f o r e v e r y t h i n g I do. (A-17). - A f t e r a while i t d i d n ' t seem l i k e a group home. I t f e l t more l i k e a f a m i l y , the way people t r e a t e d you, t r u s t e d you. (B-16). - The togetherness, and the f e e l i n g l i k e a f a m i l y . Sometimes you are not doing too w e l l with your own f a m i l y . I t h e l p s . (C-6) - People c a r e . People understand. You're no the o n l y one going through the same t h i n g . (D-2). - Other group homes don't c a r e . Here, they c a r e . (E-2) - Most p l a c e s don't care i f you are on the s t r e e t s , as long as you're i n by curfew. Here, they care about what you do, the t h i n g s you do, you i n g e n e r a l . ( F - 3 ) . - The day I admitted my sexual and p h y s i c a l abuse.to L. (the manager), we s a t down and c r i e d t o g e t h e r . I t f e l t l i k e somebody r e a l l y cared f o r me, not my p h y s i c a l being, the r e a l me i n s i d e . (G - 4 ) I I . "Opening Up" - Second Order Code A. " S t a r t i n g to t a l k " - F i r s t order code - You s t a y and then you s t a r t t a l k i n g . I t j u s t s o r t of comes. They taught me how to open up, to l e t my f e e l i n g s out. (A-8) - I s t a r t e d t a l k i n g more. I saw others f e e l c o m f o r t a b l e . I t took me a year to l e t people i n . (B-2). - T h i s i s the f i r s t home I've been i n where we r e a l l y t a l k e d about these i s s u e s . ( C - l l ) - Before I d i d n ' t t a l k about f e e l i n g s . Here I'm opening up. I'm l e a r n i n g to t r u s t people. (D-6) - You t a l k about problems more. They help you to be open. (E-2). - (the one t h i n g t h a t stands out i s ) To work out problems, to t a l k . (F-13) - I t ' s (P.H.) more open. I shared my past experiences e a s i e r . (G-2) - I t (P.H.) helps you with your problems, by t a l k i n g . I c o u l d n ' t c o n f i d e i n workers i n other p l a c e s . (H-l) B. "Understanding/Seeing" - F i r s t order code - I used to change b o y f r i e n d s l i k e c l o t h e s , b a s i c a l l y . That's bad. And we worked i n groups, and I worked on these i s s u e s with L. and I s t a r t e d s e e i n g what a h e a l t h y r e l a t i o n s h i p -162-was. (A-22) I r e a l i z e d I was abusive to other people r e l a t e d t o what was happening to me. I used to always f i g h t a f t e r being p h y s i c a l l y abused by t h i s guy. (B-8) ( s t r e n g t h s ) My a b i l i t y to see t h i n g s more c l e a r l y , to see something f o r what i t i s , not what I want i t to be. (C-15) They l e t you f i n d out from your mistakes here. (D-3) I'm more mature. I grew up. I understand more. (E-9) They d i g down deep. That's good. Then you f i n d out why you're doing s t u f f . (F-7) I r e a l i z e now when I'm r e a c t i n g to my abuse because someone has t r i g g e r e d a memory. (G-8) I I . "Taking Charge" - Second Order Code A. "Making d e c i s i o n s " - F i r s t Order Code These people made me f e e l l i k e I was a person, that I had a mind of my own, t h a t I c o u l d t h i n k and make d e c i s i o n s . (B-9) I'm t h i n k i n g smarter now, l e a r n i n g t o make the r i g h t d e c i s i o n s and a c t i n g on them. (E-9) B. "Keeping myself s a f e " - F i r s t Order Code They a l s o taught me how to keep myself s a f e . (A-24) ( s t r e n g t h s ) Being a b l e to s e t boundaries. People j u s t used to walk a l l over me. (B-9) I've got more a s s e r t i v e . I l e a r n e d i t from the g i r l s . I t e l l people what I t h i n k . I don't l e t them push me around. (D-6) L. taught me how to say no, e s p e c i a l l y i f guys j u s t want sex...P.H. taught me how to take care of myself, p h y s i c a l l y and e m o t i o n a l l y . C. " F e e l i n g b e t t e r " - F i r s t Order Code I'm v e r y s t r o n g . . . I care a l o t about people. (A-20) I t changed me so I f e e l good about doing t h i n g s . My s e l f esteem was r e a l l y low, almost at z e r o . Now i t s almost as high as i t can go. (B-12) I'm not as s u i c i d a l . My f e e l i n g s are improving. They're good at times. (D-9) I'm n i c e , I'm c o n s i d e r a t e . . . A t times I s t i l l f e e l s h i t t y . (E-6) I'm a b e t t e r person...I have r e s p e c t f o r myself. (F-9) I f e e l good about myself. Yea, I'm a good person. (G-5) -163-D. "Changing behavior" - F i r s t Order Code - I t made me r e a l i z e I had to do something with my l i f e , and I d i d end up going to s c h o o l . (A-13) - I'm not v i o l e n t now, I'm not working the s t r e e t s . (B-12) - I don't t h i n k t h a t t h e r e ' s any other p l a c e t h a t c o u l d have gotten me o f f the s t r e e t s . (C-3) - I haven't been on the s t r e e t s f o r three weeks now. (D-13) - ( t u r n i n g p o i n t ) Going to see about my a l c o h o l problem. Going back to s c h o o l . (E-5) - I've q u i t doing drugs and smoking, and hanging around with the East Indians (gangs). I don't get myself i n t o s h i t . I'm s t a y i n g here more now. I'm c l e a n e r . I'm going to s c h o o l r e g u l a r l y . (F-9) - I've been c l e a n (of drugs) f o r t h r e e months now. (G-6) E. "Learning mutual empowerment" - F i r s t Order Code - I t s l i k e everybody s o r t of i n f l u e n c e s everybody around here. (A-13) - The more I helped o t h e r s , the more I r e a l i z e d my own i s s u e s . (B-9) F. "Current i s s u e s " - F i r s t Order Code - My mom... being more open with her. Moving out. (A-22) - R e l a t i o n s h i p s with guys, l e a r n i n g not to g i v e too much, as k i n g f o r more. My f a m i l y . My h e a l t h . (B-10) - My s h o r t temper. C o n t r o l l i n g my dope smoking. My mom, moving back home. (C-16)- Keeping myself s a f e . (D-10) - My d r i n k i n g , guy problems. (E-10) - A s s e r t i v e n e s s , s a y i n g "no". I need to be home more. (F-9) - F a c i n g death. Taking care of myself. (G-5) - M o s t l y my whole l i f e . J u s t e v e r y t h i n g . (H-3) 

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