31 Child Guidance Centres

P Jagathambal

epgp books

 

 

 

 

Child guidance clinics – their relevance in the current scenario, their organisational setup, the services provided by them and benefits received.

 

As you, all aware, advancement in life styles had brought in the enormous change in the lives of man. Today’s modern technological world brings lot problems to the man kind. There are so many hindrances for the people in leading a quality life. The stress we undergo spreads across the life span – to be precise the stress has a long-lasting effect on all the human beings from all walks of life. We are concerned more with the physical health of a person and not much importance is given to the mental health. Researches prove that people experience mental health issues equal to their physical health. You could hear even a small child uttering the word tension. These young ones are stressed for various reasons which need to be given greater attention. One such attempt is child guidance clinics.

 

In this module, we are going to discuss about the

  • Origin of child guidance clinics
  • Definition and concept of child guidance clinics
  • Need and significance of child guidance clinics
  • Objectives and principles of child guidance clinics
  • Organisation of child guidance clinics
  • Services provided at child guidance clinics
  • Treatment offered at these clinics

Origin of child guidance clinics

 

Each and every parent dream about bringing up their children as healthy and happy adults with sound physical and mental status. Families were considered as a prime source of catering to the physical and psychological needs of children. When the modern health movement started, medical professionals and social workers realized that health is not merely physical wellness, it also encompasses the mental well-being. So the need to expand the components of human well-being called in for mental health services. Initial mental health services focussed only on the treatment of abnormal persons especially adults.

 

Gradual progress in this field leads to subsequent clinical studies of adult mental and behaviour disorders. The results indicated that the cases under observation had a long history of abnormality and treating them at a later stage was not of use. This necessitated the existence of preventive steps for children in mental health programmes. It became inevitable that coordinated approach is needed from the physical, mental, educational and social domains for the children to develop into wholesome adults.

 

Initially, the child guidance clinics were started as community agencies to study and treat the children in need. Social psychiatrists like Dr. Adolf Meyer, Dr. William A. White, Dr. Thomas W. Salmon, Dr. E. E. Southard insisted on the study of the individual as a whole, his environment and his reactions to it and not only to the study of his individual organ systems. The child guidance movement gained its momentum in the society through the work of these activists.Dr. William Healy and his associates were the first to apply child guidance principles in the treatment of children in 1909 at the Juvenile Psychopathic Institute (more recently known as the Institute for Juvenile Research) in Chicago, and then at the Judge Baker Foundation in Boston. Dr. Healy’s work led to a new understanding of cause-and-effect relationships and resulted in the formulation of a constructive doctrine for the treatment of juveniledelinquency.

 

The first child guidance clinic was started in 1922 as a part of Common Wealth Fund’s Programme which was a private organisation. This program took up the training of social workers and the promotion of visiting teacher service in the public schools. It also concentrated more in general establishment of clinical facilities in the larger cities throughout the country.

 

In India, the establishment of first child guidance clinic happened way back in 1939 at TATA Institute in Mumbai. Child guidance clinics in New Delhi and Chennai were simultaneously set up in 1955. Since then a gradual development is happening in the field of child guidance owing to the great input by various social psychiatrists, government, and non-governmental organizations.

 

Definition and concept of child guidance clinics

 

A child guidance clinic can be defined as the medico-social facilities established with the aim of conducting the organized and scientific study of maladjusted children and treating them effectively.

 

In the words of Stevenson and Smith, “Child guidance clinic is any organization that attempts to marshal the resources of the community on behalf of the children who are in distress because of unsatisfied inner needs or are seriously at outs with their environments; children whose development is thrown out of balance by difficulties which result in unhealthy traits, unacceptable behaviours or inability to cope with societal and educational exploitations.”

 

Child guidance clinics are specialized centers which deal with children both normal and abnormal intelligence who exhibit a range of behaviours and psychological problems. In short, child guidance centers are those which identify, analyse, treat and rehabilitate children with problems.

 

Every child has a basic right that his or her all round development should be ensured. For this to happen, a child’s physical and psychological functioning and the environmental contribution at home, school and community should be taken care off. This can be done successfully only with the proper networking of counselling services to the child and the contributing factors like family and friends.

 

Need and significance of child guidance clinics

 

Child guidance clinics form a significant part in the structure of present-day social and medical services. They are intended to develop a child into wholesome personality. They are different from traditional medical clinics and focus on the total environment of the children who are in need.

  • The child guidance clinic is needed to improve the adjustment of children to their environment.
  • Child guidance clinics consider the need for change in personality of the children and help in eliminating the factors hindering their optimum development
  • Child guidance clinics provide assistance to the family in taking care of maladjusted children
  • Children in need are provided with necessary care and services to develop them as an individual with optimum potentials
  • Child guidance clinics work in coherence with other institutions catering to the needs of children like schools, hospitals, and recreational centers. This collaborative work can result in effective treatment of children

Thus the need for child guidance is widely spread among the modern-day communities. Children and families needing such help are growing in numbers. If they go unnoticed serious consequences will be faced by the society. This scenario explains the significance of organized child guidance centers.

 

Objectives and principles of child guidance clinics

 

The child guidance clinic is an integral component of health and welfare services provided for children and families. The main objectives of child guidance clinics are

  • Providing assistance for maladjusted children. They may include children with behavioural problems like bed wetting, thumb sucking, sleep and speech disorders
  • Providing care and guidance for mentally retarded children
  • Providing care and assistance for children with academic disorders like learning disabilities, ADHD, and slow learners
  • Helping parents and families in caring and upbringing of maladjusted children
  • Providing guidance and counselling to parents and families to deal with the children in need
  • Equipping other child-related institutes like schools, general clinics and recreation centers with knowledge and skill to identify and refer the children in need

Hence the child guidance clinics work based on the following principles

  • Approaching a needy child with all the care and services
  • A maladjusted child cannot be diagnosed or treated by a single person. So a team of workers jointly help such children
  • Children are treated as a whole. Each aspect of their personality like physical, educational, emotional, social and financial are taken care by the staff specialized in the respective field

Organisation of child guidance clinics

 

A child guidance clinic deals with children in difficult situations seeking help in getting out of such situations and develop into good personalities. So a child guidance centers cannot function as a single separate unit and it needs to collaborate with a number of specialists in order to understand the disorders of children and prescribing them with ways to come out of them. Thus, child guidance clinics work on the basis of team work.

 

It is evident that the treatment procedures in child guidance clinics call for team work because children face a wide range of problems. These include psychiatric, psychological, psychopathological, sociological and educational problems of children. Members of the team not only help the children to come out of their problems but also they enrich their knowledge by sharing information and ideas among the team members. Each member of the team should understand their role and act accordingly and should work as a group to confront the issues. A democratic situation is to be maintained.

 

The basic team of the child guidance center should include three specialists – psychologist, social worker and psychiatrist. The roles and responsibilities of each of these specialists are discussed as below

 

Psychologist

 

The main task of a psychologist is to examine the child by applying routine tests to assess the mental abilities of the child brought for diagnosis. But his work does not stop with this – he has got a major role to play in the diagnosis of the problem. He can administer a wide range of psychological tests including IQ test or projective techniques to assist the psychiatrist to understand the psychological aspects of each child deeply. Psychologists also need to interpret the results of the administered tests based on the conditions and personality of the particular child.

 

Social worker

 

Asocial worker can no longer be considered as a person who engages in charitable work. But in child guidance centers they much more contribution to make. Though it is difficult to define the role of a social worker in child guidance clinics, the major responsibility of gathering the much-needed history of the child and his environment lies with the social workers only. They assist the psychiatrist in determining the treatment of a particular child and executing the treatment. At the same time, the social worker acts as an information provider to the society about the services available and mobilizes the resources available to create a conducive environment for the child guidance practitioners to function effectively. Thus the field of social work has attained a status of an independent profession whose importance is increasing in the therapeutic centers.

 

Psychiatrist

 

The role of a psychiatrist in a child guidance clinic is difficult to prescribe. But a psychiatrist can be considered as a principal member in the child guidance set up. This is due to the fact that any child psychiatrist plays the important role in the team by virtue of their training in various areas like medical, psychiatric, pediatric and sometimes psycho analytic. His or her major role is to make a thorough diagnosis of the cases. And also determines the best suitable therapy for the child in need. The psychiatrist also has the responsibility of supervising the entire team for the effective functioning of the unit. In most cases, he contributes the ideas based on which the child’s treatment procedures are fixed. Though the social worker has the responsibility of conducting interviews with the parents and others when the child comes for treatment, the psychiatrist also conducts clinical interviews with children and their parents inorder to have a better understanding of the problem.

 

Other members

 

Apart from the basic team, various other specialists may collaborate and contribute to the effective functioning of child guidance clinics. The number of team members and their activities depends upon the scope of the clinic’s activities and the services provided in that particular centers. Some centers might stop with a diagnosis of the problems where the need for additional specialists is not needed. Some centers will have functional units for which additional team members are essential. The following are some of the specialists found to be useful in child guidance set up

 

Ø Psychotherapist

 

The psychiatrist alone cannot undertake all the psychotherapy necessary in a child guidance clinic. Some of the cases require simple psychoanalysis is required to assess the problems. In such cases, a psychotherapist plays a crucial role in the setup. But care should be taken to supervise them. A psychotherapist should be integrated into the team and take part in the case conferences.

 

Ø  Specialist teacher

 

Most of the child’s maladjustments are expressed in his or her school life. This may hinder their academic progress as well bring in adjustment problems in the school and in families too. These type of children need special remedial coaching in the guidance clinics along with the treatment procedures. So the presence of a special teacher is more important in a guidance center in order to help the children to overcome their academic difficulties. The dual treatment of specialist teaching and therapies requires the collaboration of specialist teacher and psychotherapist

 

Ø  Physiotherapist

 

In any child guidance clinic, it is desirable to have a physiotherapist for diagnosis and also for therapy. Children who come to the child guidance clinic will generally some motor defects ranging in degrees of severity. So the need for physiotherapist is inevitable to provide relaxation and tonicity for enhancing their motor abilities.

 

Ø  Speech therapist

 

Experienced and trained speech therapists are needed in the child guidance clinics to undertake the tasks of correcting speech disorders which can be the underlying causes for their maladjustments in the school, family, and society.

 

Ø  Nurses

 

The duty of nurses in child guidance clinics is similar to the general health clinics. The prime duty of the nurses is to provide holistic care to the children in need and establish a good rapport with the parents.

 

Services provided at child guidance clinics

 

The major services provided at the child guidance clinics include the following

  • Early detection
  • Diagnosis
  • Treatment

These services are provided for the children and the family who are all affected by the behavioural, social, emotional, intellectual and personal problems.

 

Some centers provide intervention services for various maladjustments and coping strategies were also provided by some centers both for the child and family.

 

Child guidance clinics generally offer the following services

 

1.Parent education services – offers services to prevent developmental and behavioural problems by providing assessment, education and intervention services to parents and young children

2. Psychosocial services – services to promote, maintain or restore mental health for the children and their family members

3. Screening – checking for possible defects in domains of development using various assessment tools

4. Referral services – based on the severity of defects and maladjustments, further references are made for in-depth diagnosis and specialised treatment

 

Treatment offered in child guidance clinics

 

In child guidance clinics, the treatment of children is not carried out by a single person. It is a team work and the members of the team and their roles have already been discussed. Based on the nature and severity of the problem, the team members discuss and contribute towards the treatment. Any child who comes to child guidance center is treated as a whole personality and all the encompassing aspects like physical, intellectual, social, emotional and psychological are taken care by the specialized team members.

 

The treatment of child has two components – first one is treating the needed child himself and the second component is involving the family as a unit in the treatment.

 

1. Treatment of the child

  • The child will be diagnosed with any physical illness and if it exists treatment is given for the same.
  • Psychotherapy including suggestion, hypnosis, re-education and psychoanalysis
  • Play therapy
  • Foster home treatment and rehabilitative services
  • Institutional and school placement
  1. Family as a focus of treatment

Parents are provided with counselling and attitude therapy in order to cope up with the maladjusted children. Even the primary and secondary caretakers were given the same. Any therapeutic treatment can be given to the family members when the need arises.

 

Conclusion

 

At present when the world is fast moving and the people are kept under constant pressure, the guidance and counselling services play a pivotal role in the wellness of the society. Stress occupies a major part in the lives of individuals across lifespan right from infancy to old age. The grown-up adults have the maturity and ability to cope with a certain extent of stress and tension. Think of young children and adolescents – first of all, they won’t even know that they have some problem. If at all they realize, they don’t find any avenue to cope up and get out of it. In this scenario, the child guidance clinics become an essential part of the medical and health services. It is necessary to take into account the need for change in child’s personality and contributing factors so that the inhibiting factors for optimum development can be eliminated. Child guidance clinics are agencies for enhancing children’s adjustment to their environment and their social relationships and help them to develop their individual capacities. These clinics are to be popularised and they need to be utilized when needed to provide decent lives for our younger ones.

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